DDW Reports 2003 Orlando: Reflux Disease and Barrett’s Esophagus

Abstract

Gastroesophageal reflux disease (GERD) and Barrett's esophagus (BE) continue to be major topics in the field of clinical research. More data are accumulating on the endoscopic diagnosis of subtle abnormalities, to allow better classification of patients into endoscopy-positive and endoscopy-negative (NERD, non-erosive reflux disease) groups. The situation regarding endoscopic antireflux techniques has not become much clearer. Some abstracts were presented to both societies. Diagnosis of Reflux and EsophagitisVarious endoscopic classifications for reflux-induced changes in the distal esophagus are in use, and current efforts are apparently being directed toward achieving earlier detection of subtle abnormalities. Using Lugol staining in 39 endoscopy-negative reflux patients and 39 asymptomatic controls, unstained streaks above the Z line were found in 49 % vs. 3 % of patients and control individuals, respectively [1]; further prospective studies including pH-metry data for the value of this staining pattern are necessary, however. In an interesting study on magnification endoscopy (52 patients and 46 controls), several criteria (e. g., vascular injection, erythema, villous structures below the Z line) were developed, and sensitivity and specificity rates of 71 % and 85 % were reported when these criteria were combined with histological markers [2].A new device for pH-metry is a capsule that is placed endoscopically and attached to the distal esophagus (Bravo). The capsule measures pH for 48 h and falls off afterward. Experience in 245 consecutive patients was presented, showing that on day 2, 10 % more cases of pathological pH values were detected. In about half of the cases, capsules were placed under endoscopic control using sedation, and in the remaining cases without sedation and under manometric guidance. Three percent of capsules Institution