Background & aims: The Lyon Consensus defines LA grades C&D erosive esophagitis (EE) or acid exposure time (AET) >6% as the conclusive evidence for gastro-esophageal reflux disease (GERD). However, most of EE is LA grade A&B and the rate of AET exceeding 6% is low in China. We aimed to evaluate patients with EE in the Chinese population based on the Lyon Criteria.
Methods: A retrospective study was performed among patients with EE who had esophageal function tests performed in a tertiary hospital from 2013 to 2017. Erosive esophagitis was staged according to the Los Angeles classification. Their motor profiles from high-resolution manometry (HRM), reflux profiles from multichannel intraluminal impedance-pH (MII-pH) monitoring and proton pump inhibitor (PPI) efficacy were analyzed. Patients were categorized as conclusive or inconclusive GERD.
Results: Among 112 patients with EE who underwent esophageal function tests, EE of LA grade C&D was found in only 4.46% (N = 5). Almost 35% (N = 37) of patients with LA grade A&B EE had AET exceeded 6%, who had good PPI response similar to those with LA grade C&D EE (77.42% vs 100%, P = .559). The remaining 70 patients (62.50%) were inconclusive GERD, of whom 56.25% responded to PPI. Inconclusive GERD patients had a wide range (7.14%-97.14%) of positive adjunctive evidences from HRM and MII-pH monitoring without significant correlation to PPI response rate.
Conclusions: The reflux burden within patients with EE is predominantly low in China, and adjunctive HRM and MII-pH profiles from Lyon criteria do not segregate PPI response.
Keywords: Lyon Consensus; acid exposure time; erosive esophagitis; gastro-esophageal reflux disease.
© 2019 John Wiley & Sons Ltd.