A Grading of Reflux Esophagitis: in View of Pathophysiological Findings Moriya Machida 1 , Toshikazu Sekiguchi 1 1Department of First Internal Medicine, Gunma University, School of Medicine Keyword: 逆流性食道炎 , 重症度分類 , 色調変化型食道炎 , 24時間pHモニタリング , 食道運動機能 pp.1021-1027
Published Date 1992/9/25
DOI https://doi.org/10.11477/mf.1403109972
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 This paper reports a comparative study on endoscopical grading and pathophysiological grading of reflux esophagitis. The episodes and duration of gastroesophageal reflux (GER) were estimated by 24-hour pH monitoring in distal esophagus. Esophageal motor function was evaluated by the amplitude of primary peristalsis in the esophageal body and the lower esophageal sphincter pressure (LES) under the infused catheter method. At the same time, acid clearing tests were performed. The endoscopical grading by Savary & Miller (S & M) classification corresponds to the grading of pathophysiological findings in stage Ⅰ, Ⅱ and Ⅲ respectively. However, the pathophysiological findings of stage Ⅳ was milder than that of stage Ⅲ. The pathophysiological findings of discoloring type esophagitis were similar to that of stage Ⅰ. There were correlations between discoloring type esophagitis and episodes of GER, and between stage Ⅰ esophagitis and duration of GER. Based on these results, we proposed a grading scale of reflux esophagitis in view of pathophyBiological findings. According to our grading, Grade Ⅰ may be composed of discoloring type esophagitis and stage Ⅰ (S & M). Grade Ⅱ and Ⅲ may correspond to stage Ⅱ and Ⅲ (S & M) respectively. But stricture and Barrett's esophagus (stage Ⅳ of S&M) may be considered additional factors in view of pathophysiological findings.

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