Relevance of histology in the diagnosis of reflux esophagitis

Abstract

Reflux esophagitis is an important clinical diagnosis; however, the histologic findings can be nonspecific and overlap with other entities. Various benign changes can produce diagnostic difficulties for pathologists. In this review, the typical histologic findings of gastroesophageal reflux disease (GERD) of the esophagus are discussed, along with the issues relating to clinical correlation and technical aspects of endoscopic biopsies and specimen processing. The literature has been reviewed to discuss histologic definitions of GERD as well as current and developing controversies in the area of GERD. Histologic features are not entirely sensitive or specific for GERD. Awareness of these problems is essential; clinical and endoscopic information can be very useful in distinguishing GERD from other inflammatory lesions.

Risk factors associated with oral manifestations and oral health impact of gastro-oesophageal reflux disease: a multicentre, cross-sectional study in Pakistan

“…Accurate diagnosis of oesophagitis was crucial in this study because it is a risk factor for DE 10. Compelling evidence from plasma biomarkers (increased Erythrocyte sedimentation rate (ESR)), clinical symptoms (painful swallowing and dysphagia), signs of erythema, inflammation and ulceration on OGD were markers considered for a definitive diagnosis of oesophagitis 18…”

Histomorphological and clinicopathological correlates of reflux esophagitis

“…4 According to Tripathi et al lymphocytes should be absent in intra epithelial mucosa and their presence >10-15/ High power field indicate reflux esophagitis and presence of eosinophils are not a reliable marker of reflux esophagitis because they can be seen in case of pill induced injury and parasitic infections. 4 In our study 12 cases had increased intra epithelial lymphocytes and 7 cases had increased intra epithelial eosinophils. Increased neutrophils can be associated with endoscopic ulcers with infectious and non-infectious esophagitis.…”

“…This was earlier called kardialgia-heart pain. 4 Reflux is said to be more common in the population consuming hot beverages and carbonated drinks. 5 Incidence is interestingly lower in south Asian countries namely China and Korea.…”

“…5 Incidence is interestingly lower in south Asian countries namely China and Korea. 4 Endoscopy features and histomorphological findings have brought tremendous change in the early diagnosis and management of reflux esophagitis. Our study was conducted to determine the most reliable features to depend on for the diagnosis of reflux esophagitis.…”

“…Intercellular edema is considered when the dilatation is more than 1cm of the lymphocyte's diameter. 4 It is a very significant finding in eosinophilic and lymphocytic esophagitis. 7 In our study, 40 cases had intercellular edema.…”