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Magnification Endoscopy in Non Erosive Reflux Disease. It Is Right Classify?

2007; Elsevier BV; Volume: 65; Issue: 5 Linguagem: Inglês

10.1016/j.gie.2007.03.220

1097-6779

García R. Luis Eduardo, Sobrino Cossio Sergio, Hernández Guerrero Angélica, Sánchez Del Monte Julio, Alonso Lárraga Octavio, Pulido Moncayo Manuel,

Gastroesophageal reflux and treatments

Backgrounds: Non Erosive Reflux Disease (NERD) is a group of heterogeneous alterations that present typical symptoms of gastroesophagic reflux like heartburn, regurgitation or both, in absence of visible injuries by endoscopy. Cromoendoscopy and magnification endoscopy can detect non observed erosions with conventional endoscopy and classify correctly the patients. Objectives: To establish if the magnification endoscopy with cromoendoscopy can identify non observed erosions by conventional endoscopy in patients with NERD. Material and Methods: It's a prospective, transversal, comparative and descriptive study. They included both sex patients, age 18-75 years, with NERD. It was applied Carlsson-Dent questionnaire, was made conventional endoscopy and was classified like NERD or erosive esofagitis, patients without erosions, was made cromoscopy with lugol and magnification to re-classify them like NERD or erosive disease. The observations were made for a single endoscopist. Statistical Analysis: It was applied “t” student test to compare both groups, it was considered statistically significant with p < 0.05. It was made Kappa test to agreement for Inter and intraobserver and between conventional and magnification endoscopy. Results: A total of 8 and 8 patients in the study and control group respectively were included. It was not observe significant diferences in demographic characteristics. There was a sensivity of 100%, especificity 50%, positive predictive value 66% and negative predictive value of 100% for Carlsson-Dent test. It was observe a change in the proportion erosive-non-erosive esofagitis, 37.5% erosive and 62.5% NERD with conventional endoscopy and 68.75% erosives and 31.25% NERD with magnification endoscopy. The NERD predomine in female patients in both groups.. It wasn't significant diference between both groups in pH-metry results. The interobserver and itraobserver agreement Kappa test was 0.52 IC 95% (0.116-0.913) and 0.625 IC 95% (0.2427-1.0073) respectively. The agreement between conventional and magnification study was Kappa 0.42 IC 95% (0.03-0.89). Conclusions: The use of magnification endoscopy can identify non seen erosions with conventional endoscopy in NERD patients and then with base in a better cassification of them, decide the best treatment for each patient. It is necessary increase the sample size to obtain statistical significant diference between groups and propose characteristics of magnification endoscopy erosions images.