I just had an EGD with Biopsy and the results were as follows.... A 4 cm hiatal hernia. Evidence of Grade III erosive esophagitis of the distal esophagus. Mucosa appears erythematous and friable. They took 4 quadrant cold biopsies from the distal esophagus. Can someone help me out? I don't know what all this means. Was told I need surgery.
Erosive esophagitis is one of the more serious forms of GERD. As you probably know, if it’s left untreated or uncontrolled, the damage may lead to even more serious complications (stricture, hemorrhage, a precancerous condition known as Barrett's esophagus, and esophageal cancer).
The grading system your report is giving you is as follows: Grade I - erythema (redness or inflammation of the mucous membranes); Grade II - linear nonconfluent erosions; Grade III - circular confluent erosions; and Grade IV - stricture or Barrett esophagus.
The condition of Grade III erosive esophagitis, according to your report, is being found in the lower part of your esophagus (distal). If you want to see what it might look like, go to http://www.webgerd.com/ESpictures.htm and look at the Grade C pics. I believe this system (the Los Angeles Classification) is roughly analogous to Grade III.
If you’ve been on PPIs and a change of diet and this is the result, you may need surgery, but you should discuss all the options with your doc. Depending upon your age and other parameters you may want to compare the ‘standard’ operation – Nissen fundoplication – with other endoluminal (within the esophagus) techniques. Keep in mind that each doc may have a ‘favorite’ technique, so you may want to get a couple of opinions.
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