[Predictive factors for healing of esophagitis. Prospective study during ranitidine therapy]

This study was conducted to identify factors predicting favourable outcome after ranitidine 300 mg o.d. treatment for oesophagitis. Patients with grade 2 or 3 erosive oesophagitis were included in the study. Each investigator recruited 2 patients with the same grade of lesion in order to minimize bias in assessing symptoms. All patients received the same 6-week treatment: 300 mg ranitidine daily in the form of an effervescent tablet after the dinner. Symptomatology was assessed after 2 and 6 weeks of treatment and endoscopy was performed at the end of the treatment period. A successful outcome was defined as the absence of erosive lesions (grade 0 or 1). A total of 515 patients were recruited and 500 retained for analysis (15 patients did not follow the treatment protocol correctly): 267 grade 2 and 233 grade 3 (mean age: 52.5 years; sex ratio M/F: 1.7). Patients with grade 3 oesophagitis had more severe symptoms; hiatal hernia was also more frequent in this group. Alcohol intake and smoking habits were similar in both groups. After 6 weeks of treatment, successful healing was observed in 87 percent of the grade 2 patients and in 72 percent of the grade 3 patients. Three factors predicting successful outcome were found: grade 2 (odds ratio (OR): 1.50; p = 0.001), symptom duration less than 30 days after treatment onset (OR: 1.50; p = 0.001) and complete relief of symptoms after two weeks of treatment (OR: 1.31; p = 0.03). Disease history and the course of symptoms during treatment with ranitidine could help predict endoscopic outcome of oesophagitis.