Reflux esophagitis

Reflux esophagitis is an inflammatory condition of the esophagus caused by the reflux of gastric and duodenal contents into the esophagus, commonly known as "heartburn disease." This is because under normal circumstances, gastric acid exists only in the stomach; when it refluxes into the esophagus, it burns or irritates the esophagus, producing a "heartburn sensation." It often occurs after meals, resulting from decreased lower esophageal sphincter tone or increased intragastric pressure relative to the esophagus. This condition frequently coexists with chronic gastritis, peptic ulcers, or hiatal hernia, but it can also occur independently. Endoscopic findings reveal damage to the esophageal mucosa, namely esophageal erosion and/or esophageal ulcers. Based on the degree of endoscopic esophageal mucosal injury, reflux esophagitis is classified into grades A, B, C, and D. Grade A esophagitis refers to mucosal injury confined to the mucosal folds without confluence, with erosions less than 5 mm in length; grade B esophagitis has erosions greater than 5 mm in length; grade C esophagitis shows confluent esophageal injury that does not exceed 75% of the esophageal circumference; grade D esophagitis refers to mucosal injury involving the entire esophageal circumference. Approximately 40% of patients with gastroesophageal reflux disease present with reflux esophagitis. Reflux esophagitis can occur in individuals of any age, with the incidence in adults increasing with age. The incidence is high in Western countries and low in Asian regions. This geographical difference may be related to genetic and environmental factors. However, over the past two decades, there has been a global upward trend in incidence. Middle-aged and elderly individuals, obese people, smokers, alcohol consumers, and those under high psychological stress are populations at high risk for reflux esophagitis.