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Non-erosive and erosive gastroesophageal reflux diseases: No difference with regard to reflux pattern and motility abnormalities.
Scand J Gastroenterol 2008; 43(7):794-800SJ

Abstract

OBJECTIVE

To investigate whether gastroesophageal reflux disease (GERD) with mild to moderate erosive esophagitis (ERD) is a more severe disease regarding the amount of acid reflux, motor abnormalities, and the presence/absence of hiatus hernia than non-erosive reflux disease (NERD).

MATERIAL AND METHODS

The study comprised a retrospective analysis of prospectively collected data on 313 consecutive subjects referred for endoscopy, pH-metry, and esophageal manometry. The patients were divided into four groups: Group I (n=92), subjects without GERD with normal pH-metry, without esophagitis and without reflux symptoms; Group II (n=111), patients with NERD (no esophagitis, abnormal pH-metry); Group III (n=77), patients with mild to moderate ERD (LA A, B; abnormal pH-metry); Group IV (n=33), patients with severe or complicated esophagitis (LA C, D; Barrett's esophagus). All data are expressed as medians with 5th-95th percentiles.

RESULTS

No difference was found in the amount of acid reflux between patients with mild to moderate ERD and those with NERD. The DeMeester score was 34.5 (17-105) in NERD patients and 31.6 (15-102) in ERD patients. No significant differences were found between NERD and ERD patients regarding lower esophageal sphincter (LES) basal pressure (11.6 mmHg; 3-25 in NERD versus 10.7 mmHg; 3-22 in ERD). Similar proportions of patients with NERD and ERD had low LES basal pressure (20.7% in NERD versus 24.7% in ERD; NS) and hiatus hernia (44% and 56%; NS). A relatively high proportion of patients without GERD (Group I) had ineffective esophageal motility (39%) and hiatus hernia (30%).

CONCLUSIONS

No difference was found between NERD and mild to moderate ERD in terms of acid exposure time and esophageal motor abnormalities. To a certain extent, ERD is a "more complicated" form of the disease. Host factors related to a particular patient (e.g. mucosal defense, genetics, acid clearance) might be responsible for the development of esophagitis.

Authors+Show Affiliations

Department of Hepatogastroenterology, Institute for Clinical and Experimental Medicine (IKEM), Prague, Czech Republic. jan.martinek@medicon.czNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

18584517

Citation

Martínek, Jan, et al. "Non-erosive and Erosive Gastroesophageal Reflux Diseases: No Difference With Regard to Reflux Pattern and Motility Abnormalities." Scandinavian Journal of Gastroenterology, vol. 43, no. 7, 2008, pp. 794-800.
Martínek J, Benes M, Hucl T, et al. Non-erosive and erosive gastroesophageal reflux diseases: No difference with regard to reflux pattern and motility abnormalities. Scand J Gastroenterol. 2008;43(7):794-800.
Martínek, J., Benes, M., Hucl, T., Drastich, P., Stirand, P., & Spicák, J. (2008). Non-erosive and erosive gastroesophageal reflux diseases: No difference with regard to reflux pattern and motility abnormalities. Scandinavian Journal of Gastroenterology, 43(7), pp. 794-800. doi:10.1080/00365520801908928.
Martínek J, et al. Non-erosive and Erosive Gastroesophageal Reflux Diseases: No Difference With Regard to Reflux Pattern and Motility Abnormalities. Scand J Gastroenterol. 2008;43(7):794-800. PubMed PMID: 18584517.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Non-erosive and erosive gastroesophageal reflux diseases: No difference with regard to reflux pattern and motility abnormalities. AU - Martínek,Jan, AU - Benes,Marek, AU - Hucl,Tomás, AU - Drastich,Pavel, AU - Stirand,Petr, AU - Spicák,Julius, PY - 2008/6/28/pubmed PY - 2008/8/30/medline PY - 2008/6/28/entrez SP - 794 EP - 800 JF - Scandinavian journal of gastroenterology JO - Scand. J. Gastroenterol. VL - 43 IS - 7 N2 - OBJECTIVE: To investigate whether gastroesophageal reflux disease (GERD) with mild to moderate erosive esophagitis (ERD) is a more severe disease regarding the amount of acid reflux, motor abnormalities, and the presence/absence of hiatus hernia than non-erosive reflux disease (NERD). MATERIAL AND METHODS: The study comprised a retrospective analysis of prospectively collected data on 313 consecutive subjects referred for endoscopy, pH-metry, and esophageal manometry. The patients were divided into four groups: Group I (n=92), subjects without GERD with normal pH-metry, without esophagitis and without reflux symptoms; Group II (n=111), patients with NERD (no esophagitis, abnormal pH-metry); Group III (n=77), patients with mild to moderate ERD (LA A, B; abnormal pH-metry); Group IV (n=33), patients with severe or complicated esophagitis (LA C, D; Barrett's esophagus). All data are expressed as medians with 5th-95th percentiles. RESULTS: No difference was found in the amount of acid reflux between patients with mild to moderate ERD and those with NERD. The DeMeester score was 34.5 (17-105) in NERD patients and 31.6 (15-102) in ERD patients. No significant differences were found between NERD and ERD patients regarding lower esophageal sphincter (LES) basal pressure (11.6 mmHg; 3-25 in NERD versus 10.7 mmHg; 3-22 in ERD). Similar proportions of patients with NERD and ERD had low LES basal pressure (20.7% in NERD versus 24.7% in ERD; NS) and hiatus hernia (44% and 56%; NS). A relatively high proportion of patients without GERD (Group I) had ineffective esophageal motility (39%) and hiatus hernia (30%). CONCLUSIONS: No difference was found between NERD and mild to moderate ERD in terms of acid exposure time and esophageal motor abnormalities. To a certain extent, ERD is a "more complicated" form of the disease. Host factors related to a particular patient (e.g. mucosal defense, genetics, acid clearance) might be responsible for the development of esophagitis. SN - 1502-7708 UR - https://www.unboundmedicine.com/medline/citation/18584517/Non_erosive_and_erosive_gastroesophageal_reflux_diseases:_No_difference_with_regard_to_reflux_pattern_and_motility_abnormalities_ L2 - http://www.tandfonline.com/doi/full/10.1080/00365520801908928 DB - PRIME DP - Unbound Medicine ER -