Acid reflux describes the condition that occurs when the lower esophageal sphincter, which is the ring of muscle separating the esophagus and stomach, fails to work properly, allowing acid to rise into the esophagus. Acid reflux causes heartburn, which is the burning sensation felt when stomach acid irritates the lining of the esophagus. Doctors diagnose patients who experience acid reflux and heartburn at least twice a week with gastroesophageal reflux disease, or GERD, according to MayoClinic.com. Because not all patients with the classic symptoms of GERD exhibit the same diagnostic results, doctors now further classify GERD into different types.
Non-Erosive
Some patients present with the classic symptoms of GERD, but when doctors perform an endoscopy, a diagnostic test that uses an endoscope to visualize the tissues in the esophagus, they fail to find any tissue damage in the esophagus. Initially, doctors believed these patients suffered from a mild form of GERD, but they now classify them with NERD, or non-erosive reflux disease. Non-erosive reflux disease is the most common form of GERD, according to information published on the GI Motility Online website, a comprehensive resource on the motility of the gastrointestinal tract. Because patients with NERD often fail to respond to traditional treatments, such as the use of proton pump inhibitor medications to reduce the level of stomach acid, and many fail to show any pH change in the esophagus, researchers now believe that nonacid stimuli, such as stomach volume and nonacid reflux, may cause NERD.
Erosive
Doctors classify what most consider as traditional gastroesophageal reflux disease as erosive GERD. Those with erosive GERD suffer from frequent acid reflux that causes tissue damage to the esophagus. During diagnostic testing, patients show elevated pH levels in their esophagus due to the presence of stomach acid. They also present with esophageal breaks, or tears in the tissue that lines the esophagus. Treatment for erosive GERD includes reducing the level of stomach acid with medications. Common types of medications include H2 blockers, which block histamine from binding to the cells in the lining of the stomach, and proton pump inhibitors, which shut down the stomach cells' ability to exchange the nonacidic potassium ion for the acidic hydrogen ion, therefore shutting down stomach acid production.
Barrett's Esophagus
Barrett's esophagus describes a condition in which the lining of the esophagus appears similar to the lining of the intestines. Although the exact cause of Barrett's esophagus remains unknown, GERD contributes to the disease, as Barrett's esophagus occurs three to five times more often in patients with GERD, according to the National Digestive Diseases Information Clearinghouse. Barrett's esophagus alone does not usually cause symptoms, but those with Barrett's esophagus have an increased risk of developing a rare but deadly form of esophagus cancer. Therefore, to avoid the development of Barrett's esophagus, doctors recommend treating the GERD symptoms and lowering stomach acid.
References
- Mayo Clinic: GERD
- GI Motility Online: Non-Erosive Reflux Disease
- National Digestive Diseases Information Clearinghouse: Barrett's Esophagus
- "Journal of Korean Medical Science"; Differences in Clinical Characteristics Between Patients With Non-Erosive Reflux Disease and Erosive Esophagitis; Na Rae Ha et al.; 2010
- National Digestive Diseases Information Clearinghouse: Heartburn, GER, GERD
