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Comparison of risk factors and clinical responses to proton pump inhibitors in patients with erosive oesophagitis and non-erosive reflux disease

  1. E. S. LEE1,
  2. N. KIM1,2,
  3. S. H. LEE1,
  4. Y. S. PARK1,2,
  5. J. W. KIM1,
  6. S. H. JEONG1,
  7. D. H. LEE1,2,
  8. H. C. JUNG2,
  9. I. S. SONG2

Article first published online: 15 APR 2009

DOI: 10.1111/j.1365-2036.2009.04021.x

Issue

Alimentary Pharmacology & Therapeutics

Alimentary Pharmacology & Therapeutics

Volume 30, Issue 2, pages 154–164, July 2009

Additional Information

How to Cite

LEE, E. S., KIM, N., LEE, S. H., PARK, Y. S., KIM, J. W., JEONG, S. H., LEE, D. H., JUNG, H. C. and SONG, I. S. (2009), Comparison of risk factors and clinical responses to proton pump inhibitors in patients with erosive oesophagitis and non-erosive reflux disease. Alimentary Pharmacology & Therapeutics, 30: 154–164. doi: 10.1111/j.1365-2036.2009.04021.x

Author Information

  1. 1

    Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Korea

  2. 2

    Department of Internal Medicine and Liver Research Institute, Seoul National University College of Medicine, Seoul, Korea

*Dr N. Kim, Department of Internal Medicine, Seoul National University Bundang Hospital, 300 Gumi-dong, Bundang-gu, Seongnam, Gyeonggi-do, 463-707, Korea. E-mail: nayoungkim49@empal.com

Publication History

  1. Issue published online: 26 JUN 2009
  2. Article first published online: 15 APR 2009
  3. Publication data Submitted 2 February 2009 First decision 18 February 2009 Resubmitted 23 March 2009 Accepted 13 April 2009 Epub Accepted Article 15 April 2009

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Summary

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.

Aim  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 ≥ 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 ≥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.

Conclusion  These results suggest that the underlying pathogenic mechanisms of erosive oesophagitis and NERD are distinct.

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