Endoscopic Classification of Reflux Esophagitis: Staging Based on Observation with the Electronic Endoscope Yoshio Hoshihara 1 , Takashi Kogure 2 , Mitsuyo Hashimoto 1 , Sohtaro Fukuchi 1 1Department of Gastroenterology, Toranomon Hospital 2Department of Radiology, School of Medicine Toho University Keyword: 逆流性食道炎 , 内視鏡分類 , 電子内視鏡 , 再生上皮 , 表面微細構造 pp.1039-1045
Published Date 1992/9/25
DOI https://doi.org/10.11477/mf.1403109975
  • Abstract
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 Savary and Miller's endoscopic classification of reflux esophagitis is the most widely used, but is challenged in some points. We have claimed that it should be classified separately by two factors; surface extent and stage. Makuuchi et al divided reflux esophagitis into six stages; acute (A1, A2), healing (H1, H2) and scarring (S1, S2), referring to the endoscopic classification for gastric ulcer. We confirmed that, by treatment with H2 blocker, reflux esophagitis improved from the acute stage to the healing stage and further to the scarring stage.

 By using the electronic endoscope TGI-50 D or 70 D (TOSHIBA), we could observe spot- and rod-shaped fine patterns in the regenerated mucosa of reflux esophagitis in the H1, or early H2, stage. In the late H2 or S1 stage, these were linearly arranged and partially made straight lines. In the S2 stage some became palmside-like lines and the others were similar to the lines in the surrounding mucosa.

 It is useful to use a classification based on stage in combination with one based on grade, because stage improved in many patients with the lesion in the same grade but the reverse case was rare.

Copyright © 1992, Igaku-Shoin Ltd. All rights reserved.


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