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Image-enhanced endoscopy is specific for the diagnosis of non-erosive gastroesophageal reflux disease.
Scand J Gastroenterol. 2018 Mar; 53(3):260-264.SJ

Abstract

OBJECTIVES

We assessed the performance characteristics of image-enhanced endoscopy with i-Scan or narrow band imaging (NBI) in patients with non-erosive gastroesophageal reflux disease (GERD) compared to controls without heartburn.

MATERIAL AND METHODS

Image-enhanced endoscopic findings of vascularity at the squamocolumnar junction, distal esophageal micro-erosions, and non-round pit pattern at the squamocolumnar junction were assessed in cases (heartburn not responsive to PPIs, positive results on validated GERD questionnaire, no esophageal erosions, esophageal biopsies with histologic evidence of GERD (basal cell hyperplasia, elongation of papillae and dilation of intercellular spaces all required)) and in controls (no GERD symptoms or esophageal erosions).

RESULTS

Twenty cases and 60 controls were compared. The pre-defined features were more common in cases vs.

CONTROLS

vascularity RR = 4.9 (95% CI: 2.4-10.0), specificity = 86.7%; micro-erosions RR = 9.7 (3.6-26.5), specificity = 93.3%; non-round pit pattern RR = 2.4 (1.7-3.3), specificity = 60.0%; combination of vascularity and micro-erosions RR = 30.0 (4.1-220), specificity = 98.3%. These differences were consistent with both i-Scan and NBI.

CONCLUSIONS

Image-enhanced endoscopic findings of vascularity and micro-erosions were very specific for non-erosive GERD. Image-enhanced endoscopy may be useful in real-time diagnosis of non-erosive GERD when patients undergo upper endoscopy for heartburn. The relative utility of image-enhanced endoscopy vs. pH-impedance monitoring, based on efficacy, cost and patient acceptance, requires additional study.

Authors+Show Affiliations

a Section of Digestive Diseases , Yale School of Medicine , New Haven , CT , USA. b VA Connecticut Healthcare System , West Haven , CT , USA.a Section of Digestive Diseases , Yale School of Medicine , New Haven , CT , USA. b VA Connecticut Healthcare System , West Haven , CT , USA.c Northeastern University , Boston , MA , USA.a Section of Digestive Diseases , Yale School of Medicine , New Haven , CT , USA. b VA Connecticut Healthcare System , West Haven , CT , USA.

Pub Type(s)

Journal Article
Multicenter Study

Language

eng

PubMed ID

29368532

Citation

Parikh, Neil D., et al. "Image-enhanced Endoscopy Is Specific for the Diagnosis of Non-erosive Gastroesophageal Reflux Disease." Scandinavian Journal of Gastroenterology, vol. 53, no. 3, 2018, pp. 260-264.
Parikh ND, Viana AV, Shah S, et al. Image-enhanced endoscopy is specific for the diagnosis of non-erosive gastroesophageal reflux disease. Scand J Gastroenterol. 2018;53(3):260-264.
Parikh, N. D., Viana, A. V., Shah, S., & Laine, L. (2018). Image-enhanced endoscopy is specific for the diagnosis of non-erosive gastroesophageal reflux disease. Scandinavian Journal of Gastroenterology, 53(3), 260-264. https://doi.org/10.1080/00365521.2018.1430847
Parikh ND, et al. Image-enhanced Endoscopy Is Specific for the Diagnosis of Non-erosive Gastroesophageal Reflux Disease. Scand J Gastroenterol. 2018;53(3):260-264. PubMed PMID: 29368532.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Image-enhanced endoscopy is specific for the diagnosis of non-erosive gastroesophageal reflux disease. AU - Parikh,Neil D, AU - Viana,Artur V, AU - Shah,Saloni, AU - Laine,Loren, Y1 - 2018/01/25/ PY - 2018/1/26/pubmed PY - 2018/9/18/medline PY - 2018/1/26/entrez KW - Gastroesophageal reflux KW - endoscopy KW - gastrointestinal KW - heartburn KW - image enhancement SP - 260 EP - 264 JF - Scandinavian journal of gastroenterology JO - Scand. J. Gastroenterol. VL - 53 IS - 3 N2 - OBJECTIVES: We assessed the performance characteristics of image-enhanced endoscopy with i-Scan or narrow band imaging (NBI) in patients with non-erosive gastroesophageal reflux disease (GERD) compared to controls without heartburn. MATERIAL AND METHODS: Image-enhanced endoscopic findings of vascularity at the squamocolumnar junction, distal esophageal micro-erosions, and non-round pit pattern at the squamocolumnar junction were assessed in cases (heartburn not responsive to PPIs, positive results on validated GERD questionnaire, no esophageal erosions, esophageal biopsies with histologic evidence of GERD (basal cell hyperplasia, elongation of papillae and dilation of intercellular spaces all required)) and in controls (no GERD symptoms or esophageal erosions). RESULTS: Twenty cases and 60 controls were compared. The pre-defined features were more common in cases vs. CONTROLS: vascularity RR = 4.9 (95% CI: 2.4-10.0), specificity = 86.7%; micro-erosions RR = 9.7 (3.6-26.5), specificity = 93.3%; non-round pit pattern RR = 2.4 (1.7-3.3), specificity = 60.0%; combination of vascularity and micro-erosions RR = 30.0 (4.1-220), specificity = 98.3%. These differences were consistent with both i-Scan and NBI. CONCLUSIONS: Image-enhanced endoscopic findings of vascularity and micro-erosions were very specific for non-erosive GERD. Image-enhanced endoscopy may be useful in real-time diagnosis of non-erosive GERD when patients undergo upper endoscopy for heartburn. The relative utility of image-enhanced endoscopy vs. pH-impedance monitoring, based on efficacy, cost and patient acceptance, requires additional study. SN - 1502-7708 UR - https://www.unboundmedicine.com/medline/citation/29368532/Image_enhanced_endoscopy_is_specific_for_the_diagnosis_of_non_erosive_gastroesophageal_reflux_disease_ L2 - http://www.tandfonline.com/doi/full/10.1080/00365521.2018.1430847 DB - PRIME DP - Unbound Medicine ER -