Comparison of Clinical Characteristics of Patients with Acute Esophageal Mucosal Lesion and those with Severe Reflux Esophagitis

Sakata, Yasuhisa; Tsuruoka, Nanae; Shimoda, Ryo; Yamamoto, Kōji; Akutagawa, Takashi; Sakata, Natsuko; Iwakiri, Ryuichi; Fujimoto, Kazuma

doi:10.1159/000492492

Cited by 8 publications

(9 citation statements)

References 19 publications

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“…Several hypertensive medications (including Ca blockers) exacerbate GERD, causing an increase in gastroesophageal reflux. 1,15,[26][27][28][29] Therefore, the increased prescription rate of PPIs after H. pylori eradication in hypertensive patients might be because of the increased risk of GERD due to the condition of hypertension itself and/or because of the hypertensive medications combined with hypertension. 26,30 The present study did not find a significant influence of Ca blockers on the prescription of PPIs, which suggested that other hypertensive medications than Ca blockers and/or hypertension itself might facilitate PPIs medication.…”

Section: Discussionmentioning

confidence: 99%

“…The prescription rate of PPIs after H. pylori eradication was increased in the group of patients with hypertension. Several hypertensive medications (including Ca blockers) exacerbate GERD, causing an increase in gastroesophageal reflux 1,15,26–29 . Therefore, the increased prescription rate of PPIs after H. pylori eradication in hypertensive patients might be because of the increased risk of GERD due to the condition of hypertension itself and/or because of the hypertensive medications combined with hypertension 26,30 .…”

Section: Discussionmentioning

confidence: 99%

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Lifestyle‐ and comorbidity‐related factors for the prescription of proton pump inhibitors after Helicobacter pylori eradication in Japan

Shimada

Endo²,

Takamori

et al. 2021

JGH Open

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Background and AimThe aim of the present study was to examine the lifestyle‐ and comorbidity‐related determinant factors of the prescription of proton pump inhibitors (PPIs) for patients in whom Helicobacter pylori has been eradicated, and to evaluate the relationship between PPI prescription and the severity of endoscopic esophagitis.MethodsThis retrospective study included patients who underwent H. pylori eradication from May 2012 to September 2016 at Saiseikai Karatsu Hospital. All patients received upper gastrointestinal endoscopy before H. pylori eradication. Patients with open peptic ulcers and/or malignant diseases were excluded, and a final total of 389 patients were evaluated. Medical records were reviewed to determine the prescription of PPIs after H. pylori eradication, lifestyle‐related factors, and comorbidities. Lifestyle‐related factors were confirmed by a questionnaire.ResultsPPIs were administered to 124 of 389 patients (31.9%). The only lifestyle‐related risk factor for the prescription of PPIs after H. pylori eradication was older age (P < 0.01). Hypertension increased the prescription of PPIs (P = 0.034). The prescription of PPIs was not influenced by the presence of grade A esophagitis, whereas the PPI prescription rate was significantly increased in patients with grades B/C/D endoscopic esophagitis (P < 0.01). The grade of chronic gastritis before H. pylori eradication had no effect on the prescription of PPIs.ConclusionThe lifestyle‐ and comorbidity‐related risk factors for the prescription of PPIs after H. pylori eradication were older age and hypertension, while mild endoscopic esophagitis had no influence on PPI prescription.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Lifestyle‐ and comorbidity‐related factors for the prescription of proton pump inhibitors after Helicobacter pylori eradication in Japan

Shimada

Endo²,

Takamori

et al. 2021

JGH Open

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“…Therefore, differentiating between these diseases is important. Sakata et al reported that an important difference between sRE and AEML is the shape of the esophageal mucosal erosions on the proximal side [7]. sRE is characterized by the formation of spiny erosions (Figure 1), whereas these are absent in AEML (Figure 2).…”

Section: Introductionmentioning

confidence: 99%

Comparison of Clinical Features of Acute Esophageal Mucosal Lesions and Those of Reflux Esophagitis Los Angeles Classification Grade D

Ichita

Sasaki

Sumida

et al. 2022

Preprint

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Background: Acute esophageal mucosal lesions (AEMLs) cause circumferential mucosal damage in the lower esophagus in patients with deteriorating general health. However, its etiology remains unclear. AEML is often diagnosed and treated as severe reflux esophagitis (sRE), particularly that of Los Angeles classification grade D (sRE-D). This study aimed to determine whether it is appropriate to classify these two diseases according to the characteristics of the proximal mucosa of erosion as previously reported, and to clarify the clinical features of AEML in comparison with sRE-D.Methods: Patients were classified into AEML and sRE-D groups, based on previous reports. Patient background, presence of shock, medical history, medications, comorbidities, death during hospitalization, blood sampling data, endoscopic findings, and presence of stenosis after treatment were evaluated.Results: There were significantly more cases with comorbidities in the AEML group than in the sRE-D group, particularly comorbidities involving infectious diseases. In addition, abnormalities in blood test results were significantly more frequent in the AEML group than in the sRE-D group. This suggests that the onset of AEML may be due to peripheral circulatory disturbance caused by worsening general condition.Conclusions: AEML and sRE-D showed distinctly different features and it was considered reasonable to distinguish them. AEML, unlike sRE-D, may be caused by microcirculatory disturbances related to comorbidities rather than gastric acid reflux. However, it is under-recognized and should be considered in the setting of upper gastrointestinal bleeding in patients with deteriorating general condition.

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“…Antacid medications, including potassium-competitive acid blockers, proton pump inhibitors (PPI), and/or H 2 receptor antagonists, which suppress gastric acid secretion, are widely used to treat gastric acid-related diseases such as peptic ulcers, gastro-esophageal reflux, and Helicobacter pylori-related diseases, including eradication therapy [1][2][3][4][5][6][7]. These medications are useful for prevention of gastroduodenal mucosal damage in patients taking medications such as nonsteroidal anti-inflammatory drugs (NSAID), low-dose aspirin, and antithrombotic agents [8][9][10][11][12][13][14].…”

Section: Introductionmentioning

confidence: 99%

Lifestyle- and Comorbidity-Related Risk Factors Associated with Prescription of Gastric Acid Secretion Inhibitors to Japanese Patients Who Were Helicobacter pylori Negative and Had No Upper Gastrointestinal Lesions

Matsunaga

Endo²,

Takamori

et al. 2020

Digestion

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Objective: The aim of this study was to determine the characteristics of patients without Helicobacter pylori infection who were prescribed antacid medications (potassium-competitive acid blockers, proton pump inhibitors, and/or H₂ receptor antagonist) and had no upper gastrointestinal lesions detected by endoscopy. Methods: This cross-sectional study included the patients who underwent upper gastrointestinal endoscopy in our institution between August 2017 and July 2018. They were aged from 55 to 89 years, had no upper gastrointestinal lesions detected by endoscopy, and no H. pylori infection. Exclusion criteria comprised low-dose aspirin and/or nonsteroidal anti-inflammatory drugs. The subjects were allocated to middle-aged (55–69 years) and older age groups (70–89 years). The relationships between antacid medications and patient lifestyle and comorbidities were evaluated by multivariate analyses. Results: Of the 420 patients, 272 were in the middle-aged group and 148 patients in the older age group. Age was found to be a risk factor for antacid medications in both groups (p = 0.002, p = 0.007). No other lifestyle related factors were risk factors. As to comorbidities, hiatal hernia was positively associated with antacid medications in the middle-aged group (p = 0.002). Hypertension and Ca-blockers were positively associated with prescription of antacids in the older age group (p = 0.013); this association was not significant in the middle-aged group. Conclusions: Three lifestyle-related and/or comorbidity-associated factors known to exacerbate gastroesophageal reflux, namely, age, hiatus hernia, and Ca-blockers, were associated with prescription of antacid medications, even in patients without endoscopic reflux esophagitis.

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Comparison of Clinical Characteristics of Patients with Acute Esophageal Mucosal Lesion and those with Severe Reflux Esophagitis

Cited by 8 publications

References 19 publications

Lifestyle‐ and comorbidity‐related factors for the prescription of proton pump inhibitors after Helicobacter pylori eradication in Japan

Lifestyle‐ and comorbidity‐related factors for the prescription of proton pump inhibitors after Helicobacter pylori eradication in Japan

Comparison of Clinical Features of Acute Esophageal Mucosal Lesions and Those of Reflux Esophagitis Los Angeles Classification Grade D

Lifestyle- and Comorbidity-Related Risk Factors Associated with Prescription of Gastric Acid Secretion Inhibitors to Japanese Patients Who Were Helicobacter pylori Negative and Had No Upper Gastrointestinal Lesions

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