Endoscopic observations around the gastroesophageal junction in patients with symptomatic gastroesophageal reflux disease in South Asia

Abstract

INTRODUCTION: We studied the inter-relationships of endoscopic findings around the gastroesophageal junction in patients with symptomatic gastroesophageal reflux. METHODS: Data were collected with regard to hiatus hernia (HH), columnar-lined esophagus (CLE), reflux esophagitis (RE) and gastroesophageal flap valve (GEFV), prospectively from 1,150 patients who underwent diagnostic upper gastrointestinal endoscopy for symptomatic gastroesophageal reflux. RESULTS: The frequency of HH, CLE and RE was 14.3% (n=165), 9.5% (n=109) and 13.3% (n=153), respectively. In the CLE group, 48 were histologically proven to have Barrett's esophagus. Of all RE patients, 94.8% had mild esophagitis (LA-A and B) and this was associated with younger age, male gender, presence of HH, and grade 3 or 4 gastroesophageal flap valve (GEFV). Grades 3 and 4 GEFV were associated with HH, CLE, and RE. CONCLUSIONS: Substantial proportion of patients with symptoms of GERD has abnormal endoscopic findings around the gastroesophageal junction