Document Detail

Acid and non-acid reflux patterns in patients with erosive esophagitis and non-erosive reflux disease (NERD): a study using intraluminal impedance monitoring.
MedLine Citation:
PMID:  17934853     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Non-erosive reflux disease (NERD) and erosive esophagitis (EE) are the most common phenotypic presentations of gastroesophageal reflux disease (GERD). AIM: To assess acid and non-acid reflux patterns in patients with EE and NERD using combined esophageal pH-impedance monitoring. METHODS: A total of 26 GERD patients off acid-suppressive medication and ten healthy volunteers (HV) underwent upper endoscopy and 24-h pH-impedance monitoring. Analysis of the pH-impedance signals included total reflux time, number of reflux episodes according to gas-liquid composition, and pH (acid, non-acid). RESULTS: EE was identified in 13 patients and NERD in 13 patients. Pathologic acid reflux was found in 92.3 and 69.2% of patients with EE and NERD, respectively (P = 0.15). When compared to HV, EE patients and NERD patients showed a higher incidence of acid (P = 0.002 and P < 0.001, EE vs. HV and NERD vs. HV, respectively) and non-acid reflux episodes (P = 0.03 and P = 0.001, EE vs. HV and NERD vs. HV, respectively). Mean reflux times, as assessed by both pH-metry and impedance monitoring, and incidence of acid and non-acid reflux episodes were similar in EE and NERD patients. In the supine position, however, EE patients showed a higher incidence of acid (P = 0.048) and liquid reflux episodes (P = 0.07). CONCLUSION: Whereas EE patients have more acid reflux episodes in the supine position than NERD patients, patients with EE and NERD have similar non-acid reflux patterns. This observation lends support to the notion that non-acid reflux is less damaging to the esophageal mucosa than acid reflux.
José M Conchillo; Matthijs P Schwartz; Mohamed Selimah; Melvin Samsom; Daniel Sifrim; André J Smout
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Publication Detail:
Type:  Comparative Study; Journal Article    
Journal Detail:
Title:  Digestive diseases and sciences     Volume:  53     ISSN:  0163-2116     ISO Abbreviation:  Dig. Dis. Sci.     Publication Date:  2008 Jun 
Date Detail:
Created Date:  2008-07-07     Completed Date:  2008-08-05     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  7902782     Medline TA:  Dig Dis Sci     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1506-12     Citation Subset:  AIM; IM    
Department of Gastroenterology and Hepatology, University Medical Center, P.O. Box 85500, 3508 GA Utrecht, The Netherlands.
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MeSH Terms
Esophageal pH Monitoring / instrumentation*
Esophagitis, Peptic / physiopathology*
Gastroesophageal Reflux / physiopathology*
Middle Aged
Statistics, Nonparametric

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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