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Ask Dr. D. Love Your Own Question
Dr. D. Love
Dr. D. Love, Doctor
Category: Medical
Satisfied Customers: 21583
Experience:  Family Physician for 10 years; Hospital Medical Director for 10 years.
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I recently had a Upper GI Endoscopy. The impressions were as

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I recently had a Upper GI Endoscopy. The impressions were as follows.
JA: Have you been using any medication since the impressions? How severe are any complications?
Customer: The impressions were as follows.
JA: Have you seen a dentist about this?
Customer: I have several questions for a gastroenterologists.
JA: Anything else in your medical history you think the doctor should know?
Customer: I have a history of acid re flux.
Customer: replied 9 months ago.
I recently had Upper GI Endoscopy. The impressions were as follows. 1. The Z line irregular, 36 cm from the incisors. 2. Erythematous mucosa in the antrum. 3. Normal examined duodenum. Awaiting pathology results. Please explain each of the impressions in laymen terms. Thank you.

Hello

This is Dr. Dago. I'm board certified. I have over 10 years of experience.

I understand your concerns. I'm here to help you.

Do you have any other medical conditions?

Customer: replied 9 months ago.
No - why didn't you respond to my initial questions???

I'm trying to get more info to make an accurate statement. I'll leave the question open to someone else.

Hello. This is Dr. Love.

1. The Z line is the area of transition from the usual lining of the esophagus to the usual lining of the stomach. When saying that it is irregular, that means that it is not a simple ring at the lower end of the esophagus, but rather that the line is more of a wave form with high and low sections. Saying that it is 36 cm from the incisors is a way of measuring the exact location measuring from the point where the endoscope passes the front teeth.

The fact that the Z line is irregular is not an issue, by itself, as an irregular Z line can be seen in about 10-15% of normal people. The distance from the incisors also is not an issue, by itself. It is more a point of reference. When comparing one endoscopy to another, a comparison of the distance from a first endoscopy to a subsequent endoscopy will provide information about whether the location of the line is changing over time.

2. The antrum is a portion of the stomach. Erythematous mucosa in the antrum refers to redness of the lining of that part of the stomach, which is most often related to inflammation (gastritis). The biopsy will confirm gastritis and address what type of gastritis is present.

3. The duodenum is the first part of the small intestine, which is all that can be seen by endoscopy, and your duodenum is normal.

If I can provide any clarification, please let me know.

Dr. D. Love, Doctor
Category: Medical
Satisfied Customers: 21583
Experience: Family Physician for 10 years; Hospital Medical Director for 10 years.
Dr. D. Love and 9 other Medical Specialists are ready to help you
Customer: replied 9 months ago.
Doctor Love: Thank you for your precise detailed response.
a.Since I experience on-going GERD (acid reflex), I am concerned I may eventually be diagnosed with cancer of the esophagus. The results of the endoscopy do not address the condition of my esophagus. Should I discuss this with my Gastroenterologist?
b. My Gastroenterologist currently has me taking 60 mg daily of Dexilent which has not helped relieve my symptoms.
c. I have learned there are several surgical procedures (invasive and non-invasive) which have been used to address Acid Reflex (GERD). Of course my preference is non-invasive surgery if I meet the qualifications for surgical procedure. What procedure has shown to have the highest success rate? The non-invasive EsophyX Device appears to be the newest procedure.
d. I will appreciate your in-depth response in layman's terms and thank you in advance.

a. From the perspective of cancer, the endoscopy addressed every portion of the upper GI tract, including the esophagus, in that there is nothing that was described that would be the common appearance of cancer.

b&c. It may be that your problem is not acid reflux, although the biopsies will provide a more clear diagnosis. The area that is erythematous is the antrum of the stomach, not the esophagus, and there may be other issues that need to be addressed to treat the erythematous stomach lining. The most common is because of an infection of the lining of the stomach from H. pylori. In these cases, it is common that acid suppression alone is not effective, and it is necessary to also provide antibiotics to eradicate the germ. Until the biopsies return, though, it is speculation what may be the next step.

However, if it turns out that anti-reflux surgery is indicated, the early evidence supports that a device placement during endoscopy, such as the EsophyX Device is equivalent to surgery. Of course, there is only limited data on these newer devices, while there are studies on surgery that has followed patients for 10-15 years. But the data that is available looks positive.