Los Angeles (LA) Grading of Esophagitis
LA Grading of Esophagitis Calculator
Endoscopic Grade
LA Grade:
Grade A
Grade A
Mucosal breaks ≤5 mm, not extending between tops of mucosal folds. Mild esophagitis.
Stratifies severity of esophagitis based on endoscopic findings, recommended by ACG guidelines .
Why Use
Provides a standard nomenclature for describing esophagitis with low interrater variability ( Armstrong 1996 ). Recommended by the American College of Gastroenterology (ACG) for grading erosive esophagitis (strong recommendation, moderate level of evidence).
When to Use
Patients with findings of erosive esophagitis on endoscopy.
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 .
Pearls / Pitfalls
Developed by consensus of a working group at the 10th World Congress of Gastroenterology in 1994.
Advice
The ACG recommends that patients with LA Grade A esophagitis undergo further testing to confirm GERD diagnosis (conditional recommendation, low level of evidence).
More Information
Interpretation: Grade Severity A-B Mild reflux esophagitis C-D Severe reflux esophagitis