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Disease progression in gastro-oesophageal reflux disease as determined by repeat oesophageal pH monitoring and endoscopy 3 to 4.5 years after diagnosis.
Eur J Gastroenterol Hepatol 1997; 9(12):1161-7EJ

Abstract

OBJECTIVES

Reflux oesophagitis may progress to complications such as Barrett's mucosa and stricture formation. However, few studies have assessed long-term disease progression in oesophagitis patients and fewer still have considered disease progression in the significant proportion of gastro-oesophageal reflux disease (GORD) patients who do not have oesophagitis at diagnosis. The aim of this study was to reassess GORD patients 3 to 4 years after initial diagnosis and determine whether or not disease progression had occurred.

METHODS

Prospective follow-up of 101 GORD patients at least 32 months after initial assessment with oesophageal pH monitoring and upper gastrointestinal endoscopy. Patients were invited to complete a symptomatic questionnaire and undergo repeat investigation with the same techniques.

RESULTS

Seventy-seven (76%) patients responded (mean follow-up period 39 months, range 32-54 months) of whom 28 initially had oesophagitis (group A), 17 had normal endoscopy but abnormal pH monitoring (group B) and 32 had normal investigations but typical reflux symptoms (group C). At the time of follow-up, 57 (74%) patients either had frequent heartburn or were taking daily acid suppression therapy. Fifty-two (68%) responders had at least one repeat investigation: 44 (57%) had repeat pH monitoring; 43 (56%) had repeat endoscopy. Three (11% of the 28 responders) group A patients had developed Barrett's mucosa, 4 (24% of responders) group B patients had developed oesophagitis and 10 (31% of responders) group C patients had developed abnormal pH monitoring (4), oesophagitis (4) or both (2).

CONCLUSION

Three-quarters of GORD patients still have troublesome symptoms at least 3 years after diagnosis and a significant proportion show endoscopic progression of the condition's severity.

Authors+Show Affiliations

Department of Medicine, Queen's University of Belfast, Royal Victoria Hospital, UK.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

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

Language

eng

PubMed ID

9471021

Citation

McDougall, N I., et al. "Disease Progression in Gastro-oesophageal Reflux Disease as Determined By Repeat Oesophageal pH Monitoring and Endoscopy 3 to 4.5 Years After Diagnosis." European Journal of Gastroenterology & Hepatology, vol. 9, no. 12, 1997, pp. 1161-7.
McDougall NI, Johnston BT, Collins JS, et al. Disease progression in gastro-oesophageal reflux disease as determined by repeat oesophageal pH monitoring and endoscopy 3 to 4.5 years after diagnosis. Eur J Gastroenterol Hepatol. 1997;9(12):1161-7.
McDougall, N. I., Johnston, B. T., Collins, J. S., McFarland, R. J., & Love, A. H. (1997). Disease progression in gastro-oesophageal reflux disease as determined by repeat oesophageal pH monitoring and endoscopy 3 to 4.5 years after diagnosis. European Journal of Gastroenterology & Hepatology, 9(12), pp. 1161-7.
McDougall NI, et al. Disease Progression in Gastro-oesophageal Reflux Disease as Determined By Repeat Oesophageal pH Monitoring and Endoscopy 3 to 4.5 Years After Diagnosis. Eur J Gastroenterol Hepatol. 1997;9(12):1161-7. PubMed PMID: 9471021.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Disease progression in gastro-oesophageal reflux disease as determined by repeat oesophageal pH monitoring and endoscopy 3 to 4.5 years after diagnosis. AU - McDougall,N I, AU - Johnston,B T, AU - Collins,J S, AU - McFarland,R J, AU - Love,A H, PY - 1998/2/21/pubmed PY - 1998/2/21/medline PY - 1998/2/21/entrez SP - 1161 EP - 7 JF - European journal of gastroenterology & hepatology JO - Eur J Gastroenterol Hepatol VL - 9 IS - 12 N2 - OBJECTIVES: Reflux oesophagitis may progress to complications such as Barrett's mucosa and stricture formation. However, few studies have assessed long-term disease progression in oesophagitis patients and fewer still have considered disease progression in the significant proportion of gastro-oesophageal reflux disease (GORD) patients who do not have oesophagitis at diagnosis. The aim of this study was to reassess GORD patients 3 to 4 years after initial diagnosis and determine whether or not disease progression had occurred. METHODS: Prospective follow-up of 101 GORD patients at least 32 months after initial assessment with oesophageal pH monitoring and upper gastrointestinal endoscopy. Patients were invited to complete a symptomatic questionnaire and undergo repeat investigation with the same techniques. RESULTS: Seventy-seven (76%) patients responded (mean follow-up period 39 months, range 32-54 months) of whom 28 initially had oesophagitis (group A), 17 had normal endoscopy but abnormal pH monitoring (group B) and 32 had normal investigations but typical reflux symptoms (group C). At the time of follow-up, 57 (74%) patients either had frequent heartburn or were taking daily acid suppression therapy. Fifty-two (68%) responders had at least one repeat investigation: 44 (57%) had repeat pH monitoring; 43 (56%) had repeat endoscopy. Three (11% of the 28 responders) group A patients had developed Barrett's mucosa, 4 (24% of responders) group B patients had developed oesophagitis and 10 (31% of responders) group C patients had developed abnormal pH monitoring (4), oesophagitis (4) or both (2). CONCLUSION: Three-quarters of GORD patients still have troublesome symptoms at least 3 years after diagnosis and a significant proportion show endoscopic progression of the condition's severity. SN - 0954-691X UR - https://www.unboundmedicine.com/medline/citation/9471021/Disease_progression_in_gastro_oesophageal_reflux_disease_as_determined_by_repeat_oesophageal_pH_monitoring_and_endoscopy_3_to_4_5_years_after_diagnosis_ L2 - https://medlineplus.gov/gerd.html DB - PRIME DP - Unbound Medicine ER -