Nonerosive Gastroesophageal Reflux Disease And Mild Degree Of Esophagitis: Comparison Of Symptoms, Endoscopic, Manometric And Ph-Metric Patterns

ABSTRACT: OBJECTIVE: To compare patients presenting with gastroesophageal reflux disease in presence or in absence of mild grade of esophagitis (I-II according Savary-Miller's classification). MATERIALS AND METHOD: S: Between 2005 and 2007, two hundred and fifteen patients with gastroesophageal reflux disease (67 with reflux associated to I-II degree esophagitis and 148 without esophagitis) were evaluated at the Department of Surgery, University Hospital Tor Vergata Rome and were included in the present study. Evaluation consisted of clinical interview, endoscopy of the high digestive tract, esophageal manometry and pH monitoring. RESULTS: : There was no significant difference between the 2 groups in age, sex or symptoms. The incidence of heartburn associated to non cardiac chest pain was greater in the esophagitis group as dysphagia. The incidence of hiatal hernia was similar in both groups. Although the motor pattern was similar in both groups, the length of abdominal esophagus was greater in patients without esophagitis (1.6 cm vs 1.1 cm, p<0.05). The reflux pattern was near identical in both groups. CONCLUSIONS: : Gastroesophageal reflux without esophagitis can not be regarded as a milder form of the disease but as part of a single disease. Furthermore, these patients often demonstrate lower rates of symptom improvement after antireflux treatment, in comparison with erosive esophagitis patients. Therefore, further trials to assess the treatment algorithm for these patients are warranted.