What Is Non-Erosive Reflux Disease and What Are Its Symptoms and Suggested Treatments?

To impart the best understanding of Non-Erosive Reflux Disease (NERD), it is important to also understand the umbrella term, Gastroesophageal Reflux Disease (GERD). There are two types of Gastroesophageal Reflux Disease…

One is Erosive Reflux Disease, which tends to be more severe with more symptoms which can typically be difficult to alleviate. Plus, in a worst-case scenario, Erosive Reflux Disease is more likely to progress to a precancerous condition called Barrett’s esophagus. An erosive esophagus can also cause inflammation and ulcers to form within the esophagus.

Then there is what is referred to as Non-Erosive Reflux Disease, which is typically milder, with a lower chance of developing any severe complications. If a patient experiences little to no effect when taking acid blocking medications to relieve symptoms, he or she is more likely to be suffering from Non-Erosive Reflux Disease than Erosive Reflux Disease.

Since acid blocking medications are less effective for those with Non-Erosive Reflux Disease, some patients may look to surgery as a solution. However, a study published in the Journal of Neurogastroenterology and Motility states that anti-reflux surgery is less likely to benefit those patients suffering from Non-Erosive Reflux Disease.

Without an endoscopy, there is no way of knowing for sure which you have. To diagnose both Non-Erosive Reflux Disease and Erosive Reflux Disease, an endoscopy must be performed after the patient has abstained from any acid suppressing medications for approximately four weeks. This abstention will present physicians and other healthcare professionals with a visual of the esophagus in its natural state – a necessity for this diagnosis. Erosive Reflux Disease will present as a red, irritated esophagus and Non-Erosive Reflux Disease will conversely present as a smooth, properly colored esophagus without any irritation.

The good news is that Gastroesophageal Reflux Disease may even be downgraded to Non-Erosive Reflux Disease by taking Proton Pump Inhibitors (PPIs) over time and thereby healing the esophagus. 

Proton Pump Inhibitors are used to relieve the symptoms of acid reflux, including burning chest pain, the sensation of a lump in the throat or difficulty swallowing, hoarseness and/or a persistent cough. They work to suppress the acid within the stomach so that any leaking fluids create less irritation. Proton Pump Inhibitors, such as Nexium and Prilosec, etc., are one of the largest selling drugs in the United States. 

No matter what, as with many conditions, the best medical course of action is to first attempt to treat the condition and its symptoms with the least powerful medication at the lowest dose possible. Then, safely increase intensity and dosage until you successfully control the condition. In this instance, you would want to start with very mild antacid medication such as Tums or Maalox, etc. If that doesn’t work, the next step might be H2 blockers such as Pepcid or Tagamet, etc. Proton Pump Inhibitors, being the most aggressive medication, should not be used for more than a few weeks without physician direction. Also, if Erosive Reflux Disease worsens, the patient’s chances of developing Barrett’s esophagus increase and physician assistance for effective disease management and further treatment option information should be sought.

So, what does a person suffering from the symptoms of Non- Erosive Reflux Disease do if he or she cannot find relief with acid blocking medications? Certain lifestyle changes can help. In fact, the following lifestyle changes can help even if antacid medications do help to alleviate symptoms.  

First, you want to try to eliminate any trigger foods and drinks from your diet. These can include items like spicy foods, citrus, caffeine, chocolate, carbonated drinks and alcohol. 

Also try to eat smaller meals and don’t eat before bedtime or reclining. It’s best to give yourself about two or three hours after a meal before going to bed. 

You can also adjust your sleep positioning. Sleeping on your left side will help empty your stomach contents more quickly and no contents in the stomach equals no acid reflux. When your stomach is emptied and you are not suffering from acid reflux, your esophagus can also use that time to heal. 

Additionally, you can try elevating your head during the night. When you sleep with your head elevated, stomach acids are less likely to leak back up through the digestive system into the esophagus. 

If you are overweight or obese, that extra weight through the waistline can increase abdominal pressure, pushing stomach contents up into the esophagus. So weight loss is strongly suggested as well, as is smoking cessation.

You can also look into becoming a Non-Erosive Reflux Disease clinical study volunteer at the Riverside Clinical Research facility, as clinical research participants are often provided with access to innovative medications before those medications are made available to the general public. As a clinical research volunteer at Riverside Clinical Research, you would also be compensated for your time and insurance is not required.

Volunteering in a clinical trial is a truly noble undertaking. If you think you might be interested in aiding in the advancement of science and medical technology by becoming a clinical trial volunteer, please feel free to contact Riverside Clinical Research for more information or to be alerted about various Riverside Clinical Research trials as they become available. 

Simply call 386-428-7730 Monday through Thursday from 7 a.m. to 5 p.m. or Friday from 7 a.m. to 12 p.m. or email info@riversideclinicalresearch.com. You can also find out more about the clinical research trials being conducted at Riverside Clinical Research by accessing our patient portal which can be found at riversideclinicalresearch.com. 

Riverside Clinical Research, conveniently located at 1410 S. Ridgewood Avenue in Edgewater, is deeply committed to discovering better ways to prevent, treat, control and diagnose illnesses.