NERD is the acronym for non erosive esophageal reflux disease. It is loosely defined as the presence of gastroesophageal reflux without mucosal injury. Unfortunately there is no real “gold standard” for the diagnosis of this condition so many patients are left feeling very frustrated.
While it used to be thought that NERD patients experienced less pain it is now known that this may not be the case. Some think that there is a subgroup of NERD patients who have a hypersensitive esophagus. Which means even small changes in the pH of the esophagus can cause severe pain.
The second group of patients with NERD find that their disease is less likely to respond to standard acid reducing treatment. It is believed that this is because there are factors that can cause heartburn symptoms other than acid alone. What all of these factors entail is still unclear.
Recent research published in the World Journal of Gastroenterology discusses the use of DIS (dilated intercellular spaces) as a more specific measurement of esophageal changes when their may not be the presence of lesions or inflammation (1). The research also seemed to indicated that DIS measured esophageal changes due to both acid reflux as well as other factors.
This study might help provide testing options for those with NERD and eventually treatment modalities that address both acid reflux induced NERD as well as NERD caused by other types of irritants. While the research into NERD is still in the beginning stages it is a ray of hope for those dealing with untreated pain.