Severity of GERD and disease progression
نویسندگان
چکیده
Abstract Background Many factors may play a role in the severity and progression of gastroesophageal reflux disease (GERD) since pathophysiology is multifactorial. Data regarding GERD are controversial: some reports increased esophageal acid exposure (EAE) mucosal damage were considered as evidence for stable course, while others interprete these findings progression. The aim this study to analyze large patient-population with persisting symptoms indicative under protonpumpinhibitor-therapy identify components characterizing Methods Patients included tertiary referral center (Frankfurt, Germany). All selected patients long-term persistant symptoms. underwent investigations collect data on their physical status, EAE, esophagitis, anatomical changes, functional defects well relation duration disease. Incidence over time was plotted survival curves tested Log-rank tests four main markers. Multivariate modeling COX-regression model used estimate general impact markers course In order elucidate possible causal relationships time, path analysis (structural equation model) calculated. Results From database 1480 sets, 972 evaluated (542 males, 430 females). mean age 50.5 years (range18–89). body mass index 27.2(19–48). between onset diagnostic 8.2 (1–50). A longer history significantly associated higher risk LES-incompetence. from symptom clinical investigation 9 LES-incompetence (n = 563), compared 6 those mechanically intact LES 95). period diagnostics exposure. pathway significant following model: ‘history’ (P < 0.001➔LES-incompetence & Hiatal Hernia➔(p 0,001)➔pH-score 0.001). Conclusion: LES-incompetence, deterioration LES, alteration at esophagogastric junction (Hiatal Hernia) an EAE long suffering GERD. Path suggests sequence overtime disease-parameters, tentatively allowing prediction
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ژورنال
عنوان ژورنال: Diseases of The Esophagus
سال: 2021
ISSN: ['1120-8694', '1442-2050']
DOI: https://doi.org/10.1093/dote/doab006