title: Non-erosive and erosive gastroesophageal reflux diseases: No difference with regard to reflux pattern and motility abnormalities.
abstract: 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).
  
  
  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.affiliation: Department of Hepatogastroenterology, Institute for Clinical and Experimental Medicine (IKEM), Prague, Czech Republic. jan.martinek@medicon.cz
authors.forename: Jan
authors.initials: J
authors.lastname: Martínek
authors.forename: Marek
authors.initials: M
authors.lastname: Benes
authors.forename: Tomás
authors.initials: T
authors.lastname: Hucl
authors.forename: Pavel
authors.initials: P
authors.lastname: Drastich
authors.forename: Petr
authors.initials: P
authors.lastname: Stirand
authors.forename: Julius
authors.initials: J
authors.lastname: Spicák
mesh_terms: D000328:Adult; D016099:Endoscopy, Gastrointestinal; D015154:Esophageal Motility Disorders / Q000150:complications; D004942:Esophagitis, Peptic / Q000150:complications* / Q000473:pathology; D004947:Esophagus / Q000473:pathology / Q000503:physiopathology; D005260:Female; D005764:Gastroesophageal Reflux / Q000150:complications / Q000473:pathology / Q000503:physiopathology*; D006801:Humans; D008297:Male; D008875:Middle Aged