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May 1976

Reflux Esophagitis: Pathogenesis, Diagnosis, and Management

Author Affiliations

From the Department of Medicine, Veterans Administration Hospital, and Yale University Medical School, West Haven, Conn.

Arch Intern Med. 1976;136(5):560-566. doi:10.1001/archinte.1976.03630050046009

Although the incidence of heartburn. and regurgitation in the general population is not known, symptomatic gastroesophageal reflux is being recognized with increasing frequency as a cause of substantial morbidity. Recent advances in the pathophysiology of gastroesophageal reflux and its consequences indicate that reflux esophagitis is the result of the failure of the lower esophageal sphincter (LES) to prevent the regurgitation of gastroduodenal secretions with subsequent esophageal mucosal injury. This new information, as well as the development of new esophageal diagnostic tests, have led to a more precise diagnosis and more rational management of this disease process.

This review is concerned mainly with the clinical and the pathophysiologic aspects on which we currently base the diagnosis and management of reflux esophagitis.

SYMPTOMS  Heartburn, the most common symptom of reflux esophagitis, is usually described as a substernal burning pain or discomfort, with a moving quality from the xyphoid area up to the

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