Theme |
Recent Advances in Diagnosis and Treatment of Reflux Esophagitis |
Title |
Pathogenesis of Endoscopy Negative GERD (NERD) |
Author |
Hiroto Miwa |
Department of Gastroenterology, Hyogo Colledge of Medicine |
Author |
Kazutoshi Hori |
Department of Gastroenterology, Hyogo Colledge of Medicine |
Author |
Toshihiko Tomita |
Department of Gastroenterology, Hyogo Colledge of Medicine |
[ Summary ] |
Gastroesophageal reflux diseases (GERD) is a complex of diseases with reflux of gastric contents into the esophagus, regardless of the presence of esophageal mucosal injuries. Patients with reflux symptoms and endoscopically detected esophageal erosions are regarded as being endoscopy negative GERD or NERD. This new concept is important because these patients are majority in GERD. Endoscopy negative GERD had been thought to be a milder form of erosive GERD. However, recent advances in the understanding of the pathogenesis has shown that these two diseases may be different. Esophageal hypersensitivity, motility disorder, or psychosomatic disorders are involved in the pathogenesis of endoscopy negative GERD, in which we pay particular attention to esophageal hypersensitivity. |