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Endoscopic grading of the gastroesophageal valve in patients with symptoms of gastroesophageal reflux disease (GERD)

Oberg, S LU ; Peters, J H ; DeMeester, T R ; Lord, R V ; Johansson, Jan LU ; Crookes, P F and Bremner, C G (1999) In Surgical Endoscopy 13(12). p.8-1184
Abstract

BACKGROUND: It has been suggested that endoscopic grading of the gastroesophageal flap valve is a good predictor of the reflux status.

METHODS: To test this hypothesis, 268 symptomatic patients underwent endoscopic grading of the gastroesophageal valve using Hill's classification, with grades I through IV. Esophageal acid exposure, lower esophageal sphincter characteristics, and the degree of esophageal mucosal injury were compared among the groups.

RESULTS: The prevalence of a mechanically defective sphincter, abnormal esophageal acid exposure, erosive esophagitis, and Barrett's esophagus increased with increasing alteration of the gastroesophageal valve. The presence of a grade IV valve indicated increased esophageal acid... (More)

BACKGROUND: It has been suggested that endoscopic grading of the gastroesophageal flap valve is a good predictor of the reflux status.

METHODS: To test this hypothesis, 268 symptomatic patients underwent endoscopic grading of the gastroesophageal valve using Hill's classification, with grades I through IV. Esophageal acid exposure, lower esophageal sphincter characteristics, and the degree of esophageal mucosal injury were compared among the groups.

RESULTS: The prevalence of a mechanically defective sphincter, abnormal esophageal acid exposure, erosive esophagitis, and Barrett's esophagus increased with increasing alteration of the gastroesophageal valve. The presence of a grade IV valve indicated increased esophageal acid exposure in 75% of patients. As a predictor, this is similar to lower esophageal sphincter pressure but not as good as the presence of esophageal mucosal injury.

CONCLUSIONS: Endoscopic grading of the gastroesophageal valve provides useful information about the reflux status but is less useful as an indicator of gastroesophageal reflux disease (GERD) than the presence of esophageal mucosal injury.

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author
; ; ; ; ; and
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Adolescent, Adult, Aged, Aged, 80 and over, Endoscopy, Gastrointestinal, Esophagogastric Junction/pathology, Female, Gastroesophageal Reflux/classification, Humans, Male, Manometry, Middle Aged
in
Surgical Endoscopy
volume
13
issue
12
pages
5 pages
publisher
Springer
external identifiers
  • pmid:10594262
  • scopus:0032763205
ISSN
0930-2794
DOI
10.1007/PL00009617
language
English
LU publication?
no
id
efca698b-adb6-4b16-a425-5433866d563b
date added to LUP
2019-05-26 19:05:35
date last changed
2024-05-15 10:21:48
@article{efca698b-adb6-4b16-a425-5433866d563b,
  abstract     = {{<p>BACKGROUND: It has been suggested that endoscopic grading of the gastroesophageal flap valve is a good predictor of the reflux status.</p><p>METHODS: To test this hypothesis, 268 symptomatic patients underwent endoscopic grading of the gastroesophageal valve using Hill's classification, with grades I through IV. Esophageal acid exposure, lower esophageal sphincter characteristics, and the degree of esophageal mucosal injury were compared among the groups.</p><p>RESULTS: The prevalence of a mechanically defective sphincter, abnormal esophageal acid exposure, erosive esophagitis, and Barrett's esophagus increased with increasing alteration of the gastroesophageal valve. The presence of a grade IV valve indicated increased esophageal acid exposure in 75% of patients. As a predictor, this is similar to lower esophageal sphincter pressure but not as good as the presence of esophageal mucosal injury.</p><p>CONCLUSIONS: Endoscopic grading of the gastroesophageal valve provides useful information about the reflux status but is less useful as an indicator of gastroesophageal reflux disease (GERD) than the presence of esophageal mucosal injury.</p>}},
  author       = {{Oberg, S and Peters, J H and DeMeester, T R and Lord, R V and Johansson, Jan and Crookes, P F and Bremner, C G}},
  issn         = {{0930-2794}},
  keywords     = {{Adolescent; Adult; Aged; Aged, 80 and over; Endoscopy, Gastrointestinal; Esophagogastric Junction/pathology; Female; Gastroesophageal Reflux/classification; Humans; Male; Manometry; Middle Aged}},
  language     = {{eng}},
  number       = {{12}},
  pages        = {{8--1184}},
  publisher    = {{Springer}},
  series       = {{Surgical Endoscopy}},
  title        = {{Endoscopic grading of the gastroesophageal valve in patients with symptoms of gastroesophageal reflux disease (GERD)}},
  url          = {{http://dx.doi.org/10.1007/PL00009617}},
  doi          = {{10.1007/PL00009617}},
  volume       = {{13}},
  year         = {{1999}},
}