PMID- 11252902
OWN - NLM
STAT- MEDLINE
DCOM- 20010405
LR  - 20071115
IS  - 0035-3639 (Print)
IS  - 0035-3639 (Linking)
VI  - 22
IP  - 1
DP  - 2001 Feb
TI  - [Diagnosis and treatment of gastroesophageal reflux in the adult: guidelines 
      recommended by French and Belgian consensus].
PG  - 27-32
AB  - Usual gastroesophageal reflux (GER) presentations are heartburn and acid 
      regurgitation. The prevalence in occidental population ranges from 5 to 45% 
      according to symptoms frequency. Oesophagitis is observed in 30 to 50% of 
      examined patients and only erosive and ulcerative lesions must be considered. 
      Distinction is made between non-severe oesophagitis (isolated loss of substance), 
      severe oesophagitis (circonferential loss of substance) and complicated 
      oesophagitis (stenosis, ulcerations, brachyoesophagus). 24-hour pH-monitoring 
      analyses reflux duration and relations between symptoms and reflux specially in 
      unusual extraoesophageal presentations. Symptoms and quality of life are the main 
      criteria for staging. In few patients, oesophagitis is severe. Complications 
      (stenosis, ulcerations, bleeding, endobrachyoesophagus) are observed in 10 to 15% 
      of cases. Endobrachyoesophagus with intestinal metaplasia is a risk for 
      neoplasia. The consensus conference proposes this initial therapeutic strategy. 
      In cases of time-spaced symptoms: antiacids, alginic acid or low doses of anti-H2 
      with life style changes. In cases of typical frequent symptoms, in patients 
      younger than 50 years: 4-weeks treatment with half dosed proton pump inhibitors 
      (PPI) or standard doses of anti-H2 or prokinetics. Nowadays, the majority of the 
      experts propose empiric full-dose treatment. This attitude is more logical as 
      total symptoms suppression with full dose PPI brings positive clues for exact GOR 
      diagnostic without endoscopy. In patients older than 50 years or with alarming 
      symptoms (weight loss, dysplagia, bleeding, anemia): endoscopy must be performed. 
      Patients with non severe oesophagitis: PPI without checking endoscopy. In 
      patients with severe or complicated oesophagitis: 8-weeks treatment following by 
      endoscopy; in non relieved patients: doses are increased. In cases of 
      extraoesophageal presentations: standard PPI treatment during 4 to 8 weeks if GER 
      is well established. In long term strategy, if recidives are rare: intermittent 
      treatment. In early and frequent recidives: long term adapted PPI or surgery. 
      Stenosis are treated by PPI, pneumatic dilatation or surgery if unsuccessful. 
      Brachyoesophagus must be checked by endoscopy every 2 years (malignancy risk).
FAU - Henry, J P
AU  - Henry JP
AD  - Service de Gastro-enterologie, C.H.U. de Charleroi, Site de Charleroi, U.L.B.
FAU - Lenaerts, A
AU  - Lenaerts A
FAU - Ligny, G
AU  - Ligny G
LA  - fre
PT  - Consensus Development Conference
PT  - English Abstract
PT  - Journal Article
PT  - Review
TT  - Diagnostic et traitement du reflux gastro-oesophagien de l'adulte: les 
      orientations suggerees par les consensus francais et belge.
PL  - Belgium
TA  - Rev Med Brux
JT  - Revue medicale de Bruxelles
JID - 8003474
RN  - 0 (Anti-Ulcer Agents)
SB  - IM
MH  - Adult
MH  - Age Factors
MH  - Anti-Ulcer Agents/therapeutic use
MH  - Belgium/epidemiology
MH  - Esophagoscopy
MH  - France/epidemiology
MH  - Gastroesophageal Reflux/*diagnosis/epidemiology/etiology/psychology/*therapy
MH  - Gastroscopy
MH  - Humans
MH  - *Practice Guidelines as Topic
MH  - Prevalence
MH  - Quality of Life
MH  - Treatment Outcome
RF  - 18
EDAT- 2001/03/17 10:00
MHDA- 2001/04/06 10:01
CRDT- 2001/03/17 10:00
PHST- 2001/03/17 10:00 [pubmed]
PHST- 2001/04/06 10:01 [medline]
PHST- 2001/03/17 10:00 [entrez]
PST - ppublish
SO  - Rev Med Brux. 2001 Feb;22(1):27-32.