To explore the application of endoscopic assessment of gastroesophageal relaxation in screening for gastroesophageal reflux disease (GERD), thereby providing diagnostic evidence for early diagnosis of GERD.

A total of 198 patients who visited the Department of Gastroenterology at Xingyi City People's Hospital from January 2022 to July 2023 were included as the study subjects. The GERD Questionnaire (GERD-Q) score, gastroscopy, 24-hour esophageal pH impedance monitoring, and esophageal high-resolution manometry were collected to analyze the role of endoscopic assessment of gastroesophageal relaxation in GERD screening. Patients were divided into two groups based on the presence or absence of gastroesophageal reflux: a non-occurrence group (82 cases) and an occurrence group (116 cases).

There was no statistically significant difference in age between the two groups (P>0.05). However, there were statistically significant differences in body mass index (BMI) , smoking and drinking history, and Helicobacter pylori infection between the two groups (P<0.05). The occurrence group had higher levels of gastroesophageal relaxation, GERD-Q scores, esophageal high-resolution manometry, and esophageal pH impedance monitoring values compared to the non-occurrence group, with statistically significant differences (P<0.05). The occurrence group also had higher levels of gastroesophageal relaxation and esophagitis grade compared to the non-occurrence group, and the occurrence group had a higher incidence of esophageal hiatus hernia compared to the non-occurrence group, with statistically significant differences (P<0.05). BMI and gastroesophageal relaxation were identified as risk factors for the occurrence of gastroesophageal reflux (P<0.05). Gastroesophageal relaxation was significantly positively correlated with GERD-Q scores, esophageal high-resolution manometry, esophageal pH impedance monitoring, and esophagitis grade (P<0.05). The area under the curve for BMI was 0.713, P<0.001, sensitivity was 0.759, specificity was 0.598, and the critical value was 22.445; the area under the curve for gastroesophageal relaxation was 0.709, P<0.001, sensitivity was 0.750, specificity was 0.573, and the critical value was 1.450; the area under the curve for combined diagnosis was 0.772, P<0.001, sensitivity was 0.586, specificity was 0.829.

Endoscopic assessment of gastroesophageal relaxation is significantly related to the occurrence of GERD and can be used for GERD screening.