Validity of endoscopic classification of nonerosive reflux disease

Joh, Takashi; Miwa, Hiroto; Higuchi, Kazuhide; Shimatani, Tomohiko; Manabe, Noriaki; Adachi, Kyoichi; Wada, Takeshi; Sasaki, Makoto; Fujiwara, Yasuhiro; Hongo, Michio; Chiba, Tsutomu; Kinoshita, Yoshikazu

doi:10.1007/s00535-007-2022-3

Cited by 49 publications

(57 citation statements)

References 22 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…An investigation of the relationship between RE endoscopic findings and GERD symptoms also demonstrated that about 60% of RE relapsed cases had developed no GERD symptoms at the time of RE relapse. Several reports to date have also indicated that RE endoscopic findings were not accompanied by GERD symptoms (25)(26)(27)(28)(29)(30)(31)(32)(33)(34)(35), and this trend was often found in elderly (28). It has also been reported that the percentage of severe RE is higher in the elderly than in juveniles, whereas the frequency of severe heartburn in patients with severe RE is lower in the elderly (27,36).…”

Section: Discussionmentioning

confidence: 91%

Safety and Efficacy of Long-Term Maintenance Therapy with Oral Dose of Rabeprazole 10 mg Once Daily in Japanese Patients with Reflux Esophagitis

Fujimoto

Hongo

Group³

2011

Intern. Med.

Self Cite

View full text Add to dashboard Cite

Objective The aim of this prospective clinical study was to evaluate the efficacy and safety of long-term proton pump inhibitor (PPI) treatment for two years in Japanese patients with reflux esophagitis (RE). Methods The efficacy and safety of two-year (104-week) treatment with rabeprazole (RPZ) 10 mg were studied in patients confirmed to have been cured of RE by PPI and who required long-term maintenance therapy with PPI. We performed serial endoscopy, checked gastroesophageal reflux disease (GERD) symptoms, adverse events, laboratory values and serum gastrin. We also monitored gastric mucosal histology, atrophy and polyps. Results The endoscopic non-relapse rate for RE was 87.3% for the 104-week period. GERD symptoms improved based on the fact that the mean change from baseline in GERD symptom score after treatment was a negative value. Treatment was safe; and atrophy was found to have developed in virtually no cases. A few new benign fundic gland or hyperplastic polyps developed throughout the study, but no ECL carcinoids were found to have developed. Serum gastrin levels tended to increase up to 24 weeks, but there were no subsequent changes thereafter up to 104 weeks. Conclusion The results confirmed oral RPZ 10 mg to be effective for maintenance therapy in Japanese patients with RE. Although effects on the gastric mucosa were not ruled out, long-term use of RPZ was confirmed to be safe overall.

show abstract

Section: Discussionmentioning

confidence: 91%

Safety and Efficacy of Long-Term Maintenance Therapy with Oral Dose of Rabeprazole 10 mg Once Daily in Japanese Patients with Reflux Esophagitis

Fujimoto

Hongo

Group³

2011

Intern. Med.

Self Cite

View full text Add to dashboard Cite

show abstract

“…These clinical characteristics of NERD are also found in western countries; however, more severe gastric atrophy [54,56,84] and the higher rate of H. pylori infection [84] compared with ERD are specific characteristics of Japanese NERD. Joh et al [68] demonstrated that the frequency of abnormal acid reflux with NERD was higher in patients with minimal changes than in patients without such changes. Thus, if gastric acid secretion lead to the development of NERD (grade M or grade N) or ERD, these clinical features found in Japanese NERD could agree with the theoretically advanced features.…”

Section: Advance In the Concept Of Gerdmentioning

confidence: 99%

“…Three studies using the Medical Outcomes Study Short Form-36 (SF-36) demonstrated that HR-QOL in GERD patients was lower than that in the general Japanese population. [66][67][68] A recent study by Hongo et al [69] using a new questionnaire (QOLRAD) which has been developed as a specific QOL assessment of GERD, showed impairment of HR-QOL in GERD patients.…”

Section: Prevalence and Clinical Characteristics Of Symptomatic Gerd mentioning

confidence: 99%

Epidemiology and clinical characteristics of GERD in the Japanese population

2009

Self Cite

View full text Add to dashboard Cite

We reviewed articles on the epidemiology and clinical characteristics of gastroesophageal reflux disease (GERD) in Japan to clarify these features of GERD in this country. Although the definition of GERD depends on the individual study, the prevalence of GERD has been increasing since the end of the 1990s. The reasons for the increase in the prevalence of GERD may be due to increases in gastric acid secretion, a decrease in the Helicobacter pylori infection rate, more attention being paid to GERD, and advances in the concept of GERD. More than half of GERD patients had non-erosive reflux disease, and the majority (87%) of erosive esophagitis was mild type, such as Los Angeles classification grade A and grade B. There were several identified risk factors, such as older age, obesity, and hiatal hernia. In particular, mild gastric atrophy and absence of H. pylori infection influence the characteristics of GERD in the Japanese population. We also discuss GERD in the elderly; asymptomatic GERD; the natural history of GERD; and associations between GERD and peptic ulcer disease and H. pylori eradication. We examined the prevalence of GERD in patients with specific diseases, and found a higher prevalence of GERD, compared with that in the general population, in patients with diabetes mellitus, those with obstructive sleep apnea syndrome, and those with bronchial asthma. We provide a comprehensive review of GERD in the Japanese population and raise several clinical issues.

show abstract

“…Compared to patients with erosive esophagitis, those with minimal change esophagitis were more evenly distributed between males and females, had more gastric atrophy and lacked a hiatal hernia. Others in Japan have found minimal change esophagitis in 49 of 115 patients (43%) with symptoms of heartburn, whereas the remainder had a normal esophagus [7]. It is clear that the concept of minimal change esophagitis has become popular in Japan.…”

Section: New Endoscopic Approachesmentioning

confidence: 99%

Is Conventional Endoscopic Identification of Non-Erosive Reflux Disease Adequate?

Falk¹

2008

Digestion

View full text Add to dashboard Cite

Non-erosive reflux disease is defined as the presence of troublesome reflux-associated symptoms in the absence of mucosal breaks at endoscopy. Given the fact that the majority of patients with reflux symptoms will have a normal endoscopy, efforts are underway to determine if new endoscopic techniques can identify changes heretofore invisible at the time of standard white light endoscopy. However, for any new endoscopic technology to be useful, the grading system it uses must be accurate, reproducible, easy to remember and easy to interpret. These requirements represent a high bar indeed for any new approach to non-erosive reflux disease. Current techniques under investigation include high-resolution endoscopy, magnification endoscopy, chromoendoscopy, narrow-band imaging and confocal endomicroscopy. All of these new technologies can identify minimal abnormalities heretofore not seen with traditional white light endoscopy. All of these new techniques allow for more detailed imaging of the esophagus in gastroesophageal reflux disease patients which makes this field ripe for re-examination. The most exciting findings to date are with narrow-band imaging and confocal endomicroscopy. However, studies to date are small and require validation in larger numbers of patients by larger number of endoscopists. Furthermore, it is essential that we do not repeat the mistakes of the past as poor interobserver agreement has already been shown for minimal change esophagitis, albeit with more primitive technology.

show abstract

Validity of endoscopic classification of nonerosive reflux disease

Abstract: Frequency of abnormal acid reflux with NERD is higher in patients with minimal changes than in patients without such changes. Minimal changes are most likely attributable to gastric acid reflux.

Cited by 49 publications

References 22 publications

Safety and Efficacy of Long-Term Maintenance Therapy with Oral Dose of Rabeprazole 10 mg Once Daily in Japanese Patients with Reflux Esophagitis

Safety and Efficacy of Long-Term Maintenance Therapy with Oral Dose of Rabeprazole 10 mg Once Daily in Japanese Patients with Reflux Esophagitis

Epidemiology and clinical characteristics of GERD in the Japanese population

Is Conventional Endoscopic Identification of Non-Erosive Reflux Disease Adequate?

Contact Info

Product

Resources

About