{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,8]],"date-time":"2026-09-08T10:26:35Z","timestamp":1788863195638,"version":"build-2803163510"},"reference-count":37,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2024,6,11]],"date-time":"2024-06-11T00:00:00Z","timestamp":1718064000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/501100005762","name":"National Taiwan University Hospital","doi-asserted-by":"publisher","award":["NTUH 112\u2010S0320"],"award-info":[{"award-number":["NTUH 112\u2010S0320"]}],"id":[{"id":"10.13039\/501100005762","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100004663","name":"Ministry of Science and Technology, Taiwan","doi-asserted-by":"publisher","award":["MOST 111\u20102314\u2010B\u2010002\u2010189\u2010MY3"],"award-info":[{"award-number":["MOST 111\u20102314\u2010B\u2010002\u2010189\u2010MY3"]}],"id":[{"id":"10.13039\/501100004663","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J of Gastro and Hepatol"],"published-print":{"date-parts":[[2024,10]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background and Aim<\/jats:title><jats:p>Patients with proton\u2010pump\u2010inhibitor (PPI)\u2010unresponsive reflux symptoms, often caused by functional esophageal disorders (FED), are frequently encountered in clinical practice. We aimed to investigate the prevalence of FED and its associated clinical characteristics in patients with PPI\u2010unresponsive reflux symptoms.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We retrospectively identified patients who were evaluated for persistent typical reflux symptoms, despite \u22658\u00a0weeks of PPI treatment, at the National Taiwan University Hospital from 2014 to 2023. All patients underwent a comprehensive evaluation comprising validated gastroesophageal reflux disease (GERD) symptom questionnaires, 5\u2010item Brief Symptom Rating Scale (BSRS\u20105), Pittsburgh Sleep Quality Index (PSQI), esophagogastroduodenoscopy, high\u2010resolution impedance manometry, and 24\u2010h impedance\u2010pH monitoring off PPI therapy. Diagnosis of FED and non\u2010erosive reflux disease (NERD) was based on the Rome IV criteria.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>We analyzed 190 patients [46.8% male, median age 52 (interquartile range, 42\u201361) years], of whom 32 (16.8%) had NERD and 158 (83.2%) had FED (57.9% with functional heartburn and 25.3% with reflux hypersensitivity). Patients with FED had a lower body mass index than those with NERD and a higher prevalence of psychological comorbidities and poor sleep quality than healthy volunteers. The severity of reflux symptoms among FED patients was significantly associated with the severity of psychological comorbidities and sleep quality.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>A notably high prevalence (83.2%) of FED was observed among patients experiencing PPI\u2010unresponsive reflux symptoms. Patients with FED had a higher level of psychological distress and diminished sleep quality, both of which were associated with reflux symptom severity.<\/jats:p><\/jats:sec>","DOI":"10.1111\/jgh.16654","type":"journal-article","created":{"date-parts":[[2024,6,11]],"date-time":"2024-06-11T08:05:42Z","timestamp":1718093142000},"page":"2097-2104","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Prevalence of functional esophageal disorders and associated clinical characteristics in patients with proton\u2010pump\u2010inhibitor\u2010unresponsive reflux symptoms"],"prefix":"10.1111","volume":"39","author":[{"given":"Ming\u2010Han","family":"Wei","sequence":"first","affiliation":[{"name":"Department of Internal Medicine National Taiwan University Hospital Hsin\u2010Chu Branch  Zhubei City Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chien\u2010Chuan","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine National Taiwan University Hospital  Taipei Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hui\u2010Chuan","family":"Lee","sequence":"additional","affiliation":[{"name":"Department of Pediatrics National Taiwan University Children's Hospital  Taipei Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8160-1216","authenticated-orcid":false,"given":"Yi\u2010Chia","family":"Lee","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine National Taiwan University Hospital  Taipei Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hsiu\u2010Po","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine National Taiwan University Hospital  Taipei Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ming\u2010Shiang","family":"Wu","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine National Taiwan University Hospital  Taipei Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6343-1658","authenticated-orcid":false,"given":"Jia\u2010Feng","family":"Wu","sequence":"additional","affiliation":[{"name":"Department of Pediatrics National Taiwan University Children's Hospital  Taipei Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7483-7538","authenticated-orcid":false,"given":"Ping\u2010Huei","family":"Tseng","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine National Taiwan University Hospital  Taipei Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2024,6,11]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1136\/gutjnl\u20102012\u2010304269"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1440\u20101746.2011.06750.x"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/0140\u20106736(90)90287\u2010f"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1572\u20100241.2006.00630.x"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cgh.2022.01.025"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1572\u20100241.2003.07665.x"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365\u20102036.2010.04406.x"},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.1038\/nrgastro.2016.50"},{"key":"e_1_2_8_10_1","doi-asserted-by":"publisher","DOI":"10.1136\/gut.2007.145581"},{"key":"e_1_2_8_11_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365\u20102036.2004.02238.x"},{"key":"e_1_2_8_12_1","doi-asserted-by":"publisher","DOI":"10.1136\/gut.51.6.885"},{"key":"e_1_2_8_13_1","doi-asserted-by":"publisher","DOI":"10.1111\/nmo.13265"},{"key":"e_1_2_8_14_1","first-page":"687","article-title":"Development and verification of validity and reliability of a short screening instrument to identify psychiatric morbidity","volume":"102","author":"Lee MB","year":"2003","journal-title":"J. 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