Abstract
Gastroesophageal reflux occurs mainly during the daytime in patients with Los Angeles (LA) grade A esophagitis, but predominantly during the night in patients with grade C and D esophagitis. When we investigated whether the difference in the pattern of gastroesophageal reflux influences the circumferential localization of erosions in the esophageal wall, longitudinal mucosal breaks tended to be located most frequently in the 2 o'clock position in patients with low grade reflux esophagitis, including LA grades A and B. The longitudinal mucosal breaks in patients with LA grade B were located more dorsally than those in patients with LA grade A. In contrast, in patients with grade C esophagitis, mucosal breaks were located mainly on the most dorsal side of the esophageal wall in approximately the 6 o'clock position. Since the localization of mucosal breaks in patients with LA grade A and B could not be explained by the gravitational position of lower esophagus, the pathogenesis and significance should be investigated in future study.
