Association between Gastroesophageal Flap Valve and Gastroesophageal Reflux / 대한소화기내시경학회지

ABSTRACT

BACKGROUND/AIMS: Endoscopic grading of the gastroesophageal flap valve (GEFV) was suggested to be a good predictor of the gastroesophageal reflux status. The aim of this study was to examine the association between the GEFV and gastroesophageal reflux. METHODS: A total of 599 patients (245 men and 354 women; mean age 51.0 +/- 0.5 years) who underwent endoscopy, esophageal manometry, and ambulatory pH monitoring were included. GEFV was graded I through to IV using Hill's classification. The GEFV was classified into main 2 groups the normal GEFV (grade I and II) and the abnormal GEFV groups (grade III and IV). The findings of endoscopy, esophageal manometry, and ambulatory pH monitoring were compared. RESULTS: An increased GEFV grade was significantly associated with reflux esophagitis and Barrett's epithelium (p < 0.001). The LES pressure was significantly lower in the abnormal GEFV group (p < 0.001). All variables showing gastroesophageal reflux in the probe were significantly higher in the abnormal GEFV group (p < 0.001). The frequency of gastroesophageal reflux disease (GERD) was higher in the abnormal GEFV group (p < 0.001). CONSLUSIONS There is an association between the altered geometry of the GEFV and the presence of GERD. The endoscopic grading of the GEFV is easy and provides useful information on the gastroesophageal reflux status.