During esophagogastroduodenoscopy (gastroscopy), gastroesophageal reflux disease can be classified as follows based on the extent of lesions (tissue lesions) found:
The disease stages of reflux esophagitis are divided into four stages according to Savary and Miller:
Stage | Description |
0 | No mucosal changes |
I | One or more nonconfluent mucosal lesions with redness and exudation |
II | Confluent erosive and exudative lesions that do not yet occupy the entire circumference (lat.: circumference) of the esophagus (food pipe)
|
III | The lesion occupies the entire circumference of the esophagus |
IV | Complications: Esophageal ulcer (oesophageal ulcer), Barrett’s esophagus, strictures (high-grade narrowing), and other chronic mucosal lesions
|
The Los-Angeles classification takes into account the endoscopic extent of the defects and divides them into four stages (A-D):
Stage | Mucosal lesions (mucosal defects) |
A | In distal (“lower”) esophagus, ≤ 5 mm. |
B | In distal esophagus, > 5 mm |
C | Confluent (“flowing together”), ≤ 75% of the circumference of the esophagus |
D | Confluent, 75% of the circumference of the esophagus. |
The Los Angeles classification is the only one evaluated in numerous studies.The MUSE classification distinguishes the four endoscopically assessable formations:
Metaplasia |
Ulcer |
Stricture |
Erosion |
The four criteria are described as follows: 0 = absent; 1 = minor; 2 = moderate; 3 = severe. Although the Muse classification is the most accurate, it is also the most unwieldy classification in everyday use.