Grade M vs N NERD show little clinical difference

In terms of clinical characteristics, grade M and grade N non-erosive reflux disease (NERD) show very little difference, a recent study has found.

In 290 consecutive patients with gastroesophageal reflux disease (GERD), 45 had grade M and 62 had grade N disease; the remaining 94 were classified as grade A. None of the baseline demographic and clinical characteristics differed between grade M and N patients. Both subgroups were also statistically significant in terms of functional dyspepsia, life satisfaction, physical and mental function, and quality of life.

Meanwhile, grade M patients differed significantly from grade A comparators in terms of body mass index (p=0.008) and in scores in the sleeping (p=0.029) and mood (p=0.007) subscales of the dissatisfaction with daily life scale (DS-SS). Overall dissatisfaction with daily life was also different between the two subgroups (p=0.007).

Similarly, grade N patients were significantly different from grade A counterparts in terms of body mass index, functional dyspepsia symptoms, and several measures on the DS-SS.

Four weeks of proton pump inhibitor treatment induced similar levels of symptom improvement across all three groups.

“Minimal change as an endoscopic classification of GERD is unnecessary in clinical practice. From the viewpoint of clinical characteristics, the classification of NERD should be sufficient for endoscopy of patients who have heartburn without mucosal breaks,” the researchers said.