Endoscopic diagnosis of reflux esophagitis by the dye-spraying method

Twenty-one patients (13 patients after gastric surgery and 8 patients with hiatus hernia or other esophageal disease) in whom reflux esophagitis had been diagnosed by standard endoscopy, and who had undergone Lugol-spraying endoscopy, were reviewed. Ninety-two biopsy specimens were obtained from the esophageal mucosa under direct vision and stained with hematoxylineosin and PAS. The coincidence rate of the findings of dye-spraying endoscopy with histological findings was 89.9% (80/89), as opposed to 69.7% (62/89) attained by standard endoscopy (p less than 0.001), indicating that Lugol-spraying endoscopy is highly compatible with histology. Of 34 biopsy specimens showing papillary hyperplasia, 18 (52.9%) were stained unevenly and lightly, and 14 (41.2%) evenly and lightly. Of nine biopsy specimens showing epithelial regeneration, eight (88.9%) were unstained. All 26 biopsy specimens with erosion/ulcer were also unstained. It is concluded that Lugol-spraying endoscopy is of value in diagnosing reflux esophagitis, especially in determining the intensity and extent of the disease.