Comparison of risk factors and clinical responses to proton pump inhibitors in patients with erosive oesophagitis and non-erosive reflux disease.
BACKGROUND
There has been no report on the response to proton pump inhibitor (PPI) therapy and on-demand or the relapse rate of non-erosive reflux disease (NERD) and erosive oesophagitis in Korea.


OBJECTIVE
To compare the risk factors, clinical symptoms and PPI responses between patients with erosive oesophagitis and NERD patients.


METHODS
A survey was performed prospectively in the erosive oesophagitis (205 patients) and NERD group (200 patients). Clinical symptoms, risk factors and PPI responses were analysed. On-demand therapy and the relapse rate of GERD symptoms were investigated during a one-year follow-up.


RESULTS
BMI > or = 25 (OR 3.0, 95% CI 1.1-8.3), alcohol use (OR 2.9, 95% CI 1.0-8.3), hiatal hernia (OR 5.0, 95% CI 1.2-20) and triglyceride > or =150 mg/dL (OR 4.0, 95% CI 1.7-10) were more common in the erosive oesophagitis group than in the NERD group by multivariate analysis. The ratio of oesophageal to extra-oesophageal symptoms was higher in the erosive oesophagitis group compared with the NERD group (P < 0.001). The PPI response rates at 8 weeks were different (P = 0.02); refractory rates were higher in the NERD group (16.7%) compared with the erosive oesophagitis group (6.0%). However, there was no significant difference between the two groups in on-demand therapy or the relapse rate.


CONCLUSIONS
These results suggest that the underlying pathogenic mechanisms of erosive oesophagitis and NERD are distinct.
Lee
E S
ES
Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam 463-707, Korea.
Kim
N
N
Lee
S H
SH
Park
Y S
YS
Kim
J W
JW
Jeong
S H
SH
Lee
D H
DH
Jung
H C
HC
Song
I S
IS
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000897:Anti-Ulcer Agents / Q000627:therapeutic use*; D004941:Esophagitis / Q000188:drug therapy* / Q000453:epidemiology; D005260:Female; D005764:Gastroesophageal Reflux / Q000188:drug therapy* / Q000453:epidemiology; D006801:Humans; D007723:Korea / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D054328:Proton Pump Inhibitors / Q000627:therapeutic use*; D012307:Risk Factors; D055502:Secondary Prevention; D016896:Treatment Outcome; D055815:Young Adult
D000897:Anti-Ulcer Agents; D054328:Proton Pump Inhibitors