[Esophageal endoscopy and gastroesophageal reflux]

Authors expose the value of different tests performed in 166 patients diagnosed of gastroesophageal reflux (GER). In 24 patients, less than three months old, only radiological studies were performed. Another group of 142 patients had radiology, endoscopy and biopsy performed, with a total of 180 endoscopic procedures. From the results obtained patients were classified in four grades: Grade I, included 28 patients less than three months old, GER is due to the immaturity of antireflux system. Grade II, included 75 patients of all ages with radiology and/or positive scintigram, but endoscopy and biopsy within normal limits. Grade III, 46 patients, in whom endoscopy and biopsy revealed presence of edema, fibrinous exudates and other inflammatory changes. Grade IV, 17 patients, endoscopy revealed healing strictures or deep bleeding ulcers. Grades I, II and III should be treated with medical measures. Grade IV requires immediate surgical treatment. In 2.7% and 6.4% of grade II and grade III cases respectively, endoscopy revealed progressive disease and necessity of final surgical treatment. Authors believe that endoscopy and biopsy are not only valuable to detect complicating progression of disease, but are also an efficient method of grading and prognosis of GER disease.