Long-term clinical course of extra-oesophageal manifestations in patients with gastro-oesophageal reflux disease - A prospective follow-up analysis based on the ProGERD study

被引:29
作者
Jaspersen, D
Labenz, J
Willich, SN
Kulig, M
Nocon, M
Leodolter, A
Lind, T
Meyer-Sabellek, W
Vieth, M
Stolteg, M
Malfertheiner, P
机构
[1] Klinikum Fulda GAG, Med Klin 2, D-36043 Fulda, Germany
[2] Ev Jung Stilling Krankenhaus, Siegen, Germany
[3] Univ Klin Berlin, Charite, Berlin, Germany
[4] Univ Magdeburg, D-39106 Magdeburg, Germany
[5] AstraZeneca R&D, Molndal, Sweden
[6] AstraZeneca GMBH, Wedel, Germany
[7] Klinikum Bayreuth, Bayreuth, Germany
关键词
extra-oesophageal manifestations; gastro-oesophageal reflux disease; ProGERD study;
D O I
10.1016/j.dld.2005.10.026
中图分类号
R57 [消化系及腹部疾病];
学科分类号
摘要
Background. Gastro-oesophageal reflux disease can be associated with extra-oesophageal reflux disease such as chronic cough or laryngeal symptoms. The aim of this study was to analyse the clinical course of extra-oesophageal reflux disease in a large population with gastro-oesophageal reflux disease and extra-oesophagcal reflux disease under routine clinical care. Methods. ProGERD is a prospective multicentre cohort study of 6215 outpatients with gastro-oesophageal reflux disease. At baseline all patients underwent endoscopies and were interviewed for extra-oesophageal reflux disease. Initial standardised treatment was esomeprazole for up to 8 weeks. After 2 years of follow-up, reflux symptoms and the prevalence of extra-oesophageal reflux disease were assessed. A multivariate analysis was performed with resolved versus persistent symptoms for chronic cough and laryngeal symptoms as dependent predictors. Independent variables were gender, age, body mass index (BMI), alcohol consumption, cigarette smoking, gastro-oesophageal reflux disease classification, history of gastro-oesophageal reflux disease in the family, duration of gastro-oesophageal reflux disease and proton pump inhibitors medication. Results. Four thousand four hundred and four patients (71%) were available for analysis at 2 years, including 570 and 454 patients who had chronic cough and laryngeal disorders at baseline, respectively. In 63% and 74% of the patients, chronic cough and laryngeal disorders had resolved. Patients with persistent respiratory symptoms in year 2 had significantly more reflux symptoms. Further clinically relevant associations were smoking and non-steroidal anti-inflammatory drugs use. According to the multivariate analysis, classification of gastro-oesophageal reflux disease, proton pump inhibitors medication or duration of gastro-oesophageal reflux disease were not associated with the resolution of cough or laryngeal symptoms. Conclusion. In most patients with gastro-oesophageal reflux disease and extra-oesophageal reflux disease, respiratory symptoms resolve during long-term routine care. A high reflux symptom load was associated with the persistence of respiratory disorders. (c) 2005 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.
引用
收藏
页码:233 / 238
页数:6
相关论文
共 30 条
[1]  
BENJAMIN SB, 1997, CLIN UPDATE, V4, P1
[2]   Effect of pantoprazole on the course of reflux-associated laryngitis: a placebo-controlled double-blind crossover study [J].
Eherer, AJ ;
Habermann, W ;
Hammer, HF ;
Kiesler, K ;
Friedrich, G ;
Krejs, GJ .
SCANDINAVIAN JOURNAL OF GASTROENTEROLOGY, 2003, 38 (05) :462-467
[3]  
El-Serag HB, 2001, AM J GASTROENTEROL, V96, P979
[4]   Comorbid occurrence of laryngeal or pulmonary disease with esophagitis in United States military veterans [J].
ElSerag, HB ;
Sonnenberg, A .
GASTROENTEROLOGY, 1997, 113 (03) :755-760
[5]  
Fang J, 2001, AM J GASTROENTEROL, V96, P958
[6]  
FRASER AG, 1994, ALIMENT PHARM THER, V8, P265
[7]   FREQUENCY AND SITE OF GASTROESOPHAGEAL REFLUX IN PATIENTS WITH CHEST SYMPTOMS - STUDIES USING PROXIMAL AND DISTAL PH MONITORING [J].
GASTAL, OL ;
CASTELL, JA ;
CASTELL, DO .
CHEST, 1994, 106 (06) :1793-1796
[8]   Supra-oesophageal manifestations of gastro-oesophageal reflux disease [J].
Groen, JN ;
Smout, AJPM .
EUROPEAN JOURNAL OF GASTROENTEROLOGY & HEPATOLOGY, 2003, 15 (12) :1339-1350
[9]   The role of gastroesophageal reflux in chronic cough and asthma [J].
Harding, SM ;
Richter, JE .
CHEST, 1997, 111 (05) :1389-1402
[10]   CHRONIC PERSISTENT COUGH AND GASTROESOPHAGEAL REFLUX [J].
ING, AJ ;
NGU, MC ;
BRESLIN, ABX .
THORAX, 1991, 46 (07) :479-483