Non-erosive Reflux Disease (NERD) | Digestive Health | Loyola Medicine

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Non-erosive Reflux Disease (NERD)

Overview and Facts about Non-erosive Reflux Disease (NERD)

Non-erosive reflux disease (NERD) is a type of gastroesophageal reflux disease (GERD) in which the esophagus is unharmed by stomach acid. In more common cases of GERD, stomach acid leaks into the esophagus, causing erosion and ulcers. Some doctors believe that NERD is a less severe form of GERD that may eventually worsen into the erosive form of the disease. Left untreated, NERD can adversely affect your overall digestive health.

Symptoms and Signs of Non-erosive Reflux Disease (NERD)

Basically, NERD produces all the same symptoms as GERD, but without any damage or injury in the esophagus. These symptoms can include:

  • Chest pain
  • Feeling like you have a lump in your throat
  • Heartburn, especially at night or after eating
  • Problems swallowing
  • Regurgitating or burping up your food or stomach acid

If your NERD acts up at night, you might experience:

  • A cough that won’t go away
  • Asthma
  • Laryngitis
  • Problems sleeping

Causes and Risk Factors of Non-erosive Reflux Disease (NER

There are several risk factors that can influence the development of NERD, including:

  • Drinking an excess of alcohol or coffee
  • Developing a hiatal hernia, where your stomach bulges up into your diaphragm
  • Eating large portions
  • Eating at night
  • Eating fried or fatty foods
  • Obesity
  • Pregnancy
  • Scleroderma and other types of connective tissue disorders
  • Smoking

Doctors also believe there is a genetic component to NERD, meaning you might be able to inherit it from your parents.

Tests and Diagnosis of Non-erosive Reflux Disease (NERD)

The best way to diagnose NERD is through an endoscopy, which involves inserting a flexible tube with a camera attached to it down your throat. Before an endoscopy, you’ll have to stop taking acid-suppressing medications for at least four weeks.

If your esophagus is inflamed and red during the endoscopy, you’ll likely be diagnosed with erosive reflux disease (ERD). If your esophagus looks normal, you’ll probably be diagnosed with NERD.

You might also undergo a pH probe test. Your doctor will put a small probe inside your throat for a 24-hour period to detect any time you have acid reflux. This will help them see just how bad your reflux is.

Treatment and Care for Non-erosive Reflux Disease (NERD)

Your doctor will likely start you on proton pump inhibitors (PPI) to help put an end to your NERD. These block acid production to prevent it from leaking into the esophagus.

You might also take antacids, which help neutralize stomach acid to reduce your symptoms. Finally, H2 receptor blockers can reduce the amount of acid production on a short-term basis.

For severe NERD that doesn’t respond to medication, you might require fundoplication surgery. This involves wrapping the top of the stomach around the lower esophageal sphincter to tighten it, preventing any leakage from occurring.