Twenty Year Follow-Up of Reflux Oesophagitis: Long Term Consequences and Complications

Introduction: Reflux oesophagitis is the most common abnormal finding at OGD yet the long term outcome of the condition is unknown. This study assessed the level of reflux symptoms, drug consumption and complications in patients 20 years after diagnosis of oesophagitis.

Methods: One hundred and fifty two patients with typical reflux symptoms and a first time diagnosis by endoscopy of grade I-III oesophagitis between 1981 and 1984 at one centre were followed up using a postal questionnaire and telephone interview.

Results: Thirty-five (23%) of the 152 patients were deceased, 6 couldn't be traced, 30 failed to respond and 81 replied (mean age 63yrs, range 39–88yrs) with mean follow-up time of 20.5yrs (range 230–268 months). Fifty-nine patients (73%) still had reflux symptoms at least daily (9) or weekly (19) or required daily acid suppression therapy (31). Forty-six (57%) patients remained on daily acid suppression with either a proton pump inhibitor (36) or H2RA (10). Three patients (2%) developed a benign oesophageal stricture during follow-up and 2 (2%) developed Barrett's oesophagus. There were no deaths due to oesophageal cancer but two deaths due to throat cancer.

Conclusion: Nearly three quarters of patients previously diagnosed as having reflux oesophagitis still had significant morbidity related to gastro-oesophageal reflux disease 20 years after diagnosis.