High resolution endoscopic features of nonerosive reflux disease

Abstract

Objective To detect the changes of gastroesophageal reflux disease （GERD） with high resolution endoscopy, and to explore its diagnostic value for nonerosive reflux disease （NERD）. Methods From April 2007 to January 2008, consecutive out-patients visiting the Department of Gastroenterology due to continuous or recurrent symptoms of acid reflux, heartburn, cardiac-like chest pain for at least three months and volunteer healthy controls were recruited to the study. The subjects were classified into the normal group （n =48）, the NERD group （n =70）, the erosive esophagitis （EE） group （n =70）, and the Barrett esoph- agus （BE） group （ n = 48）. All subjects underwent endoscopy, and the shape of Z-lines, the shape of mu- cosal pits, mucosa roughness above Z-line and the shape of mucosal blood vessels were observed. The NERD changes were analyzed with optimal scale. Results Z-line shape of NERD group showed a significant differ- ence from that of EE and BE groups （P 〈 0. 01 ）, which was not different from that of normal controls （P 〉 0.01 ）. The shape of mucosal pits of NERD group was different from that of EE and BE （P 〈0.01 ）, which also was not different from that of control （P 〉 0.01 ）. Roughness of the mucosa above Z-line of NERD group was different from other 3 groups （P 〈 0. 05）. And the shape of mucosal blood vessels of NERD was different from the control （P 〈 0.05 ）, but was not from two others. Features of NERD relative images were thin, straight and spiral blood vessels, bar-like pits, plat mucosa, round, smooth and wide tooth-like Z-line and mucosa of white particle hypertrophy. Conclusion High resolution endoscopic features of most NERD patients are cloudy, white and rough mucosal surface, with white particular hypertrophy, spiral vascular dilation, extending to Z-line. These features can be indicators of NERD. Key words: Nonerosive reflux disease; High resolution endoscopic; Endoscopic classification; Minimal changes