Non-Erosive Reflux Disease (NERD), Symptomatic and Asymptomatic Erosive Reflux Disease (ERD): From Hypersensitive to Hyposensitive Esophagus

• Published in: Digestive diseases and sciences 2011-01, Vol.56 (1), p.90-96
• Main Authors: Hartono, Juanda L, Qua, Choon-Seng, Goh, Khean-Lee
• Format: Article
• Language: English
• Subjects: 2-Pyridinylmethylsulfinylbenzimidazoles - therapeutic use; Adult; Aged; Biochemistry; Biological and medical sciences; Case-Control Studies; Disease Progression; Esophagus; Feeding. Feeding behavior; Female; Fundamental and applied biological sciences. Psychology; Gastroenterology; Gastroenterology. Liver. Pancreas. Abdomen; Gastroesophageal Reflux - drug therapy; Gastroesophageal Reflux - pathology; Gastroesophageal Reflux - physiopathology; Hepatology; Humans; Hydrochloric Acid - adverse effects; Hypersensitivity - etiology; Hypersensitivity - pathology; Male; Medical sciences; Medicine; Medicine & Public Health; Middle Aged; Oncology; Original Article; Other diseases. Semiology; Proton Pump Inhibitors - therapeutic use; Rabeprazole; Sodium Chloride - adverse effects; Transplant Surgery; Treatment Outcome; Vertebrates: anatomy and physiology, studies on body, several organs or systems
• ISSN: 0163-2116; 1573-2568
• DOI: 10.1007/s10620-010-1275-5

Aims To compare the esophageal sensitivity to acid and saline in patients with symptomatic and asymptomatic erosive reflux disease (ERD), non-erosive reflux disease (NERD) and controls, and to assess the response to proton-pump inhibitors in patients with symptomatic ERD and NERD. Methodology Patients with GERD and a control group of healthy asymptomatic volunteers were recruited. All subjects underwent esophagogastroduodenoscopy and the acid-saline perfusion test. Symptomatic ERD and NERD patients were given rabeprazole 20 mg twice daily for 2 weeks and their response to treatment assessed. Results A total of 105 subjects were recruited: ERD = 37 (symptomatic = 24, asymptomatic = 13), NERD = 34 and controls = 34. During saline perfusion, only the NERD group recorded a significantly higher sensitivity score compared to controls (2.74 ± 7.28 vs. 0) (p = 0.035). During acid perfusion, symptomatic ERD (15.42 ± 13.42) and NERD (16.71 ± 15.04) had significantly higher scores versus controls and asymptomatic ERD patients (both p < 0.001). The mean %∆ reflux symptom score following treatment was significantly higher in symptomatic ERD patients compared to NERD patients (89.08 ± 21.67 vs. 58.53 ± 32.54; p < 0.001). Conclusions Patients with NERD were a generally hypersensitive group while asymptomatic ERD patients represent a hyposensitive group of patients which merits further study.