Mucosal breaks show same circumferential distribution in majority of patients with recurrent reflux esophagitis.
Background and study aimsEsophageal mucosal breaks in patients with reflux esophagitis (RE) have a unique circumferential distribution. However, the specific location of mucosal breaks during recurrence of RE remains unclear. We investigated the circumferential distribution of mucosal breaks in patients with recurrent RE and compared their location to that noted at the initial diagnosis.Patients and methodsWe retrospectively enrolled patients with recurrent RE with Los Angeles (LA) grade A-C who were treated at our University Hospital between July 1996 and June 2014. The circumferential distribution of esophageal mucosal breaks was evaluated at the time of the initial diagnosis and again at the time of recurrence. Information regarding clinical parameters, including proton pump inhibitor administration, presence of hiatal hernia, and mucosal atrophy, was also reviewed.ResultsA total of 114 patients with recurrent RE were examined during the study period, with a mean duration to recurrence after initial diagnosis of 39.4 months. The majority (72.8 %) had the same LA grade at recurrence. In addition, recurrent mucosal breaks in 96 (84.2 %) patients were observed to have occurred in the same circumferential location as at the initial diagnosis, while those in 18 (15.8 %) were observed in a different location. When recurrent lesions had a different location, the LA grade also tended to be different (P= 0.02).ConclusionsWe found that most patients with recurrent RE developed lesions in the same circumferential location as noted for the initial lesions. Those in different locations at recurrence were associated with a change in LA grade.
Department of Gastroenterology and Hepatology, Shimane University School of Medicine, Izumo, Japan; Fukuda Clinic, Ohda, Japan.
Naoki
N
Fukuda
Department of Gastroenterology and Hepatology, Shimane University School of Medicine, Izumo, Japan.
Norihisa
N
Ishimura
Department of Gastroenterology and Hepatology, Shimane University School of Medicine, Izumo, Japan.
Mayumi
M
Okada
Department of Gastroenterology and Hepatology, Shimane University School of Medicine, Izumo, Japan.
Daisuke
D
Izumi
Department of Gastroenterology and Hepatology, Shimane University School of Medicine, Izumo, Japan.
Hironobu
H
Mikami
Department of Gastroenterology and Hepatology, Shimane University School of Medicine, Izumo, Japan.
Eiko
E
Okimoto
Department of Gastroenterology and Hepatology, Shimane University School of Medicine, Izumo, Japan.
Masahito
M
Aimi
Department of Gastroenterology and Hepatology, Shimane University School of Medicine, Izumo, Japan.
Tsuyoshi
T
Mishiro
Department of Gastroenterology and Hepatology, Shimane University School of Medicine, Izumo, Japan.
Naoki
N
Oshima
Department of Gastroenterology and Hepatology, Shimane University School of Medicine, Izumo, Japan.
Shunji
S
Ishihara
Department of Gastroenterology and Hepatology, Shimane University School of Medicine, Izumo, Japan.
Yoshikazu
Y
Kinoshita