Non-Erosive Reflux Disease (NERD) and Erosive Esophagitis - a Spectrum of Disease or Special Entities?

Zusammenfassung

Das Verständnis der natürlichen Geschichte der gastroösohagealen Refluxerkrankung (reflux oesophagitis oder Gastroesophageal Reflux Disease, GERD) hat eine bedeutende Auswirkung auf die langfristige Behandlung der Krankheit. Wenn man die momentan zur Verfügung stehenden Studien bezüglich des natürlichen Verlaufs der GERD auswertet, zeigt sich, dass die GERD derzeit in drei verschiedene Phänotypen aufgeteilt wird. Zudem teilt sich das Forschungsfeld momentan in zwei verschiedene Lager, die sich entweder für oder gegen einen Paradigmenwechsel im natürlichen Verlauf der GERD aussprechen. Entsprechend der grössten (bezügl. der Population) und längsten Studien, die den natürlichen Verlauf der GERD untersuchten, wurde im Verlauf der Zeit nur bei 10 % der Patienten ein Fortschreiten von NERD zur erosiven Ösophagitis entdeckt. Der Großteil der GERD Patienten blieb jedoch im Rahmen seines jeweiligen phänotypischen Erscheinungsbildes der GERD.

Abstract

An understanding of the natural history of GERD has an important impact on the long-term management of the disorder. By assessing the currently available studies that evaluated the natural course of GERD, a new conceptual framework that suggests that GERD is composed of three distinct phenotypic presentations has been recently proposed. Presently, the field has been divided into two camps that support or oppose a paradigm shift in the natural course of GERD. Nevertheless, the largest population-based or longest duration natural course studies report only 10 % progress from NERD to erosive esophagitis over time. The other GERD patients remained within their respective phenotypic presentation of GERD.

GERD - NERD - Refluxösophagitis

GERD - NERD - reflux esophagititis

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