- Y Hoshihara: Department of Gastroenterology, Toranomon Hospital.
A new endoscopic classification of reflux esophagitis was proposed in Los Angeles in 1994(LA classification). A mucosal break was defined as 'an area of slough or an area of erythema with a discrete lined demarcation from the adjacent or normal looking mucosa'. Reflux esophagitis is divided into four grades according to the severity of its mucosal break. We can find a minimal change during endoscopy which is not a mucosal break but is histologically or chromographically reflux esophagitis. I think Los Angeles classification must include the minimal change and I propose a modification of LA classification which includes the minimal change as grade M and the esophagus without any minimal change and mucosal break as grade N.