[Clinical and laboratory correlation of severe esophagitis compared to mild or moderate esophagitis]

Between 1976-1987, 408 patients were studied for Reflux Esophagitis. Clinical, endoscopic, manometric characteristic were analyzed, and scintigraphic studies for gastroesophageal and duodenogastric reflux were done. Esophagitis was classified according endoscopic findings in Esophagitis grade I (non confluent erosion), grade II (confluent erosions), grade III ("uncomplicated Barrett syndrome") and grade IV (esophageal ulcer or stricture ("complicated Barrett syndrome"). Fifty six (56) patients with mild (grade I), 52 with moderate (grade II) and 146 patients with severe esophagitis (56 grade III, and 90 grade IV) were included in this protocol. No significative differences were found in clinical feature except dysphagia and bleeding, symptoms more frequent in severe esophagitis than mild or moderate grades. Lower esophageal sphincter pressure was similar in both groups of patients, but the frequency of motor disorders was significative higher in severe esophagitis. Scintigraphic gastroesophageal reflux was positive in all patients and no differences in gastric emptying and duodenogastric reflux were detected. In conclusion, the differences in subjective and objective analysis between different grade of esophagitis suggest to employ different models of management.