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
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