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. 2010 Jan;16(1):8-21.
doi: 10.5056/jnm.2010.16.1.8. Epub 2010 Jan 31.

Nonerosive Reflux Disease (NERD) - An Update

Tiberiu Hershcovici  1 , Ronnie Fass
Affiliations

Nonerosive Reflux Disease (NERD) - An Update

Tiberiu Hershcovici et al. J Neurogastroenterol Motil. 2010 Jan.

Abstract

Recognizing nonerosive reflux disease (NERD) as a distinct presentation of gastroesophageal reflux disease (GERD) was one of the most important developments in the field of GERD in the last decade. Whilst the definition of NERD has not changed significantly over the years, the disorder accounts for the majority of the GERD patients and those who failed proton pump inhibitor (PPI) treatment. Recent developments in NERD focused primarily on understanding the pathophysiology and natural history. The introduction of esophageal impedance + pH has led to the assessment of other forms of gastroesophageal reflux in causing NERD. Therapeutic modalities still focus on acid suppression, but there is growing recognition that other therapeutic strategies should be considered in NERD.

Keywords: Gastroesophageal reflux disease; Nonerosive reflux disease; Proton pump inhibitor.

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Conflict of interest statement

Conflicts of interest: None.

Figures

Figure 1
Figure 1
A diagnostic algorithm for NERD and functional heartburn based on Rome III criteria.
Figure 2
Figure 2
Proposed new paradigm for the natural course of NERD.
Figure 3
Figure 3
The "Fass and Tougas" conceptual model for esophageal symptom generation in NERD.
Figure 4
Figure 4
The "Barlow and Orlando" suggested model for heartburn in patients with NERD.
Figure 5
Figure 5
The "Ang, Sifrim and Tack" model for heartburn in NERD.
See this image and copyright information in PMC

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