Demographic, Clinical, and Psychological Characteristics of the Heartburn Groups Classified Using the Rome III Criteria and Factors Associated with the Responsiveness to Proton Pump Inhibitors in the Gastroesophageal Reflux Disease Group

Abstract

Background/Aims: The diagnostic criteria for nonerosive reflux disease (NERD) and functional heartburn (FH) have been changed. We investigated demographic, clinical, and psychological characteristics of the heartburn groups classified using the Rome III criteria and factors associated with the responsiveness to proton pump inhibitors (PPIs) in the gastroesophageal reflux disease (GERD) group. Methods: Ninety-five patients with heartburn underwent endoscopy, 24-hour esophageal pH-metry and then a PPI test. NERD was diagnosed when % time with pH <4 was >4%, a symptom index (SI) ≥50% or a positive PPI test in patients without erosive esophagitis. Patients without such findings were classified as FH. Results: Thirty-six patientshad erosive reflux disease (ERD), 36 had NERD, and 23 had FH. The proportion of males was significantly higher in ERD than in FH. Atypical symptoms and IBS were more prevalent in FH than in ERD. Anxiety was more prevalent in FH than in NERD. The prevalence of pathologic acid reflux, a positive SI and a positive PPI test was similar between ERD and NERD patients. In the ERD and NERD groups, depression was independently associated with nonresponsiveness to PPIs. Conclusions: FH is a different entity from ERD or NERD, particularly in terms of gender, acid reflux patterns, psychological profiles, and the responsiveness to PPIs.

Non-erosive reflux disease rather than cervical inlet patch involves globus

“…Conversely, since asymptomatic ERD was significantly less prevalent in globus patients in this study, patients with such an insensitive esophagus may be resistant to generating a globus sensation. In general, functional gastrointestinal disorders often overlap, and patients with functional heartburn have been reported to have coexisting irritable bowel syndrome more frequently than ERD patients [37]. This finding and the positive association of globus with NERD in this study may indicate an overlap between globus and functional heartburn among NERD cases, probably through a common etiology, such as visceral hypersensitivity.…”

Gastro oesophageal reflux disease (GORD)-related symptoms and its association with mood and anxiety disorders and psychological symptomology: a population-based study in women

“…Gastro-oesophageal reflux disease (GORD) is a common condition due to stomach content flowing back through the lower oesophageal sphincter (LOS), causing bothersome symptomatology characterized by acid regurgitation and heartburn [5]. Prevalence figures vary from 20% of the general population in the United States and the United Kingdom to 5% in China, with Australian studies reporting a prevalence of 9.2% [6,7].…”

Practice Pattern of Gastroenterologists for the Management of GERD Under the Minimal Influence of the Insurance Reimbursement Guideline: A Multicenter Prospective Observational Study

“…Heartburn in patients without erosive esophagitis is considered to be NERD or functional heartburn. Functional heartburn is believed to be a different entity from NERD, particularly in terms of acid reflux patterns and the responsiveness to PPIs (13). Functional heartburn can be diagnosed when there are no abnormal acid or nonacid esophageal reflux, no symptom correlation with reflux, and no response to PPIs (14).…”