Diagnostic value of histology in non-erosive gastro-oesophageal reflux disease.

Schindlbeck, Norbert E.; Wiebecke, B; Klauser, A G; Voderholzer, Winfried A.; Müller-Lissner, S

doi:10.1136/gut.39.2.151

Cited by 113 publications

(92 citation statements)

References 20 publications

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“…These cases must be confirmed with other methods (pH testing or therapeutic trial). There is little value for histological examination of normal-appearing squamous mucosa to either confirm or exclude pathological acid reflux (15,16 Although endoscopy allows for the evaluation of esophageal mucosa, the presence or absence of mucosal injury does not provide proof that the patient's symptoms are or are not related to GERD. Many patients with typical GERD symptoms and increased esophageal acid exposure do not have esophagitis (17).…”

Section: Endoscopy In Gerdmentioning

confidence: 99%

Updated guidelines for the diagnosis and treatment of gastroesophageal reflux disease

DeVault¹

1999

The American Journal of Gastroenterology

143

178

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PREAMBLEGuidelines for the diagnosis and treatment of gastroesophageal reflux disease (GERD) were published by the American College of Gastroenterology in 1995 (1). These and other guidelines undergo periodic review. Significant advances have been made in the area of GERD over the past several years, leading us to review and revise our previous guidelines statements. These advances have included an increase in our comfort with the chronic use of proton pump inhibitors and an increased acceptance of laparoscopic antireflux surgery, among other factors. These and the original guidelines are intended to apply to all physicians who address GERD and are intended to indicate the preferable, but not only acceptable, approach. Physicians must always choose the course best suited to the individual patient and the variables that exist at the moment of the decision. These guidelines are intended to apply to adult patients with the symptoms, tissue damage, or both that result from the reflux of gastric contents into the esophagus. For the purpose of these guidelines GERD is defined as chronic symptoms or mucosal damage produced by the abnormal reflux of gastric contents into the esophagus.Both these and the original guidelines were developed under the auspices of the American College of Gastroenterology and its Practice Parameters Committee, and approved by the Board of Trustees. The world literature was reviewed extensively for the original guidelines and was once again reviewed using the National Library of Medicine database. All appropriate studies were reviewed and any additional studies found in the reference list of these papers were obtained and reviewed. Evidence was evaluated along a hierarchy, with randomized controlled trials given the greatest weight. Abstracts presented at national and international meetings were only used when unique data from ongoing trials were presented. When scientific data were lacking, recommendations were based on expert consensus. During preparation, the guidelines were reviewed

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Section: Endoscopy In Gerdmentioning

confidence: 99%

Updated guidelines for the diagnosis and treatment of gastroesophageal reflux disease

DeVault¹

1999

The American Journal of Gastroenterology

143

178

View full text Add to dashboard Cite

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“…To obtain sufficient material and to ensure an almost vertical pinch biopsy specimen, the opened forceps were withdrawn towards the tip of the endoscope, which was bent forwards maximally, and hence the forceps were pressed vertically against the esophageal wall. Specimens were fixed in 40 mg/L formaldehyde [12]. …”

Section: Methodsmentioning

confidence: 99%

“…Standardized reports completed by the histopathologist comprised an evaluation of the following histological parameters: basal zone hyperplasia, papillary length, dilatation of intraepithelial blood vessels, and semi-quantitative cellular infiltration by T-lymphocytes, neutrophils and eosinophils. Alterations in glycogen content, erosion, ulceration and chronic inflammation were also assessed as described previously [12-17]. …”

Section: Methodsmentioning

confidence: 99%

Impact of hiatal hernia on histological pattern of non-erosive reflux disease

et al. 2005

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BackgroundHiatus hernia (HH) has major pathophysiological effects favoring gastroesophageal reflux and hence contributing to esophageal mucosa injury, especially in patients with severe gastroesophageal disease. However, prospective studies investigating the impact of HH on the esophageal mucosa in non-erosive reflux disease (NERD) are lacking. This study evaluated the association between the presence of (HH) and the histological findings in symptomatic patients with NERD.MethodsFifty consecutive patients with gastroesophageal reflux disease (GERD) were enrolled. After conventional endoscopy, Lugol solution was applied and biopsy specimens were obtained. Histological parameters including basal zone hyperplasia, papillary length and cellular infiltration were evaluated. The chi-square test with Yates' correlation was used for comparing discrete parameters between groups. However, Fisher's exact probability test was used where the expected frequencies were lower than 5. Wilcoxon's test for unpaired samples was preferred in cases of semi-quantitative parameters.ResultsThe presence of HH along with more severe findings (0.01

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“…Adequate assessment of reflux esophagitis has proved difficult to be assessed by endoscopy only, as the endoscopic appearance of the esophageal mucosa may be normal despite the presence of reflux symptoms [6,7] . Non-erosive gastroesophageal reflux disease (NERD) is the most common diagnosis in patients with reflux symptoms when organic diseases such as ulcers, esophageal erosions, and carcinomas, have been excluded by esophagogastroduodenoscopy [8] . Histological abnormalities have been described in GORD [6,[8][9][10][11] , and hence it seems reasonable to diagnose non-erosive reflux disease by simple esophageal biopsies during endoscopy.…”

Section: Introductionmentioning

confidence: 99%

“…Non-erosive gastroesophageal reflux disease (NERD) is the most common diagnosis in patients with reflux symptoms when organic diseases such as ulcers, esophageal erosions, and carcinomas, have been excluded by esophagogastroduodenoscopy [8] . Histological abnormalities have been described in GORD [6,[8][9][10][11] , and hence it seems reasonable to diagnose non-erosive reflux disease by simple esophageal biopsies during endoscopy. These mild histological findings are mainly basal zone thickening, elongated papillae, alterations in intracellular glycogen content, infiltration with neutrophils, eosinoiphils and T-lymphocytes, and submucosal blood vessel dilatation [6,8,9] .…”

Section: Introductionmentioning

confidence: 99%

Impact ofHelicobacter pyloriinfection on histological changes in non-erosive reflux disease

Gatopoulou¹,

Mimidis²,

Giatromanolaki³

et al. 2004

WJG

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AIM:The evidence for an association between Helicobacter pylori (H pylori) and gastroesophageal reflux disease, either in non-erosive (NERD) or erosive esophagitis (ERD) remains uncertain. The available data on the histological changes in NERD and the effect on H pylori infection on them are elusive. The aim of this study therefore was to prospectively evaluate the histological findings and the impact of H pylori infection on a group of symptomatic patients with NERD. METHODS:Fifty consecutive patients were prospectively evaluated for symptoms compatible with GORD. In all cases, routine endoscopy and lugol directed biopsies were performed and assessed histologically in a blinded manner. RESULTS:The overall prevalence of H pylori infection was 70%. Twenty-nine patients out of 50 (58%) were NERD patients. No statistical significance was observed between the H pylori status and NERD. The remaining 21 (42%) were diagnosed as follows: 13 (26%), 6 (12%), 2(4%) with esophagitis grade A, B and C respectively. A statistically significant correlation was observed between the H pylori+ and esophagitis grade A, as well as between H pylori-and grade B. Biopsies from 2 patients were not included because of insufficient materials. Histologically, a basal zone hyperplasia was found in 47 (97.91%) patients, alterations of glycogen content in 47 (97.91%), papillae elongation in 33 (68.75%), blood vessels dilatation in 35(72.91%), chronic inflammation in 21 (43.75%), infiltration with eosinophils, neutophils and T-lymphocytes in 4 (8.33%), 6 (12.5%) and 39

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Diagnostic value of histology in non-erosive gastro-oesophageal reflux disease.

Cited by 113 publications

References 20 publications

Updated guidelines for the diagnosis and treatment of gastroesophageal reflux disease

Updated guidelines for the diagnosis and treatment of gastroesophageal reflux disease

Impact of hiatal hernia on histological pattern of non-erosive reflux disease

Impact ofHelicobacter pyloriinfection on histological changes in non-erosive reflux disease

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