"Patulous" eg junction
Are there any astute gerders on the board who can clue me in to "patulous eg junction"?
I've had 3 scopes in my life: 1997; 2007, & 2009. Every one has been noted as "patulous eg junction". The photos I received this time however, showed my sphincter looking like a tightly puckered well...sphincter. My gi's assistant said maybe that's just the way I'm built. Anyways, I know that "patulous" means OPEN. And yet my photos show a tightly closed sphincter. So, is what's open, the "eg junction", not the "sphincter"? In other words, is there a distinction between the eg junction and the sphincter?? Forgive me but in spite of my having attended this board for 1 or 2 years or whatever, anatomy is still an area of challenge for me. Any clarification on this point would be greatly appreciated. I will seek clarification when I follow up with my gi in a couple weeks in any case, but I wanted to throw this question out there in the meantime.
Patulous does mean open. My first Endoscopy indicated that my sphincter was 'patulous'.
With the same notation on each EGD, I would think you would have already asked your doctor?????????
Hi Mark They use the terms patulous LES---- patulous cardia ---patulous EG junction . They all mean the very same thing .
You can't see the LES Mark . not with a scope or naked eye . It's a pressure zone . It's invisable . It is the opening basically they are talking about. . It refers to the anatomy in the GE junction region that protects us from reflux . It's the lesser curvature component of the cardia actually if we want to get technical . When the scope is retroflexed you sometimes see a gaping there , that would be called a patulous cardia ... patulous LES .... GE junction whatever . All 3 terms are used for the same thing.
Actually Hill quantified it more specifically coming up with a flap valve grading system from grade 1 to 4 [url]http://www.heartburn-help.com/hill1994.htm[/url] These pics will help you understand
What does it mean for you ? It doesn't guarantee reflux , makes you more prone , makes the odds better . You need to back it up with a manometry and ph test ... alone it really means nothing . People without GERD and who have no symptoms can have a patulous GE junction too.
Actually we have had people who have had it on one scope and not on the next . Sometimes the air from the scope or when you start retroflexing the scope can make it look patulous , or if you have a peralisistic wave .