Comparison between digestive endoscopy and 24-hour esophageal pH monitoring for the diagnosis of gastroesophageal reflux esophagitis: "presentation of 100 cases"

Hepatogastroenterology. 2000 Jan-Feb;47(31):174-80.

Abstract

Background/aims: We present the results obtained from 100 new cases of clinical esophagitis caused by gastroesophageal reflux at the Hospital of Caldas and at the Service of Gastroenterology of VIME (Endoscopical Video Medicine) in Manizales, Caldas, Colombia; between the months of June and November of 1996, evaluated by digestive endoscopy and classified based on the New Savary-Miller 5-Grade Classification.

Methodology: The patients were selected based on the presence of symptomatology suggestive of esophagitis caused by gastroesophageal reflux; an endoscopy was performed followed by 24-hour esophageal pH monitoring. The patients were grouped according to their grade of esophagitis in the New Savary-Miller Classification. The central analysis was focused on determining the existing relationship between the observed esophagitis and the results obtained by the 24-hour esophageal pH monitoring.

Results: Findings show that 51% and 48% of patients with esophagitis grades 1 and 2 had a normal DeMeester's score (< 14.7) in channel 1. In channel 2 we found normal scores in 86% and 82% of esophagitis grades 1 and 2, respectively.

Conclusions: We ask whether the average level of pathological reflux of 14.7 can be extrapolated to our population; also whether endoscopical overdiagnosis of esophagitis caused by gastroesophageal reflux exists, or if non-recognized causes of esophagitis exist. Another question is if it is justified to order 24-hour esophageal pH monitoring in patients with grades 1 and 2 esophagitis.

Publication types

  • Comparative Study

MeSH terms

  • Adult
  • Esophagitis / diagnosis*
  • Esophagitis / etiology*
  • Female
  • Gastroesophageal Reflux / complications*
  • Gastroscopy*
  • Humans
  • Hydrogen-Ion Concentration
  • Male
  • Monitoring, Physiologic / methods*