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.