Demography and treatment response in patients with predominant non‐erosive reflux disease or functional dyspepsia

Background and Aim Non‐erosive reflux disease ( NERD ) and functional dyspepsia ( FD ) share some common features, and the appropriateness of managing these diseases independently has been questioned. A post‐hoc subgroup analysis of the LEGEND study was performed to compare demographics and treatment response between patients with NERD and patients with FD . Methods Patients with reflux and dyspepsia symptoms who had no endoscopic evidence of mucosal breaks and/or erosions were included and divided into groups with predominant NERD ( n  = 1546) or FD ( n  = 614). Patients received lansoprazole for 4 weeks, and their symptoms were evaluated using questionnaires. Results FD patients were significantly younger than NERD patients (54 vs 60 years), more likely to have a body mass index < 25 kg/m 2 (72.4% vs 67.1%), less likely to have a hiatal hernia (24.0% vs 31.2%), and more likely to feel continuous stress (54.7% vs 48.0%). After 4 weeks of treatment, > 60% of both patients reported an improvement in reflux symptoms and in most dyspepsia symptoms. The improvement rate for reflux symptoms was lower in FD patients than in NERD patients ( P  < 0.05), whereas the improvement rate for dyspepsia symptoms did not differ between patient groups. Conclusion Although no clinically significant differences in pathophysiology exist between NERD and FD , there are some between‐group differences in demographic characteristics and improvement rates for reflux symptoms after treatment with lansoprazole. It remains to be discussed whether it is necessary to make a strict differential diagnosis between these two conditions.