Jornal de Hepatologia e Distúrbios Gastrointestinais
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Practice Patterns and Outcomes in Patients with Esophagitis

Pakravan A, Bhatia R, Bhatti F and Hachem C

Background: Gastroesophageal reflux disease (GERD) is a chronic condition in which acid from the stomach damages the native esophageal mucosa and commonly causes symptoms of heartburn, regurgitation, and dysphagia. Complications of GERD include erosive esophagitis, Barrett’s esophagus (BE), and esophageal cancer. Our objectives were to understand the practice patterns in the management of patients with esophagitis, characterize patients with esophagitis who presented to Saint Louis University Hospital (SLUH) for endoscopy, and to evaluate short-term outcomes in these patients

Methods: We identified patients with an endoscopic diagnosis of esophagitis, who presented to SLUH for upper endoscopy for any indication between January 1st and December 31st 2009. After exclusion criteria were considered, a total of 96 patients were identified for the study. Laboratory and pathology data were reviewed for initial and follow up endoscopy. Demographics, severity of esophagitis, length of BE, follow-up recommendations, and outcomes were recorded.

Results: Of the 96 patients involved in the study, 7 had suspected BE on EGD. Among those patients with suspected BE, 4 had a follow up EGD, none of which showed severe esophagitis. Although 23 of the 96 patients (23%) had esophageal biopsies, only 2 had tissue pathology confirming Barrett’s esophagus. Further findings are presented in this paper.

Conclusion: Our data demonstrates, among other findings, that we are not optimizing acid suppression use in disease processes that are acid mediated. More research and development of standardized protocols to guide care for patients with esophagitis and help decrease endoscopy costs are warranted.