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Type: Journal article
Title: Gastroesophageal reflux disease after diagnostic endoscopy in the clinical setting
Author: Zschau, N.
Andrews, J.
Holloway, R.
Schoeman, M.
Lange, K.
Tam, W.
Holtmann, G.
Citation: World Journal of Gastroenterology, 2013; 19(16):2514-2520
Publisher: W J G Press
Issue Date: 2013
ISSN: 1007-9327
Statement of
Nora B Zschau, Jane M Andrews, Richard H Holloway, Mark N Schoeman, Kylie Lange, William CE Tam, Gerald J Holtmann
Abstract: AIM: To investigate the outcome of patients with symptoms of gastroesophageal reflux disease (GERD) referred for endoscopy at 2 and 6 mo post endoscopy. METHODS: Consecutive patients referred for upper endoscopy for assessment of GERD symptoms at two large metropolitan hospitals were invited to participate in a 6-mo non-interventional (observational) study. The two institutions are situated in geographically and socially disparate areas. Data collection was by self-completion of questionnaires including the patient assessment of upper gastrointestinal disorders symptoms severity and from hospital records. Endoscopic finding using the Los-Angeles classification, symptom severity and it’s clinically relevant improvement as change of at least 25%, therapy and socio-demographic factors were assessed. RESULTS: Baseline data were available for 266 patients and 2-mo and 6-mo follow-up data for 128 and 108 patients respectively. At baseline, 128 patients had erosive and 138 non-erosive reflux disease. Allmost all patient had proton pump inhibitor (PPI) therapy in the past. Overall, patients with non-erosive GERD at the index endoscopy had significantly more severe symptoms as compared to patients with erosive or even complicated GERD while there was no difference with regard to medication. After 2 and 6 mo there was a small, but statistically significant improvement in symptom severity (7.02 ± 5.5 vs 5.9 ± 5.4 and 5.5 ± 5.4 respectively); however, the majority of patients continued to have symptoms (i.e., after 6 mo 81% with GERD symptoms). Advantaged socioeconomic status as well as being unemployed was associated with greater improvement. CONCLUSION: The majority of GORD patients receive PPI therapy before being referred for endoscopy even though many have symptoms that do not sufficiently respond to PPI therapy.
Keywords: Gastroesophageal reflux disease
Proton pump inhibitor
Acid suppressive therapy
Barrett’s esophagus
Functional gastrointestinal disorders
Rights: Copyright ©2013 Baishideng Publishing Group Co., Limited. All rights reserved.
DOI: 10.3748/wjg.v19.i16.2514
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