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In Reply.—Dr Greenwald questions our methods and believes our observation regarding the insensitivity of the GE scintiscan is "almost absurd." We apologize for any confusion, but believe that he has missed the major emphasis of our report.
In an attempt to keep our article brief, our methods were not fully detailed, and for this we apologize. Symptoms associated with GE reflux most commonly include heartburn and regurgitation. Later stages of the disease can have dysphagia, esophageal obstruction, or tracheal aspiration. No patient in our study had alkaline reflux or previous peptic ulcer surgery. We would agree that erythema of the esophageal mucosa is at times an unreliable indicator of esophagitis, but certainly linear erosions, mucosal friability, ulceration, and stricture formation are more objective findings. We did not use the water siphonage test for the reasons stated by Dr Greenwald.
Dr Greenwald states that it is "generally considered" that the
HOFFMAN GC, VANSANT JH. Gastrointestinal Symptoms-Reply. Arch Surg. 1980;115(5):676-677. doi:10.1001/archsurg.1980.01380050096027