refluxøsofagitis

Refluxøsofagitis, or reflux esophagitis, is inflammation of the esophagus caused by the reflux of stomach contents into the esophagus. The term is used in Danish and Norwegian medical language and is closely related to gastroesophageal reflux disease (GERD), which describes the ongoing condition that can lead to esophageal inflammation if symptoms persist.

Pathophysiology and risk factors: Reflux of gastric acid, pepsin, and sometimes bile irritates the esophageal mucosa. Contributing factors include a defective lower esophageal sphincter, hiatal hernia, impaired esophageal clearance, obesity, and delayed gastric emptying. Chronic irritation may lead to mucosal injury and structural changes over time.

Clinical features: Typical symptoms are heartburn and regurgitation. Other manifestations include dysphagia, odynophagia, chest pain, chronic cough, hoarseness, or throat clearing, especially at night. Some individuals may have little or no heartburn but show mucosal injury on endoscopy or develop complications.

Diagnosis: Diagnosis often relies on clinical history. Endoscopy is recommended if alarm features are present (bleeding, difficulty swallowing, weight loss) or to assess the extent of injury. Biopsy may be obtained to exclude other conditions. Ambulatory pH monitoring or impedance testing is used when symptoms are nonresponsive or when the diagnosis is uncertain. Esophageal manometry is typically reserved for preoperative assessment or complex cases.

Treatment and management: Management includes lifestyle modifications (weight reduction, head-of-bed elevation, avoiding trigger foods). Pharmacologic therapy with proton pump inhibitors is the mainstay for symptom control and healing; H2 receptor antagonists and antacids provide additional relief. In selected cases, antireflux surgery (such as fundoplication) or endoscopic therapies may be considered for refractory disease or to reduce dependence on medications.

Prognosis and complications: Most cases are chronic but manageable with treatment. Potential complications include esophageal stricture, Barrett's esophagus, and, less commonly, esophageal adenocarcinoma. Regular follow-up and surveillance are guided by the presence of mucosal changes and risk factors.