[Endoscopic and histological changes at the Z-line (author's transl)]

The Z-line, the transitional zone from oesophageal to gastric mucosa, is a clearly defined point of reference. Selective forceps biopsies were obtained from the Z-line, just below it from the cardia and 1-3 cm above it from the oesophagus, in 79 patients with an age average of 47 1/2 years. A comparison was made between endoscopic and histological findings, on the one hand, and symptoms on the other. Moderately severe inflammatory changes correlated positively with only minor endoscopic changes of the Z-line: patients of this group had significantly more symptoms of reflux than those with a normal line. Exact endoscopy, complemented by histological examination, can discover reflux oesphagitis in its early stages, although endoscopically and histologically the delineation from normal is difficult.