Frazzoni M., et al. Role of reflux in the pathogenesis of eosinophilic esophagitis -comprehensive appraisal with off- and on-PPI impedance-pH monitoring. OP235. UEG Journal, 2019, Vol. 7(8S) iv. Abstract issue, p. 127.

Авторы: Frazzoni M. / Penagini R. / Franzoni L. / de Bortoli N. / Mauro A. / Tolone S. / Bertani H. / Marsico M. / Conigliaro R. / Savarino E.V.

Role of reflux in the pathogenesis of eosinophilic esophagitis -comprehensive appraisal with off- and on-PPI impedance-pH monitoring

Frazzoni M.¹, Penagini R.S.², Frazzoni L.³, De Bortoli N.⁴, Mauro A.⁵,
Tolone S.⁶, Bertani H.⁷, Marsico M.⁸, Conigliaro R.⁹, Savarino E.V.¹⁰

Перевод на русский язык: Роль рефлюкса в патогенезе эозинофильного эзофагита. Комплексная оценка с применением рН-импедансометрии на фоне приёма ИПП и вне его.

¹ Baggiovara Hospital, Digestive Pathophysiology Unit, Modena, Italy,
² Università degli Studi di Milano Dipto. di Gastroenterologia, Dipartimento di Scienze Mediche, Milan, Italy,
³ S.Orsola-Malpighi Hospital, Department of Medical and Surgical Sciences, Bologna, Italy,
⁴ University of Pisa, Dept. of Gastroenterology, Pisa, Italy,
⁵ Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico, Gastroenterology and Endoscopy Unit, Milano, Italy,
⁶ University of Campania, Surgery, Naples, Italy,
⁷ Nuovo Ospedale Civile S. Agostino Endoscopy Unit, Dr., Baggiovara, Italy,
⁸ Policlinico Hospital, Department of Specialized Medicine, Modena, Italy,
⁹ Emilia Viaggi s.n.c., Dr., Casalecchio di Reno, Italy,
¹⁰ University of Padua, Department Of Surgery, Oncology And Gastroenterology, Padua, Italy


Contact E-Mail Address: edoardo.savarino(a)gmail.com

Introduction: The relationship between eosinophilic esophagitis (EoE) and gastroesofageal reflux disease (GERD) has not been fully elucidated, as well as the mechanisms of response to proton pump inhibitor (PPI) therapy. Comprehensive assessment of reflux by impedance-pH monitoring could clarify these issues

Aims & Methods: A prospective multicenter study comparing EoE and GERD patients with healthy controls was carried out. Patients were evaluated off - and on- PPI; impedance-pH appraisal included chemical clearance, assessed with post-reflux swallow-induced peristaltic wave (PSPW) index, and mucosal integrity measured with mean nocturnal baseline impedance (MNBI) in the distal and mid esophagus

Results: Sixty consecutive EoE patients entered the study, and were compared to 60 age- and sex-matched healthy controls and to 60 typical GERD cases. Number of total and acid refluxes were higher while PSPW index and distal MNBI were signifi cantly lower in EoE than in healthy controls. On therapy, all reflux parameters and MNBI improved in the 40 PPI-responsive EoE cases but PSPW index was the only variable independently associated with PPI responsiveness (OR 1.143, 95% CI 1.049-1.247, P=0.002). In PPI-refractory patients, number of total refluxes and PSPW index were not modifi ed by therapy. Distal MNBI improved much more in PPI-responsive than in PPI-refractory cases. Off -PPI, MNBI values in mid and distal esophagus were comparably low in PPI-refractory but not in PPI-responsive EoE

Conclusion: Reflux plays a role in the pathogenesis of EoE, more relevant in PPI-responsive cases. PPIs mainly act by improving chemical clearance, i.e. by an anti-reflux action, thus supporting their long-term prescription in PPI-responsive EoE

Disclosure: Nothing to disclose

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Данная публикация — тезисы доклада (abstract) на 27-й Объединённой Европейской Гастроэнтерологической Неделе UEG Week 2019, г. Барселона.

Тезисы (abstracts) всех докладов UEG Week 2019 (pdf, 12,4 Mb): https://www.ueg.eu/publications/abstractbook

См. также: Параскевова А.В. Объединённая Европейская Гастроэнтерологическая Неделя 2019 (United European Gastroenterological Week 2019) // www.gastroscan.ru, 2019.

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