Background and aims
Low‐grade esophagitis (grade A and B) are no longer believed as confirmatory evidence of gastroesophageal reflux disease, but there were no data about the association of low‐grade esophagitis with pathological acid reflux (PAR) in China. This study aimed to summarize the proportion of PAR in the patients with low‐grade esophagitis and to explore the differential factors between low‐grade esophagitis patients with and without PAR.
Methods
Database of the patients accepted 24‐hour pH monitoring in the motility laboratory of a tertiary center was retrospectively searched, and the patients were diagnosed as low‐grade esophagitis before the procedure was recruited. The demographics, symptoms and high‐resolution manometry and pH monitoring parameters were compared between the patients with pathological and physiological acid reflux and between patients with grade A and B esophagitis.
Results
About 24% of grade A and 55% of grade B esophagitis patients had pathological acid reflux. The demographics, symptoms, and almost all high‐resolution manometry findings were similar in patients with pathological and physiological acid reflux. About two‐thirds of the participants with physiological acid reflux reported symptom improvement after PPI administration. All participants with PPI‐resistant symptoms were with physiological acid reflux.
Conclusion
The proportion of PAR in low‐grade esophagitis is not high. For patients with low‐grade esophagitis in China, especially the patients with grade A esophagitis, regardless of symptom change, reflux monitoring is possibly needed for the patients whose esophageal mucosa break is not improved after 8 weeks of PPI treatment.
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