Non-erosive Reflux Esophagitis Disease (NERD)
What is Non-erosive Reflux Esophagitis Disease (NERD)?
Non-erosive Reflux Esophagitis Disease (NERD) is a type of gastroesophageal reflux disease (GERD) that is characterized by chronic acid reflux symptoms (heartburn and/or regurgitation without evidence of erosions, ulcers, or scarring in the esophagus). NERD patients are often classified as “silent refluxers” due to having acid reflux symptoms but minimal physical evidence of mucosal injury in the esophageal lining.
Symptoms of NERD
The most common symptom of NERD is heartburn. Heartburn is a burning sensation in the chest usually associated with regurgitation of acidic stomach contents into the esophagus. Other symptoms of NERD may include:
- Regurgitation
- Acidic taste in the mouth
- Bloating or fullness in the upper abdomen
- Belching
- Nausea
- Hoarseness
- Chronic coughing
- Laryngitis
Causes of NERD
NERD is caused by acid reflux, which is the regurgitation of stomach acid into the esophagus. This happens when the lower esophageal sphincter (LES), a muscular valve at the entrance of the stomach, does not close properly. This allows stomach acids and other contents to backflow into the esophagus, leading to symptoms of NERD.
Diagnosis of NERD
NERD is often difficult to diagnose as the symptoms can be mild and intermittent. It is usually diagnosed after endoscopy, a procedure used to look inside the esophagus and evaluate its condition. Endoscopy is used to determine the presence or absence of physical damage to the esophageal lining and to rule out other causes of GERD. The absence of physical damage in the esophagus suggests that the person has NERD.
Treatment of NERD
Treatment for NERD may include lifestyle changes and medications. Lifestyle changes such as avoiding certain foods that trigger symptoms, controlling portion sizes, avoiding large meals, and avoiding eating late at night can help reduce symptoms. Medications such as antacids, H2 blockers, and proton pump inhibitors can be used to reduce stomach acid production and help reduce symptoms. Surgery should only be considered after other treatment options have failed.