Savary and Miller developed an endoscopic staging system for patients with gastroesophageal reflux disease (GERD).
The mucosal lesions of reflux begin at the upper pole of the gastroesophageal vestibule and the ridge of the mucosal fold is the site of predilection for peptic changes.
Progression in the severity of GERD involves the following endoscopic changes:
(1) confluence of mucosal lesions
(2) extension to involve the entire circumference of the esophagus
(3) complications such as ulceration, fibrosis, strictures, and columnar metaplasia
one or more supravestibular, non-confluent reddish spots, with or without exudate
erosive and exudative lesions are confluent but are not circumferential
diffuse involvement of the entire circumference of the esophagus; hemorrhagic and pseudomembranous exudate typically present
complications (deep ulcers, stenosis/strictures, fibrosis, columnar metaplasia)
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