Minimal endoscopic changes in non-erosive reflux disease

Abstract

BackgroundGastroesophageal reflux disease is an increasingly common condition worldwide causing a considerable economic impact. More than half the patients with clinical symptoms of reflux disease display no mucosal erosions on esophagogastroduodenoscopy, making it impossible to confirm the diagnosis without further investigations.AimTo evaluate the correlation between minimal endoscopic changes on white-light esophagogastroduodenoscopy (carditis, mucosal thickening and invisibility of vessels) and histologic changes observed in distal esophageal biopsies in a sample of patients with symptoms suggestive of reflux disease, and to verify the specificity of these symptoms for non-erosive reflux disease.MethodsRetrospective, cross-sectional study based on information retrieved from a digital database at a Brazilian hospital for the period March-October, 2012. The sample consisted of previously untreated, non-smoking subjects aged >18 years with symptoms suggestive of reflux disease but no esophageal erosions, submitted to esophagogastroduodenoscopy and distal esophageal biopsy.ResultsThe final sample included 23 subjects. The most frequently observed change was invisibility of vessels (n=21; 91.3%), followed by mucosal thickening (n=15; 65.2%) and carditis (n=5; 21.7%). The correlation coefficient between each variable and the anatomopathological diagnosis was 0.386 for body mass index, 0.479 for mucosal thickening, -0.116 for invisibility of vessels, 0.306 for carditis and 0.462 for hiatal hernia.ConclusionAll patients displayed minimal endoscopic changes on esophagogastroduodenoscopy, but only mucosal thickening revealed a moderately significant correlation with severity of esophagitis, although increased body mass index values and the presence of hiatal hernia were also associated.

The analysis of Drug - Related Problems in patients with gastroesophageal reflux disease treated with proton-pump inhibitors

“…Јавља се и код здравих појединаца, и то до неколико пута дневно, нарочито после оброка. Када је његово трајање кратко, без симптома или знакова повреда мукозе, може се сматрати физиолошким процесом 2,3 . У 2006. години, Montreal Consensus Group дефинише гастроезофагеалну рефлуксну болест (ГЕРБ) као "стање које се развија када рефлукс желудачног садржаја узрокује проблематичне симптоме или компликације".…”

“…У 2006. години, Montreal Consensus Group дефинише гастроезофагеалну рефлуксну болест (ГЕРБ) као "стање које се развија када рефлукс желудачног садржаја узрокује проблематичне симптоме или компликације". Опсег симптома укључује кашаљ, бол у грлу и атипични бол у грудима и симптоме од других органа 2,4 . Хроничан ГЕРБ је повезан са високом учесталошћу компликација, честим рецидивима и губитком квалитета живота 2 .…”

“…Опсег симптома укључује кашаљ, бол у грлу и атипични бол у грудима и симптоме од других органа 2,4 . Хроничан ГЕРБ је повезан са високом учесталошћу компликација, честим рецидивима и губитком квалитета живота 2 .…”

Endoscopic Findings Related To Helicobacter Pylori

“…In the initial works in 1995, some authors concluded that it was not possible to establish this diagnosis based on only endoscopy [8,9]. However, newer technologies such as magnification and chromo endoscopy showed that there endoscopic aspects that are clearly associated with Hp infection, while others relate to uninfected or eradication [10][11][12]. Yagi et al described the characteristics of endoscopic findings with magnification in the gastric body with normal appearance and negative Hp: enanthema in tiny streaks or spots in "pinhole" aspect, which correspond to sub-epithelial capillaries and venules networks called RAC (regular arrangement of collecting venules) [13,14].…”

Conventional Videoendoscopy and Endoscopic Findings Related to Helicobacter Pylori

“…In the initial works in 1995, some authors concluded that it was not possible to establish this diagnosis based only on endoscopy [8,9] . However, newer technologies such as magnification and chromo endoscopy [11,12] have shown that there are endoscopic features that are clearly associated with HP infection, while other endoscopic features are related to non-infected cases or cases in which the infection has already been eradicated [10] . Yagi et al [13,14] described the characteristics of endoscopic findings with magnification in the gastric body with normal appearance and negative HP: erythema in tiny streaks or spots in "pinhole" aspect, which correspond to sub epithelial capillaries and venules networks called RAC (Regular Arrangement of Collecting venules).…”