Abstract
This study aimed to evaluate the correlation between symptoms and endoscopic findings in reflux esophagitis. Subjects, 8031 persons without medication for gastrointestinal disease, were briefly asked about the presence of heartburn, dysphagia, odynophagia, and acid regurgitation by associated medical staff before endoscopy for assessment of esophagitis utilizing the Los Angeles Classification. Endoscopically, 1199 (14.9%) were classified as positive reflux esophagitis, and 2223 (27.7%) had heartburn, 1522 (19.0%) had dysphagia, 493 (6.1%) had odynophagia, and 1466 (18.3%) had acid regurgitation. Multivariate analysis indicated that the symptom most related to esophagitis was heartburn (odds ratio: 2.46), although ∼40% of subjects with grade C or D did not complain of heartburn. Regarding the other symptoms, less than 30% subjects with severe esophagitis complained of the symptoms and the odds ratio was ∼1. These results indicate that endoscopic esophagitis was not equivalent to any reflux symptoms from which subjects suffered in their daily lives.
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References
DeVault KR, Castell DO: The practice parameters committee of the American college of gastroenterology. Updated guidelines for the diagnosis and treatment of gastroesophageal reflux disease. Am J Gastroenterol 14:34-42, 1994
Armstrong D, Bennett JR, Blum AL, Dent J, De Dombal FT, Galmiche JP, Lundell L, Margulies M, Richter JE, Spechler SJ, Tytgat GN, Wallin L: The endoscopic assessment of esophagitis: a progress report on observer agreement. Gastroenterology 111:85-92, 1996
Lundell LR, Dent J, Bennett JR, Blum AL, Armstrong D, Galmiche JP, Johnson F, Hongo M, Richter JE, Spechler SJ, Tytgat GN, Wallin L: Endoscopic assessment of esophagitis: clinical and functional correlates and further validation of the Los Angeles classification. Gut 45:172-180, 1999
Richter JE: Chest pain and gastroesophageal reflux disease. J Clin Gastroenterol 30 (Suppl 3):S39-S41, 2000
Fass R, Fennerty MB, Johnson C, Camargo L, Sampliner RE: Correlation of ambulatory 24-hour esophageal pH monitoring results with symptom improvement in patients with noncardiac chest pain due to gastroesophageal reflux disease. J Clin Gastroenterol 28:36-39, 1999
Fass R, Fennerty MB, Ofman JJ, Gralnek IM, Johnson C, Camargo E, Sampliner RE: The clinical and economic value of a short course of omeprazole in patients with noncardiac chest pain. Gastroenterology 115:42-49, 1998
Schenk BE, Kuipers EJ, Klinkenberg-Knol EC, Festen HP, Jansen EH, Tuynman HA, Schrijver M, Dieleman LA, Meuwissen SG: Omeprazole as a diagnostic tool in gastroesophageal reflux disease. Am J Gastroenterol 92:1997-2000, 1997
Brun J, Sorngard H: High dose proton pump inhibitor response as an initial strategy for a clinical diagnosis of gastro-esophageal reflux disease (GERD). Swedish multi-centre group in primary health care. Fam Pract 17:401-404, 2000
Orlando RC: Reflux esophagitis. In Textbook of Gastroenterology, 3rd ed, Vol. 1. T. Yamada (ed). Philadelphia, Lippincott Williams & Wilkins, 1999, pp 1235-1262
Azuma N, Endo T, Arimura Y, Motoya S, Itoh F, Hinoda Y, Irimura T, Hosokawa M, Imai K: Prevalence of Barrett's esophagus and expression of mucin antigens detected by a panal of monoclonal antibodies in Barrett's esophagus and esophageal adenocarcinoma in Japan. J Gastroenterol 35:583-592, 2000
Carlsson R, Dent J, Bolling-Sternevald E, Johnsson F, Junghard O, Lauritsen K, Riley S, Lundell L: The usefulness of a structured questionnaire in the assessment of symptomatic gastroesophageal reflux disease. Scand J Gastroenterol 33:1023-1029, 1998
Talley NJ, Boyce P, Jones M: Identification of distinct upper and lower gastrointestinal symptom groupings in an urban population.Gut 42:690-695, 1998
Martinez-Serna T, Tercero F Jr, Filipi CJ, Dickason TJ, Watson P, Mittal SK, Tasset MR: Symptom priority ranking in the care of gastroesophageal reflux: a review of 1,850 cases. Dig Dis 17:219-224, 1999
Haque M, Wyeth JW, Stace NH, Talley NJ, Green R: Prevalence, severity and associated features of gastro-esophageal reflux and dyspepsia: a population-based study. NZ Med J 113:178-181, 2000
Talley NJ, Fullerton S, Junghard O, Wiklund I: Quality of life in patients with endoscopy-negative heartburn: reliability and sensitivity of disease-specific instruments. Am J Gastroenterol 96:1998-2004, 2001
Rothman M, Farup C, Stewart W, Helbers L, Seldis J: Symptoms associated with gastroesophageal reflux disease: development of a questionnaire for use in clinical trials. Dig Dis Sci 46:1540-1549, 2001
Shaw MJ, Talley NJ, Beebe TJ, Rockwood T, Carlsson R, Adis S, Fendrick AM, Jones R, Dent J, Bytzer P: Initial validation of a diagnostic questionnaire for gastroesophageal reflux disease. Am J Gastroenterol 96:52-57, 2001
Quigley EM: Non-erosive reflux disease: part of the spectrum of gastro-oesophageal reflux disease, a component of functional dyspepsia, or both? Eur J Gastroenterol Hepatol 13 (Suppl 1):S13-S18, 2001
Sonnenberg A, El-Serag HB: Clinical epidemiology and natural history of gastroesophageal reflux disease. Yale J Biol Med 72:81-92, 1999
Armstrong D: Endoscopic evaluation of gastroesophageal reflux disease. Yale J Biol Med 72:93-100, 1999
Tytgat GN: Long-term use of proton pump inhibitors in GERD-help or hindrance? Aliment Pharmacol Ther 15 (Suppl 2):6-9, 2001
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Okamoto, K., Iwakiri, R., Mori, M. et al. Clinical Symptoms in Endoscopic Reflux Esophagitis: Evaluation in 8031 Adult Subjects. Dig Dis Sci 48, 2237–2241 (2003). https://doi.org/10.1023/B:DDAS.0000007857.15694.15
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DOI: https://doi.org/10.1023/B:DDAS.0000007857.15694.15