title: i-Scan detection of minimal change esophagitis in dyspeptic patients with or without Gastroesophageal Reflux disease.
abstract: BACKGROUND
  The association of minimal change esophagitis (MCE) with GERD is controversial. i-Scan endoscopy (SE) provides high resolution and modulation of images that may improve minimal change lesion (MCL) detection. We aimed to assess the efficacy of SE in detecting MCL in dyspeptic patients with GERD compared with patients without GERD by GerdQ or by endoscopy with 24-h pH monitoring (PHM) and in normal volunteers.
  
  
  METHODS
  This is a cohort study conducted at a tertiary center. All dyspeptic patients were prospectively recruited. All patients completed a validated Thai version of GerdQ and then underwent endoscopy. Forty normal volunteers as a control group were recruited for endoscopy. The distal esophagus was examined by high definition endoscopy and SE sequentially. All had PHM done. GERD was diagnosed by Los Angeles classification A-D and/or by a positive PHM. MCE was diagnosed when MCL or combination of MCL was present.
  
  
  RESULTS
  Of 174 patients, 144 completed the study protocol. After the exclusion of 6 patients, 138 remained for analysis. Overlapping GERD symptoms were found in 44.2 % and 26.8 % had confirmed GERD. Group A was comprised of 61 patients with a positive GerdQ and 77 patients in group B had a negative GerdQ. Twenty-four in group A, 28 in group B and 7 in the control group had MCE that was not significantly different. MCE in GERD was significantly higher (51.45 %) than in non-GERD (32.7 %) (p = 0.047) and in the control group (20.58 %) (p = 0.007). The sensitivity, specificity, positive predictive value, and negative predictive value of SE were 51.35 %, 67.33 %, 36.54 % and 79.06 %, respectively.
  
  
  CONCLUSIONS
  In dyspeptic patients, SE detected more MCE in GERD than in non-GERD patients and in the control group.
  
  
  BACKGROUND
  ClinicalTrials.gov number NCT01742377.
authors.affiliation: NKC institute of Gastroenterology and Hepatology, Faculty of Medicine, Prince of Songkla University, Hatyai, Songkhla, 90110, Thailand. nisasan@yahoo.com.
authors.forename: Nisa
authors.initials: N
authors.lastname: Netinatsunton
authors.affiliation: NKC institute of Gastroenterology and Hepatology, Faculty of Medicine, Prince of Songkla University, Hatyai, Songkhla, 90110, Thailand. pondjaksin@hotmail.com.
authors.forename: Jaksin
authors.initials: J
authors.lastname: Sottisuporn
authors.affiliation: NKC institute of Gastroenterology and Hepatology, Faculty of Medicine, Prince of Songkla University, Hatyai, Songkhla, 90110, Thailand. sattasar@gmail.com.
authors.forename: Siriboon
authors.initials: S
authors.lastname: Attasaranya
authors.affiliation: NKC institute of Gastroenterology and Hepatology, Faculty of Medicine, Prince of Songkla University, Hatyai, Songkhla, 90110, Thailand. dr_pom@hotmail.com.
authors.forename: Teepawit
authors.initials: T
authors.lastname: Witeerungrot
authors.affiliation: Division of Gastroenterology, Faculty of Medicine, Prince of Songkla University, Hatyai, Songkhla, 90110, Thailand. naichaya@gmail.com.
authors.forename: Naichaya
authors.initials: N
authors.lastname: Chamroonkul
authors.affiliation: Bangpakok 9 International Hospital, Bangmot, Chom Thonh, Bangkok, 10150, Thailand. theeratus@hotmail.com.
authors.forename: Theeratus
authors.initials: T
authors.lastname: Jongboonyanuparp
authors.affiliation: Division of Epidermiology, Faculty of Medicine, Prince of Songkla University, Hatyai, Songkhla, 90110, Thailand. Alan.g@psu.ac.th.
authors.forename: Alan
authors.initials: A
authors.lastname: Geater
authors.affiliation: NKC institute of Gastroenterology and Hepatology, Faculty of Medicine, Prince of Songkla University, Hatyai, Songkhla, 90110, Thailand. obancha@live.com.
authors.forename: Bancha
authors.initials: B
authors.lastname: Ovartlarnporn
mesh_terms: D000328:Adult; D000368:Aged; D016022:Case-Control Studies; D004415:Dyspepsia / Q000150:complications* / Q000503:physiopathology; D050782:Esophageal pH Monitoring / Q000379:methods; D004941:Esophagitis / Q000175:diagnosis* / Q000209:etiology / Q000503:physiopathology; D004945:Esophagoscopy / Q000379:methods*; D004947:Esophagus / Q000737:chemistry / Q000503:physiopathology; D005260:Female; D005764:Gastroesophageal Reflux / Q000150:complications* / Q000503:physiopathology; D006801:Humans; D006863:Hydrogen-Ion Concentration; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D011446:Prospective Studies; D012680:Sensitivity and Specificity; D011795:Surveys and Questionnaires; D055815:Young Adult