Elsevier

Gastrointestinal Endoscopy

Volume 84, Issue 6, December 2016, Pages 1027-1029
Gastrointestinal Endoscopy

New methods
Clinical endoscopy: Editorial
Gastric inlet patches in the cervical esophagus: what they are, what they cause, and how they can be treated

https://doi.org/10.1016/j.gie.2016.08.012Get rights and content

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Definition, histology, pathogenesis

Gastric inlet patches (GIPs) comprise islands of heterotopic gastric columnar epithelium in the cervical esophagus. They are often found incidentally at upper endoscopy and have a reported prevalence of 1% to 12%.1, 2 Factors associated with a higher detection rate of GIPs are the awareness of the endoscopist in finding this mucosal alteration as well as the use of modern endoscopes (high-definition endoscopes and the additional application of virtual chromoendoscopy).2 The histologic

Do GIPs cause symptoms? what symptoms are attributable to GIPs?

Given that around 10% of all human beings worldwide have to be classified as GIP carriers, it is remarkable that only a very few of them become symptomatic. The diagnosis of GIP is usually made by chance during upper-GI endoscopy performed for other reasons. Nevertheless, in some cases, GIPs can cause local mucosal alterations (eg, strictures, ulcers, fistula, neoplasia) that cause symptoms like pain or dysphagia.

The question of whether symptoms like globus sensations, chronic cough,

Whom, when, and how should we treat?

Most GIPs are found with no attributable symptoms. In the current issue of Gastrointestinal Endoscopy, Dunn et al7 present evidence that radiofrequency ablation (RFA) may relieve the symptoms of globus sensation or sore throat. GIPs in 10 symptomatic patients were treated. After a median of 2 RFA sessions, 8 of the 10 patients experienced complete endoscopic and histologic remission of their GIPs. Moreover, globus, sore throat, and cough improved significantly, with complete resolution of

Conclusion

Although pathogenic mechanisms are still not fully understood, there is growing evidence that GIPs can be associated with symptoms such as globus sensations and the persistent feeling of a sore throat. Owing to the ineffectiveness of nonendoscopic treatment approaches in contrast to the 80% success rate of endoscopic ablative therapies, we recommend that practitioners closely look for GIPs in symptomatic patients and, when they are detected, ablate the heterotopic mucosa with APC or RFA,

Disclosure

All authors disclosed no financial relationships relevant to this publication.

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