Dysphagia in Gastroesophageal Reflux Disease (Gerd)

Introduction. Dysphagia is considered an alarm symptom, raising the question of stricture or malignancy. We sought to determine the prevalence and severity of dysphagia and correlation with severity of gastroesophageal reflux disease and its response to therapy. Methods. A total of 642 patients with endoscopically confirmed erosive esophagitis (Los Angeles grades AD). Esophagitis was classified as mild (grade A or B) or severe (grade C or D). Results. At baseline, of 642 patients 37% had dysphagia, 43% had severe esophagitis, and 35% mild esophagitis (odds ratio, 1.39; 95% confidence interval, 1.27-1.51, p<0.001). Dysphagia resolved in 73% of patients after 4 weeks of proton pump inhibitor (PPI) treatment. Resolution of dysphagia was associated with a mean healing rate of 87% acrossall treatments. Seventeen percent of patients reported persistent dysphagia, and in these patients the healing rates were decreased significantly (mean 72%; p<0.0001). Conclusions. Dysphagia is common in patients with erosive esophagitis but is not a reliable clinical predictor of severe erosive esophagitis. Dysphagia resolved with PPI therapy in most cases, but persistent dysphagia may indicate failed healing.