Nonerosive Reflux Disease (NERD): Pathophysiology and treatment guideline

Abstract

Non-Erosive Reflux Disease (NERD) is classified as a subcategory of Gastro-Esophageal Reflux Disease (GERD), which have been found most commonly in the Western and Asian countries. The characteristics of the disease include reflux-related symptoms such as heartburn and acid regurgitation with the absence of esophageal mucosal erosions at conventional endoscopy. The exact pathophysiology of the disease is not exactly known, but it is believed that the symptoms of the disease are correlated with some physical factors such as the failure of mucosal barrier, esophageal hypersensitivity and psychological factors. The current treatment involves the use of proton pump inhibitors. The treatment has been shown to be effective in most patients, however the resistance to the treatment can be still found in some patients. Therefore, further studies involving pathophysiology of the disease should lead to the development of guideline for effective treatment, which can be a better alternative for these patients in the future.

Key words: Non-Erosive Reflux Disease, Gastro-Esophageal Reflux Disease, Proton pump inhibitor