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We read with great interest the well done pathophysiological study by Woodland et al1 showing that an impaired oesophageal mucosal integrity, expressed by low baseline impedance values, is likely due to repeated acid reflux episodes, which contribute also to slow recovery after this challenge. The above alterations are associated with increased acid sensitivity and thus mucosal integrity, recovery capacity and symptom perception seem to be strictly linked.
The study demonstrates that Non-Erosive Reflux Disease (NERD) patients have a lower baseline impedance and a slower postacid impedance recovery than patients with functional heartburn (FH), as a further confirmation that they represent clearly separate entities. It is …
Contributors ES, PZ, LM, RF and VS: design of the study, writing of the manuscript and approving final version.
Competing interests None.
Provenance and peer review Not commissioned; internally peer reviewed.