title: Association of reflux symptom index scores with gastroesophageal flap valve status.
abstract: OBJECTIVE
  Gastroesophageal reflux disease is a chronic symptom of mucosal damage caused by gastric acid reflux. Impaired gastroesophageal flap valve (GEFV) is one of the common etiologic factors of gastroesophageal reflux. The aim of this study was to investigate the association between GEFV, RSI, and GER in patients who underwent gastroesophageal endoscopy.
  
  
  METHODS
  Two hundred and fifty seven consecutive patients with reflux symptoms (151 men and 106 women, mean age was 50.22 years) who underwent routine upper gastrointestinal endoscopy were enrolled to our study. GEFV was graded as I through IV according to the Hill's classification. Symptoms of laryngopharyngeal and upper gastrointestinal disease and endoscopic severity of esophageal injury were correlated with GEFV status. The GEFV was classified into two groups: normal GEFV group (grade I) and the abnormal GEFV group (grades II-III and IV). The reflux symptom index (RSI) was used as a diagnostic tool for LPR.
  
  
  RESULTS
  Age, male gender, and body mass index were significantly related to an abnormal GEFV. The rate of abnormal grades of GEFV (Grade II+III+IV) was 31%. Age of normal and abnormal grades of GEFV (49.0/50.8 vs 52.9) and values of BMI (26.2/26.7 vs 26.5) were similar. RSI scores were correlated with gastroesophageal flap valve grades but RSI scores were not correlated with Los Angeles gastroesophageal reflux (GER) Classification. Moreover, gastroesophageal reflux grade of Los Angeles Classification was positively correlated with gastroesophageal flap valve grades.
  
  
  CONCLUSIONS
  Endoscopic grading of GEFV is a simple and useful technique which may provide an accurate diagnosis of laryngopharyngeal and gastroesophageal reflux. Also, reflux symptom index (RSI) is a simple, economic and noninvasive diagnostic tool for gastroesophageal reflux. However, in this research, we did not find any correlation between reflux symptom index and degree of esophageal mucosal injury which was classified according to LA classification.
authors.affiliation: GATA Haydarpasa Training Hospital, Gastroenterology Department, 34668 Uskudar, Istanbul, Turkey. Electronic address: dr_mustafakaplan@yahoo.com.
authors.forename: Mustafa
authors.initials: M
authors.lastname: Kaplan
authors.affiliation: GATA Haydarpasa Training Hospital, Gastroenterology Department, 34668 Uskudar, Istanbul, Turkey. Electronic address: alpaslantanoglu@yahoo.com.
authors.forename: Alpaslan
authors.initials: A
authors.lastname: Tanoglu
authors.affiliation: GATA Haydarpasa Training Hospital, Gastroenterology Department, 34668 Uskudar, Istanbul, Turkey. Electronic address: evrenerkul@yahoo.com.
authors.forename: Evren
authors.initials: E
authors.lastname: Erkul
authors.affiliation: GATA Haydarpasa Training Hospital, Gastroenterology Department, 34668 Uskudar, Istanbul, Turkey. Electronic address: drmuammerkara70@hotmail.com.
authors.forename: Muammer
authors.initials: M
authors.lastname: Kara
authors.affiliation: GATA Haydarpasa Training Hospital, Gastroenterology Department, 34668 Uskudar, Istanbul, Turkey. Electronic address: yusufyazgan@gmail.com.
authors.forename: Yusuf
authors.initials: Y
authors.lastname: Yazgan
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D015992:Body Mass Index; D015331:Cohort Studies; D016145:Endoscopy, Digestive System; D049630:Esophageal Sphincter, Lower / Q000503:physiopathology; D004943:Esophagogastric Junction / Q000503:physiopathology*; D005260:Female; D005764:Gastroesophageal Reflux / Q000503:physiopathology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D012720:Severity of Illness Index; D012737:Sex Factors
keywords: Gastroesophageal flap valve; Gastroesophageal junction; Gastroesophageal reflux; Hill classification; Laryngopharyngeal reflux