Dynamic changes in the anti-reflux mechanism observed by endoscopy: The phase concept
2025 Volume 106 Issue 1 Pages 22-26
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2025 Volume 106 Issue 1 Pages 22-26
Background: The gastroesophageal junction (GEJ) forms a barrier against gastric reflux. This study introduces the "Phase concept" to dynamically assess the anti-reflux barrier (ARB) during endoscopy.
Methods: This retrospective, single-center study included patients without reflux symptoms who underwent the endoscopic pressure study integrated system (EPSIS) between February and April 2024. ARB was classified into Phase I (gastric phase), Phase II (LES phase), and Phase III (esophageal clearance phase). Intragastric pressure (IGP) and ARB morphology were analyzed.
Results: Among 30 patients (median age: 58 years, IQR: 46.5-68.8), Phase I (IGP: 6.75 mmHg) showed gastroesophageal flap valve (GEFV) in 80%. Phase II (IGP: 11.8 mmHg) showed scope holding sign (SHS) in 86.7%. Phase III (IGP: 19 mmHg) showed SHS release and esophageal peristalsis in 80%, with a median latency of 5 seconds.
Conclusion: The Phase concept enables dynamic ARB evaluation. Further studies should explore its clinical relevance and correlation with other diagnostic modalities.
