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==Other Diagnostic Studies== | ==Other Diagnostic Studies== | ||
==Endoscopic Findings== | |||
===Reflux esophagitis=== | |||
*The [[endoscope]] has been before one of the [[diagnostic]] tools for GERD. | |||
*Endoscopy is not recommended now for the diagnosis of GERD with the typical symptoms, however, it is used in [[screening]] for the GERD complications as [[esophagitis]], [[esophageal]] [[strictures]], and [[barrett's esophagus]].<ref name="KatzGerson2013">{{cite journal|last1=Katz|first1=Philip O|last2=Gerson|first2=Lauren B|last3=Vela|first3=Marcelo F|title=Guidelines for the Diagnosis and Management of Gastroesophageal Reflux Disease|journal=The American Journal of Gastroenterology|volume=108|issue=3|year=2013|pages=308–328|issn=0002-9270|doi=10.1038/ajg.2012.444}}</ref> | |||
*[[Endoscopy]] is also beneficial in doing [[biopsies]] in the [[screening]] of [[barrett's esophagus]]. | |||
*Endoscopic findings of reflux esophagitis include: | |||
*** [[Edema]] and basal [[hyperplasia]] (non-specific [[inflammatory]] changes) | |||
*** [[Lymphocytic]] infiltration (non-specific) | |||
*** [[Neutrophilia|Neutrophilic]] [[Inflammation|infiltration]] | |||
*** [[Eosinophilic]] [[Inflammation|infiltration]] | |||
*** [[Goblet cell]] [[intestinal]] [[metaplasia]] or [[Barrett's esophagus]]. | |||
*** Elongation of the [[papillae]] | |||
*** Thinning of the [[squamous cell]] layer | |||
*** [[Dysplasia]] or [[pre-cancer]]. | |||
===Eosinophilic esophagitis=== | |||
*[[Mucosal]] [[biopsies]] of the [[esophagus]] should be obtained in all patients in whom EoE is a clinical possibility regardless of the [[Endoscopy|endoscopic]] appearance. | |||
*[[Endoscopic]] [[abnormalities]] in patients with EoE are as follows:<ref name="urlTable 3: Proposed classification and grading system for the endoscopic assessment of the esophageal features of eosinophilic esophagitis (<a id=ref-link-section-1 title= href=/articles/#ref44">44</a>)">{{cite web |url=https://www.nature.com/articles/ajg201371/tables/3 |title=Table 3: Proposed classification and grading system for the endoscopic assessment of the esophageal features of eosinophilic esophagitis (<a id=ref-link-section-1 title="" href=/articles/#ref44>44</a>) |format= |work= |accessdate=}}</ref><ref name="urlVertical lines in distal esophageal mucosa (VLEM): a true endoscopic manifestation of esophagitis in children? - PubMed - NCBI">{{cite web |url=https://www.ncbi.nlm.nih.gov/pubmed/9199905?dopt=Abstract&holding=npg |title=Vertical lines in distal esophageal mucosa (VLEM): a true endoscopic manifestation of esophagitis in children? - PubMed - NCBI |format= |work= |accessdate=}}</ref><ref name="urlFragility of the esophageal mucosa: a pathognomonic endoscopic sign of primary eosinophilic esophagitis? - PubMed - NCBI">{{cite web |url=https://www.ncbi.nlm.nih.gov/pubmed/12612531?dopt=Abstract&holding=npg |title=Fragility of the esophageal mucosa: a pathognomonic endoscopic sign of primary eosinophilic esophagitis? - PubMed - NCBI |format= |work= |accessdate=}}</ref><ref name="urlEosinophilic esophagitis: red on microscopy, white on endoscopy. - PubMed - NCBI">{{cite web |url=https://www.ncbi.nlm.nih.gov/pubmed/15383737?dopt=Abstract&holding=npg |title=Eosinophilic esophagitis: red on microscopy, white on endoscopy. - PubMed - NCBI |format= |work= |accessdate=}}</ref><ref name="urlThe prevalence and diagnostic utility of endoscopic features of eosinophilic esophagitis: a meta-analysis. - PubMed - NCBI">{{cite web |url=https://www.ncbi.nlm.nih.gov/pubmed/22610003?dopt=Abstract&holding=npg |title=The prevalence and diagnostic utility of endoscopic features of eosinophilic esophagitis: a meta-analysis. - PubMed - NCBI |format= |work= |accessdate=}}</ref> | |||
**Fixed [[esophageal]] ring which is corrugated | |||
**White [[exudate]] | |||
**Longitudinal furrows | |||
**[[Mucous membrane|Mucosal]] [[pallor]] | |||
**[[Diffuse]] [[esophageal]] narrowing | |||
**[[Mucosal]] fragility leading to [[esophageal]] lacerations during the [[endoscopy]] | |||
*However, because these [[Endoscopy|endoscopic]] features have been described in other [[esophageal]] [[disorders]], none can be considered [[pathognomonic]] for EoE. | |||
==References== | ==References== | ||
{{reflist|2}} | {{reflist|2}} | ||
Revision as of 18:26, 24 January 2018
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief:
Overview
There are no other diagnostic studies associated with esophagitis.
Other Diagnostic Studies
Endoscopic Findings
Reflux esophagitis
- The endoscope has been before one of the diagnostic tools for GERD.
- Endoscopy is not recommended now for the diagnosis of GERD with the typical symptoms, however, it is used in screening for the GERD complications as esophagitis, esophageal strictures, and barrett's esophagus.[1]
- Endoscopy is also beneficial in doing biopsies in the screening of barrett's esophagus.
- Endoscopic findings of reflux esophagitis include:
- Edema and basal hyperplasia (non-specific inflammatory changes)
- Lymphocytic infiltration (non-specific)
- Neutrophilic infiltration
- Eosinophilic infiltration
- Goblet cell intestinal metaplasia or Barrett's esophagus.
- Elongation of the papillae
- Thinning of the squamous cell layer
- Dysplasia or pre-cancer.
Eosinophilic esophagitis
- Mucosal biopsies of the esophagus should be obtained in all patients in whom EoE is a clinical possibility regardless of the endoscopic appearance.
- Endoscopic abnormalities in patients with EoE are as follows:[2][3][4][5][6]
- Fixed esophageal ring which is corrugated
- White exudate
- Longitudinal furrows
- Mucosal pallor
- Diffuse esophageal narrowing
- Mucosal fragility leading to esophageal lacerations during the endoscopy
- However, because these endoscopic features have been described in other esophageal disorders, none can be considered pathognomonic for EoE.
References
- ↑ Katz, Philip O; Gerson, Lauren B; Vela, Marcelo F (2013). "Guidelines for the Diagnosis and Management of Gastroesophageal Reflux Disease". The American Journal of Gastroenterology. 108 (3): 308–328. doi:10.1038/ajg.2012.444. ISSN 0002-9270.
- ↑ 44</a>)">"Table 3: Proposed classification and grading system for the endoscopic assessment of the esophageal features of eosinophilic esophagitis (<a id=ref-link-section-1 title="" href=/articles/#ref44>44</a>)".
- ↑ "Vertical lines in distal esophageal mucosa (VLEM): a true endoscopic manifestation of esophagitis in children? - PubMed - NCBI".
- ↑ "Fragility of the esophageal mucosa: a pathognomonic endoscopic sign of primary eosinophilic esophagitis? - PubMed - NCBI".
- ↑ "Eosinophilic esophagitis: red on microscopy, white on endoscopy. - PubMed - NCBI".
- ↑ "The prevalence and diagnostic utility of endoscopic features of eosinophilic esophagitis: a meta-analysis. - PubMed - NCBI".