Esophagitis other diagnostic studies: Difference between revisions
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==Overview== | ==Overview== | ||
The [[endoscope]] has been before one of the [[diagnostic]] tools for GERD. Endoscopy is not recommended now for the diagnosis of GERD with the typical symptoms, however, it is used in [[screening]] for the GERD complications as [[esophagitis]], [[esophageal]] [[strictures]], and [[barrett's esophagus]]. [[Endoscopy]] is also beneficial in doing [[biopsies]] in the [[screening]] of [[barrett's esophagus]]. | |||
==Endoscopic Findings== | ==Endoscopic Findings== | ||
===Reflux esophagitis=== | ===Reflux esophagitis=== | ||
Revision as of 21:03, 26 January 2018
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief:
Overview
The endoscope has been before one of the diagnostic tools for GERD. Endoscopy is not recommended now for the diagnosis of GERD with the typical symptoms, however, it is used in screening for the GERD complications as esophagitis, esophageal strictures, and barrett's esophagus. Endoscopy is also beneficial in doing biopsies in the screening of barrett's esophagus.
Endoscopic Findings
Reflux esophagitis
- The endoscope has been before one of the diagnostic tools for GERD.
- Endoscopy is not recommended now for the diagnosis of GERD with the typical symptoms, however, it is used in screening for the GERD complications as esophagitis, esophageal strictures, and barrett's esophagus.[1]
- Endoscopy is also beneficial in doing biopsies in the screening of barrett's esophagus.
- Endoscopic findings of reflux esophagitis include:
- Edema and basal hyperplasia (non-specific inflammatory changes)
- Lymphocytic infiltration (non-specific)
- Neutrophilic infiltration
- Eosinophilic infiltration
- Goblet cell intestinal metaplasia or Barrett's esophagus.
- Elongation of the papillae
- Thinning of the squamous cell layer
- Dysplasia or pre-cancer.
Eosinophilic esophagitis
- Mucosal biopsies of the esophagus should be obtained in all patients in whom EoE is a clinical possibility regardless of the endoscopic appearance.
- Endoscopic abnormalities in patients with EoE are as follows:[2][3][4][5][6]
- Fixed esophageal ring which is corrugated
- White exudate
- Longitudinal furrows
- Mucosal pallor
- Diffuse esophageal narrowing
- Mucosal fragility leading to esophageal lacerations during the endoscopy
- However, because these endoscopic features have been described in other esophageal disorders, none can be considered pathognomonic for EoE.
References
- ↑ Katz, Philip O; Gerson, Lauren B; Vela, Marcelo F (2013). "Guidelines for the Diagnosis and Management of Gastroesophageal Reflux Disease". The American Journal of Gastroenterology. 108 (3): 308–328. doi:10.1038/ajg.2012.444. ISSN 0002-9270.
- ↑ 44</a>)">"Table 3: Proposed classification and grading system for the endoscopic assessment of the esophageal features of eosinophilic esophagitis (<a id=ref-link-section-1 title="" href=/articles/#ref44>44</a>)".
- ↑ "Vertical lines in distal esophageal mucosa (VLEM): a true endoscopic manifestation of esophagitis in children? - PubMed - NCBI".
- ↑ "Fragility of the esophageal mucosa: a pathognomonic endoscopic sign of primary eosinophilic esophagitis? - PubMed - NCBI".
- ↑ "Eosinophilic esophagitis: red on microscopy, white on endoscopy. - PubMed - NCBI".
- ↑ "The prevalence and diagnostic utility of endoscopic features of eosinophilic esophagitis: a meta-analysis. - PubMed - NCBI".