How is reflux esophagitis graded?

I think everyone knows very little about reflux gastritis. Reflux gastritis is divided into many levels, from level 0 to level V, and the levels vary depending on the severity. If you have reflux esophagitis, you will have difficulty swallowing, which is usually accompanied by pain and a burning sensation in the chest. You may even experience food reflux after eating. Next, I will tell you how reflux esophagitis is classified.

Reflux esophagitis refers to the reflux of gastric and/or duodenal contents into the esophagus. Gastroesophageal reflux can be divided into physiological and pathological types. Physiological gastroesophageal reflux is common in normal people and has no clinical significance. However, if reflux occurs more frequently than in normal people and the acidic digestive gastric juice, pepsin, bile, and pancreatic juice cannot be cleared in time, it will cause inflammation, erosion, ulcers, fibrosis, and other lesions of the esophageal mucosa, which is gastroesophageal reflux disease (GERD). The symptoms of reflux esophagitis are easily confused with those of peptic ulcer and can be misdiagnosed.

Tytgat recently proposed a revision. He believed that it was inappropriate to classify superficial erosions as grade I lesions. Barrett's esophagus can be seen in all grades and should not be included in grade IV alone. He combined several classification suggestions in the literature and proposed a new classification standard as follows:

Grade 0: There is no evidence of esophageal mucosal damage caused by reflux, the esophageal squamous-columnar junction (SCMJ) is clear, there is no evidence of friability, and the distal esophageal mucosa is smooth and shiny.

Grade I: There is mild patchy or diffuse erythema at the esophageal gastric junction or dentate line (Z line) of the SCMJ, the SCMJ is slightly blurred and slightly brittle, and the distal esophageal mucosa has lost its luster, but these are often not interpreted as characteristics of mucosal damage caused by reflux, and there is no manifestation of mucosal destruction.

Grade II: One or a few relatively scattered red dot-like or strip-like superficial erosions, with or without white sticky secretions. This linear erosion is usually small and often on the ridges of the esophageal mucosal folds. The damaged area is less than 10% of the esophageal area within 5 cm above the SCMJ.

Grade III: A fused but non-circumferential erosive surface of the esophagus (regardless of the long diameter or the transverse diameter), covered with secretions or scab formation, involving less than 50% of the esophageal area within 5 cm of the distal esophagus. Grade IV: There is erosion and exudate surrounding the esophagus at the SCMJ, regardless of the size of the distal esophagus.

Grade V: Ulcers or varying degrees of stenosis in any part of the esophagus.

If you have reflux esophagitis, you must pay great attention to your diet. You cannot overeat and must control your diet. It is best to eat small meals frequently to reduce the reflux of food. Do not eat too much high-fat food to avoid reflux. You cannot eat irritating food, especially cigarettes and alcohol. Cigarettes contain a lot of nicotine, and smoking is very harmful to the body.