[Acid-sensitive esophagus: natural history and effect on the quality of life. Comparison with gastroesophageal reflux].

UNLABELLED

The acid hypersensitive esophagus (AHE) is characterized by a normal esophageal acid exposure but a significant association between symptoms and reflux episodes. The natural history of AHE remains poorly known. We therefore conducted a follow-up study to compare the initial presentation and natural history of AHE and classical GERD. Quality of life (QOL) was also assessed.

PATIENTS AND METHODS

Two groups of patients referred to our laboratory for 24-hour pH-monitoring (between 1991 and 1996) were compared. Group 1 consisted of 127 consecutive patients with AHE. Group 2 consisted of 101 patients with GERD. All patients were invited by mail to fill-in two questionnaires, the first concerning clinical course and therapeutic needs and the second QOL (questionnaire Reflux-Qual). Finally 62% and 59% of group 1 and 2 respectively did respond to both questionnaires. The corresponding follow-up periods were 4.1 and 4.3 years, respectively.

RESULTS

The two groups did not differ at initial presentation with regard to age, sex, symptoms prevalence and severity of esophagitis (80% of group 1 and 75% of group 2 were endoscopy-negative patients). At an average follow-up of 4 years symptoms persisted in 80% and 71% of patients respectively. Seventy five per cent of patients in both groups continued to take antireflux drugs. QOL scores were similarly reduced in both groups (71 +/- 26 vs 70 +/- 27).

CONCLUSIONS

The initial presentation and clinical outcome of AHE and GERD are similar. QOL is notably impaired and the majority of patients continue to receive antireflux medications.