Document Detail

A prospective multicenter clinical and endoscopic follow-up study of patients with gastroesophageal reflux disease.
MedLine Citation:
PMID:  16315125     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Despite its high prevalence, data on the course of gastroesophageal reflux disease (GERD) are still sparse. There is also an ongoing debate on the natural history of its various manifestations, i.e., non-erosive reflux disease (NERD) vs. erosive reflux disease (ERD) vs. Barrett's esophagus (BE). PATIENTS AND METHODS: This study was conducted within the framework of a prospective multicenter study on the course and prevalence of intestinal metaplasia at the gastroesophageal junction. 1014 dyspeptic patients were screened by the means of upper GI endoscopy. Clinical data were recorded by the use of a questionnaire. At least 15 months after the initial examination, all patients were invited for follow-up (FU) examination. Patients were analyzed separately with respect to their clinical and endoscopic findings. For the latter, only patients without any treatment with proton-pump-inhibitors (PPI) prior to initial and follow-up examinations were included. Patients were categorized as GERD positive if typical symptoms were present and/or proton pump inhibitors were used. RESULTS: Sufficient clinical and/or endoscopic data were available in 590 GERD patients with heartburn at least once a week. Follow-up data could be obtained in 320 patients (clinical FU: n = 304; endoscopic FU: n = 52) after a mean follow-up period of 35 months (18-48 months). 96 of 144 previously asymptomatic patients (67%) remained asymptomatic at follow-up, the rest (n = 48) were symptomatic. 143 of 304 previously symptomatic patients (47%) were symptom-free at follow-up, and only 161 patients (53%) remained symptomatic or had concomitant therapy with proton-pump-inhibitors (PPI). For follow-up endoscopy in patients off PPI (n = 52), ERD was no longer confirmed in 7/12 ERD patients (58%), whereas progress to ERD was found in 3/34 patients (9%) in the NERD group. BE was newly diagnosed in two NERD patients but could no longer be detected in 2 of 6 patients with an initial diagnosis of BE. CONCLUSIONS: With respect to its clinical as well as its endoscopic manifestations, gastroesophageal reflux disease does not appear to be very stable over time. However, in most cases this is due to regression rather than progression of the disease.
M Bajbouj; J Reichenberger; B Neu; C Prinz; R M Schmid; T R?sch; A Meining
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Publication Detail:
Type:  Clinical Trial; Journal Article; Multicenter Study    
Journal Detail:
Title:  Zeitschrift f?r Gastroenterologie     Volume:  43     ISSN:  0044-2771     ISO Abbreviation:  Z Gastroenterol     Publication Date:  2005 Dec 
Date Detail:
Created Date:  2005-11-29     Completed Date:  2006-02-14     Revised Date:  2009-11-11    
Medline Journal Info:
Nlm Unique ID:  0033370     Medline TA:  Z Gastroenterol     Country:  Germany    
Other Details:
Languages:  eng     Pagination:  1303-7     Citation Subset:  IM    
Department of Medicine II, Klinikum rechts der Isar, Technical University of Munich.
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MeSH Terms
Endoscopes, Gastrointestinal / statistics & numerical data*
Follow-Up Studies
Gastroesophageal Reflux / diagnosis*,  epidemiology*
Germany / epidemiology
Middle Aged
Prospective Studies
Risk Assessment / methods*

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