Outcome of nonerosive gastro-esophageal reflux disease patients with pathological acid exposure

Fabio Pace, Stefano Pallotta, Gianpiero Manes, Annalisa De Leone, Patrizia Zentilin, Luigi Russo, Vincenzo Savarino, Matteo Neri, Enzo Grossi, Rosario Cuomo

Research output: Contribution to journalArticlepeer-review


AIM: To assess the management and outcome of nonerosive gastro-esophageal reflux disease (NERD) patients who were identified retrospectively, after a 5-year follow-up. METHODS: We included patients with gastro-esophageal reflux disease (GERD) symptoms who had a negative endoscopy result and pathological 24-h esophageal pH-monitoring while off therapy. We interviewed them after an average period of 5 years (range 3.5-7 years) by means of a structured questionnaire to assess presence of GERD symptoms, related therapy, updated endoscopic data and other features. We assessed predictors of esophagitis development by means of univariate and multivariate statistical analysis. RESULTS: 260 patients (137 women) were included. Predominant GERD symptoms were heartburn and regurgitation in 103/260 (40%). 70% received a maintenance treatment, which was proton pump inhibitor (PPI) in 55% of cases. An average number of 1.5 symptomatic relapses per patient/year of followup were observed. A progression to erosive gastroesophageal reflux disease (ERD) was found in 58/193 (30.0%) of patients undergoing repeat endoscopy; 72% of these were Los Angeles grade A-B. CONCLUSION: This study shows that progression to ERD occurs in about 5% of NERD cases per year, despite therapy. Only two factors consistently and independently influence progression: smoking and absence of PPI therapy.

Original languageEnglish
Pages (from-to)5700-5705
Number of pages6
JournalWorld Journal of Gastroenterology
Issue number45
Publication statusPublished - Dec 7 2009


  • Acidity
  • Epidemiology
  • Esophagus
  • Gastro-esophageal reflux disease
  • Nonerosive gastro-esophageal reflux disease

ASJC Scopus subject areas

  • Gastroenterology


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