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.

1.
Ronkainen J, Aro P, Storskrubb T, Johansson SE, Lind T, Bolling-Sternevald E, Graffner H, Vieth M, Stolte M, Engstrand L, Talley NJ, Agreus L: High prevalence of gastroesophageal reflux symptoms and esophagitis with or without symptoms in the general adult Swedish population: a Kalixanda study report. Scand J Gastroenterol 2005;40:275–285.
[PubMed]
2.
Mishima I, Adachi K, Arima N, Amano K, Takashima T, Moritani M, Furuta K, Kinoshita Y: Prevalence of endoscopically negative and positive gastroesophageal reflux disease in the Japanese. Scand J Gastroenterol 2005;40:1005–1009.
[PubMed]
3.
Zagari RM, Fuccio L, Wallander MA, Johansson S, Fiocca R, Casanova S, Farahmand BY, Winchester CC, Roda E, Bazzoli F: Gastro-oesophageal reflux symptoms, oesophagitis and Barrett’s oesophagus in the general population: Loiano-Monghidoro study. Gut 2008, Epub ahead of print.
4.
El-Serag HB, Petersen NJ, Carter J, Graham DY, Richardson P, Genta RM, Rabeneck L: Gastroesophageal reflux among different racial groups in the United States. Gastroenterology 2004;126:1692–1699.
[PubMed]
5.
Ang TL, Fock KM, Ng TM, Teo EK, Chua TS, Tan J: A comparison of the clinical, demographic and psychiatric profiles among patients with erosive and non-erosive reflux disease in a multi-ethnic Asian country. World J Gastroenterol 2005;11:3558–3561.
[PubMed]
6.
Kim N, Lee SW, Cho SI, Park CG, Yang CH, Kim HS, Rew JS, Moon JS, Kim S, Park SH, Jung HC, Chung IS: The prevalence of and risk factors for erosive oesophagitis and non-erosive reflux disease: a nationwide multicentre prospective study in Korea. Aliment Pharmacol Ther 2008;27:173–185.
[PubMed]
7.
Labenz J, Jaspersen D, Kulig M, Leodolter A, Lind T, Meyer-Sabellek W, Stolte M, Vieth M, Willich S, Malfertheiner P: Risk factors for erosive esophagitis: a multivariate analysis based on the ProGERD study initiative. Am J Gastroenterol 2004;99:1652–1656.
[PubMed]
8.
Rosaida MS, Goh KL: Gastro-oesophageal reflux disease, reflux oesophagitis and non-erosive reflux disease in a multiracial Asian population: a prospective, endoscopy based study. Eur J Gastroenterol Hepatol 2004;16:495–501.
[PubMed]
9.
Dent J, El-Serag HB, Wallander MA, Johansson S: Epidemiology of gastro-oesophageal reflux disease: a systematic review. Gut 2005;54:710–717.
[PubMed]
10.
El-Serag HB: Time trends of gastroesophageal reflux disease: a systematic review. Clin Gastroenterol Hepatol 2007;5:17–26.
[PubMed]
11.
Wu JC, Cheung CM, Wong VW, Sung JJ: Distinct clinical characteristics between patients with nonerosive reflux disease and those with reflux esophagitis. Clin Gastroenterol Hepatol 2007;5:690–695.
[PubMed]
12.
Sgouros SN, Mpakos D, Rodias M, Vassiliades K, Karakoidas C, Andrikopoulos E, Stefanidis G, Mantides A: Prevalence and axial length of hiatus hernia in patients, with nonerosive reflux disease: a prospective study. J Clin Gastroenterol 2007;41:814–818.
[PubMed]
13.
Zimmerman J, Hershcovici T: Bowel symptoms in nonerosive gastroesophageal reflux disease: nature, prevalence, and relation to acid reflux. J Clin Gastroenterol 2008;42:261–265.
[PubMed]
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