title: Endoscopic grading of gastroesophageal flap valve and atrophic gastritis is helpful to predict gastroesophageal reflux.
abstract: OBJECTIVE
  The endoscopic grading of the gastroesophageal flap valve (GEFV) has been suggested to be a good predictor of reflux status. Atrophic gastritis is inversely associated with reflux esophagitis. The aim of the present study was to investigate the association between GEFV, atrophic gastritis and gastroesophageal reflux.
  
  
  METHODS
  A total of 608 patients (252 men and 356 women; mean age 51.1 years) who underwent endoscopy, esophageal manometry and ambulatory 24-h pH monitoring were included. GEFV was graded I through IV using Hill's classification: the GEFV was largely classified into two groups: the normal GEFV group (grades I and II) and the abnormal GEFV group (grades III and IV). Atrophic gastritis was classified into two groups by endoscopic atrophic border: closed-type (C-type) and open-type (O-type). Findings of endoscopy, esophageal manometry and ambulatory pH monitoring were compared among the groups.
  
  
  RESULTS
  The incidence of reflux esophagitis and gastroesophageal reflux disease was associated with an abnormal GEFV grade and was inversely associated with open-type atrophic gastritis. The patients with a coexisting abnormal GEFV and closed-type atrophic gastritis showed a significantly higher incidence of reflux esophagitis and gastroesophageal reflux disease than the patients with a coexisting normal GEFV and open-type atrophic gastritis (OR, 20.6 [95% CI, 6.2-68.4], 11.4 [95% CI, 6.3-20.7], respectively).
  
  
  CONCLUSIONS
  Endoscopic grading of GEFV and atrophic gastritis is simple and provides useful information on the status of gastroesophageal reflux.
authors.affiliation: Department of Internal Medicine, Pusan National Unviersity College of Medicine, Busan, Korea.
authors.forename: Gwang Ha
authors.initials: GH
authors.lastname: Kim
authors.forename: Geun Am
authors.initials: GA
authors.lastname: Song
authors.forename: Tae Oh
authors.initials: TO
authors.lastname: Kim
authors.forename: Hong Jae
authors.initials: HJ
authors.lastname: Jo
authors.forename: Do Hoon
authors.initials: DH
authors.lastname: Kim
authors.forename: Jeong
authors.initials: J
authors.lastname: Heo
authors.forename: Mong
authors.initials: M
authors.lastname: Cho
authors.forename: Dae Hwan
authors.initials: DH
authors.lastname: Kang
mesh_terms: D016099:Endoscopy, Gastrointestinal; D050782:Esophageal pH Monitoring; D004942:Esophagitis, Peptic / Q000453:epidemiology / Q000209:etiology*; D004943:Esophagogastric Junction / Q000473:pathology*; D004947:Esophagus / Q000473:pathology; D005260:Female; D005757:Gastritis, Atrophic / Q000145:classification / Q000150:complications* / Q000473:pathology*; D005764:Gastroesophageal Reflux / Q000150:complications* / Q000175:diagnosis / Q000453:epidemiology*; D006801:Humans; D015994:Incidence; D008297:Male; D008365:Manometry; D008679:Metaplasia; D008875:Middle Aged; D011237:Predictive Value of Tests; D012189:Retrospective Studies