Is Reflux Esophagitis Grade B Serious?

Reflux esophagitis Grade B, also known as Los Angeles Grade B, is a common classification of gastroesophageal reflux disease (GERD). This grade indicates mild inflammation where the congested mucosa in the lower esophagus measures more than 5mm in length but has not yet merged or coalesced. Compared to higher grades like C and D, Grade B is considered less severe and often responds well to treatment.

Common symptoms associated with Grade B reflux esophagitis include heartburn, acid regurgitation, and discomfort after meals, particularly after consuming acidic or fatty foods. These symptoms may worsen when lying down immediately after eating.

Managing Grade B reflux esophagitis typically involves lifestyle and dietary modifications. Avoiding high-fat foods, sweets, and overeating can significantly reduce symptoms. It's also recommended to wait at least two to three hours before lying down after a meal and to maintain a healthy weight.

In terms of medical treatment, proton pump inhibitors (PPIs) such as rabeprazole and pantoprazole are the most commonly prescribed medications to suppress acid production. Newer alternatives like P-CABs (potassium-competitive acid blockers), including vonoprazan, have also shown promising results in controlling acid secretion. In some cases, doctors may prescribe mucosal protectants or prokinetic agents like itopride to enhance gastrointestinal motility and protect the esophageal lining.

With proper management, Grade B reflux esophagitis can often be resolved completely, reducing the risk of progression to more severe stages.