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Non-erosive reflux disease (NERD)--acid reflux and symptom patterns
S D Martinez1, I B Malagon, H S Garewal
1Department of Medicine, Section of Gastroenterology and Hematology/Oncology, Southern Arizona VA Health Care System and Arizona Health Sciences Center, Tucson, AZ 85723, USA.
Alimentary Pharmacology & Therapeutics
|March 8, 2003
Summary
Patients with non-erosive reflux disease (NERD) often have normal acid reflux tests, unlike those with erosive esophagitis. This suggests NERD is a complex condition with varied patient profiles.
Area of Science:
- Gastroenterology
- Digestive Health
- Esophageal Disorders
Background:
- Non-erosive reflux disease (NERD) patients show poorer symptom improvement with anti-reflux medications compared to erosive esophagitis patients.
- Understanding NERD's distinct characteristics is crucial for effective treatment strategies.
Purpose of the Study:
- Compare acid reflux and symptom patterns in NERD, erosive esophagitis, and Barrett's esophagus.
- Identify distinct subgroups within NERD based on reflux and symptom presentation.
Main Methods:
- Evaluated 149 patients with heartburn symptoms using upper endoscopy and Hetzel-Dent criteria.
- Classified NERD patients (Hetzel-Dent grades 0-1) and assessed acid exposure via 24-h esophageal pH monitoring.
Main Results:
- NERD patients (45%) were less likely to have abnormal pH tests than erosive esophagitis (75%) or Barrett's esophagus (93%) patients.
- While Barrett's esophagus showed highest acid reflux events, perceived reflux was low across all groups.
- NERD patients with abnormal pH tests had similar acid exposure to erosive esophagitis patients and were more likely to report significant symptom correlation.
Conclusions:
- Non-erosive reflux disease (NERD) patients frequently present with normal esophageal pH monitoring results.
- Acid reflux patterns and symptom correlations indicate that NERD represents a heterogeneous patient group.
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