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Methods: 233 symptomatic patients underwent endoscopy with standardized measurement under adequate gastric insufflation and also underwent esophageal pH-impedance monitoring (acid exposure time >4% as the reference standard) between Sept 2017 and Sept 2023. Results: cutoffs were CO >2 cm and SH >1 cm; these were linked to higher acid exposure time, DeMeester score, and more reflux episodes. A nomogram using age, BMI, and SH showed good predictive performance. Conclusion: these endoscopic functional indicators can aid diagnosis, especially where resources are limited.",{"@graph":69,"@context":122},[70,84,105],{"@type":71,"itemListElement":72},"BreadcrumbList",[73,77,79,82],{"item":74,"name":75,"@type":76,"position":8},"https://docshare.wps.com","Home","ListItem",{"item":78,"name":9,"@type":76,"position":14},"https://docshare.wps.com/document/",{"item":80,"name":35,"@type":76,"position":81},"https://docshare.wps.com/document/healthcare/",3,{"item":83,"name":65,"@type":76,"position":19},"https://docshare.wps.com/document/endoscopic-assessment-of-the-gastroesophageal-junction-for-predicting-gastroesophageal-reflux-disease-article/459706/",{"url":83,"name":65,"@type":85,"image":86,"author":91,"headline":65,"publisher":94,"fileFormat":97,"inLanguage":63,"description":67,"dateModified":98,"datePublished":99,"encodingFormat":97,"isAccessibleForFree":100,"interactionStatistic":101},"DigitalDocument",{"url":87,"@type":88,"width":89,"height":90},"https://docshare.wps.com/thumbnails/endoscopic-assessment-of-the-gastroesophageal-junction-for-predicting-gastroesophageal-reflux-disease-article/459706.png","ImageObject",300,407,{"name":92,"@type":93},"วิน","Person",{"url":74,"name":95,"@type":96},"DocShare","Organization","application/pdf","2026-10-31","2026-09-30",true,{"@type":102,"interactionType":103,"userInteractionCount":39},"InteractionCounter",{"@type":104},"ViewAction",{"@type":106,"mainEntity":107},"FAQPage",[108,114,118],{"name":109,"@type":110,"acceptedAnswer":111},"What endoscopic measurements were assessed to predict GERD?","Question",{"text":112,"@type":113},"The study evaluated cardia opening diameter and sliding hernia length measured during endoscopy under adequate gastric insufflation.","Answer",{"name":115,"@type":110,"acceptedAnswer":116},"How was GERD diagnosis defined in the study?",{"text":117,"@type":113},"Esophageal pH-impedance monitoring served as the gold standard, using acid exposure time greater than 4% as the diagnostic criterion for GERD.",{"name":119,"@type":110,"acceptedAnswer":120},"What prediction model did the researchers develop?",{"text":121,"@type":113},"They built a nomogram prediction model that incorporated age, body mass index, and sliding hernia length, demonstrating good predictive performance.","https://schema.org",{"og:url":83,"og:type":124,"og:title":65,"og:site_name":95,"og:description":67},"article",{"robots":126,"canonical":83},"index,follow",{"doc_id":128,"site_id":62},459706,1791078063,{"code":4,"msg":5,"data":131},{"doc_id":128,"user_id":132,"nickname":92,"user_avatar":133,"doc_module":4,"category_id":34,"category_name":35,"doc_title":65,"doc_description":67,"doc_content":134,"file_id":135,"file_url":136,"file_type":137,"file_size":138,"view_count":39,"is_deleted":4,"is_public":8,"is_downloadable":8,"audit_status":8,"page_count":139,"language":140,"language_code":63,"site_id":62,"html_lang":63,"table_of_contents":141,"faqs":142,"seo_title":143,"seo_description":67,"update_tm":144,"read_time":145,"preview_page_count":4},2336475104736,"https://ap-avatar.wpscdn.com/avatar/22000c4c5e0e5b17e70?x-image-process=image/resize,m_fixed,w_180,h_180&k=1786591360781797222","Endoscopic assessment of the gastroesophageal junction for predicting gastroesophageal reflux disease  \nXue Fan 1, Weiran Xu2, Lei Zhang3,  \nYanyan Shi4, Yuan Li3 and Xiangchun Lin3   \nJournal of International Medical Research 2026, Vol. 54(1) 1–13! The Author(s) 2026 Article reuse guidelines:  \n[sagepub.com/journals-permissions](sagepub.com/journals-permissions)[ ](sagepub.com/journals-permissions)[DOI: 10.1177/03000605251409497](DOI: 10.1177/03000605251409497)[ ](DOI: 10.1177/03000605251409497)[journals.sagepub.com/home/imr](journals.sagepub.com/home/imr)  \nAbstract  \nObjective: This study was conducted to evaluate the predictive value of endoscopic measurements of cardia opening diameter and sliding hernia length for diagnosing gastroesophageal reflux disease.  \nMethods: A total of 233 patients with typical gastroesophageal reflux disease symptoms who underwent endoscopy and esophageal pH-impedance monitoring between September 2017 and September 2023 were enrolled in this study. Cardia opening diameter and sliding hernia length were measured during endoscopy under adequate gastric insufflation. Using esophageal pHimpedance monitoring as the gold standard (with acid exposure time >4% as the diagnostic criterion for gastroesophageal reflux disease), the correlation between cardia opening diameter/ sliding hernia length and gastroesophageal reflux disease-related parameters was analyzed. A nomogram prediction model was subsequently developed.  \nResults: The optimal cutoff values for predicting pathological acid reflux were cardia opening diameter >2cm and sliding hernia length > 1cm (area under the receiver operating characteristic curve ¼ 0.648 for both). Compared with patients with a cardia opening diameter 􀀂 2cm, those with a cardia opening diameter >2cm had significantly higher acid exposure time (6.8% vs. 2.5%), DeMeester score (25.7 vs. 10.9), and number of reflux episodes (108 vs. 59) (all p \u003C0.001). Similarly, sliding hernia length > 1cm was associated with more severe reflux parameters (p \u003C0.05) and was more prevalent in males (72.4% vs. 43.6%). Univariate and multivariate logistic regression analyses demonstrated that a nomogram incorporating age, body mass index, and sliding hernia length exhibited good predictive performance (area under the curve ¼ 0.739).  \n3Department of Gastroenterology, Peking University  \n1 Department of Gastroenterology, Peking University International Hospital, Life Science Park of Zhong Guancun, China  \n2Department of Medical Oncology, Beijing Tiantan Hospital, China  \nInternational Hospital, China  \n4Research Center of Clinical Epidemiology, Peking University Third Hospital, China Corresponding author:  \nXiangchun Lin, Department of Gastroenterology, Peking University International Hospital, China.  \nEmail: [linxiangchun@pkuih.edu.cn](linxiangchun@pkuih.edu.cn)  \nCreative Commons Non Commercial CC BY-NC: This article is distributed under the terms of the Creative  \nCommons Attribution-NonCommercial 4.0 License ([https://creativecommons.org/licenses/by-nc/4.0/](https://creativecommons.org/licenses/by-nc/4.0/)) which permits non-commercial use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access pages ([https://us.sagepub.com/en-us/nam/open-access-at-sage](https://us.sagepub.com/en-us/nam/open-access-at-sage)).  \nConclusion: Endoscopically assessed cardia opening diameter and sliding hernia length are useful functional predictors of gastroesophageal reflux disease. The integrated prediction model may serve as a valuable diagnostic aid, especially in primary care or resource-limited settings.  \nKeywords  \nGastroesophageal reflux disease, endoscopic assessment, acid exposure time, sensitivity and specificity, predictive diagnostic model  \nDate received: 24 August 2025; accepted: 5 December 2025  \nIntroduction  \nGastroesophageal reflux disease (GERD), a common chronic disorder of the digestive sys","cbCaiubE244xGQjQ","https://ap.wps.com/l/cbCaiubE244xGQjQ","pdf",512703,13,"English","# Abstract\n## Objective\n## Methods\n## Results\n## Conclusion\n# Introduction\n## Background and need for standardized assessment\n## Gold standards and limitations of existing methods\n## Rationale for functional endoscopic techniques","[{\"question\":\"What endoscopic measurements were assessed to predict GERD?\",\"answer\":\"The study evaluated cardia opening diameter and sliding hernia length measured during endoscopy under adequate gastric insufflation.\"},{\"question\":\"How was GERD diagnosis defined in the study?\",\"answer\":\"Esophageal pH-impedance monitoring served as the gold standard, using acid exposure time greater than 4% as the diagnostic criterion for GERD.\"},{\"question\":\"What prediction model did the researchers develop?\",\"answer\":\"They built a nomogram prediction model that incorporated age, body mass index, and sliding hernia length, demonstrating good predictive performance.\"}]","Endoscopic assessment of the gastroesophageal junction for predicting gastroesophageal reflux disease - Article | PDF",1790756627,33]