Natural history and quality of life of patients with acid hypersensitive esophagus syndrome. Comparison with classical gastro-esophageal reflux disease

The acid hypersensitive esophagus (AHE) is characterized by a normal esopha geal acid exposure but a significant association between symptoms and reflu x episodes. The natural history of AHE remains poorly known. We therefore c onducted a Follow-vp study to compare the initial presentation and natural history of AHE and classical GERD. Quality of life (QOL) was also assessed. Patients and methods - Two groups of patients referred to our laboratory Fo r 2d-hour pH-monitoring (between 1991 and 1996) were compared. Group 1 cons isted of 127 consecutive patients with AHE. Group 2 consisted of 101 patien ts with GERD. All patients were invited by mail to Fill-in two questionnair es, the First concerning clinical course and therapeutic needs and the seco nd QOL (questionnaire Reflux-Qual). Finally 62% and 59% of group and 2 resp ectively did respond to both questionnaires. The corresponding follow-up pe riods were 4.1 and 4.3 years, respectively. Results - The two groups did not differ at initial presentation with regard to age, sex, symptoms prevalence and severity of esophagitis (80% of group 1 and 75% of group 2 were endoscopy-negative patients). At on average foll ow-up of 4 years symptoms persisted in 80% and 71% of patients respectively . Seventy five per cent of patients in both groups continued to take antire flux drugs. QOL scores were similarly reduced in both groups (71 +/- 26 vs 70 +/- 27). Conclusions - The initial presentation and clinical outcome of AHE and GERD are similar. QOL is notably impaired and the majority of patients continue to receive antireflux medications.