Symptoms and esophageal acid exposure characteristics between non-erosive reflux diseases and reflux esophagitis

Objective To compare the clinical symptoms and characteristics of esophageal acid exposure between non-erosive reflux disease(NERD) and reflux esophagitis(RE). Methods Gastroscopy and 24 h esophageal pH monitoring were performed in 155 patients suffered from acid regurgitation. Results Seventy-six of the 155 patients were confirmed as RE by endoscopy.Among them,the number of cases with grades A,B,C,D according to the diagnostic criteria by endoscopy were 40,24,8,and 4 cases,respectively,while the other 79 cases were diagnosed as NERD.Fifty-seven(75.0%) cases of RE and 26(32.9%) cases of NERD had an abnormal pH monitoring (P0.05).The incidence of extra-esophageal manifestations in the NERD group was higher than that in the RE(P0.05).No difference of typical reflux symptoms was found between the two groups.All parameters of acid reflux in RE group were significantly higher than those in NERD group(P0.05).The parameters of acid reflux of RE(LA-A) were lower than those in RE(LA-B) and RE(LA-C+D)(P0.05).However,the difference in acid reflux parameter between RE(LA-B)and RE(LA-C+D) had no statistical significance.In the 79 cases of NERD patients,according to the symptom of the monitoring day,there were 15 patients with pH negative SI positive,28 patients with pH negative SI negative,the pH4.0(%) and reflux episodes reflux of the NERD pH-SI+ was higher than that of the NERD pH-SI-. Conclusion Gastric acid reflux may be an important factor,in which the concentration of acid reflux and the long contacting with the esophageal mucosa may be the direct and important factors of esophageal mucosal injury.The degree of acid reflux may be correlated with the severity of RE.NERD may be divided into different subtypes according to the relationship between acid reflux and symptoms,the proportion of pathologic acid reflux may be lower,the acid reflux may not play the decisive role.