Correlation between clinical endoscopic and histological findings at esophago-gastric junction in patients of gastroesophageal reflux disease.

Objective: To determine the correlation between the clinical, endoscopic and histological findings in patients of GERD.

Design: An observational, cross-sectional study.

Place And Duration Of Study: Lyari General Hospital, Dow University of Health Sciences from November 2003 to October 2004.

Patients And Methods: Patients complaining of heartburn and/or acid regurgitation at least twice per week for at least 3 months were inducted in the study. Presence of clinical symptoms of epigastric pain, retrosternal burning, and reflux were recorded. Patients were subjected to esophagogastroduodenoscopy and four biopsies were taken from esophago-gastric junction. Correlation/regression analysis was done on clinical, endoscopic and histological findings.

Results: A total of 196 patients were selected and endoscopically examined. Most common grade given by patients to epigastic pain was grade-4 (42.9%), retrosternal burning as grade-4 (41.8%) and reflux grade-5 (36.7%). There was significant correlation between the clinical severity of epigastric pain with endoscopic findings (p = 0.002) and reflux (p = 0.0) but no correlation was observed with histological findings (p = 0.19). Out of 109 (55.6%) patients who had normal mucosa on endoscopy but on histology 70 (35.7%) of them had inflammation. Grading of endoscopic and histological findings showed significant correlation with each other (p = 0.0).

Conclusion: Endoscopic negative GERD is common; severity of clinical symptoms does not correlate [corrected] with endoscopic findings while histopathological findings correlate with those of endoscopic findings [corrected]