Abstract
In order to asses whether in reflux esophagitis morphological and functional disorders persist after macroscopic healing, cimetidine was given for 6–12 weeks at a dose of 1.6 g/day to 30 patients with acid gastroesophageal reflux and esophagitis. The mucosal defects healed in 6 patients, improved in 14 patients, and remained unchanged in 10 patients. Lower esophageal sphincter pressure, acid clearance, acid perfusion test, and histological signs of mucosal inflammation were assessed before and after treatment. The histological and functional findings did not improve after healing of the mucosal defects. Therefore, endoscopic normalization in patients with reflux esophagitis is not associated with the disappearance of inflammation and abnormal motor function. The persistence of these abnormalities might explain the tendency of esophagitis to recur after symptomatic and endoscopic “healing.”
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Ferguson R, Dronfield MW, Atkinson M: Cimetidine in treatment of reflux esophagitis with peptic stricture. Br Med J 2:472–474, 1979
Wesdorp E, Bartelsman J, Pape K, Dekker W, Tytgat GN: Oral cimetidine in reflux esophagitis: A double blind controlled trial. Gastroenterology 74:821–824, 1978
Behar J, Brand DL, Brown FC, Castell DO, Cohen S, Crossley RJ, Pope II CE, Winans CS: Cimetidine in the treatment of symptomatic gastroesophageal reflux. Gastroenterology 74:441–448, 1978
Powell-Jackson P, Barkley H, Northfield TC: Effect of cimetidine in symptomatic gastroesophageal reflux. Lancet 2:1068–1069, 1978
Lepsien G, Sonnenberg A, Berges W, Weber KB, Wienbeck M, Siewert JR, Blum AL: Die Behandlung der Refluxösophagitis mit Cimetidin. Dtsch Med Wochenschr 104:901–906, 1979
Bucher P, Lepsien G, Sonnenberg A, Blum AL: Verlauf und Prognose der Refluxkrankheit bei konservativer und chirurgischer Behandlung. Schweiz Med Wochenschr 108:2072–2078, 1978
Savary M, Miller G: Der Oesophagus. Solothurn, Verlag Gassmann AG, 1977
Siewert JR, Blum AL, eds: Refluxtherapie. Heidelberg, Springer Verlag, 1981
Siewert JR, Lepsien G, Schattenmann G, Blum AL: Goettinger pH-Metrie: Telemetrische Langzeit-pH-Metrie der Speiseröhre. Chirurg 49:333–334, 1978
Seefeld U, Krejs GJ, Siebenmann RE, Blum AL: Esophageal histology in gastroesophageal reflux. Am J Dig Dis 22: 956–964, 1977
Krejs GJ, Seefeld U, Brändli HH, Bron BA, Caro G, Schmid P, Blum AL: Gastro-oesophageal reflux disease: correlation of subjective symptoms with 7 objective oesophageal function tests. Acta Hepatogastroenterol 23:130–140, 1976
Siewert JR, Blum AL, Waldeck F: Funktionsstörungen der Speiseröhre. Berlin, Springer Verlag, 1976
Bernstein LM, Baker LA: A clinical test for esophagitis. Gastroenterology 34:760–781, 1958
Crumplin MKH, Stol DW, Murphy GM, Collis JL: The pattern of bile salt reflux and acid secretion in sliding hiatal hernia. Br J Surg 61:611–616, 1974
Stol DW, Murphy GM, Collis JL: Duodenal gastric reflux and acid secretion in patients with symptomatic hiatal hernia. Scand J Gastroenterol 9:97–101, 1974
Blum AL, Siewert JR: Hat die axiale Hiatushernie einen Krankheitswert? Schweiz Med Wochenschr 109:1977–1981, 1979
Siegrist PW, Krejs GJ, Blum AL: Symptomatik der gastrooesophagealen Refluxkrankheit. Dtsch Med Wochenschr 42:2088–2094, 1974
Johnson AG: Pyloric function and gall-stone dyspepsia. Br J Surg 59:449–454, 1972
DeMeester TR, Wang CI, Wernly JA, Pellegrini CA, Little AG, Klementschitsch P, Bermudes G, Johnson LF, Skinner DB: Technique, indications, and clinical use of 24 hour esophageal pH monitoring. J Thorac Cardiovasc Surg 79:656–670, 1980
McCallum RW, Ippoliti AF, Cooney C, Sturdevant RAL: A controlled trial of metoclopramid in symptomatic gastroesophageal reflux. N Engl J Med 296:354–357, 1977
Hoare AM, Keighley MRB, Hawkins CF, Alexander-Williams J, Elkington SG: Non-ulcer dyspepsia and surgery. Gut 16:397, 0000
Allison PR: Peptic oesophagitis and oesophageal stricture. Lancet 2:199–202, 1970
Sladen GE, Riddel RH, Willoughby IMT: Oesophagoscopy, biopsy, and acid perfusion test in diagnosis of “reflux oesophagitis”. Br Med J 1:71–76, 1975
Kobayashi S, Kasugai T: Endoscopic and biopsy criteria for the diagnosis of esophagitis with a fiberoptic esophageoscope. Am J Dig Dis 19:345–352, 1974
Leu H, Schüle A, Brändli H, Pelloni S, Blum AL: Glanzverlust, Farbänderungen und erhöhte Lädierbarkeit der Speiseröhre: altersbedingte Normvarianten? Z Gastroenterol 16:414–421, 1978
Schüle A, Brändli H, Pelloni S, Koelz HR, Pirozynski WJ, Blum AL: Endoskopische Diagnose der Oesophagitis. Dtsch Med Wochenschr 102:606–609, 1977
Ismail-Beigi F, Horton PF, Pope CE: Histological consequences of gastroesophageal reflux in man. Gastroenterology 58:163–174, 1970
Brand DL, Eastwood IR, Martin D, Carter WB, Pope CE: Esophageal symptoms, manometry, and histology before and after antireflux surgery. Gastroenterology 76:1393–1401, 1979
Kaye MD, Showalter JP: Pyloric incompetence in patients with symptomatic gastroesophageal reflux. J Lab Clin Med 83:198–206, 1974
Herlihy KJ, Orlando RC, Bryson JC, Adams A, Powell DW: The Bernstein test: Conversion from a subjective to an objective test with potential difference (PD) measurements. Gastroenterology 80:1173, 1981
Ippoliti A, McCallum R, Sturdevant RAL: Gastric emptying in patients with gastroesophageal reflux. Clin Res 24:535A, 1976
Freeland G, Higgs RH, Castell DO: Lower esophageal sphincter response to oral administration of cimetidine in normal subjects. Gastroenterology 72:28–30, 1977
Goodall RJR, Temple JG: Effect of cimetidine on lower oesophageal sphincter pressure in oesophagitis. Br Med J 1:611–612, 1980
Eastwood GL, Castell DO, Higgs RH: Experimental esophagitis in cats impairs lower sphincter pressure. Gastroenterology 69:146–153, 1975
Brown F, Beck B, Fletcher J, Castell DO, Eastwood G: Evidence suggesting prostaglandins mediate lower esophageal sphincter (LES) incompetence associated with inflammation. Gastroenterology 72:1033, 1977
Bianchani P, Dodds J, Storer E, Selling J, McCallum RW: Acute experimental esophagitis affects mechanical properties of lower esophageal sphincter.In Gastrointestinal Motility, J Christensen (ed). New York, Raven Press, 1980, pp 75–78
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This study has been supported by the Swiss National Science Foundation, grant 3.158.0.77, and Deutsche Forschungsgemeinschaft, grant SI 208.
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Sonnenberg, A., Lepsien, G., Müller-Lissner, S.A. et al. When is esophagitis healed?. Digest Dis Sci 27, 297–302 (1982). https://doi.org/10.1007/BF01296747
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DOI: https://doi.org/10.1007/BF01296747