Natural history of nonerosive reflux disease. Is all gastroesophageal reflux disease the same? What is the evidence?

Currently not much can be said about the natural history of NERD. The existing data show that GERD symptoms are common, affecting one out of five adults on a weekly basis, but they fluctuate dramatically and are associated with other forms of gastrointestinal symptoms. Clinic-based studies suggest that the natural history of NERD and GERD is the same in regard to symptom duration and ratings of symptom severity. These studies show some transition between NERD and erosive reflux disease. At present, there is a need to establish more accurately the clinical condition to be labeled as NERD. This condition should be defined by noninvasive tests. A true natural history study could be performed and address the question in more detail.