Hill’s Classification of Gastro-Oesophageal Flap Valve weakness: A valuable Tool for Endoscopic Grading of Gastro-Oesophageal Reflux Disease

Abstract

Introduction: Gastro-Oesophageal Reflux Disease is one of the most common conditions needing an endoscopy evaluation. The evaluation of this condition also needs 24-hour pH-monitoring and oesophageal manometry, but in reality, these investigations are not easily available and are cumbersome. Methodology: We used the Hill’s classification for the gastro-oesophageal flap valve and objectified the evaluation of the reflux present. We were able to objectively assess the findings during endoscopy mainly the Gastro-Oesophageal Flap Valve using the Hill’s Classification and correlate its grade with the presentation of gastro-oesophageal reflux disease and its possible treatments with outcome. Inference and conclusion: We find this tool to be easy to perform and interpret as compared to the more cumbersome and complex 24-hour pH monitoring and Oesophageal Manometry. With our study we wish to encourage the use of Hill’s Classification in all endoscopies done for reflux disease. Word of Caution: Investigations like the 24-hour pH-monitoring and Oesophageal Manometry can be reserved for select cases that may either need further evaluation of this condition or have the need to rule out functional conditions of the oesophagus like the oesophageal motility disorders.