The long-term follow-up of patients with endoscopically diagnosed reflux oesophagitis with specific emphasis to complaints.

Introduction: Patients with gastroesophageal reflux disease (GERD) need long-term treatment with acid-suppressive therapy. Data on long-term follow-up are very rare. For this reason, a study was performed to detect complaints many years after diagnosis.

Patients And Methods: All patients diagnosed with reflux oesophagitis in the years 1998-2000 were included. In the summer of 2010, they received a questionnaire with four different lists of questions pertaining to reflux complaints and use of medication. Severity and frequency were scored on 5-point and 6-point Likert scales, respectively; the GerdQ, a symptom activity index, and the gastrointestinal symptom-rating scale were also used.

Results: Complaints were reported by 130 patients (63%); the majority of these, 115 (88%), used acid suppressive therapy. Only 78 patients were in clinical remission, with or without therapy. The respondents with complaints were divided into two groups. Group 1: all patients with reflux complaints using acid suppressive therapy. Group 2: all patients with complaints without medication. Patients in group 1 were significantly older at the time of the endoscopic diagnosis compared with patients of group 2, and patients in group 1 had a hiatal hernia more often (P<0.001). There was no difference in the overall symptom or the frequency score per patient between both groups, with a mean of 5.97 versus 6.8 and 13.4 versus 13.8 respectively. However, heartburn, nausea, acid regurgitation, epigastric pain, dysphagia and nocturnal complaints showed a significantly higher prevalence in patients of group 2. Scores for specific complaints were significantly lower in group 2 and there was no difference between the GerdQ, the symptom activity index and the gastrointestinal symptom-rating scale.

Conclusion: Despite effective therapy, only 37% of the patients are in complete remission. However, the individual symptom score is rather low. Patients without medication more often have reflux complaints but lower severity scores. Patients who still had complaints and used medication had a hiatal hernia significantly more often.