Severe reflux esophagitis.

Reflux esophagitis, usually the mild to moderate form, is found endoscopically in less than 50% of patients with classic symptoms of gastroesophageal reflux disease (GERD). These patients tend to have low lower esophageal sphincter pressures, poor esophageal clearance, and hiatal hernias. The endoscopic findings of distal esophageal erosions and ulcerations are a specific, but not very sensitive, marker of GERD. Treatment of reflux esophagitis usually requires H2 antagonists, omeprazole, or antireflux surgery.