title: Esophageal Intraepithelial Neutrophil Infiltration is Common in Nigerian Patients With Non-Erosive Reflux Disease.
abstract: BACKGROUND
  Non-erosive reflux disease (NERD) is a variant of gastroesophageal reflux disease (GERD) in which patients with typical reflux symptoms have no evidence of erosive esophagitis at endoscopy. An objective diagnostic tool for NERD remains an unmet need for clinicians and researchers. This study was designed to determine the types of histological alterations seen in Nigerian patients with NERD.
  
  
  METHODS
  This was a prospective cross-sectional study in which mucosal biopsy was taken from the lower esophagus in patients with NERD. Similar biopsy was also taken from patients with nonulcer dyspepsia who served as controls. The materials were processed and examined histologically.
  
  
  RESULTS
  There were 68 patients with NERD and 60 patients with nonulcer dyspepsia. Intraepithelial neutrophil infiltration was significantly more frequent in patients with NERD compared to those with nonulcer dyspepsia (47.1% vs 13.3%, P = 0.0326). Epithelial proliferative chnges in the form of basal cell hyperplasia and papilla elongation were minimal (11.8% and 3.3% respectively).
  
  
  CONCLUSIONS
  Nigerian patients with NERD have a high degree of esophageal intraepithelial neutrophil infiltration and a low prevalence of epithelial proliferative changes. This may be related to the relative rarity of Barrett's esophagus in Nigerians.
authors.affiliation: Department of Medicine, University of Nigeria Teaching Hospital, Ituku/Ozalla, PMB 01129 Enugu, Nigeria.
authors.forename: Sylvester Chuks
authors.initials: SC
authors.lastname: Nwokediuko
authors.affiliation: Department of Medicine, University of Nigeria Teaching Hospital, Ituku/Ozalla, PMB 01129 Enugu, Nigeria.
authors.forename: Uchenna
authors.initials: U
authors.lastname: Ijoma
authors.affiliation: Department of Morbid Anatomy, University of Nigeria Teaching Hospital, Ituku/Ozalla, PMB 01129 Enugu, Nigeria.
authors.forename: Okechukwu
authors.initials: O
authors.lastname: Okafor
keywords: Esophagus; Intraepithelial; NERD; Neutrophil; Nigerians