Korean Journal of Gastrointestinal Endoscopy 2007;34(1): 1-8.
위식도 판막과 위식도역류의 연관성
김경엽 · 박기태 · 김태오 · 김광하 · 허 정 · 강대환 · 송근암 · 조 몽
부산대학교 의과대학 내과학교실
Association between Gastroesophageal Flap Valve and Gastroesophageal Reflux
Kyung Yup Kim, M.D., Kee Tae Park, M.D., Tae Oh Kim, M.D., Gwang Ha Kim, M.D., Jeong Heo, M.D., Dae Hwan Kang, M.D., Geun Am Song, M.D. and Mong Cho, M.D.
Department of Internal Medicine, Pusan National University College of Medicine, Busan, Korea
Abstract
Background/Aims: Endoscopic grading of the gastroesophageal flap valve (GEFV) was suggested to be a good predictor of the gastroesophageal reflux status. The aim of this study was to examine the association between the GEFV and gastroesophageal reflux. Methods: A total of 599 patients (245 men and 354 women; mean age 51.0⁑0.5 years) who underwent endoscopy, esophageal manometry, and ambulatory pH monitoring were included. GEFV was graded I through to IV using Hill's classification. The GEFV was classified into main 2 groups: the normal GEFV (grade I and II) and the abnormal GEFV groups (grade III and IV). The findings of endoscopy, esophageal manometry, and ambulatory pH monitoring were compared. Results: An increased GEFV grade was significantly associated with reflux esophagitis and Barrett's epithelium (p＜0.001). The LES pressure was significantly lower in the abnormal GEFV group (p＜0.001). All variables showing gastroesophageal reflux in the probe were significantly higher in the abnormal GEFV group (p＜0.001). The frequency of gastroesophageal reflux disease (GERD) was higher in the abnormal GEFV group (p＜0.001). Conclusions: There is an association between the altered geometry of the GEFV and the presence of GERD. The endoscopic grading of the GEFV is easy and provides useful information on the gastroesophageal reflux status.
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