Factor to consider in gastroesophageal reflux disease refractory to proton pump inhibitor therapy: Bile reflux

INTRODUCTION: We aimed to investigate the effect of bile reflux (BR) in patients whose symptoms did not improve despite proton pump inhibitor (PPI) treatment.
METHODS: In our retrospective study, patients who were refractory to PPI treatment were divided into two groups as BR and non-BR patients based on the upper gastrointestinal endoscopy and endoscopic biopsy data. Age, sex, and endoscopic biopsy data of the patients were analyzed statistically.
RESULTS: A total of 154 patients were included in the study. BR was detected in 107 of the patients, while BR was not observed in 47. While, 53% (n=81) of the patients were male and 47% (n=73) were female. There was no statistically significant difference between the two groups in terms of age, sex, and endoscopic biopsy data. When BR and the presence of Helicobacter pylori were compared, it was found that BR was higher in patients who were refractory to PPI therapy.
DISCUSSION AND CONCLUSION: We believe that BR is a more effective factor than H. pylori in PPI-refractory gastroesophageal reflux patients.