The Clinical Significance of Endoscopic Findings of Minimal Change Esophagitis and its Diagnostic Value in Egyptian NERD Patients

Abstract

Gastroesophageal reflux disease (GERD) is defined as the reflux of gastric contents into the esophagus, leading to esophagitis, reflux symptoms sufficient to impair the quality of life, and increased risk of long-term complications (Barlow et al., 2005). This definition emphasizes that gastroesophageal reflux becomes a disease when it either causes macroscopic damage to the esophagus or affects the quality of life (Kim et al., 2011). GERD can be divided into erosive (ERD) and non erosive (NERD) reflux disease, and the presence or severity of erosive esophagitis at endoscopy has been defined using mucosal breaks based on the Los Angeles classification (Caviglia et al., 2007). In our study we recruited 60 patients in 2 groups, GERD group with GERD symptoms but negative mucosal breaks (NERD) and non GERD group according to GERDQ, Both of them were investigated for the presence of the six identified minimal changes and there significance to the symptoms. We found a high significant difference between patient and control groups as regard BMI, sex, smoking and white turbid discoloration as a minimal change, also a high significant difference was found between cardia and erythema, blurring of Z-line as a minimal change also. Also we identified two of the six minimal change esophagitis endoscopically as being more common in the patient group with GERD symptoms compared with the other findings which are erythema and white turbid discoloration. So, according to our study there is no clinical relevance in the diagnosis of NERD depending on endoscopic minimal change espphagitis.