Endoscopic findings around the gastroesophageal junction

An experience from a tertiary hospital in Korea

Ji Hyun Kim, Jin Ki Hwang, Juhyung Kim, Sehe Dong Lee, Beomjae Lee, Jae Seon Kim, Young-Tae Bak

Research output: Contribution to journalArticle

6 Citations (Scopus)

Abstract

Background/Aims: Important lesions related to gastroesophageal reflux disease (GERD) are located around the gastroesophageal junction (GEJ). This study examined the distribution of endoscopic findings around the GEJ and elucidated their relationship to each other and esophageal manometric features. Methods: Endoscopic data were collected prospectively from 2,450 consecutive diagnostic upper gastrointestinal endoscopies. The presence and degree of hiatal hernia (HH), columnar-lined esophagus (CLE), and reflux esophagitis (RE) were recorded. Esophageal manometric data were collected from 181 patients. Results: The prevalence of HH, CLE, and RE was 9.8, 18.8, and 9.9%, respectively. Of all HH and CLE cases, 62.8 and 98.9%, respectively, were of the short-segment variety. Of all RE cases, 95.0% were mild. Younger age, male gender, the presence of HH, and a higher gastroesophageal flap valve (GEFV) grades were associated with the presence of RE. Increased ZAP grades were associated with increased prevalence and grades of HH, CLE, and RE. Higher GEFV grades were associated with increased prevalence and grades of HH, CLE, and RE. Lower esophageal sphincter pressure (LESP) decreased in patients with HH or RE compared to those without HH or RE. Conclusions: Endoscopic findings around the GEJ revealed that a substantial proportion of our patients showed features potentially related to GERD. In combination with other recent reports, our study implies that Korea is no longer a very-low-prevalence area of GERD, although it may predominate in silent or milder forms.

Original languageEnglish
Pages (from-to)127-133
Number of pages7
JournalKorean Journal of Internal Medicine
Volume23
Issue number3
DOIs
Publication statusPublished - 2008 Sep 1

Fingerprint

Esophagogastric Junction
Peptic Esophagitis
Hiatal Hernia
Korea
Tertiary Care Centers
Esophagus
Gastroesophageal Reflux
Lower Esophageal Sphincter
Gastrointestinal Endoscopy
Pressure

Keywords

  • Columnar-lined esophagus
  • Gastroesophageal flap valve
  • Hiatal hernia
  • Reflux esophagitis
  • Z-line appearance

ASJC Scopus subject areas

  • Internal Medicine

Cite this

Endoscopic findings around the gastroesophageal junction : An experience from a tertiary hospital in Korea. / Kim, Ji Hyun; Hwang, Jin Ki; Kim, Juhyung; Lee, Sehe Dong; Lee, Beomjae; Kim, Jae Seon; Bak, Young-Tae.

In: Korean Journal of Internal Medicine, Vol. 23, No. 3, 01.09.2008, p. 127-133.

Research output: Contribution to journalArticle

Kim, Ji Hyun ; Hwang, Jin Ki ; Kim, Juhyung ; Lee, Sehe Dong ; Lee, Beomjae ; Kim, Jae Seon ; Bak, Young-Tae. / Endoscopic findings around the gastroesophageal junction : An experience from a tertiary hospital in Korea. In: Korean Journal of Internal Medicine. 2008 ; Vol. 23, No. 3. pp. 127-133.
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abstract = "Background/Aims: Important lesions related to gastroesophageal reflux disease (GERD) are located around the gastroesophageal junction (GEJ). This study examined the distribution of endoscopic findings around the GEJ and elucidated their relationship to each other and esophageal manometric features. Methods: Endoscopic data were collected prospectively from 2,450 consecutive diagnostic upper gastrointestinal endoscopies. The presence and degree of hiatal hernia (HH), columnar-lined esophagus (CLE), and reflux esophagitis (RE) were recorded. Esophageal manometric data were collected from 181 patients. Results: The prevalence of HH, CLE, and RE was 9.8, 18.8, and 9.9{\%}, respectively. Of all HH and CLE cases, 62.8 and 98.9{\%}, respectively, were of the short-segment variety. Of all RE cases, 95.0{\%} were mild. Younger age, male gender, the presence of HH, and a higher gastroesophageal flap valve (GEFV) grades were associated with the presence of RE. Increased ZAP grades were associated with increased prevalence and grades of HH, CLE, and RE. Higher GEFV grades were associated with increased prevalence and grades of HH, CLE, and RE. Lower esophageal sphincter pressure (LESP) decreased in patients with HH or RE compared to those without HH or RE. Conclusions: Endoscopic findings around the GEJ revealed that a substantial proportion of our patients showed features potentially related to GERD. In combination with other recent reports, our study implies that Korea is no longer a very-low-prevalence area of GERD, although it may predominate in silent or milder forms.",
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