How is esophagitis diagnosed and graded in patients with gastroesophageal reflux disease (GERD)?

Updated: Oct 16, 2020
  • Author: Marco G Patti, MD; Chief Editor: BS Anand, MD  more...
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Esophagitis may be diagnosed using endoscopy, although it cannot always be appreciated on endoscopy. As many as 50% of symptomatic patients with GERD demonstrate no evidence of esophagitis on endoscopy. Still, documentation of this complication is important in diagnosing GERD. Degrees of esophagitis are described by the Savary-Miller classification as follows.

  • Grade I – Erythema

  • Grade II – Linear nonconfluent erosions

  • Grade III – Circular confluent erosions

  • Grade IV – Stricture or Barrett esophagus.

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