The Effect of Gastroesophageal Flap Valve Appearance on the Management of Patients with Symptoms of Gastroesophageal Reflux Disease

Purpose To assess the effectiveness of anti-reflux treatment in gastroesophageal reflux disease patients classified according to esophagogastric junction morphology (Hill classification). Results A symptom score and endoscopic grading of gastrooesophageal flap valve appearance were determined in 49 symptomatic patients (female 26, male 23; mean age 49 years, range 21–76 years). Patients received 8 weeks of continuous rabeprazole at a daily dose of 20 mg and, upon symptom control, continued with on-demand treatment for 3 months. The mean symptom score at 8 weeks was significantly reduced in all groups. However, at the end of the on-demand therapy, patients with Hill grade IV had used more rabeprazole tablets than those in the two other groups (II: 10.86 ± 14.52, III: 14.73 ± 14.58, IV: 25.78 ± 15.85; P = 0.002). Conclusions Continuous treatment is effective in all groups of patients with reflux disease. Grading patients according to the gastroesophageal flap valve appearance is useful as a prognostic factor, especially when on-demand therapy is considered to be an option. The authors who have taken part in this study declare that they have no relationship with the manufacturers of the drugs involved and did not receive funding from the manufacturers to carry out their research. The authors did not receive money from any source to carry out this study.