Which severity level of reflux esophagitis is "abcd"?

Written by Wu Hai Wu
Gastroenterology
Updated on September 03, 2024
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Reflux esophagitis is divided into four grades: ABCD, with grade A being the least severe and grade D being the most severe. Grade D indicates that the esophageal mucosa shows damage and fusion, involving at least 75% of the esophageal circumference. The symptoms of reflux esophagitis mainly include reflux and a burning sensation in the stomach, and some patients may also experience heartburn, nausea, vomiting, and other symptoms. Reflux esophagitis can occur during nighttime sleep in some patients and is caused by the chemical irritation of sensory nerve endings beneath the esophageal epithelium due to acidic or alkaline reflux material.

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Written by Zhu Dan Hua
Gastroenterology
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Chronic gastritis and reflux esophagitis symptoms

Chronic gastritis and gastroesophageal reflux disease (GERD) manifest clinically with typical symptoms including abdominal pain, bloating, nausea, heartburn, and acid reflux, generally starting with gastrointestinal symptoms and often with a prolonged history. In cases presenting with abdominal pain, this generally occurs in the upper abdomen and can be characterized as dull, distending, or burning pain. These symptoms are usually related to diet, and some patients may feel better after eating. There is generally no associated nighttime pain, fever, or jaundice. GERD typically presents with heartburn and acid reflux, which are commonly seen in clinical settings. The symptoms are usually more noticeable after eating, especially after a full meal, and do not usually occur at night. The pain, generally a burning sensation, occurs in the precordial and esophageal areas and can be episodic, spontaneously resolving. There may occasionally be nausea, and even a tendency to vomit. Diagnosis of GERD primarily relies on gastroscopic examination.

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Written by Wang Hui Jie
Gastroenterology
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Symptoms of gastroesophageal reflux disease

The symptoms of gastroesophageal reflux esophagitis are quite typical and include a range of symptoms. The most typical symptom is heartburn, primarily referring to a burning discomfort or pain felt behind the sternum or beneath the xiphoid process, usually occurring about an hour after eating, often accompanied by nausea. Another common symptom is acid regurgitation, which tends to occur more frequently on an empty stomach. Additional symptoms include chest pain, mainly due to the irritation of the esophageal mucosa by refluxed digestive juices, causing esophageal spasm and resultant pain. Difficulty swallowing is also a common symptom, initially mainly due to stress-induced spasms leading to swallowing difficulties. In later stages, it is often due to the proliferation of fibrous tissue forming scars that cause esophageal narrowing, resulting in swallowing difficulties. Other common symptoms include bloating, pharyngitis, cough, asthma, and more.

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Written by Wang Hui Jie
Gastroenterology
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Reflux gastritis and reflux esophagitis are not the same.

It's different. Gastroesophageal reflux disease (GERD) refers to the abnormal reflux of stomach or duodenal fluids into the esophagus, causing a series of symptoms. Under endoscopy, severe esophageal inflammation and erosion can be seen, along with ulcers, fibrosis, etc. Prolonged episodes can lead to the development of Barrett's esophagus. On the other hand, reflux gastritis generally refers to bile reflux gastritis, which as the name suggests, is caused by the reflux of bile into the stomach. Endoscopically, swelling of the gastric mucosa can typically be seen, along with the presence of residual bile in the stomach, bile staining, and intestinal metaplasia, among others. Both conditions have clinically similar symptoms, including heartburn, acid reflux, and pain.

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Written by Wu Hai Wu
Gastroenterology
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Can I occasionally eat ice cream with reflux esophagitis?

Patients with gastroesophageal reflux disease (GERD) can occasionally eat ice cream. However, it is advisable for those with GERD to eat less high-fat food and avoid alcohol, strong tea, coffee, chocolate, etc. It is recommended to eat small, frequent meals and avoid overeating. Consuming fresh vegetables and fruits is encouraged, but patients should not have a heavy dinner or lie down immediately after eating. After taking medicine, it’s beneficial to stand and move around. Patients should maintain a regular diet, adhere to their medication schedule, and undergo regular endoscopic check-ups. Generally, GERD is not very severe.

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Written by Wu Hai Wu
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What should I do if reflux esophagitis causes a fever?

Reflux esophagitis, if accompanied by fever, might indicate the possibility of an infectious disease. It is necessary to further determine whether there is an infection and its location. Complete blood count and C-reactive protein tests can be conducted. At the same time, a follow-up gastroscopy should be done to observe the condition of the esophageal lesions, and histopathological examinations might be necessary when needed. Patients with reflux esophagitis require active treatment to suppress gastric acid secretion, and can also use gastroprotective agents, such as magnesium trisilicate and sucralfate. Prokinetic drugs like mosapride and itopride are also needed for treatment. Dietary adjustments should focus on a bland diet, avoiding spicy and irritating foods.