Digestive Diseases and Sciences

, Volume 29, Issue 3, pp 194–201

Histologic evaluation of chronic gastroesophageal reflux

An evaluation of biopsy methods and diagnostic criteria
  • Thomas E. Knuff
  • Stanley B. Benjamin
  • G. Fred Worsham
  • Joseph E. Hancock
  • Donald O. Castell
Original Articles

DOI: 10.1007/BF01296251

Cite this article as:
Knuff, T.E., Benjamin, S.B., Worsham, G.F. et al. Digest Dis Sci (1984) 29: 194. doi:10.1007/BF01296251

Abstract

Controversy exists regarding the appropriate method for biopsy confirmation of esophageal reflux injury. We have compared endoscopic pinch biopsy (PB) with endoscopicallly directed Rubin tube suction biopsy (SB) in 40 patients with symptomatic gastroesophageal reflux disease (GERD). Utilizing a plastic tube attached alongside the endoscope, SB at specific sites in the esophagus can be easily obtained. Suction biopsy was rated superior to PB for adequacy of tissue, ability to make an interpretation, and certainty in diagnosis. These differences were most pronounced in patients with endoscopic grades 0 and 1+ esophagitis in which 59% of PBs were uninterpretable compared to 23% of SBs. The passage of the Rubin tube was easily done and could be performed repeatedly. Six of 40 patients (15%) developed substernal chest discomfort in the 24 hr following SB. We conclude that SB is the most appropriate way to evaluate histologic changes related to reflux injury and that this method is mandatory in symptomatic patients with minimal endoscopic evidence of esophagitis (0−1+).

Copyright information

© Plenum Publishing Corporation 1984

Authors and Affiliations

  • Thomas E. Knuff
    • 1
    • 2
  • Stanley B. Benjamin
    • 1
    • 2
  • G. Fred Worsham
    • 1
    • 2
  • Joseph E. Hancock
    • 1
    • 2
  • Donald O. Castell
    • 1
    • 2
  1. 1.Division of Gastroenterology and Division of Anatomic Pathology Naval HospitalBethesda
  2. 2.Digestive Diseases Division, Department of Medicine, Uniformed ServicesUniversity School of MedicineBethesda
  3. 3.Division of GastroenterologyVA Medical Center Louisville, and University of LouisvilleLouisville
  4. 4.Upper Pennisula Digestive Diseases AssociatesMarquette
  5. 5.Division of Gastroenterology/Hepatology, Internal Medicine DepartmentUniversity of LouisvilleLouisville
  6. 6.Bowman-Gray UniversityWinston-Salem

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