| Theme | GERD -- Recent Clinical Advances | |
|---|---|---|
| Title | Recent Progress in Endoscopic Diagnosis of GERD | |
| Publish Date | 2009/05 | |
| Author | Hiroyasu Makuuchi | Department of Digestive Surgery, Tokai University School of Medicine |
| Author | Hideo Shimada | Department of Digestive Surgery, Tokai University School of Medicine |
| Author | Osamu Chino | Department of Digestive Surgery, Tokai University School of Medicine |
| Author | Takayuki Nishi | Department of Digestive Surgery, Tokai University School of Medicine |
| Author | Souichirou Yamamoto | Department of Digestive Surgery, Tokai University School of Medicine |
| Author | Yu Nakui | Department of Digestive Surgery, Tokai University School of Medicine |
| [ Summary ] | Recently, the endoscope and related endoscopic instruments have been dramatically improved. High resolution electronic endoscope, magnifying endoscopes, NBI and chromoendoscopy are indispensable for the diagnosis of GERD. The Los Angeles classification is used for endoscopic classification of reflux esophagitis. Magnifying endoscopy with NBI and iodine staining are useful for endoscopic diagnosis of NERD. There are some case where there is a difference between endoscopic views and subjective systems for determining reflux esophagitis. Differential diagnosis of malignant or benign lesions in erosive or ulcerative lesions in the gastro-esophageal junction is extremely difficult, even if a biopsy examination is performed. The presence of a regenerate epithelium is considered to be evidence of a benign lesion. Reexamination of endoscopic information is often requested after PPI administration. To produce a diagnosis of Barrett's cancer, we use chromoendoscopy with crystal violet or acetic acid indigocarmine staining. Magnifying endoscopy with NBI is also employed to determin emucosal and capillary patterns. |
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