The effect of gastroesophageal flap valve appearance on the management of patients with symptoms of gastroesophageal reflux disease.
OBJECTIVE
To assess the effectiveness of anti-reflux treatment in gastroesophageal reflux disease patients classified according to esophagogastric junction morphology (Hill classification).


RESULTS
A symptom score and endoscopic grading of gastrooesophageal flap valve appearance were determined in 49 symptomatic patients (female 26, male 23; mean age 49 years, range 21-76 years). Patients received 8 weeks of continuous rabeprazole at a daily dose of 20 mg and, upon symptom control, continued with on-demand treatment for 3 months. The mean symptom score at 8 weeks was significantly reduced in all groups. However, at the end of the on-demand therapy, patients with Hill grade IV had used more rabeprazole tablets than those in the two other groups (II: 10.86 +/- 14.52, III: 14.73 +/- 14.58, IV: 25.78 +/- 15.85; P = 0.002).


CONCLUSIONS
Continuous treatment is effective in all groups of patients with reflux disease. Grading patients according to the gastroesophageal flap valve appearance is useful as a prognostic factor, especially when on-demand therapy is considered to be an option.
Xirouchakis
Elias
E
GI Endoscopy Department, 1st IKA Hospital, End of Zaimi Str, PC 15127, Melissia, Athens, Greece. elmoxir@yahoo.gr
Kamberoglou
Dimitrios
D
Kalos
Dimitrios
D
Zambeli
Evanthia
E
Doulgeroglou
Vassilios
V
Tzias
Vassilios
V
D053799:2-Pyridinylmethylsulfinylbenzimidazoles / Q000627:therapeutic use*; D000328:Adult; D000368:Aged; D004943:Esophagogastric Junction / Q000473:pathology*; D005260:Female; D005764:Gastroesophageal Reflux / Q000188:drug therapy / Q000473:pathology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D054328:Proton Pump Inhibitors / Q000627:therapeutic use*; D064750:Rabeprazole; D055815:Young Adult
D053799:2-Pyridinylmethylsulfinylbenzimidazoles; D054328:Proton Pump Inhibitors; D064750:Rabeprazole