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Published on: December 14, 2020
Lugol chromoendoscopy as a diagnostic tool in so-called endoscopy-negative GERD
Ichiro Yoshikawa1, Masahiro Yamasaki, Takuji Yamasaki
1The Third Department of Internal Medicine, School of Medicine, University of Occupational and Environmental Health, Japan, Iseigaika, Kitakyushu.
Gastrointestinal Endoscopy
|October 26, 2005
Summary
Lugol chromoendoscopy detects esophageal mucosal injury in patients with endoscopy-negative GERD (ENRD). This simple staining technique identifies subtle damage not visible with conventional endoscopy, aiding GERD diagnosis.
Area of Science:
- Gastroenterology
- Endoscopic diagnostics
Background:
- Conventional endoscopy is insensitive for diagnosing gastroesophageal reflux disease (GERD), with visible mucosal breaks in less than half of symptomatic patients.
- Lugol chromoendoscopy, typically used for esophageal cancer detection, offers enhanced visualization through dye staining.
Purpose of the Study:
- To evaluate the efficacy of Lugol chromoendoscopy in diagnosing endoscopy-negative GERD (ENRD).
Main Methods:
- The study involved 61 patients with reflux symptoms and 42 controls.
- Lugol's iodine solution was applied to the esophagus, and staining patterns were analyzed.
- Biopsies were taken from Lugol-unstained and stained areas for histological examination.
Main Results:
- Conventional endoscopy revealed esophagitis in only 36% of reflux patients.
- Lugol chromoendoscopy identified unstained streaks in 19 reflux patients (49%) versus one control (p < 0.0001).
- Histology of unstained areas showed significantly increased basal cell hyperplasia, papillary length, and intraepithelial lymphocytes compared to stained areas.
Conclusions:
- Lugol chromoendoscopy effectively identifies mucosal injury in endoscopy-negative GERD patients.
- This technique is simple, safe, and can be performed during the same endoscopic session.
- Lugol chromoendoscopy is a valuable tool for diagnosing ENRD.
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