title: Presence of minimal change esophagitis closely correlates with pathological conditions in the stomach.
abstract: BACKGROUND
  It is suggested that minimal change (grade M) esophagitis is a spectrum of gastric acid reflux disease. We evaluated the clinical significance of grade M esophagitis, including its subtypes (reddish change: MR and whitish change: MW), especially with attempt to pathological conditions in the stomach that relates to gastric acid secretion.
  
  
  METHODS
  Using 241 subjects undergoing esophagogastroduodenoscopy for various indications, we investigated the association between grade M esophagitis with histological and serological severity of gastritis and endoscopic degree of atrophy. We also examined its association with ulcer diseases and various symptoms.
  
  
  RESULTS
  When grade M cases were divided into MR and MW, all MR cases had MW in considerable degrees. Dyspeptic symptoms were more likely to be associated with H. pylori negative grade M cases, while presence of duodenal ulcer and its scar were associated with Helicobacter pylori-positive grade M cases. In all subjects, histological parameters, especially in the corpus, were lower in grade M cases compared to normal appearance. In grade M cases, degree of acute and chronic inflammation, and atrophy in corpus were lowest in cases that have grade MR. Grade M cases were also associated with higher pepsinogen I/II ratio and lower endoscopic atrophy.
  
  
  CONCLUSIONS
  Pathological conditions of the stomach relate to higher gastric acid secretion correlates with grade M esophagitis. In grade M cases, appearance of MR may reflect higher gastric acid secretion or severe acid reflux than cases that have grade MW only.
authors.affiliation: Department of Gastroenterology, Fujita Health University School of Medicine, 1-98 Dengakugakubo, Kutsukake-cho, Toyoake, Aichi 470-1192, Japan. tomomiccyu@yahoo.co.jp
authors.forename: Tomomitsu
authors.initials: T
authors.lastname: Tahara
authors.forename: Tomoyuki
authors.initials: T
authors.lastname: Shibata
authors.forename: Masakatsu
authors.initials: M
authors.lastname: Nakamura
authors.forename: Joh
authors.initials: J
authors.lastname: Yonemura
authors.forename: Masaaki
authors.initials: M
authors.lastname: Okubo
authors.forename: Daisuke
authors.initials: D
authors.lastname: Yoshioka
authors.forename: Yoshio
authors.initials: Y
authors.lastname: Kamiya
authors.forename: Tomiyasu
authors.initials: T
authors.lastname: Arisawa
authors.forename: Ichiro
authors.initials: I
authors.lastname: Hirata
mesh_terms: D016099:Endoscopy, Gastrointestinal; D004941:Esophagitis / Q000150:complications / Q000473:pathology*; D004947:Esophagus / Q000473:pathology; D005260:Female; D005744:Gastric Acid / Q000378:metabolism; D005756:Gastritis / Q000473:pathology; D016481:Helicobacter Infections / Q000150:complications; D016480:Helicobacter pylori; D006551:Hernia, Hiatal / Q000150:complications; D017442:Histamine Agonists / Q000627:therapeutic use; D006801:Humans; D008297:Male; D008875:Middle Aged; D010437:Peptic Ulcer / Q000150:complications; D054328:Proton Pump Inhibitors / Q000627:therapeutic use; D013270:Stomach / Q000473:pathology*; D013272:Stomach Diseases / Q000150:complications / Q000473:pathology*
chemical_list: D017442:Histamine Agonists; D054328:Proton Pump Inhibitors
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