Disease characteristics in non-erosive reflux disease with and without endoscopically minimal change esophagitis: are they different?

Digestion. 2012;85(1):27-32. doi: 10.1159/000334715. Epub 2011 Dec 13.

Abstract

Background/aims: The majority of patients with gastroesophageal reflux disease (GERD) appear to have non-erosive reflux disease (NERD). NERD may include minimal change esophagitis (MCE) and no endoscopic abnormalities (MCE-). We aimed to determine whether intraesophageal acid reflux as well as esophageal motility differed between patients with and without MCE.

Methods: Consecutive patients with classic reflux symptoms were enrolled in the study. Patients without any mucosal injury were considered to be MCE-. Esophageal acid exposure as well as intragastric pH (<4) was determined by dual-channel ambulatory 24-hour pH monitoring.

Results: A total of 100 patients (MCE-, 52 patients; MCE, 48 patients) were studied. The percentage of effective peristalsis was found similar between patients with and without MCE (p = NS). Esophageal acid contact as well as the DeMeester score did not differ between the groups (p = NS). The prevalence of positive symptom index was greater in MCE- patients than in MCE patients (p = 0.001). Intragastric acidity (pH <4) was similar between MCE- and MCE groups (p = NS).

Conclusions: NERD, regardless of the presence of MCE, might exhibit similar disease characteristics in terms of esophageal acid exposure and motor dysfunction.

MeSH terms

  • Adult
  • Aged
  • Esophagitis, Peptic / pathology*
  • Esophagitis, Peptic / physiopathology
  • Esophagus / pathology*
  • Esophagus / physiopathology
  • Female
  • Gastric Acidity Determination
  • Gastroesophageal Reflux / pathology*
  • Gastroesophageal Reflux / physiopathology
  • Gastroscopy
  • Humans
  • Male
  • Middle Aged