Document Detail


Strategy for treatment of nonerosive reflux disease in Asia.
MedLine Citation:
PMID:  18506915     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
The paper is to review the clinical and pathophysiologic differences between of nonerosive reflux disease (NERD) and reflux esophagitis (RE), and to propose a treatment strategy for NERD, especially for patients in Asia. A Medline search was performed regarding the clinical and pathophysiologic differences between NERD and RE, and treatment of NERD and RE. The characteristics of NERD patients in Asia are as follows: (1) high proportion of female patients, (2) low frequency of hiatal hernia, (3) high frequency of H pylori infection, (4) severe glandular atrophy of the gastric mucosa, and (5) frequent resistance to proton pump inhibitor (PPI) therapy. In Asian NERD patients, exposure of the esophagus to acid is not increased, and esophageal motility is normal. These characteristics are similar to those of patients in Western countries. Our recommended first-choice treatment is administration of PPI in combination with a prokinetic agent. However, at present, because there is limited evidence regarding effective treatments for NERD, it is best to try several different treatment strategies to find the best treatment for each patient.
Authors:
Toru Hiyama; Masaharu Yoshihara; Shinji Tanaka; Ken Haruma; Kazuaki Chayama
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Publication Detail:
Type:  Journal Article; Review    
Journal Detail:
Title:  World journal of gastroenterology : WJG     Volume:  14     ISSN:  1007-9327     ISO Abbreviation:  World J. Gastroenterol.     Publication Date:  2008 May 
Date Detail:
Created Date:  2008-05-28     Completed Date:  2008-08-21     Revised Date:  2009-11-18    
Medline Journal Info:
Nlm Unique ID:  100883448     Medline TA:  World J Gastroenterol     Country:  China    
Other Details:
Languages:  eng     Pagination:  3123-8     Citation Subset:  IM    
Affiliation:
Health Service Center, Hiroshima University, 1-7-1 Kagamiyama, Higashihiroshima 739-8521, Japan. tohiyama@hiroshima-u.ac.jp
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MeSH Terms
Descriptor/Qualifier:
Asia
Atrophy
Drug Resistance
Esophagitis, Peptic / etiology,  pathology,  physiopathology
Esophagus / drug effects*,  pathology,  physiopathology
Female
Gastric Mucosa / microbiology,  pathology
Gastroesophageal Reflux / drug therapy*,  etiology,  pathology,  physiopathology
Gastrointestinal Agents / therapeutic use*
Helicobacter Infections / complications,  microbiology
Helicobacter pylori
Hernia, Hiatal / complications
Humans
Male
Middle Aged
Practice Guidelines as Topic
Proton Pump Inhibitors / therapeutic use
Risk Factors
Treatment Outcome
Chemical
Reg. No./Substance:
0/Gastrointestinal Agents; 0/Proton Pump Inhibitors
Comments/Corrections

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


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