Prevalence of minimal change lesions in patients with non-erosive reflux disease: a case-control study

Digestion. 2012;85(4):288-94. doi: 10.1159/000337198. Epub 2012 May 10.


Background/aims: Some minimal changes (MCs) are believed to have a certain relationship with gastroesophageal reflux (GERD). Nonetheless, the individual meaning of MC is still unclear. Our aim was to compare the overall and individual prevalence of MC between patients with non-erosive reflux disease (NERD) and healthy controls (HC).

Methods: Twelve endoscopic findings in the esophagogastric junction were prospectively compared between NERD (n = 64) and control (n = 104).

Results: Overall frequency of MC (≥ 1 out of 12 criteria) was higher in the NERD group (71.9%) than in the HC group (45.2%). In individual analysis, white mucosal turbidity, irregular Z-line, horizontal erosions, and mucosal protrusion of cardia were significantly more common in the NERD group compared to controls. Among them, only white mucosal turbidity was independently associated with the NERD group (OR 3.97, 95% CI 1.72-9.13). Individuals with male gender, reflux symptoms, higher height, current smoking, ethanol intake and hiatal hernia were more likely to have white mucosal turbidity compared to the group without white turbidity.

Conclusions: MC could be a useful marker to support clinical diagnosis of GERD. White mucosal turbidity in particular might be a GERD-specific sign related to acid-induced mucosal damage.

MeSH terms

  • Adult
  • Aged
  • Alcohol Drinking
  • Body Mass Index
  • Case-Control Studies
  • Esophagogastric Junction / pathology*
  • Female
  • Gastric Mucosa / pathology*
  • Gastroesophageal Reflux / pathology*
  • Hernia, Hiatal / pathology*
  • Humans
  • Male
  • Middle Aged
  • Prevalence
  • Retrospective Studies
  • Risk Factors
  • Sex Factors
  • Smoking