THE UTILITY OF NARROW BAND IMAGING IN IMPROVING THE ENDOSCOPIC DIAGNOSIS OF OESPHAGEAL DISEASE

Abstract

astroesophageal reflux disease (GERD) is caused by the reflux of gastric contentsinto the esophagus. The diagnosis of GERD is based on the combination of clinical symptoms, endoscopic findings and histological changes. Based on the findings of conventional endoscopy and histopathological examination, GERD is generally categorized into three progressive stages: nonerosive reflux disease (NERD), erosive reflux disease(ERD), and Barrett’s esophagus (BE). Narrow Band Imaging (NBI) facilitates mucosal surface evaluation and may improve the endoscopic diagnosis of GERD. In this study we tried to estimate the accuracy of NBI in diagnosing non malignant esophageal disease on 150 patients presenting with symptoms suggestive of reflux disease and comparing the results of the NBI with the conventional endoscope and the histopathology. Studied patients were 91 males (60.6%) and 59 females (39.4%).Mean age of the patients was 37.1 ± 12.5 years. In the study, 40 patients (26.6%) presented by regurgitation, 39 patients (26%) presented with heartburn, 59 patients (39.3%) presented with both heartburn and regurgitation and 12 patients (8.1%) presented with other different symptoms. D.M, IHD, smoking, NSAIDs use and Hiatus Hernia were non significant as a cause or a risk factor for GERD. Conventional upper GIT endoscopy showed, Non Erosive Reflux Disease (NERD) in 99 patients (66%), Erosive Reflux Disease (ERD) in 46 patients (30.7%) and 5patients (3.3%) were diagnosed as Barrett’s esophagus. The patients subclassification by conventional upper endoscopy are 99 patients (66%) were diagnosed as NERD, 20 patients (13.3%)were GERD A, 15 patients (10%) were GERD B, 9 patients (6%) were GERD C, 2 patients(1.4%) were GERD D and 5 patients (3.3%) were Barrett’s esophagus. While NBI showed, NERD in 81 patients (54%), ERD in 61 patients (40.6%) and 8 patients (5.4%) were diagnosed as Barrett’s esophagus.