<Things you should know> Correct knowledge about "Gastroesophageal Reflux Disease" (1) Explanation of the causes and symptoms of "Gastroesophageal Reflux Disease" What is reflux esophagitis? Causes and mechanisms of reflux esophagitis Symptoms of reflux esophagitis Self-check for reflux esophagitis Do you experience heartburn after meals, or a heavy feeling in your chest the morning after eating or drinking late at night? It might be reflux esophagitis. A gastroenterologist explains the causes and symptoms of this condition, which has been increasing among Japanese people in recent years. What is reflux esophagitis? Reflux esophagitis is a type of disease classified as "gastroesophageal reflux disease." It occurs when stomach acid flows back into the esophagus, causing unpleasant symptoms such as heartburn, and can also lead to irritation of the esophageal wall (esophagitis) due to the stomach acid.Gastroesophageal reflux disease is classified as follows, with reflux esophagitis (erosive reflux disease) being the type that causes esophagitis. Gastroesophageal reflux disease, including reflux esophagitis, is not a life-threatening illness, but it can disrupt daily life by causing heartburn that makes eating difficult and disrupting sleep. Because it lowers the quality of life (QOL), it's important to address it appropriately. In recent years, the number of patients with gastroesophageal reflux disease, including reflux esophagitis, has been increasing. Possible causes include the Westernization of dietary habits (Western diets tend to increase gastric acid secretion more than Japanese diets) and a decrease in the number of people infected with Helicobacter pylori.It was once believed that H. pylori infection was primarily transmitted through the environment, and many people were infected. Currently, environmental transmission is rare, and mother-to-child transmission during early childhood is considered the main route of infection. Causes and mechanisms of reflux esophagitis The stomach secretes stomach acid to digest the food we eat. Because stomach acid is highly acidic, the stomach protects itself from being digested by the acid by covering its inner surface with a mucous membrane. On the other hand, the mucous membrane on the inside of the esophagus has a weaker defense against stomach acid than the stomach. Therefore, when stomach acid refluxes into the esophagus, the inside of the esophagus comes into contact with the acid and becomes inflamed, causing esophagitis. Furthermore, normally, the boundary between the stomach and esophagus is closed by a sphincter muscle when food is not passing through, preventing acid reflux. However, if the function of the sphincter muscle weakens, acid can reflux into the esophagus. The following are possible causes of weakened sphincter function: Aging binge drinking High-fat meals alcohol smoking When there is pressure on the stomach (abdominal pressure), acid reflux is more likely to occur. The reasons for this include: pregnant obesity constipation These are some examples. In addition, in healthy individuals, the peristaltic movement of the esophagus (the function that moves food to the stomach) quickly returns stomach acid to the stomach even if it refluxes. However, if this function does not work properly, stomach acid remains in the esophagus for a long time, causing esophagitis. In addition, with a condition called hiatal hernia, the boundary between the stomach and esophagus is elevated higher (towards the mouth) than usual, which weakens the function that prevents reflux and makes stomach acid reflux more likely. Incidentally, in cases of non-erosive gastroesophageal reflux disease, esophagitis does not occur. This is because the esophagus is hypersensitive, and even slight reflux of stomach acid that is not enough to cause esophageal ulceration, or stomach acid that is not highly acidic, can cause symptoms. Symptoms of reflux esophagitis Earlier, I mentioned that one of the symptoms of reflux esophagitis is heartburn, but in addition to heartburn, you may also experience the following symptoms. Heartburn (a burning sensation around the upper part of the stomach) I feel acid reflux. Throat discomfort cough I burp a lot. Furthermore, repeated reflux of stomach acid and prolonged exposure of the esophagus to stomach acid can lead to a variety of other diseases.You may develop the following conditions: Esophageal ulcer (ulcer: soreness of the inner wall of the esophagus) Esophageal stricture (narrowing of the esophagus) Barrett's esophagus (cellular changes in the esophagus) When ulcers form in the esophagus, in addition to the symptoms of esophagitis, you may also experience pain in the area where you feel nausea and heartburn. Esophageal stricture can make it difficult to swallow food, and food may get stuck midway, making it difficult to breathe.Barrett's esophagus is a condition in which the mucous membrane (squamous epithelium) on the inside of the esophagus changes, and it slightly increases the risk of progressing to esophageal cancer. Self-check for reflux esophagitis If you experience any of the symptoms mentioned above, you may have reflux esophagitis. Heartburn does not necessarily mean you have reflux esophagitis, but if you have any concerning symptoms, please consult a gastroenterologist and undergo appropriate examination and testing. Be careful if you experience these symptoms. heartburn I feel heavy and in pain in my chest. Sour and bitter tastes well up inside me. Throat discomfort My throat feels scratchy. cough I burp a lot. I have a feeling of fullness in my stomach. Supervised by: Dr. Osamu Toyoshima, Director of Toyoshima Endoscopy ClinicGraduated from the Faculty of Medicine, University of Tokyo. Professor of Regional Medicine, Tokyo Medical University. Certified specialist and instructor of the Japan Gastroenterological Endoscopy Society, international member of the European Society for Gastroenterological Endoscopy (ESGE), international member of the American Society for Gastroenterological Endoscopy (ASGE), and editorial board member of the World Journal of Gastroenterology. Toyoshima Endoscopy Clinic performs 10,000 endoscopic examinations annually and conducts medical research, including academic presentations, to improve clinical practice and medical technology. They also focus on H. pylori eradication and treatment, with over 5,000 cases. Author of "The Cutting Edge of Early Detection, Prevention & Endoscopy for Esophageal/Gastric/Colon Cancer". We take care to post accurate information,Please point out any incorrect information. Please submit any comments regarding medical information here. Return to the list of guides categorized by health symptoms.