{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,7]],"date-time":"2025-12-07T02:01:19Z","timestamp":1765072879551,"version":"3.46.0"},"reference-count":37,"publisher":"BMJ","issue":"1","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Gut"],"published-print":{"date-parts":[[1994,1]]},"abstract":"<jats:p>There is little information concerning the long term outcome of patients with gastro-oesophageal reflux disease (GORD). Thus 109 patients with reflux symptoms (33 with erosive oesophagitis) with a diagnosis of GORD after clinical evaluation and oesophageal testing were studied. All patients were treated with a stepwise approach: (a) lifestyle changes were suggested aimed at reducing reflux and antacids and the prokinetic agent domperidone were prescribed; (b) H2 blockers were added after two months when symptoms persisted; (c) anti-reflux surgery was indicated when there was no response to (b). Treatment was adjusted to maintain clinical remission during follow up. Long term treatment need was defined as minor when conservative measures sufficed for proper control, and as major if daily H2 blockers or surgery were required. The results showed that one third of the patients each had initial therapeutic need (a), (b), and (c). Of 103 patients available for follow up at three years and 89 at six years, respective therapeutic needs were minor in 52% and 55% and major in 48% and 45%. Eighty per cent of patients in (a), 67% in (b), and 17% in (c) required only conservative measures at six years. A decreasing lower oesophageal sphincter pressure (p &lt; 0.001), radiological reflux (p = 0.028), and erosive oesophagitis (p = 0.031), but not initial clinical scores, were independent predictors of major therapeutic need as shown by multivariate analysis. The long term outcome of GORD is better than previously perceived.<\/jats:p>","DOI":"10.1136\/gut.35.1.8","type":"journal-article","created":{"date-parts":[[2007,9,18]],"date-time":"2007-09-18T17:41:31Z","timestamp":1190137291000},"page":"8-14","source":"Crossref","is-referenced-by-count":95,"title":["Predictive factors of the long term outcome in gastro-oesophageal reflux disease: six year follow up of 107 patients."],"prefix":"10.1136","volume":"35","author":[{"given":"E","family":"Kuster","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"E","family":"Ros","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"V","family":"Toledo-Pimentel","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"A","family":"Pujol","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"J M","family":"Bordas","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"L","family":"Grande","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"C","family":"Pera","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[1994,1,1]]},"reference":[{"key":"ref_1","article-title":"Heartburn across America: a Gallup Organisation survey","author":"Organisation, Gallup","year":"1988","unstructured":"Gallup Organisation. Heartburn across America: a Gallup Organisation survey. Princeton: Gallup Organisation, 1988."},{"key":"ref_2","first-page":"257","article-title":"Why do apparently healthy people use antacid tablets?","volume":"78","author":"Graham, D.Y.; Smith, J.L.; Patterson, D.J.","year":"1983","unstructured":"Graham DY, Smith JL, Patterson DJ. Why do apparently healthy people use antacid tablets? Amj Gastroenterol 1983; 78: 257-60.","journal-title":"Amj Gastroenterol"},{"key":"ref_3","first-page":"211","article-title":"Overview of treatment of gastroesophageal reflux disease","volume-title":"reflux disease: pathogenesis, diagnosis, therapy. Mount Kisco","author":"Castell, D.O.","year":"1985","unstructured":"Castell DO. Overview of treatment of gastroesophageal reflux disease. In: Casteli DO, Wu WC, Ott DJ, eds. Gastroesophageal reflux disease: pathogenesis, diagnosis, therapy. Mount Kisco, NY: Futura, 1985: 211-20."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"293","DOI":"10.1136\/gut.33.3.293","article-title":"Surgery for uncomplicated gastrooesophageal reflux","volume":"33","author":"Dehn, T.C.B.","year":"1992","unstructured":"Dehn TCB. Surgery for uncomplicated gastrooesophageal reflux. Gut 1992; 33: 293-4.","journal-title":"Gut"},{"issue":"168","key":"ref_5","first-page":"33","article-title":"Epidemiology of oesophageal reflux disease","volume":"24","author":"Heading, R.C.","year":"1989","unstructured":"Heading RC. Epidemiology of oesophageal reflux disease. Scandj Gastroenterol 1989; 24 (suppl 168): 33-7.","journal-title":"Scandj Gastroenterol"},{"issue":"156","key":"ref_6","first-page":"2536","article-title":"Treatment of reflux esophagitis with H2-blockers, antacids and prokinetic drugs: an analysis of randomized clinical trials","volume":"24","author":"Koelz, H.R.","year":"1989","unstructured":"Koelz HR. Treatment of reflux esophagitis with H2-blockers, antacids and prokinetic drugs: an analysis of randomized clinical trials. ScandJ Gastroenterol 1989; 24 (suppl 156): 2536.","journal-title":"ScandJ Gastroenterol"},{"key":"ref_7","first-page":"1198","article-title":"Healing and relapse of reflux oesophagitis during","volume-title":"treatment with ranitidine. Gastroenterology 1986; 91","author":"Koelz, H.R.; Birchler, R.; Bretholz, A.; Bron, B.; Capitaine, Y.; Delmore, G.","unstructured":"Koelz HR, Birchler R, Bretholz A, Bron B, Capitaine Y, Delmore G, et al. Healing and relapse of reflux oesophagitis during treatment with ranitidine. Gastroenterology 1986; 91: 1198-205."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"625","DOI":"10.3109\/00365528809093923","article-title":"Omeprazole or ranitidine in the treatment of reflux esophagitis. Results of a double-blind, randomized, Scandinavian multicenter study","volume":"23","year":"1988","unstructured":"Sandmark S, Carlsson R, Fausa 0, Lundell L. Omeprazole or ranitidine in the treatment of reflux esophagitis. Results of a double-blind, randomized, Scandinavian multicenter study. Scandj Gastroenterol 1988; 23: 625-32.","journal-title":"Scandj Gastroenterol"},{"issue":"156","key":"ref_9","first-page":"5764","article-title":"Healing, relapse rates and prophylaxis of reflux esophagitis","volume":"24","author":"Glise, H.","year":"1989","unstructured":"Glise H. Healing, relapse rates and prophylaxis of reflux esophagitis. ScandJ Gastroenterol 1989; 24 (suppl 156): 5764.","journal-title":"ScandJ Gastroenterol"},{"issue":"168","key":"ref_10","first-page":"38","article-title":"Drug therapy of reflux oesophagitis: an update","volume":"24","author":"Tytgat, G.N.J.","year":"1989","unstructured":"Tytgat GNJ. Drug therapy of reflux oesophagitis: an update. Scandj Gastroenterol 1989; 24 (suppl 168): 38-49.","journal-title":"Scandj Gastroenterol"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"1717","DOI":"10.1001\/archinte.1987.00370100031006","article-title":"Medical therapy for chronic reflux esophagitis. Long-term follow-up","volume":"147","author":"Lieberman, D.","year":"1987","unstructured":"Lieberman D. Medical therapy for chronic reflux esophagitis. Long-term follow-up. Arch Intern Med 1987; 147: 1717-20.","journal-title":"Arch Intern Med"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"240","DOI":"10.1016\/0016-5085(78)90410-9","article-title":"Food sensitivity in reflux esophagitis","volume":"75","author":"Price, S.F.; Smithson, K.W.; Castell, D.O.","year":"1978","unstructured":"Price SF, Smithson KW, Castell DO. Food sensitivity in reflux esophagitis. Gastroenterology 1978; 75: 240-3.","journal-title":"Gastroenterology"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"283","DOI":"10.3109\/00365527809179821","article-title":"Influence of body position, dry and water swallows, smoking, and alcohol on esophageal acid clearing","volume":"13","author":"Kjellen, G.; Tibbling, L.","year":"1978","unstructured":"Kjellen G, Tibbling L. Influence of body position, dry and water swallows, smoking, and alcohol on esophageal acid clearing. Scandj Gastroenterol 1978; 13: 283-8.","journal-title":"Scandj Gastroenterol"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"1223","DOI":"10.1016\/S0025-7125(16)31470-5","article-title":"Drugs, foods, and other substances in the cause and treatment of reflux esophagitis","volume":"65","author":"Richter, J.E.; Castell, D.O.","year":"1981","unstructured":"Richter JE, Castell DO. Drugs, foods, and other substances in the cause and treatment of reflux esophagitis. Med Clin North Am 1981; 65: 1223-34.","journal-title":"Med Clin North Am"},{"issue":"156","key":"ref_15","first-page":"49","article-title":"Efficacy of sucralfate in refractory reflux esophagitis. Results of a pilot study","volume":"24","author":"Ros, E.; Pujol, A.; Bordas, J.M.; Grande, L.","year":"1989","unstructured":"Ros E, Pujol A, Bordas JM, Grande L. Efficacy of sucralfate in refractory reflux esophagitis. Results of a pilot study. Scand J Gastroenterol 1989; 24 (suppl 156): 49-55.","journal-title":"Scand J Gastroenterol"},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"627","DOI":"10.1097\/00000658-197010000-00009","article-title":"Assessment of distal esophageal function in patients with hiatal hernia and\/or gastroesophageal reflux","volume":"172","author":"Skinner, D.B.; Booth, D.J.","year":"1970","unstructured":"Skinner DB, Booth DJ. Assessment of distal esophageal function in patients with hiatal hernia and\/or gastroesophageal reflux. Ann Surg 1970; 172: 627-37.","journal-title":"Ann Surg"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"1134","DOI":"10.1007\/BF01535790","article-title":"Utility of inpatient 24-hour intraesophageal pH monitoring in diagnosis of gastroesophageal reflux","volume":"33","author":"Pujol, A.; Grande, L.; Ros, E.; Pera, C.","year":"1988","unstructured":"Pujol A, Grande L, Ros E, Pera C. Utility of inpatient 24-hour intraesophageal pH monitoring in diagnosis of gastroesophageal reflux. Dig Dis Sci 1988; 33: 1134-40.","journal-title":"Dig Dis Sci"},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"187","DOI":"10.1111\/j.2517-6161.1972.tb00899.x","article-title":"Regression models and life tables","volume":"34","author":"Cox, DR","year":"1972","unstructured":"Cox DR. Regression models and life tables. J'ournal of the Royal Statistical Society 1972; 34: 187-220.","journal-title":"J'ournal of the Royal Statistical Society"},{"key":"ref_19","article-title":"BMDP Statistical Software","author":"Dixon, W.J.","year":"1983","unstructured":"Dixon WJ. BMDP Statistical Software. Berkeley: University of California Press, 1983."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"205","DOI":"10.1016\/0140-6736(90)90287-F","article-title":"Symptoms in gastro-oesophageal reflux disease","volume":"335","author":"Klauser, A.G.; Schindlbeck, N.E.; Muller-Lissner, S.A.","year":"1990","unstructured":"Klauser AG, Schindlbeck NE, Muller-Lissner SA. Symptoms in gastro-oesophageal reflux disease. Lancet 1990; 335: 205-8.","journal-title":"Lancet"},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"93","DOI":"10.7326\/0003-4819-97-1-93","article-title":"Gastroesophageal reflux. Pathogenesis, diagnosis, and therapy","volume":"97","author":"Richter, J.E.; Castell, D.O.","year":"1982","unstructured":"Richter JE, Castell DO. Gastroesophageal reflux. Pathogenesis, diagnosis, and therapy. Ann Intern Med 1982; 97: 93-103.","journal-title":"Ann Intern Med"},{"key":"ref_22","first-page":"141","article-title":"Oesophageal pH monitoring -","volume-title":"normal and abnormal. Gastroenterology International 1989; 3","author":"Tytgat, G.N.J.; Bennett, JR, Dent; J, Joelsson; B.","unstructured":"Tytgat GNJ, Bennett JR, Dent J, Joelsson B. Oesophageal pH monitoring - normal and abnormal. Gastroenterology International 1989; 3: 141-9."},{"key":"ref_23","first-page":"101","article-title":"pH monitoring versus other tests for gastroesophageal reflux disease: is this the gold standard?","volume-title":"esophageal pH monitoring","author":"Castell, D.O.","year":"1991","unstructured":"Castell DO. pH monitoring versus other tests for gastroesophageal reflux disease: is this the gold standard? In: Richter JE, ed. Ambulatowy esophageal pH monitoring. New York: Igaku-Shoin, 1991: 101-13."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"213","DOI":"10.1007\/BF01307537","article-title":"Comparison ofstationary vs ambulatory 24-hour pH monitoring systems in diagnosis of gastroesophageal reflux disease","volume":"38","author":"Grande, L.; Culell, P.; Ros, E.; Lacima, G.; Pujol, A.; GarciaValdecasas, J.C.","year":"1993","unstructured":"Grande L, Culell P, Ros E, Lacima G, Pujol A, GarciaValdecasas JC, et al. Comparison ofstationary vs ambulatory 24-hour pH monitoring systems in diagnosis of gastroesophageal reflux disease. DigDis Sci 1993; 38: 213-9.","journal-title":"DigDis Sci"},{"key":"ref_25","first-page":"635","article-title":"Nissen fundoplication. Results at 10 year follow-up","volume":"146","author":"Negre, J.B.; Markkula, H.T.; Keyrilainen, P.","year":"1983","unstructured":"Negre JB, Markkula HT, Keyrilainen P. Nissen fundoplication. Results at 10 year follow-up. Am J Surg 1983; 146: 635-8.","journal-title":"Am J Surg"},{"key":"ref_26","first-page":"9","article-title":"Nissen fundoplication for gastroesophageal reflux disease. Evaluation of primary repair in 100 consecutive patients","volume":"204","author":"DeMeester, T.R.; Bonavina, L.; Albertucci, M.","year":"1986","unstructured":"DeMeester TR, Bonavina L, Albertucci M. Nissen fundoplication for gastroesophageal reflux disease. Evaluation of primary repair in 100 consecutive patients. Ann Surg 1986; 204: 9-20."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"937","DOI":"10.1001\/archsurg.1989.01410080069011","article-title":"The significance of the gastric secretory state in gastroesophageal reflux disease","volume":"124","author":"Barlow, A.P.; DeMeester, T.R.; Ball, C.S.; Eypasch, E.P.","year":"1989","unstructured":"Barlow AP, DeMeester TR, Ball CS, Eypasch EP. The significance of the gastric secretory state in gastroesophageal reflux disease. Arch Surg 1989; 124: 937-40.","journal-title":"Arch Surg"},{"key":"ref_28","first-page":"1149","article-title":"A critical analysis, with appropriate controls, of gastric acid and pepsin secretion","volume-title":"clinical esophagitis. Gastroenterology 1991; 101","author":"Hirschowitz, B.I.","unstructured":"Hirschowitz BI. A critical analysis, with appropriate controls, of gastric acid and pepsin secretion in clinical esophagitis. Gastroenterology 1991; 101: 1149-58."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"903","DOI":"10.1016\/0016-5085(88)90162-X","article-title":"Healing and relapse of severe peptic esophagitis after treatment with omeprazole","volume":"95","author":"Hetzel, D.J.; Dent, J.; Reed, W.D.; Narielvala, F.M.; Mackinnon, M.; McCarthy, J.H.","year":"1988","unstructured":"Hetzel DJ, Dent J, Reed WD, Narielvala FM, Mackinnon M, McCarthy JH, et al. Healing and relapse of severe peptic esophagitis after treatment with omeprazole. Gastroenterology 1988; 95: 903-12.","journal-title":"Gastroenterology"},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"448","DOI":"10.1001\/archinte.1991.00400030018004","article-title":"Rationale and efficacy of conservative therapy for gastroesophageal reflux","volume":"151","author":"Kitchin, L.I.; Castell, D.O.","year":"1991","unstructured":"Kitchin LI, Castell DO. Rationale and efficacy of conservative therapy for gastroesophageal reflux. Arch Intern Med 1991; 151: 448-54.","journal-title":"Arch Intern Med"},{"key":"ref_31","first-page":"209","article-title":"Alkaline gastroesophageal reflux","volume-title":"Ambulatory esophageal pH monitoring","author":"Clark, G.W.B.; Hinder, R.A.","year":"1991","unstructured":"Clark GWB, Hinder RA. Alkaline gastroesophageal reflux. In: Richter JE, ed. Ambulatory esophageal pH monitoring. New York: Igaku-Shoin, 1991: 209-24."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"263","DOI":"10.1056\/NEJM197508072930602","article-title":"Medical and surgical management of reflux esophagitis. A 38-month report on a prospective clinical trial","volume":"293","author":"Behar, J.; Sheahan, D.G.; Biancani, P.","year":"1975","unstructured":"Behar J, Sheahan DG, Biancani P. Medical and surgical management of reflux esophagitis. A 38-month report on a prospective clinical trial. N EnglJ Med 1975; 293: 263-8.","journal-title":"N EnglJ Med"},{"key":"ref_33","first-page":"1369","article-title":"Double-blind controlled trial of bethanecol and antacid","volume-title":"the treatment of erosive esophagitis. Gastroenterology","volume":"82","author":"Saco, L.S.; Orlando, R.C.; Levinson, S.L.; Bozymsky, E.M.; Jones, J.D.; Frakes, J.T.","year":"1982","unstructured":"Saco LS, Orlando RC, Levinson SL, Bozymsky EM, Jones JD, Frakes JT. Double-blind controlled trial of bethanecol and antacid in the treatment of erosive esophagitis. Gastroenterology 1982; 82: 1369-73."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"1034","DOI":"10.1007\/BF01297443","article-title":"Provocation of transient lower esophageal sphincter relaxations by meals in patients with symptomatic gastroesophageal reflux","volume":"36","author":"Holloway, R.H.; Kocyan, P.; Dent, J.","year":"1991","unstructured":"Holloway RH, Kocyan P, Dent J. Provocation of transient lower esophageal sphincter relaxations by meals in patients with symptomatic gastroesophageal reflux. DigDis Sci 1991; 36: 1034-9.","journal-title":"DigDis Sci"},{"key":"ref_35","first-page":"78692","article-title":"Veterans Affairs Gastroesophageal Reflux Disease Study Group. Comparison of medical and surgical therapy for complicated gastroesophageal reflux disease in veterans","volume":"326","year":"1992","unstructured":"Spechler SJ, and the Department of Veterans Affairs Gastroesophageal Reflux Disease Study Group. Comparison of medical and surgical therapy for complicated gastroesophageal reflux disease in veterans. N Engl J Med 1992; 326: 78692.","journal-title":"N Engl J Med"},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"845","DOI":"10.1136\/gut.32.8.845","article-title":"Natural history of gastro-oesophageal reflux disease without oesophagitis","volume":"32","author":"Pace, F.; Santalucia, F.; Bianchi Porro, G.","year":"1991","unstructured":"Pace F, Santalucia F, Bianchi Porro G. Natural history of gastro-oesophageal reflux disease without oesophagitis. Gut 1991; 32: 845-8.","journal-title":"Gut"},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"1016","DOI":"10.1136\/gut.33.8.1016","article-title":"Three year follow up of patients with gastro-oesophageal reflux disease","volume":"33","author":"Schindibeck, N.E.; Klauser, A.G.; Beghammer, G.; Londong, W.; Miiller-Lissner, S.A.","year":"1992","unstructured":"Schindibeck NE, Klauser AG, Beghammer G, Londong W, Miiller-Lissner SA. Three year follow up of patients with gastro-oesophageal reflux disease. 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