Gastroesophageal Reflux Disease And Esophagitis: Not Exactly A Stomach Illness

When it comes to gastroesophageal reflux disease (GERD), many people mistakenly categorize it as a stomach-related illness. However, the primary damage occurs in the esophagus, not the stomach. GERD is primarily a motility disorder characterized by dysfunction of the lower esophageal sphincter, which leads to acid reflux into the esophagus.

Endoscopic findings often reveal inflammation, erosion, or even ulcers in the lining of the lower esophagus. These changes appear as linear red streaks along the mucosal folds near the gastroesophageal junction. The hallmark symptoms include heartburn and regurgitation—heartburn being a burning sensation behind the breastbone, and regurgitation involving the effortless backflow of stomach contents into the throat or mouth.

Interestingly, studies have shown that typical reflux symptoms are less common among Chinese populations compared to Western countries. Many patients present with atypical symptoms similar to those of gastritis, such as upper abdominal pain, early satiety, belching, post-meal fullness, and indigestion. This symptom overlap contributes to the misconception that GERD is simply a type of stomach disease.

However, since the main site of injury is the esophagus, follow-up evaluations should focus on healing of the esophageal mucosa rather than gastric health. Proper diagnosis and monitoring through endoscopy are essential to assess the true condition of the esophagus and prevent long-term complications like Barrett's esophagus or stricture formation.