Significance of non-erosive minimal esophageal lesions in gastro-esophageal reflux disorder

• Published in: The Korean journal of internal medicine 2004-06, Vol.19 (2), p.93-98
• Main Authors: Hong, Sung-Pyo, Park, Pil-Won, Hwang, Seong-Gyu, Ko, Kwang-Hyun, Kwak, Sun-Young, Kim, Se-Hyun, Kwon, Kye-Sook, Shin, Yong-Woon, Ryu, Ji-Kon, Ryu, Kwang-Hyun, Park, Sang-Jong, Won, Wook-Hee, Yoo, Hyo-Min, Bae, Hyung-Mee, Park, Min-Jung, Woo, Yeol-Keun, Kim, Kyung-Chul, Kim, Kyung-Hee, Na, Seon-Hwa, Kim, Jung-Wan
• Format: Article
• Language: English
• Subjects: 2-Pyridinylmethylsulfinylbenzimidazoles; Adult; Aged; Aged, 80 and over; Anti-Ulcer Agents - therapeutic use; Benzimidazoles - therapeutic use; Enzyme Inhibitors - therapeutic use; Esophageal Diseases - pathology; Female; Follow-Up Studies; Gastroesophageal Reflux - drug therapy; Gastroesophageal Reflux - epidemiology; Gastroesophageal Reflux - pathology; Humans; Korea - epidemiology; Male; Middle Aged; Omeprazole - analogs & derivatives; Omeprazole - therapeutic use; Original; Prospective Studies; Proton-Translocating ATPases - antagonists & inhibitors; Rabeprazole; Treatment Outcome
• ISSN: 1226-3303; 2005-6648
• DOI: 10.3904/kjim.2004.19.2.93

Non-erosive reflux disorder, which represents more than 60% of gastro-esophageal reflux disorders, lacks objective parameters for diagnosis. The purpose of this study was to evaluate the correlation between non-erosive minimal lesions at the lower esophagus and gastro-esophageal reflux disorder. Patients were asked to answer a symptom questionnaire. The endoscopic findings were either graded by LA classification or recorded as non-erosive minimal lesions. Patients with minimal lesions were treated with rabeprazole or a placebo and responses were evaluated at weeks 1 and 4. In 8 centers, 3454 patients were screened. In patients with heartburn or acid regurgitation as the most bothersome symptom, 23.7% had endoscopy negative reflux disorder, 40.1% showed minimal lesions, and 36.20% had mucosal break esophagitis. Thirty-four percent of patients with minimal lesions and 39.1% of patients with LA 'grade A' mild esophagitis reported typical reflux symptoms as their main symptom. In patients with minimal lesions, medication with rabeprazole reduced symptoms significantly at weeks 1 and 4, but not with the placebo. Patients with non-erosive minimal esophageal lesions had similar reflux symptoms comparable to those with mild erosive reflux esophagitis, and reflux symptoms were improved with a short-term proton pump inhibitor. Thus, non-erosive minimal esophageal lesion constitutes a great part of gastro-esophageal reflux disorder.