title: Nonerosive gastroesophageal reflux disease and mild degree of esophagitis: comparison of symptoms endoscopic, manometric and pH-metric patterns.
abstract: BACKGROUND
  Our aim in the present study was to compare patients presenting with gastroesophageal reflux disease in the presence or absence of mild-grade esophagitis (grade I or II according to the Savary-Miller classification).
  
  
  METHODS
  Between 2005 and 2007, 215 patients with gastroesophageal reflux disease (67 with reflux associated with grade I or II esophagitis and 148 without esophagitis) were evaluated at the Department of Surgery, University Hospital Tor Vergata, Rome, and were included in the present study. The evaluations consisted of clinical interviews, endoscopy of the high digestive tract, esophageal manometry and pH monitoring.
  
  
  RESULTS
  There was no significant difference between the two groups with regard to age, sex or symptoms. The incidence of heartburn associated with noncardiac chest pain was greater in the esophagitis group than in the dysphagia group. The incidence of hiatal hernia was similar in both groups. Although the motor pattern was similar in both groups, the length of the abdominal esophagus was greater in patients without esophagitis (1.6 cm vs 1.1 cm; P < 0.05). The reflux pattern was nearly identical in both groups.
  
  
  CONCLUSIONS
  Gastroesophageal reflux without esophagitis must be regarded not as a milder form of the disease but as part of a single disease. Furthermore, these patients often demonstrate lower rates of symptom improvement after antireflux treatment in comparison with patients with erosive esophagitis. Therefore, further trials to assess the treatment algorithm for these patients are warranted.
authors.affiliation: Department of Surgery, University Hospital Tor Vergata, Viale Oxford 81, I-00133 Rome, Italy.
authors.forename: Michele
authors.initials: M
authors.lastname: Grande
authors.forename: Pierpaolo
authors.initials: P
authors.lastname: Sileri
authors.forename: Grazia Maria
authors.initials: GM
authors.lastname: Attinà
authors.forename: Elisabetta
authors.initials: E
authors.lastname: De Luca
authors.forename: Paolo
authors.initials: P
authors.lastname: Ciano
authors.forename: Carolina Ilaria
authors.initials: CI
authors.lastname: Ciangola
authors.forename: Federica
authors.initials: F
authors.lastname: Cadeddu
mesh_terms: D000328:Adult; D000368:Aged; D016009:Chi-Square Distribution; D016145:Endoscopy, Digestive System; D004942:Esophagitis, Peptic / Q000175:diagnosis / Q000473:pathology*; D005260:Female; D005764:Gastroesophageal Reflux / Q000175:diagnosis / Q000473:pathology*; D006801:Humans; D008297:Male; D008365:Manometry; D008875:Middle Aged; D012307:Risk Factors; D012720:Severity of Illness Index; D055815:Young Adult