Presence Of Reflux Esophagitis Research Articles

3515 MUCH ADO ABOUT THE “ULTRASHORT” BARRETT ESOPHAGUS? RESULTS FROM THE MUNICH MULTICENTER STUDY.

<i>Background:</i>The rising incidence of cardiac adenocarcinoma has been linked to the increasing diagnostic awareness of "ultrashort" Barrett esophagus (BE) found in up to 30% of routine biopsies (Bx) even from endoscopically unconspicuous esophagogastric junction (egj) mucosa. We present the results of a multicenter study involving 8 centers (hospital/private practive endoscopists). <i>Patients and Methods:</i>In the various centers up to 3 eligible patients per day were included during various time intervals depending on the availability of research students. Patients >75 years, those with varices, neoplasia, and coag. disorders were excluded. Reflux symptoms and the endoscopic findings (anatomic locations, presence of hiatal hernia and reflux esophagitis) were recorded. 2 Bx were taken from antrum, body and cardia, and 4-quadrant Bx from the egj. <i>Results:</i>869 patients are evaluable (52% male, mean age: 48 yrs). In 16 % goblet-cells (GC) were found, but 1/4 of those had complete intestinal metaplasia (CIM); no cases of dysplasia were detected. GC were found more frequently (3x) in patients >40 yrs. There was no correlation between GERD-symptoms, antireflux therapy, presence of reflux esophagitis, and GC. Even in cases in whom the endoscopist suspected any form of BE, only 20 to 25 % had GC. The distance of the egj and the most proximal gastric folds was not correlated with the prevalence of GC: This was 16 % for a distance of 0-1 cm, 12 % for 2 cm; and 16% for ≥3cm. On the other hand, only 1/4 of the GC-positive patients had endoscopically a completely normal EGJ. <i>Conclusions:</i>The relevance of the so-called "ultrashort" BE and associated dysplasia has probably been overestimated, possibly due to a selection bias of patients undergoing "routine" Bx of the eg junction. Unfortunately, in our study, endoscopy alone was not sufficient to diagnose BE in its various forms. It has to be evaluated whether routine biopsies from any abnormal eg junction are warranted.

Corpus gastritis is protective against reflux oesophagitis

BACKGROUNDGastric acid is important in the pathogenesis of reflux oesophagitis. Acid production by the gastric corpus is reduced in corpus gastritis.AIMSTo determine whether corpus gastritis protects against reflux oesophagitis.METHODSPatients presenting...

Endoscopic evaluation of gastroesophageal sphincter dysfunction.

The introduction of modern endoscopes, light sources, and cameras has greatly improved the endoscopist's ability to diagnose and document the presence of reflux esophagitis. A reliable objective diagnosis of reflux esophagitis can be made in the presence of active erosion, friability, and ulceration. Reflux can be suspected in the presence of a patulous cardia. Gross reflux is uncommonly seen in the relaxed patient during endoscopy, but its presence is pathologic. The x-ray and endoscopic diagnosis of hiatal hernia correlate well. Endoscopists must be aware of those rare cases where an infectious cause for esophageal inflammation may be present. Although endoscopic biopsy and brush cytology are of limited value in the diagnosis of esophagitis, they permit an accurate differentiation between benign and malignant lesions in the esophagus and their use is encouraged in chronic cases of esophagitis where an increased risk of malignancy is present.

Reflux Esophagitis: Its Diagnosis, Treatment

Summary 1.The presence of reflux esophagitis has been increasingly recognized. 2.Diagnosis, both medical, surgical treatment are outlined with modifications for children, adults. 3.The association with hiatus hernia, short esophagus is correlated.