How To Diagnose Reflux Esophagitis

Reflux esophagitis is typically diagnosed by identifying both the presence of gastroesophageal reflux and associated inflammation of the esophageal lining. One of the most common and effective diagnostic tools used in clinical practice is upper endoscopy, also known as gastroscopy. During this procedure, a flexible tube with a camera is inserted through the mouth into the esophagus, allowing doctors to directly observe the condition of the lower esophageal mucosa.

Signs such as linear redness, erosion, or even circumferential ulcers in the lower esophagus are strong indicators of reflux esophagitis. The severity of the condition is often classified using the Los Angeles Classification system, which grades the disease from A to D. In Grade A, small streaks of redness less than or equal to 5mm in length are observed. When these streaks are longer than 5mm but not fused, it is classified as Grade B. If erosions begin to merge but do not encircle the esophagus, it is considered Grade C. Finally, Grade D is diagnosed when the erosions are fully circumferential.

In addition to endoscopy, another important diagnostic method is 24-hour esophageal pH monitoring. This test measures the amount of acid exposure in the lower esophagus over a full day. A very thin catheter is passed through the nose and positioned at the lower end of the esophagus to record pH levels continuously for 24 hours. This helps determine whether there is abnormal acid reflux. Prolonged periods where the pH level drops below 4 are considered indicative of pathological acid reflux.

These diagnostic methods provide valuable insight into the presence and severity of reflux esophagitis, enabling healthcare providers to develop an appropriate treatment plan tailored to each patient's condition.