Unlike symptomatic RE, QOL was not impaired at all with asymptomatic RE. No differences were seen between groups in clinical features such as endoscopic severity of RE, indicating that asymptomatic RE is a condition that should not be overlooked clinically. The prevalence of gastroesophageal reflux disease (GERD) was previously considered lower in

Asian than in Western countries.1 However, recent Japanese studies of GERD have revealed that the prevalence of GERD began to increase in the late 1990s and is now comparable to that in Western countries.2 Accordingly, GERD has become a major health problem in Japan. Gastroesophageal reflux disease is defined as a condition that develops when the reflux of stomach contents causes troublesome symptoms and/or complications.3 It includes three concepts: reflux esophagitis (RE) with symptoms, reflux symptoms without click here RE, and RE Autophagy Compound Library without symptoms. The second condition is diagnosed as non-erosive reflux disease (NERD). The first two are diagnosed either at endoscopy or by the presence of GERD-related symptoms. The existence of the third is recognized, but relatively little is known about

asymptomatic GERD. The prevalence of GERD varies in regions, there have been few Japanese studies of the clinical features of asymptomatic GERD.4,5 In this study, we investigated the clinical features in patients with GERD based on symptomatology at the time of endoscopy, using the questionnaire, the Frequency of Scale for the Symptoms of GERD (FSSG), comprising see more questions on typical and atypical symptoms (Fig. 1). Data were extracted

from the records of subjects who underwent esophagogastroduodenoscopy (EGD) at our department between April 2008 and September 2010. Of the 6409 subjects who filled in the FSSG and SF8 quality of life (QOL) questionnaires, after excluding proton pump inhibitor (PPI) and histamine-2 receptor antagonist (H2RA) users, we analyzed 388 subjects diagnosed with RE (Los Angeles Classification grade A, B, C, D). In this study, we defined “asymptomatic RE” as “positive findings of esophagitis at EGD but without symptoms” as per Fujiwara and Arakawa.2 Previous Japanese studies of asymptomatic GERD have used the questionnaire for the diagnosis of reflux esophagitis (QUEST) questionnaire,4,6 and a questionnaire with question about typical and atypical symptoms.5 In this study, we employed the FSSG, which was developed for evaluation of GERD symptoms in Japanese, and comprises the 12 most frequent symptoms.7 Some questions relate to atypical symptoms, including extraesophageal symptoms such as “Do you have an unusual (e.g. burning) sensation in your throat?”, and dysmotility symptoms such as “Does your stomach get bloated?”, “Does your stomach ever feel heavy after meals?”, “Do you ever feel sick after meals?”, “Do you feel full while eating meals?”, and “Do you burp a lot?”.