Skip to main content
SpringerLink
Log in

L’histoire naturelle du reflux gastro-œsophagien

The natural history of reflux esophagitis

  • Published:
Acta Endoscopica

Résumé

La littérature comporte un nombre limité de données relatives à l’histoire naturelle et l’épidémiologie du reflux gastroœsophagien (RGO). En revanche, les mécanismes pathogéniques de l’œsophagite sont mieux connus mais les connaissances demeurent encore fragmentaires.

Entre 12 et 36 % de la population présentent du pyrosis, 40 à 60 % des patients souffrant de pyrosis présentent une œsophagite reconnue par l’endoscopie, et parmi les patients porteurs de lésions d’œsophagite endoscopique, 8 à 10 % ont un œsophage de Barrett. Certains patients souffrant de reflux gastro-œsophagien présentent seulement des signes histologiques de maladie par reflux, en l’absence d’anomalies endoscopiques. Chez la majorité des patients souffrant d’une maladie par reflux décelée à l’endoscopie ou par l’histologie, on constate des récidives systématiques et des rechutes chroniques des symptômes, entraînant une prise en charge thérapeutique à long terme. L’histoire naturelle de la pathologie du reflux et de l’œsophagite a été modifiée dans le sens favorable depuis l’utilisation des antagonistes H2 à l’histamine, de l’Omeprazole et des médicaments prokinétiques. Grâce à une compréhension améliorée des mécanismes pathogéniques de l’œsophagite, le traitement de cette affection chronique va vraisemblablement s’améliorer et modifier par conséquent, l’histoire naturelle du reflux gastro-œsophagien.

Summary

There are limited data in the literature regarding the natural history and epidemiology of gastroesophageal reflux disease (GERD). Much is known about the pathomechanisms of esophagitis, but even more remains to be learned.

Twelve to thirty-six percent of people experience heartburn, 40–60 % of patients with heartburn have endoscopic evidence of esophagitis, and 8–10 % of patients with endoscopic esophagitis have Barrett’s esophagitis. Some patients with gastroesophageal reflux disease have only histological evidence of GERD, with normal endoscopic findings. In the majority of patients with endoscopic or histologic GERD, it is a symptomatically recurrent and chronic relapsing process requiring longterm therapy. The natural history of GERD and esophagitis is being altered to a more favorable status with the use of Histamine-2 antagonists and Omeprazole as well as prokinetic agents. With increased understanding of the pathomechanisms of esophagitis, treatment of this chronic disease is likely to improve and result in further modifications in the natural history of gastroesophageal reflux disease.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Références

  1. ALLISON P.R. — Reflux œsophagitis; its pathology and treatment.Scan. J. Thor. Cardiovasc. Surg., 1972,6, 318–322.

    CAS  Google Scholar 

  2. BORRIE J., GOLDWATER L. — Columnar cell-lined esophagus: assessment of etiology and treatment. A 22 year experience.J. thorac. Cardiovasc. Surg., 1976,71, 825–834.

    PubMed  CAS  Google Scholar 

  3. GLISE H. — Healing, relapse rates and prophylaxis of reflux esophagitis.Scan. J. Gastroenterol., 1989,24 (suppl. 156), 57–64.

    Article  Google Scholar 

  4. GOLDMAN M.C., BECKMAN R.C. — Barrett syndrome: case report with discussion about concepts of pathogenesis.Gastro., 1960,39, 104–110.

    CAS  Google Scholar 

  5. GRAHAM D.Y., SMITH J.L., PATTERSON D.J. — Why do apparently healthy people use antacid tablets?Am. J. Gastro., 1983,78, 257–260.

    CAS  Google Scholar 

  6. HANDS L.J., DENNISON A.R., PAPAVRAMIDIS S., McINTYRE R.L., BISHOP H., KETTLEWELL M.G. — The natural history of peptic oesophageal strictures treated by dilatation and antireflux therapy alone.Ann. Royal College Surg. Engl., 1989,71, 306–310.

    CAS  Google Scholar 

  7. HEADING R.C. — Epidemiology of œsophageal reflux disease.Scan. J. Gastroenterol., 1989,24 (suppl. 168), 33–37.

    Google Scholar 

  8. Heartburn across America : a Gallup organization national survey. Princeton, N.J., Gallup Organization, 1988.

  9. HELM J.F., DODDS W.J., PELC L.R. et al. — Effect of esophageal emptying and saliva on clearance of acid from the esophagus.NRJM, 1984,310, 284–288.

    CAS  Google Scholar 

  10. HETZEL D.P., SAROSIEK J., PEURA D.A., PIASCIK R., FENG T., McCALLUM R.W. — Mucus secretion by human esophageal mucosa : the effect of challenge with acid and pepsin.Gastro., 1992,102, A83 (abstract).

  11. HETZEL D.J., DENT J., REED W.D. et al. — Healing and relapse of severe peptic esophagitis after treatment with omeprazole.Gastro., 1988,95, 903–912.

    CAS  Google Scholar 

  12. HOLLOWAY R.H., DENT J. — Pathophysiology of gastroesophageal reflux.Gastro. Clinics No. America., 1990,19, 517–535.

    CAS  Google Scholar 

  13. KINGSNORTH A.W., SMITH P., RICHARDS R.C. — Parotid salivary epidermal growth factor levels in human reflux esophagitis and PUD.Gastro., 1989,96, A257 (abstract).

  14. LIEBERMAN D.A. — Medical therapy for chronic reflux esophagitis: long-term follow-up.Arch. Intern. Med., 1987,147, 1717–1720.

    Article  PubMed  CAS  Google Scholar 

  15. MOLD J.W., REED L.E., DAVIS A.B., ALLEN M.L., DECKTOR D.L., ROBINSON M. — Prevalence of gastrœsophageal reflux in elderly patients in a primary care setting.Am. J. Gastro., 1991,86, 965–970.

    CAS  Google Scholar 

  16. MOSSBERG S.M. — The columnar-lined esophagus (Barrett syndrome): an aquired condition ?Gastro., 1966,50, 671–676.

    CAS  Google Scholar 

  17. NEBEL O.T., FORNES M.F., CASTELL D.O. — Symptomatic gastrœsophageal reflux: incidence and precipitating factors.Dig. Dis. Sci., 1976,21, 953–956.

    Article  CAS  Google Scholar 

  18. ORLANDO R.C. — Reflux esophagitis. In Yamada T et al.: Textbook of Gastroenterology. New York, Lippincott, 1991.

    Google Scholar 

  19. PACE F., SANTALUCIA F., BIANCHI PORRO G. — Natural history of gastroesophageal reflux disease without oesophagitis.Gut, 1991,32, 845–848.

    Article  PubMed  CAS  Google Scholar 

  20. PALMER E.D. — The hiatus hernia-esophagitis-esophageal stricture complex: twenty year prospective study.Am. J. Medicine, 1968,44, 566–577.

    Article  CAS  Google Scholar 

  21. PATTERSON D.J., GRAHAM D.Y., SMITH J.L., SCHWARTZ J.T., ALPERT E.L., LANZA F.L., CAIN G.D. — Natural history of benign esophageal stricture treated by dilatation.Gastro., 1983,85, 346–350.

    CAS  Google Scholar 

  22. PHILLIPS R.W., WONG R.K.H. — Barrett’s esophagus: natural history, incidence, etiology, and complications.Gastro. Clinics No. Amer., 1991,20, 791–816.

    CAS  Google Scholar 

  23. REX J.C., ANDERSEN H.A., BARTHOLOMEW L.G., CAIN J.C. — Esophageal hiatal hernia: a 10-year study of medically treated cases.JAMA, 1961,178, 117–120.

    Google Scholar 

  24. RICHTER J.E. — Surgery for reflux disease: reflections of a gastroenterologist.NEJM, 1992,326, 825–827.

    PubMed  CAS  Google Scholar 

  25. SALTZMAN M., BARWICK K., McCALLUM R.W. — Progression of cimetidine-treated reflux esophagitis to a Barrett’s stricture.Dig. Dis. Sci., 1982,27, 181–186.

    Article  PubMed  CAS  Google Scholar 

  26. SAROSIEK J., HETZEL D.P., PEURA D.A., PIASCIK R., FENG T., MCCALLUM R.W. — Human esophageal bicarbonate : the rate of secretion during perfusion with NaCl, HCl, and HCl/Pepsin solution.Gastro, 1992,102, A158 (abstract).

  27. SCHNELL T., SONTAG S., WANNER J., CHINTAM R., CHEJFEC G., O’CONNELL S., MORONI B. — Endoscopic screening for Barrett’s esophagus (BE), esophageal adenocarcinoma (AdCa) and other mucosal changes in ambulatory subjects with symptomatic gastroesophageal reflux (GER).Gastro, 1985,88, 1576 (abstract).

    Google Scholar 

  28. SPECHLER S.J., GOYAL R.K. — Barrett’s esophagus.NEJM, 1986,315, 363–371.

    Google Scholar 

  29. STALNIKOWICZ-DARVASI R. — H2 antagonists in the treatment of reflux esophagitis: a critical analysis.Am. J. Gastro., 1989,84, 245–248.

    CAS  Google Scholar 

  30. TALLEY N.J., ZINSMEISTER A.R., SCHLECK C., MELTON L.J. — Natural history of gastroesophageal reflux : a population-based study.Gastro., 1992,102, A28 (abstract).

  31. TREEM W.R., DAVIS P.M., HYAMS J.S. — Gastroesophageal reflux in the older child: presentation, response to treatment and long-term follow-up.Clin. Pediatrics, 1991,30, 435–440.

    Article  CAS  Google Scholar 

  32. TUOHY C.D., ALLEN V., SAMPLINER R.E., AICKEN M., GAREWAL H. — Can symptoms alone differentiate patients with Barrett’s esophagus from patients with gastroesophageal reflux disease lacking Barrett’s ?Gastro, 1990,98, A141 (abstract).

  33. WIENBECK M., BARNERT J. — Epidemiology of reflux disease and reflux esophagitis.Scan. J. Gastroenterol., 1989,24 (suppl. 156), 7–13.

    Article  Google Scholar 

  34. WINTERS C., SPURLING T.J., CHOBANIAN S.J., CURTIS D.J., ESPOSITO R.L., HACKER J.F., JOHNSON D.A., CRUESS D.F., COTELINGAM J.D., GURNEY M.S., CATTAU E.L. — Barrett’s esophagus: a prevalent, occult complication of gastroesophageal reflux disease.Gastro, 1987,92, 118–124.

    Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Division of Gastroenterology, University of Virginia Health Sciences Center, Box 145, 22908, Charlottesville, Virginia, U.S.A.

    D. P. Hetzel & R. W. McCallum MD (Chief)

Authors
  1. D. P. Hetzel
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. R. W. McCallum MD
    View author publications

    You can also search for this author in PubMed Google Scholar

About this article

Cite this article

Hetzel, D.P., McCallum, R.W. L’histoire naturelle du reflux gastro-œsophagien. Acta Endosc 23, 73–81 (1993). https://doi.org/10.1007/BF02968617

Download citation

  • Issue Date:

  • DOI: https://doi.org/10.1007/BF02968617

Mots-clés

Key-words

Search

Navigation