title: Recent effectiveness of proton pump inhibitors for severe reflux esophagitis: the first multicenter prospective study in Japan.
abstract: Proton pump inhibitors are the first-line treatment for reflux esophagitis. Because severe reflux esophagitis has very low prevalence in Japan, little is known about the effectiveness of proton pump inhibitors in these patients. This prospective multicenter study assessed the effectiveness of proton pump inhibitors for severe reflux esophagitis in Japan. Patients with modified Los Angeles grade C or D reflux esophagitis were treated with daily omeprazole (10 or 20 mg), lansoprazole (15 or 30 mg), or rabeprazole (10, 20, or 40 mg) for 8 weeks. Healing was assessed endoscopically, with questionnaires administered before and after treatment to measure the extent of reflux and dyspepsia symptoms. Factors affecting healing rates, including patient characteristics and endoscopic findings, were analyzed. Of the 115 patients enrolled, 64 with grade C and 19 with grade D reflux esophagitis completed the study. The healing rate was 67.5% (56/83), with 15 of the other 27 patients (55.6%) improving to grade A or B. No patient characteristic or endoscopic comorbidity was significantly associated with healing rate. Reflux and dyspepsia symptoms improved significantly with treatment. The low healing rate suggests the need of endoscopic examination to assess healing of reflux esophagitis at the end of therapy. (UMIN000005271).
authors.affiliation: Department of Gastroenterology, Toyama City Hospital, 2-1 Imaizumihokubo-machi, Toyama 939-8511, Japan.
authors.forename: Hideki
authors.initials: H
authors.lastname: Mizuno
authors.affiliation: Department of Gastroenterology, NTT Medical Center Tokyo, 5-9-22 Higasigotanda, Shinagawa-ku, Tokyo 141-8625, Japan.
authors.forename: Nobuyuki
authors.initials: N
authors.lastname: Matsuhashi
authors.affiliation: Department of Internal Medicine, Moriguchi Keijinkai Hospital, 2-47-12 Yakumohigashi-machi, Moriguchi-shi, Osaka 570-0021, Japan.
authors.forename: Masahiro
authors.initials: M
authors.lastname: Sakaguchi
authors.affiliation: Department of Gastroenterology, National Hospital Organization Kochi Hospital, 1-2-25 Asakuranishi, Kochi 780-8077, Japan.
authors.forename: Syuji
authors.initials: S
authors.lastname: Inoue
authors.affiliation: Department of Surgery, The Jikei University School of Medicine, 3-25-8 Nishisinbashi, Minato-ku, Tokyo 105-8461, Japan ; Study Committee, GERD Society, 12 Floor, Oasaka-Nakanosima-Bill, 2-2-2 Nakanoshima, Kita-ku, Osaka 530-0005, Japan.
authors.forename: Koji
authors.initials: K
authors.lastname: Nakada
authors.affiliation: Study Committee, GERD Society, 12 Floor, Oasaka-Nakanosima-Bill, 2-2-2 Nakanoshima, Kita-ku, Osaka 530-0005, Japan ; Second Department of Internal Medicine, Osaka Medical College, 2-7 Daigaku-machi, Takatsuki-shi, Osaka 569-8686, Japan.
authors.forename: Kazuhide
authors.initials: K
authors.lastname: Higuchi
authors.affiliation: Study Committee, GERD Society, 12 Floor, Oasaka-Nakanosima-Bill, 2-2-2 Nakanoshima, Kita-ku, Osaka 530-0005, Japan ; Division of Gastroenterology, Department of Internal Medicine, Kawasaki Medical School, 577 Matsushima, Kurashiki-shi, Okayama 701-0192, Japan.
authors.forename: Ken
authors.initials: K
authors.lastname: Haruma
authors.affiliation: Study Committee, GERD Society, 12 Floor, Oasaka-Nakanosima-Bill, 2-2-2 Nakanoshima, Kita-ku, Osaka 530-0005, Japan ; Department of Gastroenterology and Metabolism, Nagoya City University Graduate School of Medical Sciences, 1 Kawasumi, Mizuho-cho, Mizuho-ku, Nagoya 467-8601, Japan.
authors.forename: Takashi
authors.initials: T
authors.lastname: Joh
keywords: asymptomatic reflux esophagitis; healing rate; proton pump inhibitor; severe reflux esophagitis