Microscopic esophagitis distinguishes patients with non-erosive reflux disease from those with functional heartburn

Edoardo Savarino, Patrizia Zentilin, Luca Mastracci, Pietro Dulbecco, Elisa Marabotto, Lorenzo Gemignani, Luca Bruzzone, Nicola De Bortoli, Anna Chiara Frigo, Roberto Fiocca, Vincenzo Savarino

Research output: Contribution to journalArticlepeer-review

Abstract

Background Microscopic esophagitis (ME) is common in patients with non-erosive reflux disease (NERD), and dilation of intercellular spaces (DIS) has been regarded as the potential main mechanism of symptom generation. We aimed to compare these histological abnormalities in healthy volunteers (HVs) and patients with erosive esophagitis (EE), NERD, and functional heartburn (FH). Methods Consecutive patients with heartburn prospectively underwent upper endoscopy and impedance-pH off-therapy. Twenty EE patients and fifty-seven endoscopy- negative patients (NERD), subclassified as 22 with pH-POS (positive for abnormal acid exposure), 20 with hypersensitive esophagus (HE; normal acid/symptom association probability [SAP]+ or symptom index [SI]+), and 15 with FH (normal acid/SAP-/SI-/ proton pump inhibitor [PPI] test-), were enrolled. Twenty HVs were also included. In each patient/control, multiple specimens (n = 5) were taken from the distal esophagus and histological alterations were evaluated. ME was diagnosed when the global histological score was > 0.35. Results The prevalence of ME was higher (p

Original languageEnglish
Pages (from-to)473-482
Number of pages10
JournalJournal of Gastroenterology
Volume48
Issue number4
DOIs
Publication statusPublished - Apr 2013

Keywords

  • Dilated intercellular spaces
  • Functional heartburn
  • Gastroesophageal reflux
  • NERD

ASJC Scopus subject areas

  • Gastroenterology

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