The anatomy of the junction of the stomach and esophagus - the lower esophageal sphincter (LESP)

Sjogren's syndrome

Stomach acid and pepsin

Reflux, heartburn, burning sensation

Retrosternal pain, belching, difficulty swallowing, and upper abdominal pain. (not typical)

Chronic cough, hoarseness, asthma, throat pain or foreign body sensation.

Small, recurring bleeding, less severe bleeding. Can cause anemia.

Repeated inflammation occurs and heals, resulting in scar fibrosis, mostly in the distal esophagus.

The squamous epithelium of the lower esophagus is replaced by metaplastic columnar epithelium

Provide objective evidence of abnormal acid exposure in the esophagus

Can measure LES pressure, length and relaxation degree

Proton pump inhibitors (H-K pump inhibitors) are suitable for severely ill patients. Treatment duration: 8-12 weeks. Representative drugs: omeprazole, lansoprazole, rabeprazole, and semitoprazole.

Mild and moderate patients or maintenance treatment stage, cimetidine, ranitidine, famotidine

Domperidone

endoscopic dilation

PPI long course maintenance therapy

Severe dysplasia or early cancer - endoscopic or surgical resection