Two-thirds of patients have microscopic esophageal abnormalities despite the absence of visible mucosal damage at endoscopy. This paper presents the findings of the "Esohisto project"--an attempt to describe and standardize criteria for recognizing these findings.
This paper provides standardized definitions and shows the interobserver agreement within a group of "well-published experts in the field" before and after an intervention--using digitized images with a pertinent area of interest circled.
This is worth reading for the definitions and basically reinforces what I suspect most of us who sign out esophageal biopsies every day already do in practice. But this still doesn't answer the question of how microscopic esophagitis relates to clinical findings. You may find some of the statements in the discussion unintentionally amusing if you are not a "well-published expert in the field" ("the evaluation of the slides and photos was done by highly specialized experts, thus, limiting the generalizability of the results obtained."
Come on, ladies and gentlemen, they're esophageal biopsies!
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