Strategy for treatment of nonerosive reflux disease in Asia |
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Authors: | Hiyama Toru Yoshihara Masaharu Tanaka Shinji Haruma Ken Chayama Kazuaki |
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Institution: | 1. Health Service Center,Hiroshima University,Higashihiroshima 739-8521,Japan 2. Department of Endoscopy,Hiroshima University Hospital,Hiroshima 734-8551,Japan 3. Division of Gastroenterology,Department of Internal Medicine,Kawasaki Medical School,Kurashiki 701-0192,Japan 4. Department of Medicine and Molecular Science,Division of Frontier Medical Science,Programs for Biomedical Research,Graduate School of Biomedical Sciences,Hiroshima University,Hiroshima 734-8551,Japan |
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Abstract: | The paper is to review the clinical and pathophysiologic differences between of nonerosive reflux disease (NERD) and reflux esophagitis (RE),and to propose a treatment strategy for NERD,especially for patients in Asia.A Nedline search was performed regarding the clinical and pathophysiologic differences between NERD and RE,and treatment of NERD and RE.The characteristics of NERD patients in Asia are as follows:(1) high proportion of female patients,(2)low frequency of hiatal hernia,(3) high frequency of H pylori infection,(4) severe glandular atrophy of the gastric mucosa,and (5) frequent resistance to proton pump inhibitor (PPI) therapy.In Asian NERD patients,exposure of the esophagus to acid is not increased,and esophageal motility is normal.These characteristics are similar to those of patients in Western countries.Our recommended first-choice treatment is administration of PPI in combination with a prokinetic agent.However,at present,because there is limited evidence regarding effective treatments for NERD,it is best to try several different treatment strategies to find the best treatment for each patient. |
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Keywords: | Nonerosive reflux disease Asia Treatment |
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