title: Gastroesophageal reflux disease after diagnostic endoscopy in the clinical setting.
abstract: OBJECTIVE
  To investigate the outcome of patients with symptoms of gastroesophageal reflux disease (GERD) referred for endoscopy at 2 and 6 mo post endoscopy.
  
  
  METHODS
  Consecutive patients referred for upper endoscopy for assessment of GERD symptoms at two large metropolitan hospitals were invited to participate in a 6-mo non-interventional (observational) study. The two institutions are situated in geographically and socially disparate areas. Data collection was by self-completion of questionnaires including the patient assessment of upper gastrointestinal disorders symptoms severity and from hospital records. Endoscopic finding using the Los-Angeles classification, symptom severity and it's clinically relevant improvement as change of at least 25%, therapy and socio-demographic factors were assessed.
  
  
  RESULTS
  Baseline data were available for 266 patients and 2-mo and 6-mo follow-up data for 128 and 108 patients respectively. At baseline, 128 patients had erosive and 138 non-erosive reflux disease. Allmost all patient had proton pump inhibitor (PPI) therapy in the past. Overall, patients with non-erosive GERD at the index endoscopy had significantly more severe symptoms as compared to patients with erosive or even complicated GERD while there was no difference with regard to medication. After 2 and 6 mo there was a small, but statistically significant improvement in symptom severity (7.02 ± 5.5 vs 5.9 ± 5.4 and 5.5 ± 5.4 respectively); however, the majority of patients continued to have symptoms (i.e., after 6 mo 81% with GERD symptoms). Advantaged socioeconomic status as well as being unemployed was associated with greater improvement.
  
  
  CONCLUSIONS
  The majority of GORD patients receive PPI therapy before being referred for endoscopy even though many have symptoms that do not sufficiently respond to PPI therapy.
authors.affiliation: Department of Gastroenterology and Hepatology, Royal Adelaide Hospital, Adelaide, SA 5000, Australia.
authors.forename: Nora B
authors.initials: NB
authors.lastname: Zschau
authors.forename: Jane M
authors.initials: JM
authors.lastname: Andrews
authors.forename: Richard H
authors.initials: RH
authors.lastname: Holloway
authors.forename: Mark N
authors.initials: MN
authors.lastname: Schoeman
authors.forename: Kylie
authors.initials: K
authors.lastname: Lange
authors.forename: William Ce
authors.initials: WC
authors.lastname: Tam
authors.forename: Gerald J
authors.initials: GJ
authors.lastname: Holtmann
mesh_terms: D000328:Adult; D000368:Aged; D016099:Endoscopy, Gastrointestinal; D005260:Female; D005764:Gastroesophageal Reflux / Q000150:complications / Q000175:diagnosis* / Q000188:drug therapy; D006356:Heartburn / Q000175:diagnosis / Q000209:etiology; D006801:Humans; D008019:Life Style; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D011237:Predictive Value of Tests; D011379:Prognosis; D011446:Prospective Studies; D054328:Proton Pump Inhibitors / Q000627:therapeutic use; D012017:Referral and Consultation; D012307:Risk Factors; D012720:Severity of Illness Index; D012959:Socioeconomic Factors; D013021:South Australia; D011795:Surveys and Questionnaires; D013997:Time Factors; D014478:Unemployment; D055815:Young Adult
chemical_list: D054328:Proton Pump Inhibitors
keywords: Acid suppressive therapy; Barrett’s esophagus; Endoscopy; Epidemiology; Functional gastrointestinal disorders; Gastroesophageal reflux disease; Proton pump inhibitor