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

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Abstract

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.

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Acknowledgments

We thank the Malaysian Society of Gastroenterology and Hepatology Research Grant 2008 for partial financial support and Eisai HHC Malaysia for supplies of trial medication.

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Authors and Affiliations

  1. Department of Medicine, University of Malaya, 50603, Kuala Lumpur, Malaysia

    Juanda L. Hartono, Choon-Seng Qua & Khean-Lee Goh

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  1. Juanda L. Hartono
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  2. Choon-Seng Qua
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  3. Khean-Lee Goh
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Correspondence to Khean-Lee Goh.

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Hartono, J.L., Qua, CS. & Goh, KL. Non-Erosive Reflux Disease (NERD), Symptomatic and Asymptomatic Erosive Reflux Disease (ERD): From Hypersensitive to Hyposensitive Esophagus. Dig Dis Sci 56, 90–96 (2011). https://doi.org/10.1007/s10620-010-1275-5

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  • DOI: https://doi.org/10.1007/s10620-010-1275-5

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