Accuracy of diagnosing gastroesophageal reflux disease by <scp>GerdQ</scp>, esophageal impedance monitoring and histology

Zhou, Li; Wang, Ye; Lu, Jing; Lin, Lin; Cui, Rong; Zhang, He Jun; Xue, Yan; Ding, Shi Gang; Lin, Sanren

doi:10.1111/1751-2980.12135

Cited by 31 publications

(43 citation statements)

References 21 publications

(47 reference statements)

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…None of the established histological parameters can fulfill standards of a diagnostic tool. 15,16 Thus, routine biopsy is not recommended in patients who do not exhibit visible esophageal erosions in China. 17 However, the need for routine biopsy in such patients in the Chinese context should be evaluated in large-scale studies.…”

Section: Discussionmentioning

confidence: 99%

Assessment of Esophageal Motor Disorders Using High-resolution Manometry in Esophageal Dysphagia With Normal Endoscopy

Wang

et al. 2019

J Neurogastroenterol Motil

View full text Add to dashboard Cite

Background/AimsThe distribution and esophageal motor characteristics of Chinese patients with esophageal dysphagia who exhibit no structural abnormalities on esophagogastroduodenoscopy remain unclear. Our aim is to assess the esophageal motor patterns using high-resolution manometry (HRM) and classify them according to the Chicago classification version 3.0 (CC v3.0). Furthermore, we compared the CC v3.0 and the previous version 2.0 (CC v2.0) for diagnosis of motor disorders.MethodsTwo hundred thirty-six (mean age 48.4 ± 12.2 years, 61.9% female) patients with esophageal dysphagia were included for analysis of motor function using HRM. All participants were administered a questionnaire to determine Eckardt scores before HRM.ResultsAccording to the CC v3.0, 57 (24.2%) patients showed evidence of esophagogastric junction outflow obstruction and were classified as Group 1. Eighteen (7.6%) patients with major disorders of peristalsis were classified as Group 2. Minor disorders of peristalsis (Group 3) were much more frequent (129 [54.7%] patients). Thirty-two (13.6%) patients had normal esophageal manometry were classified as Group 4. All patients with abnormal pH or pH impedance monitoring (n = 44) had minor motor disorders (ineffective esophageal motility [IEM] = 34, fragmented peristalsis = 10). Based on motor category, the Eckardt score was 4.7 ± 0.1 in Group 1, 4.5 ± 0.3 in Group 2, 3.5 ± 0.1 in Group 3, and 3.9 ± 0.1 in Group 4.ConclusionsIEM was the most common esophageal motor disorder in patients with esophageal dysphagia who showed no structural abnormality on endoscopy. While a high Eckardt score suggests outflow obstruction or a major motor disorder, a low score suggests IEM.

show abstract

Section: Discussionmentioning

confidence: 99%

Assessment of Esophageal Motor Disorders Using High-resolution Manometry in Esophageal Dysphagia With Normal Endoscopy

Wang

et al. 2019

J Neurogastroenterol Motil

View full text Add to dashboard Cite

show abstract

“…Histopathology has long been considered inferior due to its nonspecificity. Our study is based on a large, prospective, controlled clinical study, which had investigated GerdQ, 24‐hour pH‐impedance monitoring, histopathologic parameters, and PPI test results in patients suspected with GERD . In this study, we only assessed the histopathologic results of patients with GERD, FH, and controls, including the quantitative measurement of intercellular space under light microscopy and the histological scores of the inflammatory and hyperplasia indicators of the squamous epithelium in lower esophagus.…”

Section: Discussionmentioning

confidence: 99%

Diagnostic value of dilated intercellular space and histopathologic scores in gastroesophageal reflux disease

et al. 2014

View full text Add to dashboard Cite

The aim of this paper is to investigate the diagnostic value of histopathologic score and the dilated intercellular space (DIS) in patients with gastroesophageal reflux disease (GERD) and functional heartburn (FH). Participants with GERD symptoms including reflux esophagitis, non-erosive reflux disease (NERD), Barrett's esophagus (BE), functional heartburn (FH), along with a control group with atypical GERD-like symptom (Sym-C), and asymptomatic healthy volunteers (H-C) were administered GERD questionnaire, and subjected to endoscopy and biopsies, as well as 24-hour pH-impedance monitoring. Biopsies were evaluated using standards from the 2011 Esohisto Project after Hematoxylin-Eosin staining. DIS was measured quantitatively under light microscopy. Among the total of 565 participants with qualified biopsy specimens, the mean DIS of the reflux esophagitis (RE) group was significantly wider compared with the other five groups. DIS in patients with GERD-like symptoms was significantly wider compared with the H-C. No significant differences were observed between NERD and FH. Results from 24-hour pH-impedance monitoring indicated that only the DIS of patients with acid reflux or the amount of acid reflux episodes in patients with DIS was significantly wider compared with patients with nonacid reflux or patients without DIS (P < 0.001). With DIS = 0.9 μm as the cutoff value, the sensitivity and specificity were 62.6% and 54.1%, respectively. Using the total histopathologic score > 3 as the diagnostic criterion, the sensitivity and specificity were 71.7% and 47.4%. DIS is closely associated with GERD and acid reflux. The diagnostic value of histological scores in lower esophagus in GERD is very similar to that of the quantitative measurement of DIS.

show abstract

“…History is still 'the first and most important thing to do', but it is obvious that history has also its limitations. A GER questionnaire score or 'response to PPI' does not accurately diagnose GERD [61]. Orenstein et al developed the 'infant GER questionnaire' (I-GER) [62], intended to result in an objective, validated and repeatable quantification of symptoms suggestive for GERD.…”

Section: Diagnosismentioning

confidence: 99%

“…If the baseline is already very low, there will be fewer episodes in which the impedance still decreases by >50%. MII-pH monitoring does increase the sensitivity to diagnose GERD; however, when used alone, it results in poor specificity in patients without acid suppressive therapy [61].…”

Section: Diagnosismentioning

confidence: 99%

An updated review on gastro-esophageal reflux in pediatrics

Vandenplas¹,

Hauser

2015

Expert Review of Gastroenterology & Hepatology

View full text Add to dashboard Cite

Comprehensive guidelines for the diagnosis and management of gastro-esophageal reflux (GER) and GER disease (GERD) were developed by the European and North American Societies for Pediatric Gastroenterology, Hepatology and Nutrition. GERD is reflux associated with troublesome symptoms or complications. The recognition of GER and GERD is relevant to implement best management practices. A conservative management is indicated in infants with uncomplicated physiologic reflux. Children with GERD may benefit from further evaluation and treatment. Since the publications of the European and North American Societies for Pediatric Gastroenterology, Hepatology and Nutrition guidelines in 2009, no important novelties in drug treatment have been reported. Innovations are mainly restricted to the management of regurgitation in infants. During the last 5 years, pros and cons of multichannel intraluminal impedance have been highlighted. However, overall 'not much has changed' in the diagnosis and management of GER and GERD in infants and children.

show abstract

Accuracy of diagnosing gastroesophageal reflux disease by GerdQ, esophageal impedance monitoring and histology

Cited by 31 publications

References 21 publications

Assessment of Esophageal Motor Disorders Using High-resolution Manometry in Esophageal Dysphagia With Normal Endoscopy

Assessment of Esophageal Motor Disorders Using High-resolution Manometry in Esophageal Dysphagia With Normal Endoscopy

Diagnostic value of dilated intercellular space and histopathologic scores in gastroesophageal reflux disease

An updated review on gastro-esophageal reflux in pediatrics

Contact Info

Product

Resources

About