Endoscopic appearances of the gastro-esophageal valve and competence of the cardia

ABSTRACT

The endoscopic appearances of the gastro-oesophegal valve, viewed by the retroflexed gastroscope have been studied in 51 patients with and without reflux oesophagitis. Oesphagitis was graded according to its severity and the yield pressure [YP] was measured in all patients and to assess the competence of the cardia. There was a close relationship between the YP and the grades of the gastro-oesophageal valve. Yield prerssure was significantly lower in patients with endoscopic oesophagitis than in patients with no evidence of reflux oesophagitis [p< 0.0001]. An increased abnormality of the gastro-oesophageal valve was associated with all grades of oesophagitis and with a low YP. The valve mechanism at the cardia has an important role in determining its competence. YP is possibly a measure of the flap valve component of the gastro-oesphageal junction