Air swallowing can be responsible for non-response of heartburn to high-dose proton pump inhibitor

P. Zentilin, L. Accornero, P. Dulbecco, E. Savarino, V. Savarino

Research output: Contribution to journalArticlepeer-review


Intraluminal electrical impedance is a novel technique, which is able for the first time to provide a qualitative assessment of refluxed material moving from the stomach to the oesophagus. In other words, the presence of air can be differentiated from that of liquid, because the former is characterised by high and the latter by low impedance compared with baseline. Moreover, the combined measurement of electrical impedance and pH-metry permits to distinguish acid from non-acid liquid reflux. One of the most important clinical applications of this method is to assess the reasons for poor response of GORD patients to high-dose proton pump inhibitors. This case report describes the results of impedance in the evaluation of a young woman, who did not respond to twice-daily doses of rabeprazole. She continued to complain of heartburn as major symptom and impedance allowed us to clarify that it was not related to acid or non-acid reflux, but to air swallowing. Therefore, this technique identified aerophagia to be responsible for persistent heartburn despite high-dose proton pump inhibitor and prevented the adoption of more aggressive, but probably unuseful therapies, such as the surgical one.

Original languageEnglish
Pages (from-to)454-457
Number of pages4
JournalDigestive and Liver Disease
Issue number6
Publication statusPublished - Jun 2005


  • Air swallowing
  • Electrical impedance
  • Non response to PPI

ASJC Scopus subject areas

  • Gastroenterology


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