Abstract
BackgroundOur aim in the present study was to compare patients presenting with gastroesophageal reflux disease in the presence or absence of mild-grade esophagitis (grade I or II according to the Savary-Miller classification).MethodsBetween 2005 and 2007, 215 patients with gastroesophageal reflux disease (67 with reflux associated with grade I or II esophagitis and 148 without esophagitis) were evaluated at the Department of Surgery, University Hospital Tor Vergata, Rome, and were included in the present study. The evaluations consisted of clinical interviews, endoscopy of the high digestive tract, esophageal manometry and pH monitoring.ResultsThere was no significant difference between the two groups with regard to age, sex or symptoms. The incidence of heartburn associated with noncardiac chest pain was greater in the esophagitis group than in the dysphagia group. The incidence of hiatal hernia was similar in both groups. Although the motor pattern was similar in both groups, the length of the abdominal esophagus was greater in patients without esophagitis (1.6 cm vs 1.1 cm; P < 0.05). The reflux pattern was nearly identical in both groups.ConclusionsGastroesophageal reflux without esophagitis must be regarded not as a milder form of the disease but as part of a single disease. Furthermore, these patients often demonstrate lower rates of symptom improvement after antireflux treatment in comparison with patients with erosive esophagitis. Therefore, further trials to assess the treatment algorithm for these patients are warranted.
Highlights
Our aim in the present study was to compare patients presenting with gastroesophageal reflux disease in the presence or absence of mild-grade esophagitis
Between 2005 and January 2007, 258 consecutive patients with Gastroesophageal reflux disease (GERD) symptoms were evaluated at the Department of Surgery, Tor Vergata University Hospital, Rome
A significant association between heartburn and noncardiac chest pain (NCCP) was recorded in 38.8% of RE patients and 9.4% of the RE-free group (χ2 = 24.811; P = 0.0001)
Summary
Our aim in the present study was to compare patients presenting with gastroesophageal reflux disease in the presence or absence of mild-grade esophagitis (grade I or II according to the Savary-Miller classification). Gastroesophageal reflux disease (GERD) represents an important medical problem in Western countries: about 20% of the population in Western countries complain of experiencing typical symptoms of this disease (heartburn and acid regurgitation). GERD is associated with a variety of lesions, including esophageal erosion, ulceration, stricture and Barrett’s esophagus. Reflux-related symptoms and lesions do not necessarily coexist, given that about 30% to 70% of patients who complain of typical symptoms have no signs of esophagitis based on endoscopy [1]. Nonerosive reflux disease (NERD) and erosive esophagitis (EE) represent the most common clinical features of GERD. The increasing use of 24-hour pHmetry allowed us to select patients with or without an increase in the acidification time of the esophagus
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