Endoscopy-negative reflux

Patients with Endoscopy-Negative Reflux Disease... 

Havelund, T. and Aalykke, C. 1997. The efficacy of a pectin-based raft-forming anti-reflux agent in endoscopy-negative reflux disease, Scand. J. Gastroenterol., 32(8) 773-777. 

BE Barrett s esophagus ENRD endoscopy-negative reflux disease GERD gastroesophageal reflux disease LES lower esophageal sphincter NERD nonerosive reflux disease... 

Van Rnxteren B, Numans ME, Ponis PA, Lau J. Short-term treatment with proton pump inhibitors, H2-receptor antagonists and prokinetics for gastro-oesophageal reflux disease-like symptoms and endoscopy negative reflux disease. Cochrane Database Syst Rev 2000 CD002095 1-27. 

Symptom relapse also occurs in most endoscopy-negative reflux disease patients after cessation of treatment. Therefore, long-term maintenance therapy needs to be developed also for this patient group [20]. Two therapeutic approaches with omeprazole have been evaluated, either continuous [83] or on demand treatment [84]. Continuous treatment maintains most patients in clinical remission, but a similar effect on patient satisfaction was obtained with omeprazole therapy on demand (Fig. 5). On an average, omeprazole 20 mg was taken every other day when the on-demand strategy was tested. It is important to identify patients who complain of frequent and severe reflux symptoms and who will sub-... 

Figure 5. Sufficient control of heartburn during 6 months of maintenance therapy in endoscopy-negative reflux disease. Omeprazole was either given on demand (b) in doses of 10 or 20 mg or as continuous therapy (a) with 10 mg daily compared with placebo. Adopted from refs. 83 and 84.

Lind T, Havelund T, Glise H et al (1995) Omeprazole improves quality of life in patients with endoscopy negative reflux disease. Gastroenterology 108 A151... 

To assess symptom control, esomeprazole 20 mg on demand has been compared with placebo on demand (maximum of one dose a day) for 6 months in a multicenter, double-blind study in 342 endoscopy-negative patients with gastro-esophageal reflux disease (2). There was complete resolution of heartburn after 4 weeks of daily esomeprazole therapy. On-demand therapy with esomeprazole was significantly more effective than placebo in controlling symptoms. The frequencies of adverse effects and laboratory profiles were similar in the two groups when adjusted for the time spent in the study. 

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