Abnormal gastroesophageal flap valve is highly associated with gastroesophageal reflux disease among subjects undergoing routine endoscopy in Taiwan

Cathay General Hospital, T’ai-pei, Taipei, Taiwan
Journal of Gastroenterology and Hepatology (Impact Factor: 3.5). 04/2006; 21(3):556-62. DOI: 10.1111/j.1440-1746.2005.04003.x
Source: PubMed


Gastroesophageal flap valve (GEFV) grade predicts severe gastroesophageal reflux disease in Caucasians, but its role in other populations is unclear. This study evaluated the significance of endoscopic grading of the GEFV in Taiwanese subjects.
Five hundred and six consecutive patients undergoing routine check-ups at the National Taiwan University Hospital were enrolled. Symptoms of upper gastrointestinal disease and endoscopic severity of esophageal mucosal injury were correlated to GEFV grades according to the Hill classification.
The frequency of abnormal valves (Hill grades III or IV) was 27.3%. Of these, 42.7% had erosive esophagitis (EE). The majority of patients with EE were classified as Los Angeles grades A and B (79.7 and 16.9%, respectively). The prevalence of EE, hiatal hernia and, to a lesser degree, non-erosive reflux disease, increased with altered GEFV. Patients with abnormal valves were younger and more likely to be male, overweight, and to have atypical and extraesophageal symptoms.
Taiwanese patients with abnormal GEFVs share similar characteristics and risk factors with the patients who have EE. Endoscopic grading of the GEFV is highly associated with GERD, and in particular EE, in subjects undergoing routine endoscopy.

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Available from: Pei Ming Yang, Feb 12, 2014
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    • "The GEFV, the sling or oblique fibers of the stomach located below the LES, contribute to the barrier function via a flap valve mechanism. Since Hill et al.2) developed an endoscopic grading system to assess the GEFV, several reports have noted a correlation between increased GEFV grades and the increased prevalence of GERD and Barrett's esophagus10, 26, 27). We found that male gender was associated with higher GEFV grades and our data confirm the association between an increased GEFV grade and the increased prevalence and grade of HH, CLE, and RE. "
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