Gastroesophageal reflux disease after diagnostic endoscopy in the clinical setting

Nora Zschau, Jane Andrews, Richard Holloway, Mark Schoeman, Kylie Lange, William Tam, Gerald Holtmann

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    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 selfcompletion 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.

    Original languageEnglish
    Pages (from-to)2514-2520
    Number of pages7
    JournalWorld Journal of Gastroenterology
    Volume19
    Issue number16
    DOIs
    Publication statusPublished - Apr 2013

    Keywords

    • Acid suppressive therapy
    • Barrett's esophagus
    • Endoscopy
    • Epidemiology
    • Functional gastrointestinal disorders
    • Gastroesophageal reflux disease
    • Proton pump inhibitor

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  • Cite this

    Zschau, N., Andrews, J., Holloway, R., Schoeman, M., Lange, K., Tam, W., & Holtmann, G. (2013). Gastroesophageal reflux disease after diagnostic endoscopy in the clinical setting. World Journal of Gastroenterology, 19(16), 2514-2520. https://doi.org/10.3748/wjg.v19.i16.2514