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Erschienen in: Journal of Gastroenterology 2/2017

27.04.2016 | Original Article—Alimentary Tract

New endoscopic classification of cascade stomach, a risk factor for reflux esophagitis

verfasst von: Motoyasu Kusano, Hiroko Hosaka, Hidetoshi Yasuoka, Osamu Kawamura, Akiyo Kawada, Shiko Kuribayashi, Yasuyuki Shimoyama, Masafumi Mizuide, Taku Tomizawa, Shingo Ishihara, Toshihiko Sagawa, Junichi Akiyama, Ken Sato, Satoru Kakizaki, Fumitaka Moki

Erschienen in: Journal of Gastroenterology | Ausgabe 2/2017

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Abstract

Background

We recently demonstrated that cascade stomach detected by barium studies was correlated with upper gastrointestinal symptoms. We developed a new endoscopic classification of cascade stomach and examined its relationship with reflux esophagitis.

Methods

Study 1: the classification (grades 0–3) was based on detecting a ridge that runs from the cardia toward the anterior wall crossing the greater curvature. Inter-observer variation was evaluated by kappa statistics when ten experienced endoscopists used this classification three times each. Study 2: in 710 consecutive subjects (500 men and 210 women) undergoing endoscopic screening, the grade of cascade stomach and incidence of reflux esophagitis were compared.

Results

In study 1, the kappa values at the third assessment were 0.85, 0.58, 0.50, and 0.78 for each grade, respectively, while overall agreement was 0.68. In study 2, the incidence of reflux esophagitis in men was 20 % in grade 0, 17 % in grade 1, 25 % in grade 2, and 30 % in grade 3, showing significant differences. Among women, the incidence of reflux esophagitis in each grade was 9, 3, 6, and 35 %, respectively, also showing significant differences. Multivariate analysis showed that independent risk factors for reflux esophagitis were cascade stomach (odds ratio = 2.20), body mass index, and hiatus hernia in men, as well as cascade stomach (odds ratio = 9.01) and smoking tobacco in women.

Conclusions

This endoscopic classification of cascade stomach showed acceptable inter-observer variation. Cascade stomach is a risk factor for reflux esophagitis.
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Metadaten
Titel
New endoscopic classification of cascade stomach, a risk factor for reflux esophagitis
verfasst von
Motoyasu Kusano
Hiroko Hosaka
Hidetoshi Yasuoka
Osamu Kawamura
Akiyo Kawada
Shiko Kuribayashi
Yasuyuki Shimoyama
Masafumi Mizuide
Taku Tomizawa
Shingo Ishihara
Toshihiko Sagawa
Junichi Akiyama
Ken Sato
Satoru Kakizaki
Fumitaka Moki
Publikationsdatum
27.04.2016
Verlag
Springer Japan
Erschienen in
Journal of Gastroenterology / Ausgabe 2/2017
Print ISSN: 0944-1174
Elektronische ISSN: 1435-5922
DOI
https://doi.org/10.1007/s00535-016-1214-0

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