Symptomatic non-erosive gastroesphageal reflux disease

What is Symptomatic Non-Erosive Gastroesophageal Reflux Disease (NERD)?

Symptomatic non-erosive gastroesophageal reflux disease (NERD) is a chronic condition characterized by frequent episodes of gastroesophageal reflux that causes symptoms in the chest or abdomen. Gastroesophageal reflux is the movement of acidic stomach contents into the esophagus, the tube that carries food and beverages from your mouth to your stomach.

NERD is one of the two main types of gastroesophageal reflux disease (GERD). The other type, erosive GERD, is diagnosed when a person’s symptoms are associated with inflammation in the stomach and esophagus. People with NERD often experience the same physical symptoms as those with erosive GERD, such as chest pain, difficulty swallowing, and heartburn, but their damage to the esophagus is not as severe as in erosive GERD.

Who Is at Risk for NERD?

Anyone can develop a symptomatic non-erosive gastroesophageal reflux disease. The most common risk factors for NERD include:

  • Age (NERD is more common in adults over 40)
  • Being overweight
  • Smoking
  • Drinking alcohol
  • Eating large meals
  • Wearing tight-fitting clothing
  • Eating spicy, acidic, or fatty foods
  • Lying down after eating
  • Stress and/or anxiety
  • Pregnancy (hormone changes can cause increased NERD symptoms)

Symptoms of NERD

The physical symptoms of symptomatic non-erosive gastroesophageal reflux disease can vary in severity and can include:

  • Heartburn (burning sensation in the chest or throat)
  • Regurgitation (food or beverage coming back into the mouth after being swallowed)
  • Indigestion (feeling of fullness, gas, or pain in the stomach after eating)
  • Difficulty swallowing
  • Chest pain
  • Hoarseness/sore throat
  • Sour taste in the mouth
  • Belching
  • Bad breath

Diagnosis and Treatment of NERD

If you have the symptoms of symptomatic non-erosive gastroesophageal reflux disease, your doctor will first do a physical exam and review your medical history. They may also recommend laboratory tests such as a blood test to rule out other conditions that can cause similar symptoms.

If your doctor suspects you have NERD, they may also refer you for an upper endoscopy to examine the inside of your esophagus for any signs of damage. However, because the damage to the esophagus is typically not as severe in NERD as in erosive GERD, it is unlikely that this diagnosis will be made through an endoscopy.

Treatment of symptomatic non-erosive gastroesophageal reflux disease typically involves lifestyle modifications and medications to reduce or alleviate symptoms. Your doctor may recommend making changes to your diet such as avoiding trigger foods, eating smaller meals, quitting smoking, or decreasing your stress levels. They may also prescribe medications such as H2 blockers or proton pump inhibitors to reduce the amount of acid in your stomach.