TITLE

Outcome of nonerosive gastro-esophageal reflux disease patients with pathological acid exposure

AUTHOR(S)
Pace, Fabio; Pallotta, Stefano; Manes, Gianpiero; De Leone, Annalisa; Zentilin, Patrizia; Russo, Luigi; Savarino, Vincenzo; Neri, Matteo; Grossi, Enzo; Cuomo, Rosario
PUB. DATE
December 2009
SOURCE
World Journal of Gastroenterology;12/7/2009, Vol. 15 Issue 45, p5700
SOURCE TYPE
Academic Journal
DOC. TYPE
Article
ABSTRACT
AIM: To assess the management and outcome of nonerosive gastro-esophageal reflux disease (NERD) patients who were identified retrospectively, after a 5-year follow-up. METHODS: We included patients with gastro-esophageal reflux disease (GERD) symptoms who had a negative endoscopy result and pathological 24-h esophageal pH-monitoring while off therapy. We interviewed them after an average period of 5 years (range 3.5-7 years) by means of a structured questionnaire to assess presence of GERD symptoms, related therapy, updated endoscopic data and other features. We assessed predictors of esophagitis development by means of univariate and multivariate statistical analysis. RESULTS: 260 patients (137 women) were included. Predominant GERD symptoms were heartburn and regurgitation in 103/260 (40%). 70% received a maintenance treatment, which was proton pump inhibitor (PPI) in 55% of cases. An average number of 1.5 symptomatic relapses per patient/year of follow-up were observed. A progression to erosive gastro-esophageal reflux disease (ERD) was found in 58/193 (30.0%) of patients undergoing repeat endoscopy; 72% of these were Los Angeles grade A-B. CONCLUSION: This study shows that progression to ERD occurs in about 5% of NERD cases per year, despite therapy. Only two factors consistently and independently influence progression: smoking and absence of PPI therapy.
ACCESSION #
47234803

 

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