Predictive factors in the long term outcome in gastro-oesophageal reflux disease: six years follow up of 107 patients

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 tre...

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Detalles Bibliográficos
Autores: Kuster, Elbio, Ros Rahola, Emilio, Toledo-Pimentel, Victor, Pujol, Amadeo, Bordas Alsina, Josep M., Grande Posa, Luis, Pera Blanco-Morales, Cristóbal
Tipo de recurso: artículo
Estado:Versión publicada
Fecha de publicación:1994
País:España
Institución:Universidad de Barcelona
Repositorio:Dipòsit Digital de la UB
OAI Identifier:oai:diposit.ub.edu:2445/18646
Acceso en línea:https://hdl.handle.net/2445/18646
Access Level:acceso abierto
Palabra clave:Reflux gastroesofàgic
Esòfag
Pronòstic mèdic
Gastroesophageal reflux
Esophagus
Prognosis
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spelling Predictive factors in the long term outcome in gastro-oesophageal reflux disease: six years follow up of 107 patientsKuster, ElbioRos Rahola, EmilioToledo-Pimentel, VictorPujol, AmadeoBordas Alsina, Josep M.Grande Posa, LuisPera Blanco-Morales, CristóbalReflux gastroesofàgicEsòfagPronòstic mèdicGastroesophageal refluxEsophagusPrognosisThere 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.BMJ Group1994info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersionapplication/pdfhttps://hdl.handle.net/2445/18646Articles publicats en revistes (Medicina)reponame:Dipòsit Digital de la UBinstname:Universidad de BarcelonaInglésReproducció digital del document publicat a: http://dx.doi.org/10.1136/gut.35.1.8Gut, 1994, vol. 35, p. 8-14http://dx.doi.org/10.1136/gut.35.1.8(c) BMJ Publishing Group Ltd and British Society of Gastroenterology, 1994info:eu-repo/semantics/openAccessoai:diposit.ub.edu:2445/186462026-05-27T06:46:51Z
dc.title.none.fl_str_mv Predictive factors in the long term outcome in gastro-oesophageal reflux disease: six years follow up of 107 patients
title Predictive factors in the long term outcome in gastro-oesophageal reflux disease: six years follow up of 107 patients
spellingShingle Predictive factors in the long term outcome in gastro-oesophageal reflux disease: six years follow up of 107 patients
Kuster, Elbio
Reflux gastroesofàgic
Esòfag
Pronòstic mèdic
Gastroesophageal reflux
Esophagus
Prognosis
title_short Predictive factors in the long term outcome in gastro-oesophageal reflux disease: six years follow up of 107 patients
title_full Predictive factors in the long term outcome in gastro-oesophageal reflux disease: six years follow up of 107 patients
title_fullStr Predictive factors in the long term outcome in gastro-oesophageal reflux disease: six years follow up of 107 patients
title_full_unstemmed Predictive factors in the long term outcome in gastro-oesophageal reflux disease: six years follow up of 107 patients
title_sort Predictive factors in the long term outcome in gastro-oesophageal reflux disease: six years follow up of 107 patients
dc.creator.none.fl_str_mv Kuster, Elbio
Ros Rahola, Emilio
Toledo-Pimentel, Victor
Pujol, Amadeo
Bordas Alsina, Josep M.
Grande Posa, Luis
Pera Blanco-Morales, Cristóbal
author Kuster, Elbio
author_facet Kuster, Elbio
Ros Rahola, Emilio
Toledo-Pimentel, Victor
Pujol, Amadeo
Bordas Alsina, Josep M.
Grande Posa, Luis
Pera Blanco-Morales, Cristóbal
author_role author
author2 Ros Rahola, Emilio
Toledo-Pimentel, Victor
Pujol, Amadeo
Bordas Alsina, Josep M.
Grande Posa, Luis
Pera Blanco-Morales, Cristóbal
author2_role author
author
author
author
author
author
dc.subject.none.fl_str_mv Reflux gastroesofàgic
Esòfag
Pronòstic mèdic
Gastroesophageal reflux
Esophagus
Prognosis
topic Reflux gastroesofàgic
Esòfag
Pronòstic mèdic
Gastroesophageal reflux
Esophagus
Prognosis
description 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.
publishDate 1994
dc.date.none.fl_str_mv 1994
dc.type.none.fl_str_mv info:eu-repo/semantics/article
info:eu-repo/semantics/publishedVersion
format article
status_str publishedVersion
dc.identifier.none.fl_str_mv https://hdl.handle.net/2445/18646
url https://hdl.handle.net/2445/18646
dc.language.none.fl_str_mv Inglés
language_invalid_str_mv Inglés
dc.relation.none.fl_str_mv Reproducció digital del document publicat a: http://dx.doi.org/10.1136/gut.35.1.8
Gut, 1994, vol. 35, p. 8-14
http://dx.doi.org/10.1136/gut.35.1.8
dc.rights.none.fl_str_mv (c) BMJ Publishing Group Ltd and British Society of Gastroenterology, 1994
info:eu-repo/semantics/openAccess
rights_invalid_str_mv (c) BMJ Publishing Group Ltd and British Society of Gastroenterology, 1994
eu_rights_str_mv openAccess
dc.format.none.fl_str_mv application/pdf
dc.publisher.none.fl_str_mv BMJ Group
publisher.none.fl_str_mv BMJ Group
dc.source.none.fl_str_mv Articles publicats en revistes (Medicina)
reponame:Dipòsit Digital de la UB
instname:Universidad de Barcelona
instname_str Universidad de Barcelona
reponame_str Dipòsit Digital de la UB
collection Dipòsit Digital de la UB
repository.name.fl_str_mv
repository.mail.fl_str_mv
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score 15,298079

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