Background: The association of minimal change esophagitis (MCE) with GERD is controversial. i-Scan endoscopy\n(SE) provides high resolution and modulation of images that may improve minimal change lesion (MCL) detection.\nWe aimed to assess the efficacy of SE in detecting MCL in dyspeptic patients with GERD compared with patients\nwithout GERD by GerdQ or by endoscopy with 24-h pH monitoring (PHM) and in normal volunteers.\nMethods: This is a cohort study conducted at a tertiary center. All dyspeptic patients were prospectively recruited.\nAll patients completed a validated Thai version of GerdQ and then underwent endoscopy. Forty normal volunteers\nas a control group were recruited for endoscopy. The distal esophagus was examined by high definition endoscopy\nand SE sequentially. All had PHM done. GERD was diagnosed by Los Angeles classification A-D and/or by a positive\nPHM. MCE was diagnosed when MCL or combination of MCL was present.\nResults: Of 174 patients, 144 completed the study protocol. After the exclusion of 6 patients, 138 remained for\nanalysis. Overlapping GERD symptoms were found in 44.2 % and 26.8 % had confirmed GERD. Group A was\ncomprised of 61 patients with a positive GerdQ and 77 patients in group B had a negative GerdQ. Twenty-four in\ngroup A, 28 in group B and 7 in the control group had MCE that was not significantly different. MCE in GERD was\nsignificantly higher (51.45 %) than in non-GERD (32.7 %) (p = 0.047) and in the control group (20.58 %) (p = 0.007).\nThe sensitivity, specificity, positive predictive value, and negative predictive value of SE were 51.35 %, 67.33 %,\n36.54 % and 79.06 %, respectively.\nConclusion: In dyspeptic patients, SE detected more MCE in GERD than in non-GERD patients and in the control\ngroup.
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