{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,10]],"date-time":"2026-04-10T18:20:22Z","timestamp":1775845222753,"version":"3.50.1"},"reference-count":26,"publisher":"S. Karger AG","issue":"2","license":[{"start":{"date-parts":[[2017,1,1]],"date-time":"2017-01-01T00:00:00Z","timestamp":1483228800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/www.karger.com\/Services\/SiteLicenses"},{"start":{"date-parts":[[2017,1,1]],"date-time":"2017-01-01T00:00:00Z","timestamp":1483228800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.karger.com\/Services\/SiteLicenses"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Digestion"],"published-print":{"date-parts":[[2017]]},"abstract":"<b><i>Background:<\/i><\/b> Various mechanisms have been suggested to be responsible for contributing to the occurrence of proton pump inhibitor (PPI)-resistant non-erosive reflux disease (NERD). The aims of this study were to clarify the pathogenesis of PPI-resistant NERD. <b><i>Methods:<\/i><\/b> Fifty-three patients with NERD, who had persistent reflux symptoms despite taking double-dose PPI, were included in this study. After excluding eosinophilic esophagitis (EoE) and primary esophageal motility disorder, esophageal impedance-pH monitoring was carried out. In symptom index (SI)-positive patients, the mechanism of SI positivity and the percent time with intragastric pH >4 were investigated according to the presence or absence of <i>Helicobacter pylori<\/i> infection. <b><i>Results:<\/i><\/b> One of the 53 patients had EoE, and 4 had primary esophageal motility disorder. Twenty-three and 2 patients were SI-positive for liquid and gas-only reflux respectively. Of 17 SI-positive, <i>H. pylori<\/i>-negative patients, 5 were SI-positive for acid reflux, whereas all of the <i>H. pylori<\/i>-positive patients were SI-positive for non-acid reflux. The percent time with intragastric pH >4 was significantly lower in the <i>H. pylori<\/i>-negative patients than in the <i>H. pylori<\/i>-positive patients. <b><i>Conclusions:<\/i><\/b> The pathogenesis of double-dose PPI-resistant NERD was identified in 57%. In some of <i>H. pylori<\/i>-negative patients, acid-related symptoms were observed. However, in <i>H. pylori<\/i>-positive patients, these symptoms were excluded by taking double-dose PPI.<\/jats:p>","DOI":"10.1159\/000455834","type":"journal-article","created":{"date-parts":[[2017,2,8]],"date-time":"2017-02-08T12:59:54Z","timestamp":1486558794000},"page":"140-145","source":"Crossref","is-referenced-by-count":16,"title":["Pathogenesis of Double-Dose Proton Pump Inhibitor-Resistant Non-Erosive Reflux Disease, and Mechanism of Reflux Symptoms and Gastric Acid Secretion-Suppressive Effect in the Presence or Absence of <b><i>Helicobacter pylori <\/i><\/b>Infection"],"prefix":"10.1159","volume":"95","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0993-8399","authenticated-orcid":false,"given":"Noriyuki","family":"Kawami","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nana","family":"Takenouchi","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mariko","family":"Umezawa","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shintaro","family":"Hoshino","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yuriko","family":"Hanada","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yoshimasa","family":"Hoshikawa","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hirohito","family":"Sano","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yoshio","family":"Hoshihara","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tsutomu","family":"Nomura","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Eiji","family":"Uchida","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Katsuhiko","family":"Iwakiri","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"127","published-online":{"date-parts":[[2017,2,4]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","DOI":"10.1046\/j.1365-2036.2001.00904.x"},{"key":"ref2","doi-asserted-by":"publisher","DOI":"10.1007\/s00535-016-1227-8"},{"key":"ref3","doi-asserted-by":"publisher","DOI":"10.1097\/01.mcg.0000225631.07039.6d"},{"key":"ref4","doi-asserted-by":"publisher","DOI":"10.1136\/gutjnl-2011-301897"},{"key":"ref5","doi-asserted-by":"publisher","DOI":"10.1159\/000368766"},{"key":"ref6","doi-asserted-by":"publisher","DOI":"10.3748\/wjg.v21.i16.5009"},{"key":"ref7","doi-asserted-by":"publisher","DOI":"10.1038\/ajg.2013.71"},{"key":"ref8","doi-asserted-by":"publisher","DOI":"10.1053\/j.gastro.2014.07.055"},{"key":"ref9","doi-asserted-by":"publisher","DOI":"10.1007\/s00535-009-0070-6"},{"key":"ref10","doi-asserted-by":"publisher","DOI":"10.1159\/000309483"},{"key":"ref11","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2982.2011.01834.x"},{"key":"ref12","doi-asserted-by":"publisher","DOI":"10.1023\/A:1018802908358"},{"key":"ref13","doi-asserted-by":"publisher","DOI":"10.1111\/j.1572-0241.2006.00711.x"},{"key":"ref14","doi-asserted-by":"publisher","DOI":"10.1136\/gut.2003.033290"},{"key":"ref15","doi-asserted-by":"publisher","DOI":"10.1136\/gut.2005.087668"},{"key":"ref16","doi-asserted-by":"publisher","DOI":"10.1111\/j.1440-1746.2012.07074.x"},{"key":"ref17","doi-asserted-by":"publisher","DOI":"10.1540\/jsmr.48.125"},{"key":"ref18","doi-asserted-by":"publisher","DOI":"10.1016\/j.cgh.2008.01.006"},{"key":"ref19","doi-asserted-by":"publisher","DOI":"10.1111\/j.1572-0241.2008.02033.x"},{"key":"ref20","doi-asserted-by":"publisher","DOI":"10.1136\/gut.2007.133470"},{"key":"ref21","doi-asserted-by":"publisher","DOI":"10.1111\/apt.13121"},{"key":"ref22","doi-asserted-by":"publisher","DOI":"10.1067\/mcp.2002.127637"},{"key":"ref23","doi-asserted-by":"publisher","DOI":"10.1111\/nmo.12477"},{"key":"ref24","doi-asserted-by":"publisher","DOI":"10.1007\/s00535-009-0179-7"},{"key":"ref25","doi-asserted-by":"publisher","DOI":"10.1016\/j.cgh.2012.04.019"},{"key":"ref26","doi-asserted-by":"publisher","DOI":"10.1111\/jgh.12746"}],"container-title":["Digestion"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.karger.com\/Article\/Pdf\/455834","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.karger.com\/Article\/Pdf\/455834","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.karger.com\/Article\/Pdf\/455834","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,4,23]],"date-time":"2025-04-23T17:10:47Z","timestamp":1745428247000},"score":1,"resource":{"primary":{"URL":"https:\/\/karger.com\/article\/doi\/10.1159\/000455834"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2017]]},"references-count":26,"journal-issue":{"issue":"2","published-online":{"date-parts":[[2017,3,16]]},"published-print":{"date-parts":[[2017,3,21]]}},"URL":"https:\/\/doi.org\/10.1159\/000455834","archive":["Portico"],"relation":{},"ISSN":["0012-2823","1421-9867"],"issn-type":[{"value":"0012-2823","type":"print"},{"value":"1421-9867","type":"electronic"}],"subject":[],"published":{"date-parts":[[2017]]}}}