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Long-term clinical course of extra-oesophageal manifestations in patients with gastro-oesophageal reflux disease. A prospective follow-up analysis based on the ProGERD study.

Abstract

BACKGROUND

Gastro-oesophageal reflux disease can be associated with extra-oesophageal reflux disease such as chronic cough or laryngeal symptoms. The aim of this study was to analyse the clinical course of extra-oesophageal reflux disease in a large population with gastro-oesophageal reflux disease and extra-oesophageal reflux disease under routine clinical care.

METHODS

ProGERD is a prospective multicentre cohort study of 6215 outpatients with gastro-oesophageal reflux disease. At baseline all patients underwent endoscopies and were interviewed for extra-oesophageal reflux disease. Initial standardised treatment was esomeprazole for up to 8 weeks. After 2 years of follow-up, reflux symptoms and the prevalence of extra-oesophageal reflux disease were assessed. A multivariate analysis was performed with resolved versus persistent symptoms for chronic cough and laryngeal symptoms as dependent predictors. Independent variables were gender, age, body mass index (BMI), alcohol consumption, cigarette smoking, gastro-oesophageal reflux disease classification, history of gastro-oesophageal reflux disease in the family, duration of gastro-oesophageal reflux disease and proton pump inhibitors medication.

RESULTS

Four thousand four hundred and four patients (71%) were available for analysis at 2 years, including 570 and 454 patients who had chronic cough and laryngeal disorders at baseline, respectively. In 63% and 74% of the patients, chronic cough and laryngeal disorders had resolved. Patients with persistent respiratory symptoms in year 2 had significantly more reflux symptoms. Further clinically relevant associations were smoking and non-steroidal anti-inflammatory drugs use. According to the multivariate analysis, classification of gastro-oesophageal reflux disease, proton pump inhibitors medication or duration of gastro-oesophageal reflux disease were not associated with the resolution of cough or laryngeal symptoms.

CONCLUSION

In most patients with gastro-oesophageal reflux disease and extra-oesophageal reflux disease, respiratory symptoms resolve during long-term routine care. A high reflux symptom load was associated with the persistence of respiratory disorders.

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  • Authors+Show Affiliations

    ,

    Klinikum Fulda gAG, Germany. d.jaspersen.medII@klinikum-fulda.de

    , , , , , , , , ,

    Source

    MeSH

    Anti-Inflammatory Agents, Non-Steroidal
    Chronic Disease
    Cough
    Europe
    Female
    Follow-Up Studies
    Gastroesophageal Reflux
    Humans
    Laryngeal Diseases
    Male
    Middle Aged
    Multivariate Analysis
    Prospective Studies
    Proton Pump Inhibitors
    Recovery of Function
    Severity of Illness Index
    Smoking

    Pub Type(s)

    Journal Article
    Multicenter Study
    Research Support, Non-U.S. Gov't

    Language

    eng

    PubMed ID

    16413233

    Citation

    Jaspersen, D, et al. "Long-term Clinical Course of Extra-oesophageal Manifestations in Patients With Gastro-oesophageal Reflux Disease. a Prospective Follow-up Analysis Based On the ProGERD Study." Digestive and Liver Disease : Official Journal of the Italian Society of Gastroenterology and the Italian Association for the Study of the Liver, vol. 38, no. 4, 2006, pp. 233-8.
    Jaspersen D, Labenz J, Willich SN, et al. Long-term clinical course of extra-oesophageal manifestations in patients with gastro-oesophageal reflux disease. A prospective follow-up analysis based on the ProGERD study. Dig Liver Dis. 2006;38(4):233-8.
    Jaspersen, D., Labenz, J., Willich, S. N., Kulig, M., Nocon, M., Leodolter, A., ... Malfertheiner, P. (2006). Long-term clinical course of extra-oesophageal manifestations in patients with gastro-oesophageal reflux disease. A prospective follow-up analysis based on the ProGERD study. Digestive and Liver Disease : Official Journal of the Italian Society of Gastroenterology and the Italian Association for the Study of the Liver, 38(4), pp. 233-8.
    Jaspersen D, et al. Long-term Clinical Course of Extra-oesophageal Manifestations in Patients With Gastro-oesophageal Reflux Disease. a Prospective Follow-up Analysis Based On the ProGERD Study. Dig Liver Dis. 2006;38(4):233-8. PubMed PMID: 16413233.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - Long-term clinical course of extra-oesophageal manifestations in patients with gastro-oesophageal reflux disease. A prospective follow-up analysis based on the ProGERD study. AU - Jaspersen,D, AU - Labenz,J, AU - Willich,S N, AU - Kulig,M, AU - Nocon,M, AU - Leodolter,A, AU - Lind,T, AU - Meyer-Sabellek,W, AU - Vieth,M, AU - Stolte,M, AU - Malfertheiner,P, Y1 - 2006/01/18/ PY - 2005/09/20/received PY - 2005/10/12/revised PY - 2005/10/27/accepted PY - 2006/1/18/pubmed PY - 2006/10/13/medline PY - 2006/1/18/entrez SP - 233 EP - 8 JF - Digestive and liver disease : official journal of the Italian Society of Gastroenterology and the Italian Association for the Study of the Liver JO - Dig Liver Dis VL - 38 IS - 4 N2 - BACKGROUND: Gastro-oesophageal reflux disease can be associated with extra-oesophageal reflux disease such as chronic cough or laryngeal symptoms. The aim of this study was to analyse the clinical course of extra-oesophageal reflux disease in a large population with gastro-oesophageal reflux disease and extra-oesophageal reflux disease under routine clinical care. METHODS: ProGERD is a prospective multicentre cohort study of 6215 outpatients with gastro-oesophageal reflux disease. At baseline all patients underwent endoscopies and were interviewed for extra-oesophageal reflux disease. Initial standardised treatment was esomeprazole for up to 8 weeks. After 2 years of follow-up, reflux symptoms and the prevalence of extra-oesophageal reflux disease were assessed. A multivariate analysis was performed with resolved versus persistent symptoms for chronic cough and laryngeal symptoms as dependent predictors. Independent variables were gender, age, body mass index (BMI), alcohol consumption, cigarette smoking, gastro-oesophageal reflux disease classification, history of gastro-oesophageal reflux disease in the family, duration of gastro-oesophageal reflux disease and proton pump inhibitors medication. RESULTS: Four thousand four hundred and four patients (71%) were available for analysis at 2 years, including 570 and 454 patients who had chronic cough and laryngeal disorders at baseline, respectively. In 63% and 74% of the patients, chronic cough and laryngeal disorders had resolved. Patients with persistent respiratory symptoms in year 2 had significantly more reflux symptoms. Further clinically relevant associations were smoking and non-steroidal anti-inflammatory drugs use. According to the multivariate analysis, classification of gastro-oesophageal reflux disease, proton pump inhibitors medication or duration of gastro-oesophageal reflux disease were not associated with the resolution of cough or laryngeal symptoms. CONCLUSION: In most patients with gastro-oesophageal reflux disease and extra-oesophageal reflux disease, respiratory symptoms resolve during long-term routine care. A high reflux symptom load was associated with the persistence of respiratory disorders. SN - 1590-8658 UR - https://www.unboundmedicine.com/medline/citation/16413233/Long_term_clinical_course_of_extra_oesophageal_manifestations_in_patients_with_gastro_oesophageal_reflux_disease__A_prospective_follow_up_analysis_based_on_the_ProGERD_study_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S1590-8658(05)00492-5 DB - PRIME DP - Unbound Medicine ER -