Kahrilas et al classified the response to potent acid suppression in a patient with reflux oesophagitis (RO). The authors are from Northwestern University, AstraZeneca and PharmaGenesis, Ltd.
Patient selection: reflux oesophagitis with breaks in the distal esophageal mucosa seen on endoscopy in the setting of gastroesophageal reflux disease (GERD)
Status
Response Term
healed at 2 weeks
rapid healing
healed at 4 weeks but not at 2 weeks
? intermediate healing (no term given)
healed at 8 weeks but not at 4 weeks
slow healing
not healed at 8 weeks
refractory
Some patients classified as refractory at 8 weeks may heal with continued therapy. The number of patients who are completely refractory (never heal) is probably low.
Low-grade on the Los Angeles classification (Grade A or B) was associated with rapid healing, but almost half of patients with higher grades (C or D) also showed rapid healing.
Factors associated with refractory disease (items 2 and 3 not in paper):
(1) frequent regurgitation (>= 4 days per week, more severe GERD)
(2) inadequate dosing of the acid suppression
(3) poor compliance with medication and dietary changes
To read more or access our algorithms and calculators, please log in or register.