Assessing Gastro-esophageal Reflux Using Hill’s Endoscopic Grading of the Gastro-esophageal Flap Valve

The Hill's classification of Gastro-Oesophageal Flap Valve (GEFV) evaluation is a useful tool for identifying abnormalities and confirming GERD. It can be used to assess GERD, LPRD, and the outcomes of dyspeptic conditions such as H. pylori-related Reflux Esophagitis and Atrophic Gastritis. This tool to be easy to perform and interpret as compared to the more cumbersome and complex 24-hour pH monitoring and Oesophageal Manometry. We wish to encourage the use of Hill’s Classification in all endoscopies done for GERD. Investigations like the 24-hour pH-monitoring and Oesophageal Manometry can be reserved for select cases that may either need further evaluation of GERD or have the need to rule out functional conditions of the oesophagus like the oesophageal motility disorders. Our understanding of the link between GEFV and GERD based on the functional relationship of the lower oesophageal sphincter establishes the credibility of this classification. Regarding the use of this classification in circumstances where oesophageal motility disorders are being considered as a diagnosis, we do issue a warning.