Korean J Intern Med.  2004 Jun;19(2):93-98.

Significance of Non-erosive Minimal Esophageal Lesions in Gastro-esophageal Reflux Disorder

Affiliations
  • 1Department of Internal Medicine, Pochon CHA University, Bundang, Korea. sphong@cha.ac.kr
  • 2Department of Preventive Medicine, Pochon CHA University, Bundang, Korea.
  • 3Department of Internal Medicine, Inha University, Incheon, Korea.
  • 4Department of Internal Medicine, Bundang Jesaeng General Hospital, Korea.
  • 521st Century Clinic, Seoul Clinic, Korea.
  • 6Yonsei Plus Clinic, Korea.
  • 7Medipia Clinic, Korea.
  • 8Happy Clinic, Sungnam, Korea.

Abstract

BACKGROUND
Non-erosive reflux disorder, which represents more than 60% of gastro-esophageal reflux disorders, lacks objective parameters for diagnosis. The purpose of this study was to evaluate the correlation between non-erosive minimal lesions at the lower esophagus and gastro-esophageal reflux disorder. METHODS: Patients were asked to answer a symptom questionnaire. The endoscopic findings were either graded by LA classification or recorded as non-erosive minimal lesions. Patients with minimal lesions were treated with rabeprazole or a placebo and responses were evaluated at weeks 1 and 4. RESULTS: In 8 centers, 3454 patients were screened. In patients with heartburn or acid regurgitation as the most bothersome symptom, 23.7% had endoscopy negative reflux disorder, 40.1% showed minimal lesions, and 36.2% had mucosal break esophagitis. Thirty-four percent of patients with minimal lesions and 39.1% of patients with LA 'grade A' mild esophagitis reported typical reflux symptoms as their main symptom. In patients with minimal lesions, medication with rabeprazole reduced symptoms significantly at weeks 1 and 4, but not with the placebo. CONCLUSION: Patients with non-erosive minimal esophageal lesions had similar reflux symptoms comparable to those with mild erosive reflux esophagitis, and reflux symptoms were improved with a short-term proton pump inhibitor. Thus, non-erosive minimal esophageal lesion constitutes a great part of gastro-esophageal reflux disorder.

Keyword

Gastro-esophageal Reflux Disease; Endoscopes; Gastrointestinal

MeSH Terms

2-Pyridinylmethylsulfinylbenzimidazoles
Adult
Aged
Aged, 80 and over
Anti-Ulcer Agents/*therapeutic use
Benzimidazoles/*therapeutic use
Enzyme Inhibitors/*therapeutic use
Esophageal Diseases/*pathology
Female
Follow-Up Studies
Gastroesophageal Reflux/drug therapy/epidemiology/*pathology
Humans
Korea/epidemiology
Male
Middle Aged
Omeprazole/*analogs & derivatives/therapeutic use
Prospective Studies
Proton-Translocating ATPases/*antagonists & inhibitors
Treatment Outcome
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