Prolonged remission of oesophagitis does not alter the magnitude of oesophageal acid exposure. Natural history of reflux oesophagitis: a 10 year follow up of its effect on patient symptomatology and quality of life. Rx drugs

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Scand J Gastroenterol. 1994 Jan;29(1):11-6.
Prolonged remission of oesophagitis does not alter the magnitude of oesophageal acid exposure.

Singh P, Taylor RH, Colin-Jones DG.

Dept. of Gastroenterology, Queen Alexandra Hospital, Cosham, Portsmouth, UK.

In a previous study we reported lack of improvement in oesophageal motor function after complete healing of oesophagitis achieved by treatment with omeprazole for a median duration of 12 weeks. This study investigates the effect on oesophageal acid exposure of a longer period of complete remission. It was decided to approach all patients who had 24-h pH monitoring as part of the earlier project and whose second endoscopy showing complete healing of oesophagitis as done at least 24 weeks previously. Of 38 such patients, 24 underwent endoscopy, which showed relapse of oesophagitis in 5 of them. In 18 patients who were eligible and agreed to take part, omeprazole/ranitidine was withdrawn for at least 7 days, after which pH monitoring was repeated. The median duration of remission was 39.5 weeks (range, 26-81 weeks). The median percentage of total time with pH below 4 was 11.5% before and 11.0% after (NS). The corresponding figures for the upright and supine reflux, the number of reflux episodes longer than 5 min, and the duration of the longest reflux episode were 10.7% versus 7.7%, 11.4% versus 12.1%, 7.5 versus 7.5, and 35.5 versus 30.5 min, respectively (NS for all variables). These results suggest that maintenance of remission of oesophagitis for prolonged periods does not alter the degree of acid reflux on discontinuation of medication. This has important implications for the understanding of the natural history of gastro-oesophageal reflux disease.

online pharmacy ref source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=8128170&dopt=Abstract

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Gut. 1996 Apr;38(4):481-6.
Natural history of reflux oesophagitis: a 10 year follow up of its effect on patient symptomatology and quality of life.

McDougall NI, Johnston BT, Kee F, Collins JS, McFarland RJ, Love AH.

Department of Medicine, Queen's University of Belfast.

BACKGROUND--Although oesophagitis is the most common diagnosis made at upper gastrointestinal endoscopy, data on the longterm outcome of affected patients are sparse. AIMS--This study assessed the level of reflux symptoms, quality of life, drug consumption, and complications in patients at least 10 years after diagnosis of oesophagitis at one centre. PATIENTS--One hundred and fifty two patients with typical reflux symptoms and a first time diagnosis by endoscopy of grade I-III oesophagitis between 1981 and 1984, were followed up using a postal questionnaire and telephone interview. RESULTS--Eighteen of 152 patients had died, 33 failed to respond, and 101 replied (mean follow up 11 years, range 121-160 months). Over 70% of patients still had heartburn at least daily (32%) or weekly (19%) or required daily acid suppression treatment (20%). Two patients (2%) had developed oesophageal strictures and one had Barrett's oesophagus. Two of eight quality of life scores (physical function and social function) measured by the Short Form-36 were significantly lower than Northern Ireland population scores. CONCLUSION--Nearly three quarters of patients previously diagnosed as having oesophagitis still had significant morbidity related to gastro-oesophageal reflux disease more than 10 years after diagnosis. Some quality of life scores were significantly lower than those of the general population.

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pado.krict.re.kr

AU-461 (1-(2-methyl-4-methoxyphenyl)-4-[(2-hydroxyethyl)amino]-6-beta,beta, beta-trifluoroethoxy-2,3-dihydropyrrolo[3,2-c]quinoline) was tested for its ability to act as an anti-ulcer agent. AU-461 inhibited gastric H(+)/K(+) ATPase activities with IC(50) values of 12.15 and 4.20 micromol/l for rabbit and pig enzymes, respectively. The inhibition was reversible, and competitive with respect to the activating cation K(+). When AU-461 was examined for the in vivo antisecretory activity, we found that AU-461 reduced the histamine-stimulated acid secretion as well as the basal secretion in rat stomach. Duration of the antisecretory effect was about 6 h upon oral administration. AU-461 prevented dose-dependently the ulcer formation produced by either ethanol or NaOH. This protective effect was not altered by indomethacin pretreatment. In addition, the elevated plasma gastrin by the oral administration of AU-461 was returned to control by 12 h. Taken together, these results suggest that AU-461 could be developed as a new therapeutic agent for peptic ulcer disease. Copyright 2000 S. Karger AG, Basel.

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