Persistent gastroesophageal reflux disease symptoms in patients treated with proton pump inhibitors

An observational study

Abstract

Introduction: gastroesophageal reflux disease (GERD) has a high prevalence, affecting quality of life and generating high healthcare costs. Although proton pump inhibitors (PPIs) are the main treatment, up to 55% of patients have persistent symptoms.

Objective: to determine the prevalence of persistent GERD symptoms in patients with current or recent PPI treatment.

Method: a descriptive, cross-sectional observational study of 434 patients over the age of 18 with a prior GERD diagnosis who were seen as outpatients by a panel of selected physicians in Colombia. Symptom persistence and/or relapse was evaluated, and sociodemographic and clinical variables were analyzed through descriptive statistics and bivariate analyses.

Results: 94.5% of patients reported at least one GERD symptom in the previous seven days, with heartburn (75.8%) and reflux (74.2%) being the most frequent. There were fewer symptoms among patients who took PPIs in the morning and before meals. Dexlansoprazole and esomeprazole were associated with a lower frequency of symptoms, compared to other PPIs.

Conclusion: the high persistence of symptoms despite PPI use exceeds the international figures, which could reflect differences in adherence to treatment, genetic factors or cultural behaviors in the Colombian population. The variable effectiveness between PPIs underscores the need to individualize treatment, optimize dosing, and educate on correct treatment administration