It Is Possible to Classify Non-erosive Reflux Disease (NERD) Patients into Endoscopically Normal Groups and Minimal Change Groups by Subjective Symptoms and Responsiveness to Rabeprazole—A Report from a Study with Japanese Patients

Kusano, Motoyasu; Shirai, Naohito; Yamaguchi, Kuniko; Hongo, Michio; Chiba, Tsutomu; Kinoshita, Yoshikazu

doi:10.1007/s10620-008-0290-2

Cited by 21 publications

(15 citation statements)

References 28 publications

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“…heartburn), but do not have breaks in the esophageal mucosa (i.e. erosion or ulcer) on endoscopy [8,9]. Moreover, there is also a group of asymptomatic patients with endoscopic redness alone, not with esophageal mucosal breaks, in esophagocardial junction.…”

Section: Introductionmentioning

confidence: 99%

Impact of Acid Inhibition on Esophageal Mucosal Injury Induced by Low-Dose Aspirin

Sugimoto

Nishino²,

Kodaira³

et al. 2011

Digestion

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Background and Aim: Aspirin enjoys widespread use as an antithrombotic drug, but such ubiquity also increases the risk of gastrointestinal mucosal injury. Recent studies have shown that aspirin can also induce esophageal mucosal injury. We resolved to determine the intragastric pH value necessary to prevent aspirin-induced esophageal mucosal injury. Methods: 15 healthyJapanese volunteers were dosed for 7 days in a four-way random crossover trial with 100 mg entero-coated type aspirin only once daily, 100 mg aspirin + 20 mg famotidine twice daily, 15 mg lansoprazole once daily, or 10 mg rabeprazole once daily. All subjects underwent endoscopy and intragastric pH monitoring on day 7. Results: 7 individuals (46.7%) developed esophageal mucosal injury when ingesting aspirin alone. The incidence of esophageal mucosal injury was reduced however with concomitant dosing of aspirin and famotidine (26.6%; p = 0.193), lansoprazole (0%; p = 0.004), and rabeprazole (6.7%; p = 0.019). Among individuals for whom mean 24-h pH was >5.0 and who experienced pH <4.0 less than 40% of the time, none developed aspirin-induced esophageal mucosal injury. Conclusion: Acid inhibition achieved with a half-dose of a proton pump inhibitor effectively prevented development of aspirin-induced esophageal mucosal injury, whereas a standard dose of a histamine-2-receptor antagonist failed to achieve the same results.

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Section: Introductionmentioning

confidence: 99%

Impact of Acid Inhibition on Esophageal Mucosal Injury Induced by Low-Dose Aspirin

Sugimoto

Nishino²,

Kodaira³

et al. 2011

Digestion

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“…6,38,39 Another study evaluated response to 4 weeks of rabeprazole 10 mg daily in patients with EE, minimal changes, and NERD. 28 In terms of heartburn, patients with minimal changes had similar response rates to patients with NERD (38.7% and 41.7%, respectively, P = 0.81) and both had a statistically lower response rate as compared with patients with EE (68.6%, P = 0.005).…”

Section: Minimal Changes and Response To Treatmentmentioning

confidence: 78%

“…However, those with minimal changes had rates of functional gastrointestinal symptoms (epigastric heaviness, constipation) that were closer to patients with NERD, than for patients with EE. 28 In conclusion, the available data are limited and contradictory regarding the physiological difference between patients with and those without minimal changes. Lack of standardized criteria for the diagnosis of minimal changes also limits comparison between studies.…”

Section: Minimal Changes and Symptomsmentioning

confidence: 97%

Identifying Minimal Changes in Nonerosive Reflux Disease

Gabbard

Fass

Maradey–Romero

et al. 2016

Journal of Clinical Gastroenterology

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Gastroesophageal reflux disease has a variable presentation on upper endoscopy. Gastroesophageal reflux disease can be divided into 3 endoscopic categories: Barrett's esophagus, erosive esophagitis, and normal mucosa/nonerosive reflux disease (NERD). Each of these phenotypes behave in a distinct manner, in regards to symptom response to treatment, and risk of development of complications such as esophageal adenocarcinoma. Recently, it has been proposed to further differentiate NERD into 2 categories: those with and those without "minimal changes." These minimal changes include endoscopic abnormalities, such as villous mucosal surface, mucosal islands, microerosions, and increased vascularity at the squamocolumnar junction. Although some studies have shown that patients with minimal changes may have higher rates of esophageal acid exposure compared with those without minimal changes, it is currently unclear if these patients behave differently than those currently categorized as having NERD. The clinical utility of identifying these lesions should be weighed against the cost of the requisite equipment and the additional time required for diagnosis, compared with conventional white light endoscopy.

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“…It was pointed out that regarding esophagitis, it is difficult to rely on the histopathological findings to determine grade M in non-erosive reflux disease [14,15]. It was indicated that eosinophilic esophagitis is a chronic disease caused by inflammatory conditions associated with massive eosinophilic infiltration in the epithelium of esophageal mucosa (≥15 eosinophils in high-power field) [16], and it was also indicated that it is characterized by allergic disease causing esophageal stenosis due to the fibrosis located in the submucosa of the esophagus in long-term follow-up patients who are likely to relapse.…”

Section: Second Session: Pathological Diagnosis For Inflammation and mentioning

confidence: 99%

Digestive Disease Management in Japan: A Report on The 6th Diagnostic Pathology Summer Fest in 2012

et al. 2013

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The 6th Diagnostic Pathology Summer Fest, held in Tokyo on August 25-26, 2012, opened its gates for everyone in the medical profession. Basic pathology training can contribute to the improvement of algorithms for diagnosis and treatment. The 6th Summer Fest with the theme ‘Pathology and Clinical Treatment of Gastrointestinal Diseases' was held at the Ito International Research Center, The University of Tokyo. On August 25, ‘Treatment of Early Gastrointestinal Cancer and New Guidelines' was discussed in the first session, followed by ‘Biopsy Diagnosis of Digestive Tract: Key Points of Pathological Diagnosis for Inflammation and Their Clinical Significance' in the second session. On August 26, cases were discussed in the third session, and issues on pathological diagnosis and classification of neuroendorcrine tumor in the fourth session. The summaries of speeches and discussions are introduced along with the statements of each speaker. This meeting was not a formal evidence-based consensus conference, and 20 experts gave talks on their areas of specialty. Discussion was focused on how the management strategy should be standardized on the algorithm of patient care.

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It Is Possible to Classify Non-erosive Reflux Disease (NERD) Patients into Endoscopically Normal Groups and Minimal Change Groups by Subjective Symptoms and Responsiveness to Rabeprazole—A Report from a Study with Japanese Patients

Cited by 21 publications

References 28 publications

Impact of Acid Inhibition on Esophageal Mucosal Injury Induced by Low-Dose Aspirin

Impact of Acid Inhibition on Esophageal Mucosal Injury Induced by Low-Dose Aspirin

Identifying Minimal Changes in Nonerosive Reflux Disease

Digestive Disease Management in Japan: A Report on The 6th Diagnostic Pathology Summer Fest in 2012

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