Managing gastroesophageal reflux disease in children: The role of endoscopy

Table 1 Classification criteria and grading system of esophago-gastroduodenoscopy findings

Classification criteria	Grades	Findings
Hetzel-Dent[41]	0	Indicates no mucosal abnormalities
	1	Erythema, hyperemia, or mucosal friability without macroscopic erosions
	2	Superficial erosions involving less than 10% of the surface of the distal 5 cm of squamous epithelium
	3	Erosions or ulcerations involve 10%–50% of the mucosal surface of the distal 5 cm of squamous epithelium
	4	Deep ulceration anywhere in the esophagus or confluent erosion involving more than 50% of the mucosal surface of the distal 5 cm of squamous epithelium
Savary-Miller[42]	I	One or more supravestibular, nonconfluent reddish spots with or without exudates
	II	Erosive and exudative lesions in the distal esophagus that may be confluent, but not circumferential
	III	Circumferential erosions in the distal esophagus, covered by hemorrhagic and pseudomembranous exudates
	IV	Presence of chronic complications such as deep ulcers, stenosis, or scarring with Barrett’s metaplasia
Los Angeles[21]	A	One or more mucosal breaks, each ≤ 5 mm in length
	B	At least one mucosal break > 5 mm long, but not continuous between the tops of adjacent mucosal folds
	C	At least one mucosal break that is continuous between the tops of adjacent mucosal folds, but which is not circumferential (< 75% of luminal circumference)
	D	Mucosal break that involves at least 75% of the luminal circumference