Is minimal change esophagitis really part of the spectrum of endoscopic findings of gastroesophageal reflux disease? A prospective, multicenter study

Title
Is minimal change esophagitis really part of the spectrum of endoscopic findings of gastroesophageal reflux disease? A prospective, multicenter study
Author(s)
김태년J. H. Kim[J. H. Kim]H. Park[H. Park]Y. C. Lee[Y. C. Lee]김진홍 외 3명[김진홍 외 3명]김성훈 외 1명[김성훈 외 1명]최창환[최창환]신정은[신정은]이준규[이준규]박영숙[박영숙]정혜경 외 1인[정혜경 외 1인]손주현[손주현]김형길[김형길]박경식 외 1인[박경식 외 1인]진전조 외 1인[진전조 외 1인]허규찬[허규찬]이상우 외 2인[이상우 외 2인]조재희 외 1인[조재희 외 1인]김성국[김성국]김태오[김태오]이동호 외 2인[이동호 외 2인]손종일 외 1인[손종일 외 1인]이상진[이상진]신성관[신성관]
Keywords
MANAGEMENT; DIAGNOSIS
Issue Date
201103
Publisher
GEORG THIEME VERLAG KG
Citation
ENDOSCOPY, v.43, no.3, pp.190 - 195
Abstract
Background and study aims: Although minimal changes are one of the endoscopic findings of nonerosive reflux disease (NERD), the clinical significance of minimal changes is controversial. This study evaluated the clinical significance of minimal changes and examined whether such changes have diagnostic value in gastroesophageal reflux disease (GERD). Patients and methods: The endoscopic findings were assessed from 1445 patients identified as having minimal changes who were seen across 30 institutions between April and September 2009. Six endoscopic criteria reported to have acceptable-to-good agreement between endoscopists were used for assessing minimal changes: erythema, blurring of the Z-line, friability, decreased vascularity, white turbid discoloration, and edema or accentuation of the mucosal folds. The diagnosis of GERD was based on the GerdQ, a questionnaire for identifying GERD among patients with upper gastrointestinal symptoms. Results: Of the 1445 patients, 44.5% were categorized into the GERD group based on the GerdQ. No significant differences in clinical characteristics were found between the GERD and non-GERD groups, except in age and height. Blurring of the Z-line and erythema were the most common endoscopic findings of minimal changes in this study. Only one of the six findings (16.7%) was more common in the GERD group than in the non-GERD group. Using more than one endoscopic finding was not more useful for identifying GERD than using only one endoscopic finding. Conclusions: Most of the endoscopic findings indicating minimal changes are not associated with GERD. The clinical significance of minimal changes should be reconsidered.
URI
http://hdl.handle.net/YU.REPOSITORY/25524http://dx.doi.org/10.1055/s-0030-1256101
ISSN
0013-726X
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의과대학 > 내과학교실 > Articles
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