Endoscopic Diagnosis of Reflux Esophagitis by the Dye-spraying Method

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Abstract
Twenty-one patients (13 patients after gastric surgery and 8 patients with hiatus hernia or other esophageal disease) in whom reflux esophagitis had been diagnosed by standard endoscopy, and who had undergone Lugol-spraying endoscopy, were reviewed. Ninety-two biopsy specimens were obtained from the esophageal mucosa under direct vision and stained with hematoxylineosin and PAS. The coincidence rate of the findings of dye-spraying endoscopy with histological findings was 89.9 % (80/89), as opposed to 69.7 % (62/89) attained by standard endoscopy (p < 0.001), indicating that Lugol-spraying endoscopy is highly compatible with histology. Of 34 biopsy specimens showing papillary hyperplasia, 18 (52.9 %) were stained unevenly und lightly, and 14 (41.2 %) evenly and lightly. Of nine biopsy specimens showing epithelial regeneration, eight (88.9 %) were unstained. All 26 biopsy specimens with erosion/ulcer were also unstained. It is concluded that Lugol-spraying endoscopy is of value in diagnosing reflux esophagitis, especially in determining the intensity and extent of the disease.

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