PubMed · 1932982
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1991-10-05. Omeprazole.. https://pubmed.ncbi.nlm.nih.gov/1932982/
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The natural history of gastro-oesophageal reflux disease (GORD) is still a matter for research. The follow-up of GORD patients under placebo and after suspension of the drugs that healed the disease, along with observations of large patient populations treated with, or without, antisecretory drugs for long periods of time, may give some information on the spontaneous evolution of the disease. To single out the outcome of each patient, predictive factors based on demographic, morphologic and pathophysiologic characteristics have been devised, but their reliability is debatable. The reason for their many discrepancies could lie in the fact that, to date, the large majority of investigators have focused their research on the characteristics of gastro-oesophageal reflux and underlying motor activity, and have overlooked the resistance of the oesophageal mucosa. As many studies have shown that the severity of GORD is not proportional to the amount of reflux, we strongly believe that knowledge of the capacity of the mucosa to resist injury and repair the damage is the key to understanding why patients with low reflux may have severe disease, while patients with high reflux may not. Research on the kind and degree of mucosal defects in patients with GORD should receive more attention and because it may help to clarify the laws that govern the GORD evolution.
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Acute esophagogastroduodenal mucosal lesions are the demonstrable adverse events occurred after H. pylori eradication. In our study, acute duodenal erosions were observed in 13.5% of the eradicated patients. Duodenal erosions which occurred mainly at the early phase after eradication were temporal and asymptomatic. Acute gastric erosion showed the same clinical manner. However, it needs to pay attention for rare occurrence of acute ulcers with severe symptoms. On the other hand, mild but persistent reflux esophagitis occurred at relatively late phase after eradication. Their occurrence rates were 9.8% after 1 year and 11.4% after 3 years. Acute mucosal lesions occurred probably due to the increase of acid output accompanied with the recovery of gastritis. Symptomatic treatment with antacids were need occasionally for acute ulcer and reflux esophagitis.