Consensus changed the previous understanding of endoscopic gastroesophageal reflux disease (GERD) and revealed that only high-grade reflux esophagitis (RE), Barrett’s esophagus, or peptic stricturing were considered confirmatory evidence for GERD but low-grade RE was regarded as a possible cause. The objective of the study was to combine the results of previous studies on endoscopic GERD and gastroesophageal flap valve (GEFV) in order to summarize the possible link between them. To discover eligible papers published before September 22, 2019, researchers conducted comprehensive searches of PubMed, WOS, Embase, SinoMed, and CNKI databases. Approximately 30% of the papers were excluded, leaving a total of 237 articles for evaluation and 2 reviewers who conducted independent assessments of eligibility, extraction, and statistical analysis. The association was examined with the pooled risk ratios (RRs) with 95% CI. Heterogeneity was investigated using various random-effects models. The models were applied when significant heterogeneity emerged. A total of 15 analysis were included and investigators found that abnormal GEFV (III and IV) could have been related to RE and the correlation become stronger as the grade increases (RE-A vs. controls—RR: 2.186, 95% CI: 1.560-3.064, P<0.001; RE-B vs. RE-A—RR: 1.268, 95% CI: 1.128-1.425, P<0.001; RE-C vs. RE-B—RR: 1.181, 95% CI: 1.000-1.395, P=0.049; RE-D vs. RE-C—RR: 1.471, 95% CI: 1.151-1.879, P=0.002). Both suspected GERD (RR: 2.400, 95% CI: 1.761-3.271, P<0.001) and endoscopic GERD (RR: 1.388, 95% CI: 1.127-1.711, P=0.002) were related to abnormal GEFV. Under endoscopy, the abnormal GEPFV could have offered useful data for reflux problems, but was unable to distinguish confirmatory GERD from low-grade RE.
Source:journals.lww.com/jcge/Abstract/2022/05000/Association_Between_Gastroesophageal_Flap_Valve.5.aspx
