The endoscopic assessment of esophagitis: A progress report on observer agreement

Armstrong, David; Bennett, J R; Al, Blum; Dent, John; Dombal, FT de; Jp, Galmiche; Lundell, Lars; Margulies, M; Richter, Joachim; Sj, Spechler; Tytgat, G. N. J.; Wallin, L

doi:10.1053/gast.1996.v111.pm8698230

Cited by 991 publications

(779 citation statements)

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“…Four gastric biopsies were carried out, two in the body and two in the antrum, always in the greater gastric curvature. Los Angeles and Sydney classification were used in the endoscopic analysis of esophagitis and gastritis (1,8) .…”

Section: Methodsmentioning

confidence: 99%

Prevalence of upper digestive endoscopy and gastric histopathology findings in morbidly obese patients

Dietz¹,

Ulbrich-Kulcynski

Souto³

et al. 2012

Arq. Gastroenterol.

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Section: Methodsmentioning

confidence: 99%

Prevalence of upper digestive endoscopy and gastric histopathology findings in morbidly obese patients

Dietz¹,

Ulbrich-Kulcynski

Souto³

et al. 2012

Arq. Gastroenterol.

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“…28 Erosive reflux oesophagitis was considered to be present when at least one mucosal break was detected. 29 Hiatal hernia was considered to be present when the gastro-oesophageal junction was detected 3 cm or more above the diaphragmatic impression. The presence of Helicobacter pylori was determined by histological assessment, rapid urease test or 13 C-urea breath test.…”

Section: Methodsmentioning

confidence: 99%

Different patterns of oesophageal acid exposure distinguish complicated reflux disease from either erosive reflux oesophagitis or non‐erosive reflux disease

Frazzoni

Micheli

Savarino

2003

Aliment Pharmacol Ther

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SummaryBackground : The reason why less than one‐half of patients with gastro‐oesophageal reflux disease develop complicated reflux disease (ulcerative oesophagitis, oesophageal strictures and Barrett's oesophagus) and erosive reflux oesophagitis is not fully understood. Supine nocturnal oesophageal acid reflux is considered to be critically involved in this phenomenon, but reliable data are lacking.Aim : To clarify whether high levels of supine nocturnal oesophageal acid exposure are associated with complicated reflux disease.Methods : Ambulatory 24‐h oesophageal pH monitoring was performed in 220 patients with gastro‐oesophageal reflux disease (56 with complicated reflux disease, 76 with erosive reflux oesophagitis and 88 with non‐erosive reflux disease). The total, supine nocturnal and upright diurnal percentage acid reflux times were calculated.Results : The total percentage acid reflux time was significantly greater in complicated reflux disease than in either erosive reflux oesophagitis (P = 0.024) or non‐erosive reflux disease (P = 0.000). These differences were entirely due to a greater supine nocturnal percentage acid reflux time (P = 0.038 and P = 0.000, respectively), whereas no difference was observed in the upright diurnal percentage acid reflux time.Conclusions : Complicated reflux disease is characterized by high levels of supine nocturnal percentage acid reflux time. Prospective studies would be appropriate to clarify whether the normalization of this parameter is relevant to the effective management of this subset of patients with gastro‐oesophageal reflux disease.

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“…A classificação endoscópica proposta por Savary & Miller e a classificação de Los Angeles, proposta mais recentemente, são amplamente utilizadas por especialistas em endoscopia de adultos [2][3][4][5] . Esses sistemas de classificação têm o inconveniente de diagnosticar o processo inflamatório somente a partir da esofagite erosiva.…”

Section: J Pediatr (Rio Junclassified

Diagnosis of reflux esophagitis in infants: histology of the distal esophagus must complement upper gastrointestinal endoscopy

Vieira¹,

Pisani²,

Mulinari³

2004

J Pediatr (Rio J)

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Objective: The aim of this study was to validate the endoscopic findings against histologic features of the distal esophageal mucosa for the diagnosis of reflux esophagitis in infants.Methods: The data records of 167 patients (88 M; 79F) aged 38-364 days, referred for investigation of reflux esophagitis, between January 1995 and December 2000 were retrospectively reviewed. The association between nominal (presence or absence of esophagitis) and ordinal (grades of esophagitis) variables was analyzed through a correlation between the results of endoscopic findings and histology.Results: Endoscopy when compared with histologic analysis had a sensitivity of 45%; specificity of 71%; positive and negative predictive value of 89% and 21% respectively; and accuracy of 50%. Additionally, this study demonstrated that there was a poor correlation between endoscopic and histologic findings when endoscopy was normal or when endoscopic grade I esophagitis was observed (p = 0.10). Normal esophageal appearance failed to identify 79.2% of patients with histologic esophagitis. Conversely, amongst patients with endoscopic grade I esophagitis, 12.1% had normal histology. Conclusions:We concluded that whilst endoscopy had a specificity of 71%, it did not attain an acceptable range of sensitivity (45%) to justify performing an endoscopy without biopsy, as many true cases of esophagitis would not be detected; and that the presence of grade I (non-erosive) esophagitis at endoscopy did not increase the value of the test in predicting histologic abnormality. ResumoObjetivo: O objetivo deste estudo foi o de validar os resultados do exame de endoscopia digestiva alta contra a histologia do esôfago distal para o diagnóstico da esofagite de refluxo em lactentes.Métodos: Foram revisados os prontuários de 167 pacientes (88 do sexo masculino e 79 do sexo feminino) com idade de 38 a 364 dias, encaminhados para investigação de esofagite de refluxo no período de janeiro de 1995 a dezembro de 2000. Analisou-se a associação entre as variáveis nominais (presença ou ausência de esofagite) e ordinais (graus de esofagite) através da comparação entre os resultados da endoscopia digestiva alta e histologia.Resultados: A endoscopia digestiva alta, quando comparada à histologia, apresentou sensibilidade de 45%, especificidade de 71%, valores preditivos positivo de 89% e negativo de 21%, e acurácia de 50%. Verificou-se baixa concordância entre os achados endoscópicos e histológicos na endoscopia digestiva alta normal ou na esofagite grau I (eritema leve ao nível da transição epitelial, apagamento, friabilidade e perda do brilho da mucosa) (p = 0,10). A endoscopia digestiva alta normal não identificou 79,2% dos pacientes com esofagite histológica. Entre os pacientes com esofagite grau I à endoscopia digestiva alta, 12,1% não apresentaram alterações histológicas.Conclusões: Concluiu-se que, enquanto a endoscopia digestiva alta apresentou especificidade de 71%, não atingiu sensibilidade aceitável (45%) para justificar sua realização sem biópsia; e que ...

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The endoscopic assessment of esophagitis: A progress report on observer agreement

Cited by 991 publications

References 10 publications

Prevalence of upper digestive endoscopy and gastric histopathology findings in morbidly obese patients

Prevalence of upper digestive endoscopy and gastric histopathology findings in morbidly obese patients

Different patterns of oesophageal acid exposure distinguish complicated reflux disease from either erosive reflux oesophagitis or non‐erosive reflux disease

Diagnosis of reflux esophagitis in infants: histology of the distal esophagus must complement upper gastrointestinal endoscopy

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