Can Reflux Esophagitis Recur After Treatment?

Reflux esophagitis has a high chance of recurrence even after successful treatment. This condition primarily occurs due to dysfunction of the lower esophageal sphincter, which compromises the anti-reflux barrier, either structurally or functionally. Other contributing factors include delayed gastric emptying and obesity, both of which can increase the likelihood of gastroesophageal reflux. The main mechanism behind this disorder is the backflow of stomach contents into the esophagus, where gastric acid and digestive enzymes cause direct damage to the esophageal mucosa. Common symptoms include heartburn, regurgitation, and retrosternal pain.

Chronic or recurring episodes can lead to serious complications such as esophageal stricture, bleeding, and even Barrett's esophagus, which increases the risk of esophageal cancer. Therefore, it's crucial to manage the condition effectively to prevent relapse and reduce long-term health risks.

To minimize the chances of recurrence, maintenance therapy with proton pump inhibitors (PPIs) such as omeprazole or pantoprazole is often recommended. These medications help reduce gastric acid production and promote healing of the esophageal lining. Prokinetic agents like domperidone or mosapride can also be used to enhance gastrointestinal motility, while protective agents such as sucralfate or aluminum magnesium carbonate may help shield the esophageal mucosa from further damage.

Lifestyle modifications are equally important in preventing relapse. Elevating the head of the bed during sleep can help prevent nighttime reflux. Regular physical activity supports healthy digestion and helps maintain an ideal weight, reducing pressure on the stomach. It's also essential to avoid smoking and alcohol consumption, as these can weaken the lower esophageal sphincter.

Dietary changes play a key role in managing reflux esophagitis. Patients should avoid high-fat foods, spicy dishes, strong tea, coffee, carbonated drinks, and chocolate—especially before bedtime. Additionally, lying down immediately after meals should be avoided, and eating at least two to three hours before sleeping can significantly decrease the risk of acid reflux.

By combining medical treatment with consistent lifestyle and dietary adjustments, patients can greatly reduce the risk of recurrent reflux esophagitis and its potential complications.