the evaluation of treatment failures and risk manage- ment. Endoscopy may detect esophageal mucosal due to GERD (erosive esophagitis, ulceration stricture, Barrett's esophagus). The endoscopists are directed to grade esophageal mucosal breaks with esophagitis according to the Los Angeles Classification of Esophagitis in 1996 [43] Typical esophagitis is essential for the diagnosis of GERD [43]. The identification of esophagitis is highly specific (90%-95%) for GERD, but the endoscopy has a quit low sensitivity mainly because the majority of symptomatic GERD patients will have no evidence of mucosal injuries [44]. In clinical practice endoscopy is used as a screening test for BE esophagus or esophageal carcinoma in patients with chronic GERD [45, 46]. Thus, all patients 250 years of age with 5-10 years of heartburn should perform endoscopic