Symptom resolution does not predict healing of erosive oesophagitis in Chinese.
BACKGROUND
Previous studies suggested that Chinese have a milder spectrum of gastro-oesophageal reflux disease and a lower dose of proton pump inhibitors (PPI) is sufficient for the control of symptoms as compared with the Western population.


OBJECTIVE
To determine if 8 weeks of esomeprazole 20 mg daily would be adequate for both symptom resolution and oesophagitis healing in Chinese patients and the predictive factors for the response.


METHODS
66 patients with oesophagitis were included. Oesophagitis severity was graded by Los Angeles (LA) classification. 61 patients underwent 24-hour ambulatory pH study at baseline. All were given esomeprazole 20 mg daily for 8 weeks. Symptom response and healing of oesophagitis was assessed at the end of the treatment period.


RESULTS
75.8% of the patients had complete reflux symptom resolution but only 48% had complete healing of the oesophagitis at endoscopy after 8 weeks of treatment. LA classification grading at baseline endoscopy (p < 0.0001) and total number acid reflux episodes on 24-hour pH monitoring prior to treatment (p = 0.007) were both good predictors of oesophagitis healing but not for symptom resolution.


CONCLUSIONS
Our results suggested that 8 weeks of lower dose PPI is not sufficient for oesophagitis healing. Symptom resolution with PPI does not predict oesophagitis healing in Chinese.
Cheung
Ting Kin
TK
Department of Medicine, University of Hong Kong, Hong Kong, SAR, China.
Wong
Wai Man
WM
Wong
Nina Y H
NY
Chan
Chi Kuen
CK
Fung
James
J
Yuen
Man Fung
MF
Chan
Annie O O
AO
Tong
Teresa S M
TS
Wong
Benjamin C Y
BC
D000897:Anti-Ulcer Agents / Q000627:therapeutic use*; D016009:Chi-Square Distribution; D002681:China; D064098:Esomeprazole / Q000627:therapeutic use*; D004941:Esophagitis / Q000188:drug therapy* / Q000208:ethnology*; D004945:Esophagoscopy; D005260:Female; D005745:Gastric Acidity Determination; D006801:Humans; D006863:Hydrogen-Ion Concentration; D016015:Logistic Models; D008297:Male; D008365:Manometry; D008875:Middle Aged; D012307:Risk Factors; D012720:Severity of Illness Index; D011795:Surveys and Questionnaires; D016896:Treatment Outcome
D000897:Anti-Ulcer Agents; D064098:Esomeprazole