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      We read the commentary from Deng et al
      • Deng K.
      • Chen Y.
      • Chen M.
      • et al.
      Obtaining slight changes for the detection of nonerosive reflux disease needs assistance from magnifying endoscopy with narrow-band imaging.
      pertaining to our study of narrow-band imaging (NBI) for nonerosive reflux disease (NERD).
      • Desai M.
      • Srinivasan S.
      • Sundaram S.
      • et al.
      Narrow-band imaging for diagnosis of non-erosive reflux disease: an international, multicenter, randomized controlled trial.
      We thank the authors for their interest in our study findings and the use of NBI for the workup of NERD. In our study, we recognized and noted subtle and distinct features in the distal esophagus using NBI in the near-focus magnification mode.
      • Desai M.
      • Srinivasan S.
      • Sundaram S.
      • et al.
      Narrow-band imaging for diagnosis of non-erosive reflux disease: an international, multicenter, randomized controlled trial.
      As the authors acknowledge, several of these features (such as intrapapillary capillary loops) can be ascertained by the use of dual mode (normal and near focus) of currently available high-definition gastroscopes with second-generation NBI technology (ie, Olympus GIF-HQ-190) that were used in this study. We cited the use of dual-focus endoscopes (normal mode and near focus) in the methods and provided examples of high-quality images as a supplementary Figure 1. The utility of this methodology has been reported in several other studies.
      • Goda K.
      • Dobashi A.
      • Yoshimura N.
      • et al.
      Dual-focus versus conventional magnification endoscopy for the diagnosis of superficial squamous neoplasms in the pharynx and esophagus: a randomized trial.
      ,
      • Kakushima N.
      • Yoshida N.
      • Doyama H.
      • et al.
      Near-focus magnification and second-generation narrow-band imaging for early gastric cancer in a randomized trial.
      Such dual-focus mode endoscopes are routinely used in the United States, and the high-magnifying endoscopes referred to by Deng et al
      • Deng K.
      • Chen Y.
      • Chen M.
      • et al.
      Obtaining slight changes for the detection of nonerosive reflux disease needs assistance from magnifying endoscopy with narrow-band imaging.
      are not commercially available here.
      We examined the presence of not only increased intrapapillary capillary loops in patients with NERD and control individuals but also features such as the ridge-villous pattern, increased vascularity, and columnar islands at or above the squamocolumnar junction. These features can be recognized without any magnification. Given that the dual-focus modes (with or without near focus) are commonly used in the United States, our study findings are generalizable and can be adopted by all practicing endoscopists in patients suspected to have GERD.

      Disclosure

      Dr Sharma is a consultant for Medtronic , Olympus , Boston Scientific , Fujifilm , Salix Pharmaceuticals, and Lumendi, and the recipient of grant support from Ironwood , Erbe, Docbot, Cosmo Pharmaceuticals, and CDX laboratories. The other author disclosed no financial relationships.

      References

        • Deng K.
        • Chen Y.
        • Chen M.
        • et al.
        Obtaining slight changes for the detection of nonerosive reflux disease needs assistance from magnifying endoscopy with narrow-band imaging.
        Gastrointest Endosc. 2022; 96: 1087
        • Desai M.
        • Srinivasan S.
        • Sundaram S.
        • et al.
        Narrow-band imaging for diagnosis of non-erosive reflux disease: an international, multicenter, randomized controlled trial.
        Gastrointest Endosc. 2022; 96: 457-466
        • Goda K.
        • Dobashi A.
        • Yoshimura N.
        • et al.
        Dual-focus versus conventional magnification endoscopy for the diagnosis of superficial squamous neoplasms in the pharynx and esophagus: a randomized trial.
        Endoscopy. 2016; 48: 321-329
        • Kakushima N.
        • Yoshida N.
        • Doyama H.
        • et al.
        Near-focus magnification and second-generation narrow-band imaging for early gastric cancer in a randomized trial.
        J Gastroenterol. 2020; 55: 1127-1137

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