Oesophageal ulcer

Digestive health
1

Hi, I have an oesophageal ulcer which they graded on the savary millers system as grade 4 at my first endoscopy. When I had my second endoscopy last week they've now staged it at grade D - "Grade D    One (or more) mucosal break which involves at least 75% of the esophageal circumference" Can anyone explain this please? Does it mean that 75% of the whole oesophagus is affected or 75% of the area at the ulcer? Thanks for your help, Heather

2

All I know is a grade d is a reference to the size of your hiatus hernia which is on the largest grade  in so doing a lot of reflux  I am not sure what the 75% thing means 

what meds have you got to take ? 

You need to ask doctor what it means 

ie is it 75% through oesophagus wall or 75% round whole of the oesophagus . Have they tested for h/pylori ?

im not a doctor but you need to get answers and a plan of action from your doctor

regards 

Trev

3

Hi Heather; yes I agree with Trev....I can't give you any answers either, but am very interested in what the Results do mean, too.  Ring your GP for an appointment, for the first available one, and let us all know.  As you know, we are all on your side...with you in this, and would like to be there for this  journey with you.....Bron

4

Hi Trev, thanks for your reply. I don't have a hiatus hernia, I had a nissen fundoplication done in 2000 and that got rid of the hernia. The grade d is part of the Los Angeles classification of gastroesophageal reflux disease. I don't understand why the nurse is using 2 diff end classification systems. I've already asked 2 GPs about the illness and I was told not to have anything spivey to eat. I have another GP appointment next week and I'm hoping she is more clued up than the other two. My next hospital appointment isn't until July.  I'll come back on here and hopefully will be better informed.  Heather

5

Hi Bron, thanks for your reply.  It's a great comfort to know others are out there and that there is support also.  I'm hoping to get some answers next week and will put a post on here to let you know how I get on.  Heather

6

Morning Heather, please do, as I will be waiting.....am very interested in your situation.     Bron

7

Grading of Severity

The severity of esophagitis is commonly classified into four grades according to the Los Angeles Classification:[5][6]

Grade A One or more mucosal breaks < 5 mm in maximal length

Grade B One or more mucosal breaks > 5mm, but without continuity across mucosal folds

Grade C Mucosal breaks continuous between > 2 mucosal folds, but involving less than 75% of the esophageal circumference

Grade D Mucosal breaks involving more than 75% of esophageal circumference

Grade 1: single erosion above gastro-esophageal mucosal junction.

Grade 2: multiple, non-circumferential erosions above gastro-esophageal mucosal junction.

Grade 3: circumferential erosion above mucosal junction.

Grade 4: chronic change with esophageal ulceration and associated stricture.

Grade 5: Barrett's esophagus with histologically confirmed intestinal differentiation within columnar

Heather Barretts Esophagus is precancerous if u are stage 4 u probably

should get an EGD at least once a year