IntroductionThe gastroesophageal reflux disease is a common condition in the western world but
less than half of patients present endoscopic abnormalities, making a standard
procedure unsuitable for diagnosis. High definition endoscopy coupled with narrow
band imaging has shown potential for differentiation of lesions and possible
biopsy, allowing early diagnosis and treatment.MethodsThis review describes the principles of biotic and their influence in obtaining
images with better definition of the vessels in the mucosa, through the narrow
band imaging. Selected papers using it in patients with reflux disease and
Barrett's esophagus are analyzed in several ways, highlighting the findings and
limitations.ConclusionThe meaning of the narrow band imaging in the endoscopic diagnosis of reflux
disease will be defined by large scale studies, with different categories of
patients, including assessment of symptoms and response to treatment.
Introduction: Gastroesophageal reflux disease (GERD) is considered one of the most prevalent digestive diseases in Western countries. In many cases, the symptomatic GERD is linked to a normal upper gastrointestinal endoscopy and new endoscopic techniques to identify the abnormalities are need. The high-definition digestive endoscopy coupled with narrow band imaging (NBI) could achieve a more detailed mucosal evaluation, allowing the identification of distal esophageal microerosions.Objectives: To validate the presence of distal esophageal microerosions as found in high-definition endoscopy with NBI and the associative pHmetry, histological, immunohistochemical findings of tissue specimens obtained from esophageal biopsies of patients with typical symptoms of GERD.Methods: A total of 70 participants were enrolled in a prospective, descriptive and cross-sectional study from a gastroenterology outpatient clinic. Endoscopic evaluation was sequentially performed after the pHmetry. Esophageal mucosal biopsies were obtained to perform the histological and immunohistochemical analysis.Results: From 70 participants, 30/70 (42.9%) showed mucosal microerosions. Both, pHmetry and histologic score for esophageal mucosa did not showed difference between participants with or without endoscopic microerosions. The quantitative cellular evaluation by immunohistochemistry of the esophageal mucosa was performed in 56/70 (80%) participants, which 27/56 (48.21%) showed microerosions. Also, no difference occurred between participants with or without endoscopic microerosions regarding total number of cells immunolabelled and number of cells per tissue area.
Conclusions:No difference occurred between the groups of participants with typical symptoms of GERD and with or without esophageal microerosions screened by high-definition digestive endoscopy coupled with NBI regarding pHmetric, histological and immunohistochemical analysis.
Conclusão: A presença de microerosões esofágicas observadas em endoscopia de alta definição com NBI em pacientes com sintomas típicos da DRGE, não evidenciou diferença estatística significativa nos estudos pHmétricos, manométricos, histológicos e de imunohistoquímicos em relação aos controles.
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