Non-erosive reflux disease (NERD)

Non-erosive reflux disease (NERD) is the most common phenotypic presentation of GERD. While definition of NERD remains an area of controversy, many studies continue to define these patients as having classic symptoms of GERD in the absence of esophageal mucosal injury. As compared with patients with erosive esophagitis, NERD patients tend to be younger, female and lack hiatal hernia. Despite the common clinical presentation and similar endoscopic findings, NERD patients represent a complex, heterogeneous group of patients. Functional heartburn patients account for approximately half of the NERD group. This subgroup is likely responsible for the low symptom response rate of NERD patients to PPIs and the rising clinical dilemma in GI practice-PPI failure.