title: Non-erosive reflux disease compared with erosive esophagitis with regards to acid reflux and symptom patterns.
abstract: OBJECTIVE
  Non-erosive reflux disease and erosive esophagitis are the most common phenotypic presentations of gastroesophageal reflux disease. Recent reports suggest that patients with non-erosive reflux disease treated with antireflux medications show lower symptom improvement rates than patients with erosive esophagitis treated with the same medications. The aim was to assess the acid reflux and symptom patterns of patients with non-erosive reflux disease in comparison with those with erosive esophagitis and to identify different non-erosive reflux disease subgroups.
  
  
  METHODS
  One hundred and twenty consecutive patients (67 male, age: 37.6±12.9 years) seen for classic heartburn symptoms were evaluated for the study. The patients underwent upper endoscopy and 24-hour ambulatory pH monitoring.
  
  
  RESULTS
  Erosive esophagitis was identified in 51 patients and nonerosive reflux disease in 69 patients. According to pH metric findings (DeMeester Score >14.72 or Fraction Time >4%), 31.9% of the non-erosive reflux disease group and 47.1% of the erosive gastroesophageal reflux disease group had abnormal acid reflux (p=0.134). Erosive esophagitis patients showed a similar pattern of acid reflux to non-erosive reflux disease patients in the different positions (supine and upright). Non-erosive reflux disease-negative (normal pH test) patients demonstrated a significantly lower degree of esophageal acid exposure when compared with those with erosive esophagitis. About 10.6% of the non-erosive reflux disease-negative patients and 45.5% of the non-erosive reflux disease-positive (abnormal pH test) patients had a positive symptom index (≥50%) during the distal pH metry (p=0.003).
  
  
  CONCLUSIONS
  Acid reflux characteristics and symptom patterns suggest that the non-erosive reflux disease group represents a heterogeneous group of patients.
authors.affiliation: Research Center for Gastroenterology & Liver Disease, Shahid Beheshti University MC, Tehran, Islamic Republic of Iran. swt_f@yahoo.com
authors.forename: Mojgan
authors.initials: M
authors.lastname: Frootan
authors.forename: Sahar
authors.initials: S
authors.lastname: Choobtashani
authors.forename: Eznollah
authors.initials: E
authors.lastname: Azargashb
authors.forename: Pourhoseingholi Mohamad
authors.initials: PM
authors.lastname: Amin
authors.forename: Moosapour
authors.initials: M
authors.lastname: Hamide
authors.forename: Mohamad Reza
authors.initials: MR
authors.lastname: Zali
authors.forename: Ashraf
authors.initials: A
authors.lastname: Haleh
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D004942:Esophagitis, Peptic / Q000175:diagnosis*; D004945:Esophagoscopy; D005260:Female; D005744:Gastric Acid; D005764:Gastroesophageal Reflux / Q000175:diagnosis*; D005773:Gastroscopy; D006356:Heartburn / Q000209:etiology; D006801:Humans; D006863:Hydrogen-Ion Concentration; D008297:Male; D008875:Middle Aged; D055815:Young Adult