Korean J Gastrointest Motil.  2001 Jun;7(1):29-35.

Relationship between the Shape of the Gastroesophageal Junction and Gastroesophageal Acid Reflux

• Kang CD
• Song CW
• Koo JS
• Sohn SM
• Kim HR
• Jeen YT
• Chun HJ
• Um SH
• Kim CD
• Ryu HS
• Hyun JH

Abstract

BACKGROUND/AIMS: The competency of the gastroesophageal junction (GEJ) holds the key in unlocking pathophysiologic mechanisms of gastroesophageal reflux disease (GERD). However, a relationship between GERD and the incompetent GEJ has not been established. The aim of our study was to assess the relationship between the shape of the GEJ and gastroesophageal acid reflux.
METHODS
Forty six patients with reflux symptoms underwent an endoscopy, esophageal manometry and 24-hour esophageal pH monitoring. Patients were placed in 3 groups according to the shape of their GEJ, categorized by a retroflex view of the endoscopy; type I - gastroesophageal fold without a pouch, type II - no pouch and no fold, and type III - a pouch without a fold.
RESULTS
In type II and III, LESP was reduced. However, % of time with the pH < 4.0 was increased in type III only. There was a significant correlation between the size of a hiatal hernia and the shape of the GEJ. There was a relationship between the grade of esophagitis and the shape of the GEJ.
CONCLUSIONS
The retroflex endoscopic finding of the GEJ focusing on the presence or absence of a GE fold and hiatal pouch, could be an indicator of whether a patient has GERD.

Keyword

Gastresophageal junction; Gastresophageal reflux; Hiatal hernia; Lower esophageal sphincter

MeSH Terms

Endoscopy
Esophageal pH Monitoring
Esophageal Sphincter, Lower
Esophagitis
Esophagogastric Junction*
Gastroesophageal Reflux
Hernia, Hiatal
Humans
Hydrogen-Ion Concentration
Manometry