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Predictive factors in the long term outcome in gastro-oesophageal reflux disease: six years follow up of 107 patients
Kuster, Elbio; Ros Rahola, Emilio; Toledo-Pimentel, Victor; Pujol, A.; Bordas Alsina, Josep M.; Grande Posa, Luis; Pera Blanco-Morales, Cristóbal
Universitat de Barcelona
There is little information concerning the long term outcome of patients with gastro-oesophageal reflux disease (GORD). Thus 109 patients with reflux symptoms (33 with erosive oesophagitis) with a diagnosis of GORD after clinical evaluation and oesophageal testing were studied. All patients were treated with a stepwise approach: (a) lifestyle changes were suggested aimed at reducing reflux and antacids and the prokinetic agent domperidone were prescribed; (b) H2 blockers were added after two months when symptoms persisted; (c) anti-reflux surgery was indicated when there was no response to (b). Treatment was adjusted to maintain clinical remission during follow up. Long term treatment need was defined as minor when conservative measures sufficed for proper control, and as major if daily H2 blockers or surgery were required. The results showed that one third of the patients each had initial therapeutic need (a), (b), and (c). Of 103 patients available for follow up at three years and 89 at six years, respective therapeutic needs were minor in 52% and 55% and major in 48% and 45%. Eighty per cent of patients in (a), 67% in (b), and 17% in (c) required only conservative measures at six years. A decreasing lower oesophageal sphincter pressure (p < 0.001), radiological reflux (p = 0.028), and erosive oesophagitis (p = 0.031), but not initial clinical scores, were independent predictors of major therapeutic need as shown by multivariate analysis. The long term outcome of GORD is better than previously perceived.
01-09-2011
Reflux gastroesofàgic
Esòfag
Pronòstic mèdic
Gastroesophageal reflux
Esophagus
Prognosis
(c) BMJ Publishing Group Ltd and British Society of Gastroenterology, 1994
Artículo
BMJ Group
         

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Kuster, Elbio; Ros Rahola, Emilio; Toledo-Pimentel, Victor; Pujol, A.; Bordas Alsina, Josep M.; Grande Posa, Luis; Pera Blanco-Morales, Cristóbal
Grande Posa, Luis; Monforte Martínez, Roser; Ros Rahola, Emilio; Toledo-Pimentel, Victor; Estruch Riba, Ramon; Lacima Vidal, Gloria; Urbano Márquez, A. (Álvaro); Pera Blanco-Morales, Cristóbal
Grande Posa, Luis; Monforte Martínez, Roser; Ros Rahola, Emilio; Toledo-Pimentel, Victor; Estruch Riba, Ramon; Lacima Vidal, Gloria; Urbano Márquez, A. (Álvaro); Pera Blanco-Morales, Cristóbal