Oesophageal hypersensitivity in Japanese patients with non-erosive gastro-oesophageal reflux diseases.
BACKGROUND
Visceral hypersensitivity plays a major role in the pathogenesis of non-erosive oesophageal reflux disease (NERD). Prevalence of NERD differs according to the population and geographical region. Oesophageal hypersensitivity in NERD has not been well studied, especially in Japanese patients.


OBJECTIVE
To investigate oesophageal hypersensitivity in Japanese NERD patients.


METHODS
We performed upper GI endoscopy and the modified acid perfusion test on 14 control subjects and 68 GERD patients, including 26 with NERD, 34 with erosive GERD, and six with Barrett's oesophagus. The stimulus-response function to acid was quantified by three parameters (lag time, intensity rating and the acid perfusion sensory score) and compared among four groups.


RESULTS
The mean value of the lag time, intensity rating, and acid perfusion scores in NERD patients (4.6 +/- 3.4, 4.4 +/- 3.4, 27.8 +/- 26.7, respectively) were higher than in erosive GERD (3.2 +/- 3.3, 3.0 +/- 3.2, 18.2 +/- 24.8) and Barrett patients (2.5 +/- 4.0, 1.8 +/- 3.3, 15.0 +/- 28.8), and significantly higher than in the control group (1.7 +/- 2.7, 1.1 +/- 2.0, 5.4 +/- 11.8). The ratio of patients with higher sensory scores was also greater in the NERD group (57.7%) than in erosive GERD (32.3%) and Barrett group (16.7%), and significantly greater than in control group (6.7%).


CONCLUSIONS
Our findings suggest that oesophageal sensitivity is likely to be enhanced especially in NERD patients also in Japanese population in comparison with erosive GERD, Barrett's oesophagus and controls.
Department of Gastroenterology, Juntendo University, School of Medicine, Tokyo, Japan.
H
H
Miwa
T
T
Minoo
M
M
Hojo
R
R
Yaginuma
A
A
Nagahara
M
M
Kawabe
A
A
Ohkawa
D
D
Asaoka
A
A
Kurosawa
T
T
Ohkusa
N
N
Sato
D000328:Adult; D001471:Barrett Esophagus / Q000150:complications; D004935:Esophageal Diseases / Q000150:complications*; D005260:Female; D005745:Gastric Acidity Determination; D005764:Gastroesophageal Reflux / Q000209:etiology*; D006356:Heartburn / Q000209:etiology; D006801:Humans; D008297:Male