GERD (EE and NERD)

UNDERSTANDING THE CHARACTERISTICS OF GERD

Gastroesophageal reflux disease (GERD) is a chronic and highly prevalent disorder caused by repeated reflux of gastric contents into the esophagus.

GERD is characterized by a wide variety of symptoms:

  • Heartburn and acid regurgitation are the most reported symptoms1
  • These symptoms significantly affect patients’ quality of life and work productivity2

The most common phenotypic presentations of GERD include non-erosive reflux disease (NERD) and erosive esophagitis (EE):3

  • EE is usually clinically differentiated from NERD by the presence of mucosal inflammation and lesions in the distal esophagus3,4
  • Additional reflux-monitoring studies may be performed to establish the extent of abnormal esophageal acid exposure1,3

THE NEED FOR EFFECTIVE TREATMENT IS SIGNIFICANT

The U.S. prevalence of GERD has been estimated at approximately 20%, or 65.7M individuals (based on current census data). As many as 60% to 70% of these patients are NERD patients. That means they have symptoms, but no visible EE during endoscopy.3-6

While proton pump inhibitors (PPIs) are the mainstay of therapy for GERD, 35% to 54% of patients fail to achieve complete relief of symptoms. This represents a large unmet and underappreciated patient need.1,3,7

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References

1. Katz PO, Dunbar KB, Schnoll-Sussman FH, et al. ACG clinical guideline for the diagnosis and management of gastroesophageal reflux disease. Am J Gastroenterol. 2022;117(1):27-56. doi:10.14309/ajg.0000000000001538

2. Tack J, Becher A, Mulligan C, et al. Systematic review: the burden of disruptive gastro-oesophageal reflux disease on health-related quality of life. Aliment Pharmacol Ther. 2012;35(11):1257-1266. doi: 10.1111/j.1365-2036.2012.05086

3. Fass R. Gastroesophageal Reflux Disease. N Engl J Med. 2022 Sep 29;387(13):1207-1216. doi: 10.1056/NEJMcp2114026. PMID: 36170502.

4. Hershcovici T, Fass R. Nonerosive reflux disease (NERD)—an update. J Neurogastroenterol Motil. 2010;16(1):8-21. doi:10.5056/jnm.2010.16.1.8

5. El-Serag HB, Sweet S, Winchester CC, et al. Update on the epidemiology of gastro-oesophageal reflux disease: a systematic review. Gut. 2014;63(6):871-880. doi: 10.1136/gutjnl-2012-304269

6. US Census Bureau 2020. Quick facts. Available at https://www.census.gov/quickfacts/fact/table/US/PST045221. Accessed August 15, 2022.

7. Chey WD, Mody RR, Izat E. Patient and physician satisfaction with proton pump inhibitors (PPIs): are there opportunities for improvement? Dig Dis Sci. 2010;55(12):3415-3422. doi: 10.1007/ s10620-010-1209-2