title: Stratification and symptom characteristics of non-erosive reflux disease based on acid and duodenogastroesophageal reflux.
abstract: OBJECTIVE
  The subgroups and symptom characteristics of non-erosive reflux disease (NERD) based on acid and duodenogastroesophageal reflux may be different in Chinese patients to Western patients. This study aimed to explore the stratification and symptom characteristics of patients with NERD.
  
  
  METHODS
  Patients with typical heartburn and/or acid regurgitation symptoms were enrolled. Each patient filled out a questionnaire. An upper gastrointestinal endoscopy was performed for each patient followed by simultaneous ambulatory 24-h esophageal pH and Bilitec (bilirubin) monitoring. A symptom index (SI) of > or =50% was considered to be positive.
  
  
  RESULTS
  Eighty-two consecutive NERD patients were evaluated. Abnormal (NERD pH+) and normal (NERD pH-) 24-h pH tests were found in 24 (29.3%) and 58 (70.7%) patients, respectively. Among 42 NERD pH- patients who reported heartburn symptoms during monitoring, SI was positive in 19 (45.2%) patients (NE-SI+) and negative in 23 (54.8%) patients (NE-SI-). Pathological duodenogastroesophageal reflux (DGER) was found in 43 (52.4%) patients. No significant differences were noted regarding the prevalence of other upper gastrointestinal symptoms, except for acid regurgitation in NERD pH+ and NERD pH- groups. Additionally, no significant differences were seen in the prevalence of other symptoms, except for chest pain, in groups with pathological and normal DGER.
  
  
  CONCLUSIONS
  The proportion of NERD patients with pathological acid reflux was somewhat lower than that reported in Western countries. The role of DGER in NERD may be important. It is difficult to differentiate whether NERD patients have pathological acid or bile reflux according to symptoms.
authors.affiliation: Department of Gastroenterology, First Affiliated Hospital, Sun Yat-Sen University, Guangzhou, China.
authors.forename: Li-Shou
authors.initials: LS
authors.lastname: Xiong
authors.forename: Min-Hu
authors.initials: MH
authors.lastname: Chen
authors.forename: Jin-Kun
authors.initials: JK
authors.lastname: Lin
authors.forename: Pin-Jin
authors.initials: PJ
authors.lastname: Hu
mesh_terms: D000328:Adult; D000368:Aged; D002637:Chest Pain / Q000453:epidemiology / Q000209:etiology; D002681:China / Q000453:epidemiology; D004383:Duodenogastric Reflux / Q000150:complications / Q000175:diagnosis* / Q000453:epidemiology / Q000503:physiopathology; D050782:Esophageal pH Monitoring; D005260:Female; D005764:Gastroesophageal Reflux / Q000150:complications / Q000175:diagnosis* / Q000453:epidemiology / Q000503:physiopathology; D005767:Gastrointestinal Diseases / Q000453:epidemiology / Q000209:etiology; D006356:Heartburn / Q000209:etiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D012720:Severity of Illness Index