Tailoring follow-up endoscopy in patients with severe oesophagitis

Rebecca K. Grant*, William M. Brindle, Caitlyn L. Taylor, Edward J. Rycroft, Oluwadara Oyewole, Sarah C. Morgan, Eleanor F. Watson, Atul Anand, Norma C. McAvoy, Ian D. Penman, Nicholas I. Church, Kenneth C. Trimble, Colin L. Noble, John N. Plevris, Gail S.M. Masterton, Rahul Kalla

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

Abstract / Description of output

Objective We aimed to investigate the clinical utility of follow-up oesophagogastroduodenoscopy (OGD2) in patients with severe oesophagitis (Los Angeles grades C or D) through evaluating the yield of Barrett's oesophagus (BO), cancer, dysplasia and strictures. Second, we aimed to determine if the Clinical Frailty Scale (CFS) may be used to identify patients to undergo OGD2s. Design/method Patients in NHS Lothian with an index OGD (OGD1) diagnosis of severe oesophagitis between 1 January 2014 and 31 December 2015 were identified. Univariate analysis identified factors associated with grade. Patients were stratified by frailty and a diagnosis of stricture, cancer, dysplasia and BO. Results In total 964 patients were diagnosed with severe oesophagitis, 61.7% grade C and 38.3% grade D. The diagnostic yield of new pathology at OGD2 was 13.2% (n=51), new strictures (2.3%), dysplasia (0.5%), cancer (0.3%) and BO (10.1%). A total of 140 patients had clinical frailty (CFS score ≥5), 88.6% of which were deceased at review (median of 76 months). In total 16.4% of frail patients underwent OGD2s and five new pathologies were diagnosed, none of which were significantly associated with grade. Among non-frail patients at OGD2, BO was the only pathology more common (p=0.010) in patients with grade D. Rates of cancer, dysplasia and strictures did not vary significantly between grades. Conclusion Our data demonstrate that OGD2s in patients with severe oesophagitis may be tailored according to clinical frailty and only be offered to non-frail patients. In non-frail patients OGD2s have similar pick-up rates of sinister pathology in both grades of severe oesophagitis.

Original languageEnglish
Pages (from-to)117-123
Number of pages7
JournalFrontline Gastroenterology
Issue number2
Early online date2 Nov 2023
Publication statusE-pub ahead of print - 2 Nov 2023

Keywords / Materials (for Non-textual outputs)

  • ageing
  • endoscopy
  • erosive oesophagitis
  • oesophagitis


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