Zhang WT, Xu M, Zheng Y, Wu J, Zheng YJ, Wei J, Kang T, Jiang J, Cheng Y. Endoscopic diagnosis of non-erosive reflux disease. World J Gastroenterol 2026; 32(30): 119177 [DOI: 10.3748/wjg.119177]
Corresponding Author of This Article
Yan Cheng, PhD, Chief Physician, Professor, Department of Gastroenterology, The Second Affiliated Hospital of Xi’an Jiaotong University, Shaanxi Key Laboratory of Gastrointestinal Motility Disorders, Shaanxi Provincial Clinical Research Center for Gastrointestinal Diseases, Digestive Disease Quality Control Center of Shaanxi Province, No. 3 Jiandong Street, Beilin District, Xi’an 710004, Shaanxi Province, China. 15609264849@163.com
Research Domain of This Article
Gastroenterology & Hepatology
Article-Type of This Article
review-article
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Gastroenterol. Aug 14, 2026; 32(30): 119177 Published online Aug 14, 2026. doi: 10.3748/wjg.119177
Endoscopic diagnosis of non-erosive reflux disease
Wen-Ting Zhang, Min Xu, Ying Zheng, Jie Wu, Yi-Jun Zheng, Jia Wei, Tong Kang, Jiong Jiang, Yan Cheng
Wen-Ting Zhang, Min Xu, Ying Zheng, Yi-Jun Zheng, Jia Wei, Tong Kang, Jiong Jiang, Yan Cheng, Department of Gastroenterology, The Second Affiliated Hospital of Xi’an Jiaotong University, Shaanxi Key Laboratory of Gastrointestinal Motility Disorders, Shaanxi Provincial Clinical Research Center for Gastrointestinal Diseases, Digestive Disease Quality Control Center of Shaanxi Province, Xi’an 710004, Shaanxi Province, China
Jie Wu, Department of Pathology, The Second Affiliated Hospital of Xi’an Jiaotong University, Xi’an 710004, Shaanxi Province, China
Co-corresponding authors: Jiong Jiang and Yan Cheng.
Author contributions: Zhang WT wrote the original draft; Zhang WT, Zheng YJ, Wei J, and Kang T performed literature analysis; Zhang WT, Jiang J, and Cheng Y designed the research; Xu M and Zheng Y performed image acquisition; Wu J, Jiang J, and Cheng Y reviewed and edited the manuscript; Jiang J and Cheng Y supervised the study, contributed equally to this work as co-corresponding authors; all of the authors read and approved the final version of the manuscript to be published.
AI contribution statement: Grammarly and DeepSeek were used for language polishing, and DeepL was used for translation. The main text and the response to reviewers are not AI-generated. All scientific content, analysis, and conclusions are original work of the authors.
Conflict-of-interest statement: All authors declare no conflict of interest in publishing the manuscript.
Corresponding author: Yan Cheng, PhD, Chief Physician, Professor, Department of Gastroenterology, The Second Affiliated Hospital of Xi’an Jiaotong University, Shaanxi Key Laboratory of Gastrointestinal Motility Disorders, Shaanxi Provincial Clinical Research Center for Gastrointestinal Diseases, Digestive Disease Quality Control Center of Shaanxi Province, No. 3 Jiandong Street, Beilin District, Xi’an 710004, Shaanxi Province, China. 15609264849@163.com
Received: January 21, 2026 Revised: March 9, 2026 Accepted: May 22, 2026 Published online: August 14, 2026 Processing time: 183 Days and 22.3 Hours
Abstract
Non-erosive reflux disease is the predominant subtype of gastroesophageal reflux disease and significantly impairs patient quality of life. Minimal mucosal changes in the esophagus are difficult to detect using conventional white-light endoscopy; thus, reflux monitoring is required for accurate diagnosis. With advances in endoscopic technology, innovative procedures have recently identified minimal mucosal alterations in the esophagus of non-erosive reflux disease patients. These developments have considerably enhanced diagnostic accuracy and provided a foundation for clinical practice. This mini-review examines advances in common endoscopic techniques. It intends to improve clinical diagnosis and management, and to reduce the economic burden and patient suffering that result from the disease.
Core Tip: This mini-review emphasizes the importance of advanced endoscopic imaging for detecting subtle microstructural changes in the diagnosis of non-erosive reflux disease. We evaluate the diagnostic validity of these findings and propose a practical clinical framework. Looking forward, we highlight the emerging potential of artificial intelligence for automated analysis of imaging data. We also advocate the development of integrative, multimodal diagnostic strategies combining symptom questionnaires, endoscopic methods, functional measures, and clinical biomarkers to enhance non-erosive reflux disease management.
