Comparison of symptoms and gastric acid reflux between non-erosive reflux diseases and reflux esophagitis in children

Objectives Comparing the clinical symptoms and characteristics of esophageal acid exposure between non-erosive reflux disease(NERD)and reflux esophagitis(RE)in children.Methods One hundred and twenty-seven(127)patients with vomiting and acid regurgitation and diagnosed as gastroesophageal refiux disease(GERD)were divided into NERD group and RE group according to gastroscopic findings.Symptoms and the severity of esophageal acid exposure by twenty-four-hour esophageal pH monitoring in the two groups were compared.Results Of 127 children,79(62.2%)had NERD and 48(37.8%)had RE.Among them,the number of cases with grades Ⅰ,Ⅱ and Ⅲ RE was 34,10 and 4 respectively.The positive rate of acid reflux in NERD group was(64.6%),while 62.5% in RE group(χ2 = 0.05,P 0.05).The incidence of vomiting/regurgitation,abdominal pain,extra-esophageal manifestations in the NERD group was higher than that in the RE(P 0.05).No differences of acid regurgitation and heartburn/retrosternal pain were found between the two groups.The accumulated regurgitation frequencies and the percentage of regurgitation with pH 4 in patients with RE are significantly higher than those in NERD patients(P 0.05).All parameters of abnormal acid ruflux in RE group were significantly higher than those in NERD group(P 0.05).There were no differences of parameters of acid ruflux among patients with different grade RE(P 0.05).Conclusions The incidence of the atypical reflux symptom and extra-esophageal manifestations are more prevalent in children with NERD.The development of GERD was closely related to gastric acid reflux.Prolonged acid exposure and more reflux frequency may be important factors to result in RE.Quantity of acid reflux was not clearly correlative with the severity of RE.