El-Serag Hashem B
Department of Medicine, Baylor College of Medicine and the Houston Center for Quality of Care and Utilization Studies, Health Services Research and Development Service, Department of Veterans Affairs Medical Center, Houston, Tex 77030, USA.
Digestion. 2008;78 Suppl 1:6-10. doi: 10.1159/000151249. Epub 2008 Oct 2.
Non-erosive reflux disease (NERD) is a relatively new entity, the definition of which has been evolving and involves the use of symptoms, endoscopy, and objective evidence of reflux or reflux-related damage. The closest entity to NERD that is examined by available epidemiologic studies is defined by the presence of gastroesophageal reflux disease (GERD) symptoms in the absence of esophageal erosions or Barrett's esophagus. In this review, I identified two population-based studies, one non-community study, and several endoscopy-based studies that provided information on several aspects of NERD. Most of GERD is NERD (50-85%), and therefore one can estimate 11-12% of the general population and considerably higher proportions of patients presenting to endoscopy (37-87%) may have NERD. Risk factors for NERD including absence of hiatus hernia, low BMI, and presence of Helicobacter pylori indicate that it is a 'milder' part of the GERD spectrum. Other associations of NERD include younger age, female sex, and psychological comorbidities that resemble those of functional gut disorders. The temporal trends in NERD are unclear, and are probably increasing because GERD symptom prevalence has increased.
非糜烂性反流病（NERD）是一个相对较新的概念，其定义一直在演变，涉及症状、内镜检查以及反流或反流相关损伤的客观证据。现有流行病学研究所考察的与NERD最接近的概念是指在无食管糜烂或巴雷特食管的情况下出现胃食管反流病（GERD）症状。在本综述中，我确定了两项基于人群的研究、一项非社区研究以及几项基于内镜检查的研究，这些研究提供了有关NERD几个方面的信息。大多数GERD属于NERD（50 - 85%），因此可以估计普通人群中有11 - 12%可能患有NERD，而在内镜检查患者中这一比例要高得多（37 - 87%）。NERD的危险因素包括无食管裂孔疝、低体重指数以及幽门螺杆菌感染，这表明它是GERD谱系中“较轻”的一部分。NERD的其他相关因素包括较年轻、女性以及与功能性肠道疾病相似的心理合并症。NERD的时间趋势尚不清楚，可能在增加，因为GERD症状的患病率有所上升。
