Characteristics of symptomatic reflux episodes in Japanese proton pump inhibitor-refractory non-erosive reflux disease patients

Figure 1 Total liquid reflux episodes and symptoms above the proximal margin of the lower esophagogastric junction at each impedance site. The 325 distal reflux episodes were significantly more frequent (84.9%) than the 58 proximal ones (15.1%) (P < 0.001, distal reflux episodes vs proximal ones). LES: Lower esophagogastric junction.

Figure 2 Occurrence rates of reflux symptoms. A: Occurrence rates of reflux symptoms above the proximal margin of the lower esophagogastric junction at each impedance site with liquid reflux. The occurrence rate of reflux symptoms in proximal reflux episodes was significantly more frequent (44.8%) than in distal ones (7.7%) (P < 0.001, proximal reflux episodes vs distal ones); B: Occurrence rates of reflux symptoms above the proximal margin of the lower esophagogastric junction at each impedance site with acid reflux. There were no significant differences in the occurrence rate of reflux symptoms between proximal reflux episodes (38.5%) and distal ones (20.5%) (NS); C: Occurrence rates of reflux symptoms above the proximal margin of the lower esophagogastric junction at each impedance site with liquid weakly acid reflux. The occurrence rate of reflux symptoms in proximal reflux episodes was significantly more frequent (46.7%) than in distal ones (5.7%) (P < 0.001, proximal reflux episodes vs distal ones); D: Occurrence rates of reflux symptoms above the proximal margin of the lower esophagogastric junction at each impedance site with mixed gas-liquid reflux. The occurrence rate of reflux symptoms in proximal reflux episodes was significantly more frequent (30.7%) than in distal ones (5.3%) (P < 0.001, proximal reflux episodes vs distal ones); E: Occurrence rates of reflux symptoms above the proximal margin of the lower esophagogastric junction at each impedance site with mixed liquid-gas acid reflux. There were no significant differences in the occurrence rate of reflux symptoms between the proximal reflux episodes (29.4%) and distal ones (14.3%) (NS); F: Occurrence rates of reflux symptoms above the proximal margin of the lower esophagogastric junction at each impedance site with mixed liquid-gas weakly acid reflux. The occurrence rate of reflux symptoms in proximal reflux episodes was significantly more frequent (31.0%) than in distal ones (3.3%) (P < 0.001, proximal reflux episodes vs distal ones). LES: Lower esophagogastric junction.

Figure 3 Total mixed liquid-gas reflux episodes and symptoms above the proximal margin of the lower esophagogastric junction at each impedance site. The 113 distal reflux episodes were significantly more frequent (60.1%) than 35 proximal reflux (39.9%) (P = 0.0047, distal reflux episodes vs proximal reflux). LES: Lower esophagogastric junction.