Clinical Improvement of Severe Reflux Esophagitis in Korea: Follow-up Observation by Endoscopy |
Bong Han Kong, Dong Ryul Kim, Ryong Heo, Eung Koo Lee, Juhee Kim, Deok Jae Han, Won Jik Lee, Jung Hwan Oh |
Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, Korea. ojh@catholic.ac.kr |
중증 역류성식도염의 임상경과: 내시경 추적 관찰 |
공봉한, 김동률, 허 룡, 이응구, 김주희, 한덕재, 이원직, 오정환 |
가톨릭대학교 의과대학 내과학교실 |
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Abstract |
BACKGROUND/AIMS The natural history of severe erosive reflux disease in Korea remains uncertain. We aimed to evaluate endoscopic follow-up results in subjects with severe reflux esophagitis under routine clinical care. MATERIALS AND METHODS: A total 61,891 subjects underwent an upper endoscopic examination in the health check-up program from January 2007 to December 2013. We reviewed medical charts of patients who had been diagnosed with severe reflux esophagitis. The severity of reflux esophagitis was determined by the Los Angeles (LA) classification system. Patients underwent at least one follow up endoscopy after diagnosis of severe reflux esophagitis. We classified the patients into two groups; regressed in severity and remained unchanged, according to follow up endoscopic status. RESULTS: Based on endoscopic findings, 5,938 subjects (9.6%) were found to have reflux esopohagitis: 121 subjects (0.2%) in LA-C; 39 subjects (0.06%) in LA-D. Among 31 patients who had endoscopic follow-up, 23 patients (74.2%) showed regression from LA C/D to LA A/B or minimal change disease or normal. The mean follow up duration was 42.2 months in regression group and 53.2 months in no change group. All patients had been treated with proton pump inhibitors (PPIs) on a regular or on-demand basis. Age, sex, smoking, alcohol, exercise, hypertension, diabetes mellitus, dyslipidemia, sliding hiatal hernia, body mass index, waist circumference and duration of PPIs therapy did not significantly influence regression of severe reflux esophagitis. CONCLUSIONS: The majority of severe reflux esophagitis patients under routine clinical care showed improvement on endoscopic follow-up. |
Key Words:
Endoscopy; Esophagitis; Gastroesophageal reflux; Natural history; Proton pump inhibitors |
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