Histopathology of the endoscopic esophagogastric junction in patients with gastroesophageal reflux disease

Abstract

In patients with gastroesophageal reflux disease the esophagogastric junction cannot be identified by endoscopy but requires histopathology of multilevel biopsies. The squamocolumnar junction harbors the highest yield of intestinal metaplasia.

Selected Commentary to "The position of the acid pocket as a major risk factor for acidic reflux in healthy subjects and GERD patients"

“…In GERD patients the proximal 1.0-2.0 cm of the gastric type folds contain columnar lined esophagus (CLE) (Fig. 5) [14]. It is assumed that the length of the segments of DESE interposed between the squamous lined esophagus and the proximal stomach (containing oxyntic mucosa) reflects the duration and severity of reflux disease (Fig.…”

Barrett's esophagus: filling the gap

“…The proximal to distal distribution of the mucosal types within the squamo-oxyntic gap follows a specific zonation with intestinal metaplasia at the squamocolumnar junction followed by cardiac and oxyntocardiac mucosa more distally [2,3,7]. According to the surgeon Steven DeMeester, Los Angeles, this zonation is paralleled by the pH gradient and the genetic profile gradient across the squamo-oxyntic gap [8] (Fig.…”

“…squamo-oxyntic gap may be visible during endosopy, this endoscopically visible CLE, the length of the CLE covering the dilated distal esophagus (i.e., the cardia) can be assessed by multi-level biopsies obtained from the proximal portion of the endoscopically visible ''gastric type folds'' [3,7].…”

Roboterassistierte laparoskopische Cardiomyotomie

“…Viral infections, inflammation, autoimmune processes and a genetic predisposition are discussed as possible causes. The condition begins with slight swallowing disturbances and progresses slowly over years; if untreated it often results in a dilated aperistaltic (sigmoid or mega-) esophagus at risk for aspiration, malignoma [1][2][3][4] or even perforation. The main symptoms are dysphagia for liquid and solid food, regurgitation of indigested food, and heartburn.…”