Guidelines For Clinical Practice
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World J Gastrointest Endosc. Apr 16, 2010; 2(4): 121-129
Published online Apr 16, 2010. doi: 10.4253/wjge.v2.i4.121
Role of digital chromoendoscopy in detecting minimal change esophageal reflux disease
Roongruedee Chaiteerakij, Rungsun Rerknimitr, Pinit Kullavanijaya
Roongruedee Chaiteerakij, Rungsun Rerknimitr, Pinit Kullavanijaya, Division of Gastroenterology, Department of Medicine, Chulalongkorn University, Bangkok 10310, Thailand
Author contributions: Chaiteerakij R reviewed the literature and wrote the paper; Rerknimitr R and Kullavanijaya P commented on and reviewed the paper.
Correspondence to: Rungsun Rerknimitr, MD, Division of Gastroenterology, Department of Internal Medicine, Faculty of Medicine. Chulalongkorn University, Bangkok 10310, Thailand.
Telephone: +66-2-2564265 Fax: +66-2-2527839
Received: October 15, 2009
Revised: March 18, 2010
Accepted: March 25, 2010
Published online: April 16, 2010

Endoscopy is a widely used diagnostic tool to detect reflux esophagitis. Although its specificity was reported to be excellent at 90%-95%, its sensitivity was only 50%. Therefore, it is quite difficult to detect these lesions under the standard white light endoscopy especially in patients with minimal change esophageal reflux disease (MERD). In recent years, endoscopic technologies have evolved tremendously; these include high resolution and magnification digital chromoendoscopy. These technologies are useful practically for detecting various subtle lesions along the gastrointestinal tract starting from esophagus to colon. Currently, these technologies can be classified in 2 systems; pre-processed system (NBI, Olympus) and post processed system (FICE and i-SCAN, Fujinon and Pentax respectively). Over a few years, there have been many emerging publications on the benefit of these systems on MERD detection. The overall sensitivities to diagnose MERD were reported as much better than controls. However, large, multi-center and randomized controlled studies comparing these new imaging modalities with the conventional white light chromoendoscopy are warranted to validate its accuracy. Standard, simple and precise endoscopic reading criteria for the identification of MERD are also required.

Keywords: Digital, Chromoendoscopy, Minimal change, Erosive reflux esophagitis, Diagnosis, Pre-processed, Post processed