Regurgitation Is Less Responsive to Acid Suppression Than Heartburn in Patients With Gastroesophageal Reflux Disease  Peter J. Kahrilas, Andreas Jonsson, Hans Denison, Börje Wernersson, Nesta Hughes, Colin W. Howden  Clinical Gastroenterology and Hepatology  Volume 10, Issue 6, Pages 612-619 (June 2012) DOI: 10.1016/j.cgh.2012.01.022 Copyright © 2012 AGA Institute Terms and Conditions

Figure 1 Baseline symptom profile in the RDQ heartburn and regurgitation domains collected at the initial screening visit. In each panel, the number and corresponding percentage of NERD and RE patients with evaluable data for that specific item are indicated. All patients were required to have “substernal burning” of at least moderate intensity on at least 4 days per week to qualify for the studies. Most patients also reported experiencing at least 1 of the regurgitation items. Clinical Gastroenterology and Hepatology 2012 10, 612-619DOI: (10.1016/j.cgh.2012.01.022) Copyright © 2012 AGA Institute Terms and Conditions

Figure 2 Magnitude of residual heartburn and regurgitation symptoms after 4 weeks of acid suppressive therapy in healed vs nonhealed RE patients. Note that if RE patients were healed at 2 weeks they completed the study at that point, but their symptom data were carried forward for the purpose of this analysis. No consistent differences were seen between groups. Clinical Gastroenterology and Hepatology 2012 10, 612-619DOI: (10.1016/j.cgh.2012.01.022) Copyright © 2012 AGA Institute Terms and Conditions

Figure 3 Responsiveness of high severity regurgitation and heartburn items on the RDQ to 4 weeks of acid suppressive therapy. Complete resolution indicates no report of the item for all 7 days. For each item, the numbers given next to the symbols indicate the number of evaluable patients reporting each RDQ item at high severity at baseline. The RE numbers are somewhat lower than the NERD numbers because patients in the RE study who healed at 2 weeks completed the study at that point and did not have data for analysis at 4 weeks. Clinical Gastroenterology and Hepatology 2012 10, 612-619DOI: (10.1016/j.cgh.2012.01.022) Copyright © 2012 AGA Institute Terms and Conditions

Figure 4 Concordance between residual RDQ regurgitation items during the fourth week of therapy. (A) Patients with NERD; (B) patients with RE. All included patients reported either high severity “regurgitation-taste” or “regurgitation-movement” at baseline. Severity on each axis is the average intensity with which the symptom was reported during the fourth week of treatment with a potential range of 0–3; high severity is indicated by a score of at least 1.14. The size of the bubbles is proportional to the number of patients represented at specific coordinates. Colors indicate concordance or discordance between RDQ items: red, residual high severity “regurgitation-taste” and “regurgitation-movement”; blue, residual high severity “regurgitation-taste” only; green, residual high severity “regurgitation-movement” only; yellow, residual low severity “regurgitation-taste” and “regurgitation-movement”; white, complete resolution of both regurgitation items. Clinical Gastroenterology and Hepatology 2012 10, 612-619DOI: (10.1016/j.cgh.2012.01.022) Copyright © 2012 AGA Institute Terms and Conditions