Symptoms in gastro-oesophageal reflux disease

Klauser, A G; Schindlbeck, Norbert E.; Müller-Lissner, S

doi:10.1016/0140-6736(90)90287-f

Cited by 687 publications

(416 citation statements)

References 14 publications

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“…The predictive value of recurrent heartburn for the relapse of oesophagitis during maintenance therapy in patients shown previously to have oesophagitis should not be confused with the observed low sensitivity of heartburn for the presence of gastro-oesophageal re¯ux in untreated patients. 34,35 In such patients, around half to two-thirds will have no clear-cut endoscopic oesophagitis before treatment. 5,6 Furthermore, the frequency and intensity of heartburn in this setting are of no value as predictors of the presence or absence of oesophagitis.…”

Section: Discussionmentioning

confidence: 99%

Prognostic factors influencing relapse of oesophagitis during maintenance therapy with antisecretory drugs: a meta‐analysis of long‐term omeprazole trials

Carlsson

Galmiche

Lundell

et al. 1997

Aliment Pharmacol Ther

132

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Background: This meta‐analysis investigated factors that may affect the risk of relapse of oesophagitis, and evaluated the predictive value of symptoms for the presence of relapse during long‐term treatment. Methods: Individual data from 1154 patients included in five independently conducted, randomized, long‐term clinical trials of the efficacy of different dosage regimens of omeprazole, standard ranitidine treatment and placebo for the prevention of relapse of oesophagitis were pooled for this meta‐analysis. The therapeutic regimens studied were omeprazole 20 mg o.m. (OME20) in 366 patients, omeprazole 10 mg o.m. (OME10) in 225 patients, omeprazole 20 mg weekends (OMEW) in 235 patients, ranitidine 150 mg b.d. (RAN) in 179 patients, or placebo (PLA) in 149 patients. Results: OME20 maintained 82.4% (95% CI: 78.2–86.6%) of patients in endoscopic remission over the 6‐month period compared to 71.9% (95% CI: 65.5–78.3%) for OME10, 52.3% (95% CI: 44.4–60.1%) for RAN, 42.7% (95% CI: 35.8–49.5%) for OMEW, and 10.6% (95% CI: 5.0–16.3%) for PLA. A Cox's regression analysis of time to recurrence of oesophagitis showed that four factors were associated with a higher relapse rate during placebo and active maintenance therapy: (a) pre‐treatment severity of oesophagitis (P<0.0001), (b) young age (P=0.01), (c) non‐smoking (P=0.02) and (d) moderate/severe regurgitation before entry into the trials (P=0.03). Asymptomatic relapse of oesophagitis was uncommon, being found in only 8.6% of the patients. Conclusions: Maintenance treatment with omeprazole 10 and 20 mg daily is superior to all other regimens tested, and is only marginally influenced by the pre‐treatment severity of oesophagitis. Age contributes to the factors that influence the outcome during long‐term treatment with omeprazole. Symptom relief is highly predictive for the maintenance of healing.

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Section: Discussionmentioning

confidence: 99%

Prognostic factors influencing relapse of oesophagitis during maintenance therapy with antisecretory drugs: a meta‐analysis of long‐term omeprazole trials

Carlsson

Galmiche

Lundell

et al. 1997

Aliment Pharmacol Ther

132

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“…The median age of onset of reflux symptoms was 45 years. Case participants were more overweight (BMI [25][26][27][28][29][30] or obese (BMI >30) than control participants (46.7% and 33.4% respectively). Ever use of estrogen was more common in the case group (30.6%) than in the control group (21.7%).…”

Section: Study Participantsmentioning

confidence: 99%

Postmenopausal Hormone Therapy as a Risk Factor for Gastroesophageal Reflux Symptoms Among Female Twins

et al. 2008

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“…(5,6) The Montreal definition and classification of GERD states that: "GERD is a condition which develops when the reflux of stomach contents causes troublesome symptoms and/or complications" and the definition recognizes that heartburn and acid regurgitation are characteristic symptoms of GERD. (7,8) Overweight, defined according to the World Health Organization's classification as body mass index (BMI) ≥25 kg/m 2 ,(9) increases the risk of gastroesophageal reflux symptoms (GERS) (10)(11)(12) and is independently associated with esophageal adenocarcinoma. (11) The increasing weight seen in the general population will have unfortunate effects on the prevalence of GERD.…”

Section: Introductionmentioning

confidence: 99%

Weight Loss and Reduction in Gastroesophageal Reflux. A Prospective Population-Based Cohort Study: The HUNT Study

Ness-Jensen

Lindam

Lagergren³

et al. 2013

American Journal of Gastroenterology

125

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Word count 3000Weight loss and gastroesophageal reflux 3 ABSTRACT Objective High body mass index (BMI) is an established risk factor of gastroesophageal reflux symptoms (GERS). The aim of this study was to clarify if weight loss reduces GERS. DesignThe study was part of the Nord-Trøndelag health study (the HUNT study), a prospective population-based cohort study conducted in Nord-Trøndelag County, Norway. All residents of the county from 20 years of age were invited. In 1995-7 (HUNT 2) and 2006-9 (HUNT 3), 58,869 and 44,997 persons, respectively, responded to a questionnaire on heartburn and acid regurgitation. Among these, 29,610 persons (61% response rate) participated at both times and were included in the present study. The association between weight loss and reduction of GERS was calculated using logistic regression. The analyses were stratified by antireflux medication and the results adjusted for sex, age, cigarette smoking, alcohol consumption, education, and physical exercise.Results Weight loss was dose-dependently associated with a reduction of GERS and an increased treatment success with antireflux medication. Among persons with >3.5 units decrease in BMI, the adjusted OR of loss of any (minor or severe) GERS was 1.98 (95% CI 1.45 to 2.72) when using no or less than weekly antireflux medication, and 3.95 (95% CI 2.03 to 7.65) when using at least weekly antireflux medication. The corresponding ORs of loss of severe GERS was 0.90 (95% CI 0.32 to 2.55) and 3.11 (95% CI 1.13 to 8.58). ConclusionWeight loss was dose-dependently associated with both a reduction of GERS and an increased treatment success with antireflux medication in the general population.

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Symptoms in gastro-oesophageal reflux disease

Cited by 687 publications

References 14 publications

Prognostic factors influencing relapse of oesophagitis during maintenance therapy with antisecretory drugs: a meta‐analysis of long‐term omeprazole trials

Prognostic factors influencing relapse of oesophagitis during maintenance therapy with antisecretory drugs: a meta‐analysis of long‐term omeprazole trials

Postmenopausal Hormone Therapy as a Risk Factor for Gastroesophageal Reflux Symptoms Among Female Twins

Weight Loss and Reduction in Gastroesophageal Reflux. A Prospective Population-Based Cohort Study: The HUNT Study

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