Nonerosive reflux disease: clinical concepts

Annals of the New York Academy of Sciences
C Prakash GyawaliJustin C Y Wu

Abstract

Esophageal symptoms can arise from gastroesophageal reflux disease (GERD) as well as other mucosal and motor processes, structural disease, and functional esophageal syndromes. GERD is the most common esophageal disorder, but diagnosis may not be straightforward when symptoms persist despite empiric acid suppressive therapy and when mucosal erosions are not seen on endoscopy (as for nonerosive reflux disease, NERD). Esophageal physiological tests (ambulatory pH or pH-impedance monitoring and manometry) can be of value in defining abnormal reflux burden and reflux-symptom association. NERD diagnosed on the basis of abnormal reflux burden on ambulatory reflux monitoring is associated with similar symptom response from antireflux therapy for erosive esophagitis. Acid suppression is the mainstay of therapy, and antireflux surgery has a definitive role in the management of persisting symptoms attributed to NERD, especially when the esophagogastric junction is compromised. Adjunctive approaches and complementary therapy may be of additional value in management. In this review, we describe the evaluation, diagnosis, differential diagnosis, and management of NERD.

References

Mar 27, 1997·The New England Journal of Medicine·R K Mittal, D H Balaban
Mar 26, 1998·European Journal of Gastroenterology & Hepatology·R C HeadingM Wienbeck
Sep 11, 1999·Journal of Gastrointestinal Surgery : Official Journal of the Society for Surgery of the Alimentary Tract·G M CamposC G Bremner
Jul 10, 2001·Surgical Endoscopy·A R PerezD W Rattner
May 10, 2003·The American Journal of Gastroenterology·John E PandolfinoPeter J Kahrilas
Jul 19, 2003·Clinical Transplantation·Denis HadjiliadisScott M Palmer
Jan 26, 2005·The American Journal of Gastroenterology·Samer CharbelMichael F Vaezi
Apr 12, 2005·Clinical Gastroenterology and Hepatology : the Official Clinical Practice Journal of the American Gastroenterological Association·Chandra Prakash, Ray E Clouse
May 4, 2005·The Journal of Thoracic and Cardiovascular Surgery·Frank D'OvidioShaf Keshavjee
Jun 2, 2005·The Surgical Clinics of North America·Patricia A Limpert, Keith S Naunheim
Aug 27, 2005·Gut·A J BredenoordA J P M Smout
Mar 18, 2006·The American Journal of Gastroenterology·Chandra Prakash, Ray E Clouse
Jul 20, 2006·The American Journal of Gastroenterology·Frank ZerbibDaniel Sifrim
Aug 16, 2006·Alimentary Pharmacology & Therapeutics·R ThibaultJ P Galmiche
Jul 12, 2007·Surgical Endoscopy·Craig B MorgenthalC Daniel Smith
Aug 11, 2007·American Journal of Physiology. Gastrointestinal and Liver Physiology·Sudip K GhoshPeter J Kahrilas
Sep 19, 2007·Alimentary Pharmacology & Therapeutics·R DickmanR Fass
Mar 13, 2008·Gut·Mark Fox, Werner Schwizer
Sep 9, 2008·The American Journal of Gastroenterology·Edoardo SavarinoVincenzo Savarino
Nov 11, 2008·Surgery for Obesity and Related Diseases : Official Journal of the American Society for Bariatric Surgery·J Esteban VarelaNinh T Nguyen
Feb 3, 2009·Gastrointestinal Endoscopy·Robert A GanzDean Klein
Aug 5, 2009·Neurogastroenterology and Motility : the Official Journal of the European Gastrointestinal Motility Society·G J M HemminkA J P M Smout
Aug 20, 2009·The American Journal of Gastroenterology·William J BulsiewiczJohn E Pandolfino
Sep 1, 2009·The Journal of Heart and Lung Transplantation : the Official Publication of the International Society for Heart Transplantation·Benjamin J KingMartin R Carby
Nov 19, 2009·The American Journal of Gastroenterology·Vladimir M KushnirC Prakash Gyawali
Jan 14, 2010·Neurogastroenterology and Motility : the Official Journal of the European Gastrointestinal Motility Society·I NasrS S C Rao
May 18, 2010·The British Journal of Surgery·J A BroedersH G Gooszen
Aug 14, 2010·World Journal of Surgery·Urs ZinggGlyn G Jamieson
Nov 4, 2010·Digestive Diseases and Sciences·Vladimir M KushnirC Prakash Gyawali
Jan 29, 2011·World Journal of Gastroenterology : WJG·Anne L KrarupAsbjørn M Drewes
Feb 10, 2011·Alimentary Pharmacology & Therapeutics·J TackN Rommel
Mar 8, 2011·Digestive and Liver Disease : Official Journal of the Italian Society of Gastroenterology and the Italian Association for the Study of the Liver·Edoardo SavarinoVincenzo Savarino
Mar 23, 2011·Surgical Endoscopy·Walter W ChanC Prakash Gyawali
May 19, 2011·JAMA : the Journal of the American Medical Association·Jean-Paul GalmicheUNKNOWN LOTUS Trial Collaborators
May 24, 2011·Journal of Neurogastroenterology and Motility·Georgios KaramanolisSpiros D Ladas

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Citations

Aug 20, 2020·Annals of the New York Academy of Sciences·John O ClarkeMarcelo F Vela
Jun 11, 2020·Esophagus : Official Journal of the Japan Esophageal Society·Liting XiAirong Wu
Jun 24, 2020·Neurogastroenterology and Motility : the Official Journal of the European Gastrointestinal Motility Society·Nicola de BortoliEdoardo V Savarino
Jun 14, 2021·Phytomedicine : International Journal of Phytotherapy and Phytopharmacology·Jiaqi ZhangXudong Tang

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