PMID- 31907769
OWN - NLM
STAT- MEDLINE
DCOM- 20210203
LR  - 20210203
IS  - 1573-2568 (Electronic)
IS  - 0163-2116 (Linking)
VI  - 65
IP  - 11
DP  - 2020 Nov
TI  - Erosive Esophagitis Portends a Benign Clinical Course in the Majority of 
      Patients.
PG  - 3244-3252
LID - 10.1007/s10620-019-06027-1 [doi]
AB  - INTRODUCTION: Indefinite proton pump inhibitor (PPI) therapy and endoscopic 
      evaluation for Barrett's esophagus is recommended for erosive esophagitis (EE). 
      However, the clinical course of EE remains undefined. METHODS: Adults with EE on 
      esophagogastroduodenoscopy (EGD) were identified at Mayo Clinic Rochester between 
      January 2003 and September 2005. Patients with repeat EGD performed after index 
      endoscopy were included. Patients with a history of upper gastrointestinal 
      surgery, esophageal cancer, achalasia, or Barrett's on initial EGD were excluded. 
      RESULTS: Of 219 patients identified, 98 had LA grade A, 72 LA grade B, and 49 LA 
      grade C esophagitis. Persistent EE was found in 27% on repeat endoscopy. No 
      patients progressed to more severe grades of esophagitis. While discontinuation 
      of PPI was associated with persistent esophagitis, long-term healing of 
      esophagitis occurred in the majority of patients despite discontinuation of PPI. 
      Grade A or B esophagitis and the absence of hiatal hernia were also independent 
      predictors of esophagitis healing on multivariate analysis. The rate of Barrett's 
      esophagus was similar among patients with LA grade A/B and C esophagitis on 
      initial EGD (5% vs. 14%, p = 0.6). CONCLUSION: The majority of patients with EE 
      demonstrated healing at follow-up endoscopy regardless of continued PPI use. A 
      small proportion developed Barrett's esophagus, including those with LA grade A 
      and B esophagitis, highlighting a potential role for repeat endoscopy in all 
      grades of EE. A more conservative long-term PPI strategy may be reasonable in 
      patients with LA grade A or B esophagitis in the absence of hiatal hernia.
FAU - Bi, Danse
AU  - Bi D
AD  - Division of Gastroenterology and Hepatology, Mayo Clinic, 200 First Street, SW, 
      Rochester, MN, 55905, USA.
FAU - Katzka, David A
AU  - Katzka DA
AD  - Division of Gastroenterology and Hepatology, Mayo Clinic, 200 First Street, SW, 
      Rochester, MN, 55905, USA.
FAU - Lavey, Crystal J
AU  - Lavey CJ
AD  - Division of Gastroenterology and Hepatology, Mayo Clinic, 200 First Street, SW, 
      Rochester, MN, 55905, USA.
FAU - Geno, Debra M
AU  - Geno DM
AD  - Division of Gastroenterology and Hepatology, Mayo Clinic, 200 First Street, SW, 
      Rochester, MN, 55905, USA.
FAU - Ravi, Karthik
AU  - Ravi K
AD  - Division of Gastroenterology and Hepatology, Mayo Clinic, 200 First Street, SW, 
      Rochester, MN, 55905, USA. ravi.karthik@mayo.edu.
LA  - eng
PT  - Journal Article
DEP - 20200106
PL  - United States
TA  - Dig Dis Sci
JT  - Digestive diseases and sciences
JID - 7902782
RN  - 0 (Proton Pump Inhibitors)
SB  - IM
MH  - Adolescent
MH  - Adult
MH  - Aged
MH  - Aged, 80 and over
MH  - Barrett Esophagus/*prevention & control
MH  - Disease Progression
MH  - Esophagitis/*diagnosis/*drug therapy
MH  - Esophagoscopy
MH  - Gastroesophageal Reflux/*drug therapy
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Prognosis
MH  - Proton Pump Inhibitors/*therapeutic use
MH  - Retrospective Studies
OTO - NOTNLM
OT  - Barrett's esophagus
OT  - Erosive esophagitis
OT  - GERD
OT  - LA grade
EDAT- 2020/01/08 06:00
MHDA- 2021/02/04 06:00
CRDT- 2020/01/08 06:00
PHST- 2019/06/27 00:00 [received]
PHST- 2019/12/22 00:00 [accepted]
PHST- 2020/01/08 06:00 [pubmed]
PHST- 2021/02/04 06:00 [medline]
PHST- 2020/01/08 06:00 [entrez]
AID - 10.1007/s10620-019-06027-1 [pii]
AID - 10.1007/s10620-019-06027-1 [doi]
PST - ppublish
SO  - Dig Dis Sci. 2020 Nov;65(11):3244-3252. doi: 10.1007/s10620-019-06027-1. Epub 
      2020 Jan 6.