Gastroesophageal flap valve is associated with gastroesophageal and gastropharyngeal reflux

Kim, Gwang Ha; Kang, Dae Hwan; Song, Geun Am; Kim, Tae Oh; Heo, Jeong; Cho, Mong; Kim, Jin Seon; Lee, Byung Joo; Wang, Soo Geun
July 2006
Journal of Gastroenterology;Jul2006, Vol. 41 Issue 7, p654
Academic Journal
The endoscopic grade of the gastroesophageal flap valve (GEFV) is suggested to be a good predictor of reflux status. The aim of this study was to investigate the association of the GEFV and gastroesophageal and gastropharyngeal reflux. A total of 364 patients (151 men and 233 women; mean age, 52.2 years) who underwent endoscopy, esophageal manometry, and ambulatory 24-h dual-probe pH monitoring were included. GEFV was graded I through IV using Hill's classification; then, GEFV was classified into two groups: a normal GEFV group (grades I and II) and an abnormal GEFV group (grades III and IV). Findings of endoscopy, esophageal manometry, and ambulatory pH monitoring were compared between the groups. Increased GEFV grade was significantly associated with an increased prevalence of both reflux esophagitis and Barrett's epithelium ( P < 0.001). Lower esophageal sphincter pressure was significantly lower in the abnormal GEFV group than in the normal GEFV group ( P < 0.001). All variables showing gastroesophageal reflux in the distal probe were significantly higher in the abnormal GEFV group than in the normal GEFV group ( P < 0.001). In addition, all variables, except the supine time of pH < 4, showing gastropharyngeal reflux in the proximal probe were significantly higher in the abnormal GEFV group than in the normal GEFV group ( P < 0.001). The frequency of gastroesophageal reflux disease and of gastropharyngeal reflux disease was significantly higher in the abnormal GEFV group than in the normal GEFV group ( P < 0.001). Endoscopic grading of the GEFV is easy and provides useful information about the status of gastroesophageal and gastropharyngeal reflux.


Related Articles

  • Barrett's esophagus specialist clinic: what difference can it make? Anagnostopoulos, G. K.; Pick, B.; Cunliffe, R.; Fortun, P.; Kaye, P.; Ragunath, K. // Diseases of the Esophagus;Apr2006, Vol. 19 Issue 2, p84 

    A ‘Barrett's specialist clinic’ was set up in our institution consisting of a specialist nurse, research fellow, and a consultant gastroenterologist. The aim of our study was to examine the impact of this clinic in the management of patients with Barrett's esophagus (BE). Patients...

  • The Role of Nonacid Reflux in NERD: Lessons Learned From Impedance-pH Monitoring in 150 Patients off Therapy. Savarino, Edoardo; Zentilin, Patrizia; Tutuian, Radu; Pohl, Daniel; Casa, Domenico D.; Frazzoni, Marzio; Cestari, Renzo; Savarino, Vincenzo // American Journal of Gastroenterology;Nov2008, Vol. 103 Issue 11, p2685 

    INTRODUCTION: Nonerosive reflux disease (NERD) is the most common form of gastroesophageal reflux disease. While the role of acid reflux has been established, the relevance of nonacid reflux in generating symptoms in NERD is unknown. AIM: To evaluate the diagnostic utility of impedance-pH...

  • GERD, DGER, OR BOTH IN BARRETT'S ESOPHAGUS? Sharma, Prateek; Sampliner, Richard // American Journal of Gastroenterology;May1997, Vol. 92 Issue 5, p903 

    The authors have described the role of gastroesophageal and duodenogastroesophageal reflux across the spectrum of gastroesophageal reflux disease (GERD) in this original contribution. They studied 20 controls, 30 patients with GERD (documented hy an abnormal 24-h esophageal pH), including 16...

  • The Yield of Upper Gastrointestinal Endoscopy in Patients with Suspected Reflux-Related Chronic Ear, Nose, and Throat Symptoms. Poelmans, Johan; Feenstra, Louw; Demedts, Ingrid; Rutgeerts, Paul; Tack, Jan // American Journal of Gastroenterology;Aug2004, Vol. 99 Issue 8, p1419 

    OBJECTIVES: It is well established that various ENT disorders and symptoms may be a manifestation of gastroesophageal reflux disease (GERD). Erosive esophagitis is considered a rare finding in ENT patients and therefore upper gastrointestinal (GI) endoscopy is not recommended in the diagnostic...

  • Risk Factors for Barrett's Esophagus in Community-Based Practice. Lieberman, David A.; Oehlke, Megan; Helfand, Mark; Consortium, Gorge // American Journal of Gastroenterology;Aug1997, Vol. 92 Issue 8, p1293 

    Objectives: Endoscopy is often performed in patients with gastroesophageal reflux (GER) disease because of concern about the presence of Barrett's esophagus (BE). The purpose of this study was to determine whether the duration of GER symptoms and/or a history of esophagitis was associated with...

  • Progression or regression of barrett's esophagus—is it all in the eye of the beholder? Dekel, Roy; Wakelin, Donald E.; Wendel, Chris; Green, Colleen; Sampliner, Richard E.; Garewal, Harinder S.; Martinez, Patricia; Fass, Ronnie // American Journal of Gastroenterology (Springer Nature);Dec2003, Vol. 98 Issue 12, p2612 

    Accurate measurements of Barrett's esophagus length are important in clinical follow-up as well as in studies of therapeutic intervention in Barrett's esophagus. Our aim was to evaluate both the inter- and intraobserver reliability in measuring Barrett's length during two consecutive endoscopies...

  • Chronic Laryngitis Associated with Gastroesophageal Reflux: Prospective Assessment of Differences in Practice Patterns Between Gastroenterologists and ENT Physicians. Ahmed, Tasneem F.; Khandwala, Farah; Abelson, Tom I.; Hicks, Douglas M.; Richter, Joel E.; Milstein, Claudio; Vaezi, Michael F. // American Journal of Gastroenterology;Mar2006, Vol. 101 Issue 3, p470 

    OBJECTIVES: Ear, nose, and throat (ENT) physicians often diagnose gastroesophageal reflux disease (GERD)-related laryngitis on the basis of symptoms and laryngeal signs; and may refer patients to gastroenterologists who contend that many such patients do not have reflux. Because of this...

  • Healing or Amelioration of Esophagitis Does Not Result in Increased Lower Esophageal Sphincter or Esophageal Contractile Pressure. Allen, Melvin L.; McIntosh, David L.; Robinson, Malcolm G. // American Journal of Gastroenterology;Oct1990, Vol. 85 Issue 10, p1331 

    There is conflicting evidence regarding whether lower esophageal sphincter and esophageal contractile pressures are affected by changes in the severity of gastroesophageal reflux disease. We compared the manometric and endoscopic findings from 30 patients before and after treatment for...

  • Achalasia: Should We or Should We Not Follow the Bag? Wong, Colonel Roy K. H. // American Journal of Gastroenterology;Apr2006, Vol. 101 Issue 4, p698 

    This article concerns the long-term therapeutic effect of pneumatic dilations (PDs) in achalasia. Specifically, it is a retrospective study that follows a large cohort of achalasia patients treated with PD. Efficacy and need for repeat PDs were determined utilizing a score obtained from...


Read the Article


Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics