Despite the Rome IV Consensus recommending esophageal biopsies for patients being investigated for dysphagia with a normal appearance of the mucosa, studies in this regard were limited, especially in those patients already using proton pump inhibitors (PPIs). The authors performed esophageal biopsies on 361 dysphagic patients using PPIs. Microscopic alterations were found in 68% of biopsies, with microscopic signs of GERD being the most common abnormal finding (39% - p=0.0495). This study supports the recommendation of serial biopsies in normal-appearing mucosa in patients being investigated for dysphagia.
