Increased Prandial Air Swallowing and Postprandial Gas-Liquid Reflux Among Patients Refractory to Proton Pump Inhibitor Therapy

Some patients with GERD who do not respond to PPI therapy swallow more air at mealtime than those who respond to PPIs and also have more reflux episodes that contain gas. These factors, combined with mucosal sensitization by previous exposure to acid, could affect perception of symptoms. These patients, who can be identified on standard 24-hour pH impedance monitoring, might be given behavioral therapy to reduce mealtime air swallowing.