Diagnostics

A medical history, i.e. an initial interview, the corresponding clinical symptoms and the initial probationary use of a certain drug are often the first diagnostic steps taken by the treating physician. The actual diagnosis is made by means of a gastroscopy (endoscopy). Based on the endoscopically determined tissue disorder, reflux esophagitis, the inflammation of the esophagus, can be divided into three classifications.

The Savary and Miller classification: Another classification is the MUSE classification according to Armstrong. The word here stands for metaplasia, ulcer, stricture and erosion. The third classification of reflux esophagitis is the Los Angeles Classification.

Four stages from A to D are distinguished.

0. there is a reflux of gastric juice, but without changes in the mucous membranes.
1.
unconnected mucosal changes, either there are only red spots or white specimens are deposited in the middle of the red spots
2. spreading spots along the mucosal folds.
3. here the lesion (damage) takes up the entire circumference of the lower esophagus.
4.
is the complication stage. This stage involves ulcerations, strictures (severe narrowing of the esophagus) and the beretted esophagus.
From 0 = missing;
1= negligible;
2= medium;
Up to 3 = heavy.
Stage A: the mucous membrane changes (erosions) have a diameter of less than 5mm and are located between the individual mucous membrane folds.
Stage B: here the changes in the mucous membranes are larger than 5mm.
Stage C: the erosions are connected to each other via the mucosal folds. However, the defects cover less than 75% of the circumference of the esophagus.
Stage D: is very similar to stage C, except that the defects affect more than 75% of the circumference of the esophagus. A further diagnostic step is the 24-h-pH metry. Here, the acidic stomach content is measured for 24 hours using a thin probe passing through the nose.