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


METHODS
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.


RESULTS
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.


CONCLUSIONS
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.
Hong
Sung-Pyo
SP
Department of Internal Medicine, Pochon CHA University, Bundang, Korea. sphong@cha.ac.kr
Park
Pil-Won
PW
Hwang
Seong-Gyu
SG
Ko
Kwang-Hyun
KH
Kwak
Sun-Young
SY
Kim
Se-Hyun
SH
Kwon
Kye-Sook
KS
Shin
Yong-Woon
YW
Ryu
Ji-Kon
JK
Ryu
Kwang-Hyun
KH
Park
Sang-Jong
SJ
Won
Wook-Hee
WH
Yoo
Hyo-Min
HM
Bae
Hyung-Mee
HM
Park
Min-Jung
MJ
Woo
Yeol-Keun
YK
Kim
Kyung-Chul
KC
Kim
Kyung-Hee
KH
Na
Seon-Hwa
SH
Kim
Jung-Wan
JW
D053799:2-Pyridinylmethylsulfinylbenzimidazoles; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000897:Anti-Ulcer Agents / Q000627:therapeutic use*; D001562:Benzimidazoles / Q000627:therapeutic use*; D004791:Enzyme Inhibitors / Q000627:therapeutic use*; D004935:Esophageal Diseases / Q000473:pathology*; D005260:Female; D005500:Follow-Up Studies; D005764:Gastroesophageal Reflux / Q000188:drug therapy / Q000453:epidemiology / Q000473:pathology*; D006801:Humans; D007723:Korea / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D009853:Omeprazole / Q000031:analogs & derivatives* / Q000627:therapeutic use; D011446:Prospective Studies; D006180:Proton-Translocating ATPases / Q000037:antagonists & inhibitors*; D064750:Rabeprazole; D016896:Treatment Outcome
D053799:2-Pyridinylmethylsulfinylbenzimidazoles; D000897:Anti-Ulcer Agents; D001562:Benzimidazoles; D004791:Enzyme Inhibitors; D064750:Rabeprazole; D006180:Proton-Translocating ATPases; D009853:Omeprazole