Is an Endoscopy Necessary for Reflux Esophagitis?

Understanding the Role of Endoscopy in Diagnosing Reflux Esophagitis

When a person experiences classic symptoms of gastroesophageal reflux disease (GERD), such as a burning sensation in the upper abdomen or behind the breastbone, a doctor may recommend an endoscopic examination. This procedure allows for a detailed view of the lower esophagus and helps determine the extent of any damage caused by acid reflux.

Types of GERD and the Importance of Endoscopic Evaluation

Reflux esophagitis is a specific form of GERD. If a patient has symptoms like heartburn and regurgitation but no visible esophageal damage during endoscopy, the condition is classified as non-erosive reflux disease (NERD). However, if the endoscopy reveals linear red streaks or even shallow ulcers in the esophagus, it is diagnosed as reflux esophagitis.

Potential Complications of Reflux Esophagitis

During the healing process of esophageal erosions, a condition known as Barrett's esophagus may develop. This occurs when the normal lining of the esophagus undergoes intestinal metaplasia — a change in cell type that can be a precursor to more serious complications. Barrett's esophagus, especially when accompanied by goblet cells, increases the risk of developing precancerous changes in the esophagus.

Identifying Hiatal Hernia Through Endoscopy

Endoscopy also plays a key role in identifying structural abnormalities such as hiatal hernia, which is commonly associated with severe cases of reflux esophagitis. Detecting the presence of a hiatal hernia helps doctors tailor the most effective treatment plan and estimate the duration of therapy required.

The Los Angeles Classification System for Reflux Esophagitis

Reflux esophagitis is categorized using the Los Angeles classification system, which includes four grades: LA-A, LA-B, LA-C, and LA-D. Each grade reflects the severity of esophageal damage and influences both the treatment approach and long-term prognosis. Accurate staging through endoscopy ensures patients receive appropriate care based on their individual condition.