Nonerosive reflux disease: clinical concepts
Esophageal symptoms can arise from gastroesophageal reflux disease (GERD) as well as other mucosal and motor processes, structural disease, and functional esophageal syndromes. GERD is the most common esophageal disorder, but diagnosis may not be straightforward when symptoms persist despite empiric...
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| Veröffentlicht in: | Annals of the New York Academy of Sciences 2018-12, Vol.1434 (1), p.290-303 |
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| creator | Gyawali, C. Prakash Azagury, Dan E. Chan, Walter W. Chandramohan, Servarayan M. Clarke, John O. Bortoli, Nicola Figueredo, Edgar Fox, Mark Jodorkovsky, Daniela Lazarescu, Adriana Malfertheiner, Peter Martinek, Jan Murayama, Kenric M. Penagini, Roberto Savarino, Edoardo Shetler, Katerina P. Stein, Ellen Tatum, Roger P. Wu, Justin |
| description | Esophageal symptoms can arise from gastroesophageal reflux disease (GERD) as well as other mucosal and motor processes, structural disease, and functional esophageal syndromes. GERD is the most common esophageal disorder, but diagnosis may not be straightforward when symptoms persist despite empiric acid suppressive therapy and when mucosal erosions are not seen on endoscopy (as for nonerosive reflux disease, NERD). Esophageal physiological tests (ambulatory pH or pH‐impedance monitoring and manometry) can be of value in defining abnormal reflux burden and reflux–symptom association. NERD diagnosed on the basis of abnormal reflux burden on ambulatory reflux monitoring is associated with similar symptom response from antireflux therapy for erosive esophagitis. Acid suppression is the mainstay of therapy, and antireflux surgery has a definitive role in the management of persisting symptoms attributed to NERD, especially when the esophagogastric junction is compromised. Adjunctive approaches and complementary therapy may be of additional value in management. In this review, we describe the evaluation, diagnosis, differential diagnosis, and management of NERD. |
| doi_str_mv | 10.1111/nyas.13845 |
| format | Article |
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Prakash ; Azagury, Dan E. ; Chan, Walter W. ; Chandramohan, Servarayan M. ; Clarke, John O. ; Bortoli, Nicola ; Figueredo, Edgar ; Fox, Mark ; Jodorkovsky, Daniela ; Lazarescu, Adriana ; Malfertheiner, Peter ; Martinek, Jan ; Murayama, Kenric M. ; Penagini, Roberto ; Savarino, Edoardo ; Shetler, Katerina P. ; Stein, Ellen ; Tatum, Roger P. ; Wu, Justin</creator><creatorcontrib>Gyawali, C. Prakash ; Azagury, Dan E. ; Chan, Walter W. ; Chandramohan, Servarayan M. ; Clarke, John O. ; Bortoli, Nicola ; Figueredo, Edgar ; Fox, Mark ; Jodorkovsky, Daniela ; Lazarescu, Adriana ; Malfertheiner, Peter ; Martinek, Jan ; Murayama, Kenric M. ; Penagini, Roberto ; Savarino, Edoardo ; Shetler, Katerina P. ; Stein, Ellen ; Tatum, Roger P. ; Wu, Justin</creatorcontrib><description>Esophageal symptoms can arise from gastroesophageal reflux disease (GERD) as well as other mucosal and motor processes, structural disease, and functional esophageal syndromes. GERD is the most common esophageal disorder, but diagnosis may not be straightforward when symptoms persist despite empiric acid suppressive therapy and when mucosal erosions are not seen on endoscopy (as for nonerosive reflux disease, NERD). Esophageal physiological tests (ambulatory pH or pH‐impedance monitoring and manometry) can be of value in defining abnormal reflux burden and reflux–symptom association. NERD diagnosed on the basis of abnormal reflux burden on ambulatory reflux monitoring is associated with similar symptom response from antireflux therapy for erosive esophagitis. Acid suppression is the mainstay of therapy, and antireflux surgery has a definitive role in the management of persisting symptoms attributed to NERD, especially when the esophagogastric junction is compromised. Adjunctive approaches and complementary therapy may be of additional value in management. In this review, we describe the evaluation, diagnosis, differential diagnosis, and management of NERD.</description><identifier>ISSN: 0077-8923</identifier><identifier>EISSN: 1749-6632</identifier><identifier>DOI: 10.1111/nyas.13845</identifier><identifier>PMID: 29761528</identifier><language>eng</language><publisher>United States: Wiley Subscription Services, Inc</publisher><subject>ambulatory reflux monitoring ; antireflux surgery ; Diagnosis ; Differential diagnosis ; Endoscopy ; esophageal manometry ; Esophagitis ; Esophagus ; Gastroesophageal reflux ; Hernias ; Management ; Monitoring ; Mucosa ; nonerosive reflux disease ; pH effects ; Physiological tests ; proton pump inhibitors ; Structure-function relationships ; Surgery ; Therapy</subject><ispartof>Annals of the New York Academy of Sciences, 2018-12, Vol.1434 (1), p.290-303</ispartof><rights>2018 New York Academy of Sciences.</rights><rights>2018 The New York Academy of Sciences</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c3575-45cab2d7e8269db549cd054212945e2846876cd5ab6e92f194146714e9dc4f133</citedby><cites>FETCH-LOGICAL-c3575-45cab2d7e8269db549cd054212945e2846876cd5ab6e92f194146714e9dc4f133</cites><orcidid>0000-0002-3388-0660 ; 0000-0002-5156-6042</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1111%2Fnyas.13845$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1111%2Fnyas.13845$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>314,776,780,1411,27901,27902,45550,45551</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/29761528$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Gyawali, C. Prakash</creatorcontrib><creatorcontrib>Azagury, Dan E.</creatorcontrib><creatorcontrib>Chan, Walter W.</creatorcontrib><creatorcontrib>Chandramohan, Servarayan M.</creatorcontrib><creatorcontrib>Clarke, John O.</creatorcontrib><creatorcontrib>Bortoli, Nicola</creatorcontrib><creatorcontrib>Figueredo, Edgar</creatorcontrib><creatorcontrib>Fox, Mark</creatorcontrib><creatorcontrib>Jodorkovsky, Daniela</creatorcontrib><creatorcontrib>Lazarescu, Adriana</creatorcontrib><creatorcontrib>Malfertheiner, Peter</creatorcontrib><creatorcontrib>Martinek, Jan</creatorcontrib><creatorcontrib>Murayama, Kenric M.</creatorcontrib><creatorcontrib>Penagini, Roberto</creatorcontrib><creatorcontrib>Savarino, Edoardo</creatorcontrib><creatorcontrib>Shetler, Katerina P.</creatorcontrib><creatorcontrib>Stein, Ellen</creatorcontrib><creatorcontrib>Tatum, Roger P.</creatorcontrib><creatorcontrib>Wu, Justin</creatorcontrib><title>Nonerosive reflux disease: clinical concepts</title><title>Annals of the New York Academy of Sciences</title><addtitle>Ann N Y Acad Sci</addtitle><description>Esophageal symptoms can arise from gastroesophageal reflux disease (GERD) as well as other mucosal and motor processes, structural disease, and functional esophageal syndromes. GERD is the most common esophageal disorder, but diagnosis may not be straightforward when symptoms persist despite empiric acid suppressive therapy and when mucosal erosions are not seen on endoscopy (as for nonerosive reflux disease, NERD). Esophageal physiological tests (ambulatory pH or pH‐impedance monitoring and manometry) can be of value in defining abnormal reflux burden and reflux–symptom association. NERD diagnosed on the basis of abnormal reflux burden on ambulatory reflux monitoring is associated with similar symptom response from antireflux therapy for erosive esophagitis. Acid suppression is the mainstay of therapy, and antireflux surgery has a definitive role in the management of persisting symptoms attributed to NERD, especially when the esophagogastric junction is compromised. Adjunctive approaches and complementary therapy may be of additional value in management. In this review, we describe the evaluation, diagnosis, differential diagnosis, and management of NERD.</description><subject>ambulatory reflux monitoring</subject><subject>antireflux surgery</subject><subject>Diagnosis</subject><subject>Differential diagnosis</subject><subject>Endoscopy</subject><subject>esophageal manometry</subject><subject>Esophagitis</subject><subject>Esophagus</subject><subject>Gastroesophageal reflux</subject><subject>Hernias</subject><subject>Management</subject><subject>Monitoring</subject><subject>Mucosa</subject><subject>nonerosive reflux disease</subject><subject>pH effects</subject><subject>Physiological tests</subject><subject>proton pump inhibitors</subject><subject>Structure-function relationships</subject><subject>Surgery</subject><subject>Therapy</subject><issn>0077-8923</issn><issn>1749-6632</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2018</creationdate><recordtype>article</recordtype><recordid>eNp9kD1PwzAQQC0EoqWw8ANQJBaESLEdf3arKr6kqgzAwGQ5zkVKlSYlboD-exxSGBi45Zanp7uH0CnBYxLmutpaPyaJYnwPDYlkOhYioftoiLGUsdI0GaAj75cYE6qYPEQDqqUgnKohulrUFTS1L94haiAv288oKzxYD5PIlUVVOFtGrq4crDf-GB3ktvRwstsj9HJ78zy7j-ePdw-z6Tx2CZc8ZtzZlGYSFBU6SznTLsOcUUI14xBOEEoKl3GbCtA0J5oRJiRhoDPHcpIkI3TRe9dN_daC35hV4R2Upa2gbr2hONGdS3Xo-R90WbdNFa4zlHAudSihAnXZUy686sOfZt0UK9tsDcGma2i6hua7YYDPdso2XUH2i_5ECwDpgY-ihO0_KrN4nT710i9K0nm9</recordid><startdate>201812</startdate><enddate>201812</enddate><creator>Gyawali, C. 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GERD is the most common esophageal disorder, but diagnosis may not be straightforward when symptoms persist despite empiric acid suppressive therapy and when mucosal erosions are not seen on endoscopy (as for nonerosive reflux disease, NERD). Esophageal physiological tests (ambulatory pH or pH‐impedance monitoring and manometry) can be of value in defining abnormal reflux burden and reflux–symptom association. NERD diagnosed on the basis of abnormal reflux burden on ambulatory reflux monitoring is associated with similar symptom response from antireflux therapy for erosive esophagitis. Acid suppression is the mainstay of therapy, and antireflux surgery has a definitive role in the management of persisting symptoms attributed to NERD, especially when the esophagogastric junction is compromised. Adjunctive approaches and complementary therapy may be of additional value in management. 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| ispartof | Annals of the New York Academy of Sciences, 2018-12, Vol.1434 (1), p.290-303 |
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| language | eng |
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| source | Wiley Online Library Journals Frontfile Complete |
| subjects | ambulatory reflux monitoring antireflux surgery Diagnosis Differential diagnosis Endoscopy esophageal manometry Esophagitis Esophagus Gastroesophageal reflux Hernias Management Monitoring Mucosa nonerosive reflux disease pH effects Physiological tests proton pump inhibitors Structure-function relationships Surgery Therapy |
| title | Nonerosive reflux disease: clinical concepts |
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