Calc Function

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    Patent Pending

    Los Angeles (LA) Grading of Esophagitis

    Stratifies severity of esophagitis based on endoscopic findings, recommended by ACG guidelines.
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    When to Use
    Pearls/Pitfalls
    Why Use

    Patients with findings of erosive esophagitis on endoscopy.

    Developed by consensus of a working group at the 10th World Congress of Gastroenterology in 1994.

    Mucosal break(s) ≤5 mm, without continuity across mucosal folds
    Mucosal break(s) >5 mm, without continuity across mucosal folds
    Mucosal break(s) continuous between ≥2 mucosal folds, involving <75% of the esophageal circumference
    Mucosal break(s) involving ≥75% of the esophageal circumference

    Result:

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    Next Steps
    Evidence
    Creator Insights

    Advice

    The ACG recommends that patients with LA Grade A esophagitis undergo further testing to confirm GERD diagnosis (conditional recommendation, low level of evidence).

    Formula

    Selection of the appropriate criteria:

    Features

    Grade

    Mucosal break(s) ≤5 mm, without continuity across mucosal folds

    A

    Mucosal break(s) >5 mm, without continuity across mucosal folds

    B

    Mucosal break(s) continuous between ≥2 mucosal folds, involving <75% of the esophageal circumference

    C

    Mucosal break(s) involving ≥75% of the esophageal circumference

    D

    From Nayar 2004.

    Facts & Figures

    Interpretation:

    Grade

    Severity

    A-B

    Mild reflux esophagitis

    C-D

    Severe reflux esophagitis

    Dr. David Armstrong

    About the Creator

    David Armstrong, MA, MB BChir, FRCP, FRCPC, FACG, AGAF, is a gastroenterologist and associate professor of medicine at McMaster University. He is a past president of the Canadian Association of Gastroenterology and the Canadian Association of Gastroenterology, and served on the board of directors for the Canadian Digestive Health Foundation. Dr. Armstrong's research interests include upper GI diseases, nutrition, and endoscopy education.

    To view Dr. David Armstrong's publications, visit PubMed

    Dr. Lars R. Lundell

    About the Creator

    Lars R. Lundell, MD, PhD, is a practicing surgeon and professor of surgery at Karolinska University Hospital in Stockholm, Sweden. He previously served as board member and president of the European Association for Gastroenterology and on the leadership of other societies including Endoscopy and Nutrition (EAGEN), European Society for Esophagology (ESE), the United European Gastroenterology (UEG) Education Committee, the International Working Group for Classification of Oesophagitis (IWGCO), and the International Society for Diseases of the Esophagus (ISDE). Dr. Lundell's primary research interest is GERD, and he has also studied cancer of the stomach and esophagus.

    To view Dr. Lars R. Lundell's publications, visit PubMed