Abstract

GONZALEZ, Juan Carlos. Minimal change esophagitis and its relation with esophageal intra papillary epithelial capillary loops in patients with gerd using Flexible Spectral Imaging Color Enhancement endoscopes. Gen [online]. 2013, vol.67, n.3, pp.133-138. ISSN 0016-3503.

Introduction: Reflux esophagitis is a clinical entity that is part of Gastroesophageal Reflux Disease (GERD). Although endoscopy has an excellent specificity of 90% -95%, its sensitivity is only 50%. Over 50% of patients with symptoms of GERD have been diagnosed as non-erosive reflux disease (NERD). More careful analysis of the published studies reported that most NERD patients had minor changes in the distal esophageal mucosa, specifically proximal to the Z line; introducing with these findings the term of Minimal Change Esophagitis. Also changes characteristic of Intra Papillary Epithelial Capillary Loops (BCPIE) have been demonstrated in patients with Minimal Change Esophagitis by GERD. Objective: To evaluate and compare patients with the diagnosis of NERD and controls, BCPIE morphological alteration in the distal esophagus, with the intention of diagnosing minimal change esophagitis, using high-resolution magnification endoscopes, electronic and spectral imaging chromoscopy FICE. Materials and methods: prospective, cross-sectional study with a non-probability sampling, intentional kind and control group, of patients attending the outpatient clinic of the Department of Gastroenterology, University Hospital of Caracas and of Avila Clinic, from May 2007 to November 2011. Of 156 patients diagnosed with NERD and 100 patients in the control group. Results: Control group: 100 patients, 3 patients with type II BCPIE (1%). NERD group 156 patients, 5 had a pattern: Type I considered normal and 151 had a pattern of altered BCPIE: 146 BCPIE with a Type II pattern (96, 68%), sensitivity 97%, specificity 97%; 5 (3, 31%), had BCPIE with a Type III pattern Sensitivity 5% and Specificity 0%. Conclusions: The anatomical changes found in BCPIE at the esophageal mucosa, when an endoscopy is performed in patients with GERD, allow the diagnosis of Minimal Change Esophagitis. The BCPIE type II pattern is the most frequently found in Minimal Change Esophagitis. The indication of Endoscopy with high definition magnification and electronic chromoscopy as FICE ® system, are essential in the study of patients with diagnosis of GERD.

Keywords : GERD; Reflux esophagitis; Minimal Change Esophagitis; BCPIE; FICE.

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