الفهرس 
INTRODUCTIONOnly 14 pages are availabe for public view
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Abstract
Gastroesophageal reflux disease (GERD) is a multifactorial process, one of the most common diseases which is significant for its prevalence, variety of clinical presentations and under recognized morbidity, together with significant economic consequences.
The typical manifestations of GERD are heartburn, regurgitation, and dysphagia. Atypical manifestations of GERD refer to symptoms that are extraesophageal, particularly pulmonary or ear, nose, and throat manifestations, as well as noncardiac chest pain. Complications of GERD are reflux esophagitis, hemorrhage, stricture and Barrett’s esophagus (BE).
BE is the condition in which a metaplastic columnar mucosa of intestinal type replaces esophageal squamous mucosa damaged by gastroesophageal reflux disease. It is considered the strongest risk factor for esophageal adenocarcinoma.
BE can’t be detected on clinical grounds as there are no specific symptoms that distinguish this condition from GERD without BE. In addition, BE cannot be reliably detected radiologically. The gold standard for the diagnosis of BE is upper endoscopy with biopsy of the distal esophagus. The diagnosis of BE requires findings salmon-pink mucosa extends above the gastroesophageal junction in endoscopy, lining the distal esophagus, in addition to esophageal biopsy that confirms the presence of columnar metaplasia.
Seattle protocol described as targeted and random four-quadrant biopsies every 2 cm has been considered the gold standard of screening and surveillance of BE. However, the difficulty and the time consuming of this protocol limits its applicability in screening for BE. Narrow band imaging -by changing the wave lengths of light used during endoscopy to blue light- highlights mucosal surface patterns and microvascular details which can improve the detection of small and subtle mucosal lesions.
The aim of our study was to compare the accuracy of the narrow band guided biopsy relative to the standard four quadrant biopsies in detecting BE in chronic GERD patients and its utility as the screening method for BE in chronic GERD patients.
This study was conducted on 100 patients who gave history of GERD. They were recruited from the patients scheduled for upper gastrointestinal endoscopy in endoscopy unit, Medical Research Institute, Alexandria University. All studied patients –after applying the inclusion and the exclusion criteria and explanation of the study aim- were asked to sign an informed consent, to fill a questionnaire including age, sex, occupation, residency, special habits and review about systemic diseases as diabetes mellitus and scleroderma and to fill GERD health‑related quality of life (HRQL) heartburn questionnaire.
The patients were subjected to upper gastrointestinal endoscopy and biopsies were taken by standard four quadrant technique, th