[Common Diseases] Gastroesophageal Reflux Disease with Esophagitis (GERD)
🥼 What is reflux esophagitis?
Reflux esophagitis is an inflammation caused by the reflux of gastric acid or gastric contents into the esophagus, which irritates or even damages the esophageal mucosa .
This is one of the manifestations of gastroesophageal reflux disease (GERD), which is a type of mucosal damage .
In Hong Kong, the number of patients suffering from reflux esophagitis is increasing. In addition to the Westernized diet (high in oil and sugar) and high work pressure, long hours of sitting in the office and lack of exercise also make the disease more common.
🔍 Common causes in Hong Kong
Based on information from the Hong Kong Hospital Authority, the Hong Kong Society of Gastroenterology, and international medical journals, the editor has compiled the main reasons:
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Lower esophageal sphincter relaxation
- Causes include obesity, pregnancy, smoking, and long-term high-fat diet.
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Excessive gastric acid secretion or delayed gastric emptying
- For example, excessive gastric acid recovery after Helicobacter pylori treatment and diabetes affecting gastric emptying.
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Hiatal Hernia
- Part of the stomach slides into the chest cavity, causing the sphincter to function less effectively.
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Lifestyle and eating habits
- Overeating, eating before bed, and drinking coffee or alcohol for a long time.
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Drug side effects
- Certain antihypertensive drugs, bronchodilators, sedatives, etc. can affect sphincter function.
⚠️ Common symptoms
The editor lists the most common conditions of patients in Hong Kong for your reference:
- Heartburn
- Regurgitation of sour or bitter water
- Difficulty swallowing or a choking sensation
- Chronic cough, hoarseness, and throat discomfort
- Symptoms that are worse at night (more pronounced when lying down)
🏥 Hong Kong Reflux Esophagitis Treatment
The editor emphasizes : The treatment goals are to reduce gastric acid reflux, repair the esophageal mucosa, and prevent complications and recurrence .
1. Drug treatment (first line)
According to the Hong Kong Hospital Authority guidelines and international consensus:
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Proton pump inhibitors (PPIs)
- Such as omeprazole, esomeprazole, and rabeprazole
- It is most effective in promoting mucosal healing and is usually taken for 4-8 weeks.
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H2 receptor antagonists
- For example, famotidine has better control over nocturnal gastric acid secretion, but its healing rate is lower than that of PPI.
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antacids
- Such as magnesium hydroxide and aluminum hydroxide, which can quickly relieve symptoms in the short term, but cannot replace long-term PPI treatment.
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Prokinetic drugs (such as domperidone)
- Helps gastric emptying and reduces reflux, but be aware of side effects.
2. Lifestyle and diet adjustments (must be combined with medication)
- Eat small meals frequently and avoid eating too much at one time
- Avoid high-fat, spicy, and acidic foods (such as lemon, orange juice, coffee, chocolate, and soda)
- Avoid eating 2-3 hours before bedtime
- Quit smoking and drinking
- Raise the head of the bed (about 15-20 cm) to reduce nocturnal reflux
- Maintain a healthy weight and reduce abdominal pressure
3. Surgery and other interventional treatments
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Laparoscopic fundoplication (Nissen fundoplication)
- Suitable for patients who are ineffective with medication or have long-term drug dependence
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Endoscopic treatment (radiofrequency therapy, endoscopic suturing)
- Some private hospitals in Hong Kong provide it, but its popularity is relatively low.
🏥 Examination and medical treatment options in Hong Kong
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Gastroscopy
- It can directly observe the degree of esophageal mucosal damage and rule out other lesions (such as esophageal cancer).
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24-hour esophageal pH monitoring
- Measures the frequency and severity of acid reflux.
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Esophageal pressure test (Manometry)
- Assess esophageal motility and sphincter function.
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public hospitals
- Referral from a general practitioner to a medical or surgical specialist is suitable for patients with severe or long-term recurring symptoms.
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Private medical care
- Gastroscopy and functional tests can be arranged more quickly, suitable for those who urgently need a diagnosis.
🚨 Possible complications
If reflux esophagitis is not treated for a long time, you may develop:
- Esophageal stricture (due to recurrent inflammation and scarring)
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Barrett's esophagus
- It is a precancerous lesion and increases the risk of esophageal cancer.
- Esophageal bleeding
- Chronic pharyngitis, vocal cord disease, worsening asthma
💡 Editor's Tips
- The course of medication must be completed . Do not stop taking the medication once the symptoms have been alleviated, otherwise the symptoms may relapse easily.
- Pay attention to relapse triggers , such as staying up late, overeating, drinking coffee, etc.
- Seek medical attention immediately if you have any warning symptoms : difficulty swallowing, rapid weight loss, persistent vomiting of blood, or black stools.
- Long-term patients should undergo regular gastroscopy follow-up , especially those suspected of having Barrett's esophagus.
- Food diary : Record every time you feel unwell, in what food and what situations, to help you adjust your lifestyle habits.
💬Editor’s summary :
Reflux esophagitis is becoming increasingly common in Hong Kong. While most patients can manage the condition with medication and lifestyle adjustments , untreated esophageal reflux can lead to irreversible esophageal changes or even cancer. Both public and private healthcare providers offer comprehensive testing and treatment options. Early intervention is crucial, and patients should not wait until symptoms become severe before seeking medical attention.
📌 Disclaimer <br>This article is for reference only and does not constitute any medical advice. It is sourced from major medical articles.
