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.
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: Vittorio Bresadola; Gian Luigi Adani; Francesco Londero; Cosimo Alex Leo; Vittorio Cherchi; Dario Lorenzin; Anna Rossetto; Gianmatteo Vit; Umberto Baccarani; Giovanni Terrosu; Dino De Anna Journal: World J Gastrointest Pathophysiol Date: 2011-06-15
Authors: Abdallah A Kobeissy; Jana G Hashash; Faek R Jamali; Assaad M Skoury; Reham Haddad; Sarah El-Samad; Rami Ladki; Rola Aswad; Assaad M Soweid Journal: World J Gastroenterol Date: 2012-05-21 Impact factor: 5.742
Authors: I M Modlin; R H Hunt; P Malfertheiner; P Moayyedi; E M Quigley; G N J Tytgat; J Tack; R C Heading; G Holtman; S F Moss Journal: Digestion Date: 2009-06-17 Impact factor: 3.216