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Relationship of the frequency scale for symptoms of gastroesophageal reflux disease with endoscopic findings of cardiac sphincter morphology

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Abstract

Background

Kusano et al. developed a questionnaire for the evaluation of gastroesophageal reflux disease (GERD), the frequency scale for the symptoms of GERD (FSSG). The FSSG is now widely used in Japan. We investigated the relationship between FSSG results and cardiac sphincter endoscopic findings.

Methods

The subjects were 470 patients who responded to the FSSG before undergoing endoscopy. From the FSSG results, we calculated the total, acid reflux, and dysmotility scores. Endoscopic findings were assessed in terms of the anatomic-functional-pathological (AFP) classification as the A factor, or degree and type of hiatal hernia, and the valve factor, or laxity of the cardiac sphincter. The degree of esophagitis was assessed using the modified Los Angeles classification. We investigated correlations between each score and the anatomy of the cardia.

Results

With either definition of esophagitis (grade M or greater, or grade A or greater), the total and acid reflux scores were both significantly higher in the group with reflux esophagitis than in the group without reflux esophagitis. Examination of the relationship between FSSG scores and the A factor revealed no significant differences in the total, acid reflux, or dysmotility scores whether a hiatal hernia was present or absent. Similarly, examination of the valve factor showed no significant difference in any scores between V0 and V1 versus V1 and V2, indicating no correlation between cardiac sphincter laxity and FSSG scores.

Conclusions

The FSSG was useful in determining whether reflux esophagitis is present, but it did not predict the anatomy of the cardia.

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References

  1. Ruth M, Mansson I, Sandburg N. The prevalence of symptoms suggestive of esophageal disorders. Scand J Gastroenterol 1991;26:73–81.

    Article  PubMed  CAS  Google Scholar 

  2. Isolauri J, Laippala P. Prevalence of symptoms suggestive of gastro-oesophageal reflux disease in an adult population. Ann Med 1995;27:67–70.

    Article  PubMed  CAS  Google Scholar 

  3. Frank L, Kleinman L, Ganoczy D, McQuaid K, Sloan S, Eggleston A, et al. Upper gastrointestinal symptoms in North America: prevalence and relationship to healthcare utilization and quality of life. Dig Dis Sci 2000;45:809–818.

    Article  PubMed  CAS  Google Scholar 

  4. Kennedy T, Jones R. The prevalence of gastro-oesophageal reflux symptoms in a UK population and the consultation behavior of patients with these symptoms. Aliment Pharmacol Ther 2000;14:1589–1594.

    Article  PubMed  CAS  Google Scholar 

  5. Spechler SJ, Jain SK, Tendler DA, Parker RA. Racial differences in the frequency of symptoms and complications of gastrooesophageal reflux disease. Aliment Pharmacol Ther 2002;16:1795–1800.

    Article  PubMed  CAS  Google Scholar 

  6. Ho KY, Kang JY, Seow A. Prevalence of gastrointestinal symptoms in a multiracial Asian population, with particular reference to reflux-type symptoms. Am J Gastroenterol 1998;93:1816–1822.

    Article  PubMed  CAS  Google Scholar 

  7. Goh KL, Chang CS, Fock KM, Ke M, Park HJ, Lam SK. Gastrooesophageal reflux disease in Asia. J Gastroenterol Hepatol 2000;15:230–238.

    Article  PubMed  CAS  Google Scholar 

  8. Wong WM, Hui WM, Wong BC. Asia-Pacific consensus on gastroesophageal reflux disease. J Gastroenterol Hepatol 2004;19:353–356.

    Article  PubMed  Google Scholar 

  9. Fock KM, Talley N, Hunt R, Fass R, Nandurkar S, Lam SK, et al. Report of the Asia-Pacific consensus on the management of gastroesophageal reflux disease. J Gastroenterol Hepatol 2004;19:357–367.

    Article  PubMed  Google Scholar 

  10. Carlsson R, Dent J, Bolling-Sternevald E, Johnsson F, Junghard O, Lauritsen K, et al. The usefulness of a structured questionnaire in the assessment of symptomatic gastroesophageal reflux disease. Scand J Gastroenterol 1998;33:1023–1029.

    Article  PubMed  CAS  Google Scholar 

  11. Kusano M, Shimoyama Y, Sugimoto S, Kawamura O, Maeda M, Minashi K, et al. Development and evaluation of FSSG: frequency scale for the symptoms of GERD. J Gastroenterol 2004;39:888–891.

    Article  PubMed  Google Scholar 

  12. Emerenziani S, Habib FI, Ribolsi M, Caviglia R, Guarino MP, Petitti T, et al. Effect of hiatal hernia on proximal oesophageal acid clearance in gastro-oesophageal reflux disease patients. Aliment Pharmacol Ther 2006;23:751–757.

    Article  PubMed  CAS  Google Scholar 

  13. Jones MP, Sloan S, Rabine JC, Ebert CC, Huang CF, Kahrilas PJ. Hiatal hernia size is the dominant determinant of esophagitis presence and severity in gastroesophageal reflux disease. Am J Gastroenterol 2001;96:1711–1717.

    Article  PubMed  CAS  Google Scholar 

  14. McGouran RC, Galloway JM, Spence DS, Morton CP, Marchant D. Does measurement of yield pressure at the cardia during endoscopy provide information on the function of the lower oesophageal sphincter mechanism? Gut 1988;29:275–278.

    Article  PubMed  CAS  Google Scholar 

  15. Armstrong D, Bennett JR, Blum AL, Dent J, Timothy de Dombal F, Galmiche JP, et al. The endoscopic assessment of esophagitis: a progress report on observer agreement. Gastroenterology 1996;111:85–92.

    Article  PubMed  CAS  Google Scholar 

  16. Hoshihara Y. Reflux esophagitis. In: Nagasako K, Fujimori T, et al., editors. Atlas of gastroenterologic endoscopy by highresolution video-endoscope. Tokyo: Igaku-shoin; 1998. p. 32.

    Google Scholar 

  17. Bancewicz J, Matthews HR, O’Hanrahan T, Adams I. A comparison of surgically treated reflux patients in two surgical centers. In: Little AG, Ferguson MK, Skinner DB, editors. Diseases of the esophagus. New York: Futura; 1990. p. 177–180.

    Google Scholar 

  18. Ismail T, Bancewicz J, Barlow J. Yield pressure, anatomy of the cardia and gastro-oesophageal reflux. Br J Surg 1995;82:943–947.

    Article  PubMed  CAS  Google Scholar 

  19. Kang JY, Tay HH, Yap I, Guan R, Lim KP, Math MV. Low frequency of endoscopic esophagitis in Asian patients. J Clin Gastroenterol 1993;16:70–73.

    Article  PubMed  CAS  Google Scholar 

  20. Okamoto K, Iwakiri R, Mori M, Hara M, Oda K, Danjo A, et al. Clinical symptoms in endoscopic reflux esophagitis: evaluation in 8031 adult subjects. Dig Dis Sci 2003;48:2237–2241.

    Article  PubMed  Google Scholar 

  21. Cameron AJ. Barrett’s esophagus: prevalence and size of hiatal hernia. Am J Gastroenterol 1999;94:2054–2059.

    Article  PubMed  CAS  Google Scholar 

  22. Fass R. Epidemiology and pathophysiology of symptomatic gastroesophageal reflux disease. Am J Gastroenterol 2003;98(suppl):S2–S7.

    Article  PubMed  Google Scholar 

  23. Omura N, Kashiwagi H, Yano F, Tsuboi K, Yanaga K. Characteristics of symptomatic GERD in Japanese patients based on 24-h pH monitoring. J Gastroenterol 2005;40:791–795.

    Article  PubMed  Google Scholar 

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Tsuboi, K., Omura, N., Yano, F. et al. Relationship of the frequency scale for symptoms of gastroesophageal reflux disease with endoscopic findings of cardiac sphincter morphology. J Gastroenterol 43, 798–802 (2008). https://doi.org/10.1007/s00535-008-2228-z

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  • DOI: https://doi.org/10.1007/s00535-008-2228-z

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