Korean J Gastroenterol.  2010 Feb;55(2):100-108. 10.4166/kjg.2010.55.2.100.

Clinical Analysis of Recurrence Rate and Symptom Improvement in Gastro-esophageal Reflux Disease Patients

• Jeong YJ
• Lee DH
• Choi TH
• Hwang TJ
• Lee BH
• Nah JC
• Lee SH
• Park YS
• Hwang JH
• Kim JW
• Jeong SH
• Kim N
• Jung HC
• Song IS

• KMID: 1718293
• DOI: http://doi.org/10.4166/kjg.2010.55.2.100

Abstract

BACKGROUND/AIMS
Gastro-esophageal reflux disease (GERD) is a chronic condition, with 50-80% of patients experiencing recurrence within one year following completion of initial treatment. The present study aimed to estimate recurrence rate and treatment response in GERD patients treated with proton pump inhibitor.
METHODS
A total of 207 symptomatic GERD patients, which were confirmed by endoscopy from July 2008 till January 2009, were enrolled. They were divided into non-erosive reflux disease (NERD) group and erosive reflux disease (ERD) group by endoscopic findings. Patients were treated with lansoprazole 15 mg (NERD group) or 30 mg (ERD group) once daily for 8 weeks. The presence of symptoms was assessed in each patient at baseline and post-treatment using a questionnaire. Subsequent symptomatic recurrence on the cessation of therapy in each improved patients was checked by telephone survey or outpatient interview.
RESULTS
Ninety-four patients and 113 patients were first diagnosed with NERD and ERD, respectively. The mean post-treatment follow-up period was 24.4+/-8.5 weeks. Recurrence rate was 40.0% (NERD, 43.8%; ERD, 37.1% (p=0.224)). Recurrence time was 10.1+/-5.8 weeks (NERD 9.6 weeks; ERD, 10.6 weeks (p=0.444)). Regarding the symptom improvement after 8 week therapy with lansoprazole, 89.4% (NERD, 85.1%; ERD, 92.9% (p=0.056)) of total patients were symptomatically improved.
CONCLUSIONS
Forty percentage of GERD patients recurred within 6 months following the completion of 8 week therapy with lansoprazole. Recurrence rate, recurrence time, and rate of symptom improvement were not significantly different between NERD group treated with half dose and ERD group treated with full dose lansoprazole.

Keyword

Gastroesophageal reflux disease; Recurrence; Treatment outcome; Proton pump inhibitor

MeSH Terms

2-Pyridinylmethylsulfinylbenzimidazoles/therapeutic use
Adult
Aged
Anti-Ulcer Agents/therapeutic use
Female
Follow-Up Studies
Gastroesophageal Reflux/*drug therapy
Gastroscopy
Humans
Interviews as Topic
Male
Middle Aged
Proton Pump Inhibitors/therapeutic use
Questionnaires
Recurrence

Figure

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  Fig. 1. Algorithm of study protocol in symptomatic GERD patients. NERD, nonerosive reflux disease; ERD, erosive reflux disease.

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  Fig. 2. Treatment outcome among 207 GERD patients with NERD and ERD. NERD, nonerosive reflux disease; ERD, erosive reflux disease.

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  Fig. 3. Recurrence rate in GERD patients with symptom improvement after PPI treatment. NERD, nonerosive reflux disease; ERD, erosive reflux disease.

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  Fig. 4. Recurrence time by Kaplan-Meier Method and Log Rank comparisons of the NERD (n=35) and ERD (n=39) group. NERD, nonerosive reflux disease; ERD, erosive reflux disease.

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