Clinical and Endoscopic Features of Esophageal Mucosal White Plaques: Associations With Symptoms and Etiological...

To evaluate the clinical and endoscopic characteristics of esophageal mucosal white plaques (EMWPs) and to investigate potential underlying etiologies.

A total of 162 patients presenting with EMWPs were included as the case group. An equal number of patients without EMWPs served as the control group. Clinical symptoms, endoscopic findings, and fungal examination results were compared between the groups to identify potential contributing factors.

EMWPs were most frequently observed in the middle and lower segments of the esophagus (87.1%). Compared with the control group, patients in the case group exhibited significantly higher frequencies of psychological stress (P=0.036), heartburn (P<0.001), acid regurgitation (P<0.001), retrosternal pain (P<0.001), pharyngitis (P=0.017), and globus sensation (P=0.042). Endoscopic examination revealed significantly higher detection rates of reflux esophagitis (P<0.001), hiatal hernia (P<0.001), duodenogastroesophageal reflux (P<0.001), antral hyperemia (P=0.019), and fundic hyperemia (P<0.001) in the case group. Helicobacter pylori (H. pylori) infection was significantly less prevalent among patients with EMWPs compared with controls (P=0.001). Among 142 patients who underwent fungal examination, no significant differences were identified between those with positive and negative results regarding reflux esophagitis, H. pylori infection, or ulcerative disease.

EMWPs primarily involve the middle and lower esophageal segments and are associated with symptoms, such as heartburn, acid regurgitation, retrosternal pain, pharyngitis, and globus sensation. The lower prevalence of H. pylori infection, along with elevated rates of psychological stress and reflux-related findings, indicates a possible association with gastroesophageal reflux disease and stress-related factors.