INTRODUCTION Indefinite proton pump inhibitor (PPI) therapy and endoscopic evaluation for Barrett's esophagus is recommended for erosive esophagitis (EE). However, the clinical course of EE remains undefined. METHODS Adults with EE on esophagogastroduodenoscopy (EGD) were identified at Mayo Clinic Rochester between January 2003 and September 2005. Patients with repeat EGD performed after index endoscopy were included. Patients with a history of upper gastrointestinal surgery, esophageal cancer, achalasia, or Barrett's on initial EGD were excluded. RESULTS Of 219 patients identified, 98 had LA grade A, 72 LA grade B, and 49 LA grade C esophagitis. Persistent EE was found in 27% on repeat endoscopy. No patients progressed to more severe grades of esophagitis. While discontinuation of PPI was associated with persistent esophagitis, long-term healing of esophagitis occurred in the majority of patients despite discontinuation of PPI. Grade A or B esophagitis and the absence of hiatal hernia were also independent predictors of esophagitis healing on multivariate analysis. The rate of Barrett's esophagus was similar among patients with LA grade A/B and C esophagitis on initial EGD (5% vs. 14%, p = 0.6). CONCLUSION The majority of patients with EE demonstrated healing at follow-up endoscopy regardless of continued PPI use. A small proportion developed Barrett's esophagus, including those with LA grade A and B esophagitis, highlighting a potential role for repeat endoscopy in all grades of EE. A more conservative long-term PPI strategy may be reasonable in patients with LA grade A or B esophagitis in the absence of hiatal hernia.

中文翻译：

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糜烂性食道炎预示着大多数患者的良性临床过程。

引言对于糜烂性食管炎（EE），建议对Barrett食管进行不确定的质子泵抑制剂（PPI）治疗和内窥镜评估。但是，EE的临床过程仍然不确定。方法2003年1月至2005年9月在罗切斯特市梅奥诊所鉴定出食管胃十二指肠镜检查（EGD）的成人EE。包括经内镜检查重复EGD的患者。初次EGD时有上消化道手术史，食道癌，门失弛缓症或Barrett病史的患者被排除在外。结果在确定的219例患者中，有98例患有LA级食管炎，72例患有LA B级和49例患有LA级食管炎。重复内镜检查发现持久性EE占27％。没有患者进展为更严重的食管炎。PPI停用与持续性食管炎有关，尽管中断了PPI，大多数患者仍可长期治愈食管炎。A或B级食管炎和食管裂孔疝的缺失也是多因素分析中食管炎愈合的独立预测因素。在初次EGD时，LA / A / B级和C级食管炎患者的Barrett食管发生率相似（5％vs. 14％，p = 0.6）。结论不管继续使用PPI，大多数EE患者在随访内窥镜检查中均显示出healing愈。一小部分人发展出了Barrett食道，包括患有A级和B级LA食道炎的人，这突显了在所有级别的EE中重复内镜检查的潜在作用。对于没有食管裂孔疝的LA级A或B级食管炎患者，较保守的长期PPI策略可能是合理的。