STUDY ON FINE MUCOSAL STRUCTURE IN REFLUX ESOPHAGITIS

Abstract

Fine mucosal structure in the lower esophagus and at the squamo-columnar junction were studied in 73 patients with reflux esophagitis with magnifying electronic endoscope (Olympus, GIF-200Z). Discoloring esophagitis was defined as that the longitudinal vessels of the lower esophagus diappear before the squamo-columnar junction. Discoloring esophagitis was classified into four types, i. e., D type: only discoloring change in the lower esophagus compatible with a narrow definition as discoloring esophagitis, E type: regenerated epithelium converging in the esophagus, C type: regenerated epithelium converging in the cardia of the stomach, EC type: regenerated epithelium converging in both the cardia and esophagus. Duodenal ulcers and hiatal hernia were more frequently noted in active and healing stages than in discoloring and scarring stages. In active and healing stages fine cardiac mucosal structures classified into D pattern could not be found across the Z-line, and it changed to the normal BC pattern in scarring stage. Although discoloring esophagitis was found more frequently than we thought, clinical symptoms were few. Then, further study should be done pathophysiologically whether the classification "discoloring esophagitis" is needed or not.