Triantos C, Koukias N, Karamanolis G, Thomopoulos K. Changes in the esophageal mucosa of patients with non erosive reflux disease: How far have we gone? World J Gastroenterol 2015; 21(19): 5762-5767 [PMID: PMC4438010 DOI: 10.3748/wjg.v21.i19.5762]
Corresponding Author of This Article
Christos Triantos, MD, Department of Gastroenterology, University Hospital of Patras, Stamatopoulou 4, Rio, 26504 Patras, Greece. chtriantos@hotmail.com
Research Domain of This Article
Gastroenterology & Hepatology
Article-Type of This Article
Editorial
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Christos Triantos, Nikolaos Koukias, Konstantinos Thomopoulos, Department of Gastroenterology, University Hospital of Patras, 26504 Patras, Greece
Georgios Karamanolis, Gastroenterology Unit, 2nd Department of Surgery, “Aretaieio” University Hospital, Athens University, 11528 Athens, Greece
Author contributions: Triantos C conceptualized and designed this editorial; Triantos C and Koukias N reviewed the literature and wrote the manuscript; Karamanolis G and Thomopoulos K reviewed the manuscript critically for important intellectual content; all authors approved the final version of the manuscript.
Conflict-of-interest: The authors declare that there are no conflicts of interest.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Christos Triantos, MD, Department of Gastroenterology, University Hospital of Patras, Stamatopoulou 4, Rio, 26504 Patras, Greece. chtriantos@hotmail.com
Telephone: +30-697-2894651 Fax: +30-261-0625382
Received: November 27, 2014 Peer-review started: November 28, 2014 First decision: February 10, 2015 Revised: March 13, 2015 Accepted: April 17, 2015 Article in press: April 17, 2015 Published online: May 21, 2015 Processing time: 173 Days and 22.5 Hours
Abstract
The normal esophageal mucosa creates a protective epithelial barrier that constrains the acidic reflux in the esophageal lumen. Microscopic findings and functional studies indicate that this barrier might be impaired in patients with non erosive reflux disease (NERD) but not in patients with functional heartburn (FH). Whereas endoscopy and pH monitoring are the most important diagnostic tools in the diagnosis of NERD, recent studies suggest that esophageal biopsies might have a complementary role. Particularly in the differential diagnosis between NERD and FH, the application of histological severity scores showed very promising results. Further evaluation of the scores could lead to routine application of histology in specific NERD populations.
Core tip: The normal esophageal mucosa creates a protective epithelial barrier that might be impaired in patients with non erosive reflux disease (NERD). Whereas endoscopy and pH monitoring are the most important diagnostic tools in the diagnosis of NERD, recent studies suggest that esophageal biopsies might have a complementary role. Particularly in the differential diagnosis between NERD and functional heartburn, the application of histological severity scores showed very promising results. Further evaluation of the scores could lead to routine application of histology in specific NERD populations.
