[New trends in diagnosis of reflux esophagitis]

Reflux esophagitis is acid peptic disorder at the lower part of the esophageal mucosa. Acid reflux into the esophagus also induces typical and atypical reflux symptoms. Endoscopy is the definitive diagnostic procedure for reflux esophagitis, the consequence of acid reflux. Evaluation of pathophysiology of acid reflux is also important for the diagnosis of gastroesophageal reflux disease. 24hr esophageal pH monitoring measures acid reflux semiquantitatively. Fluoroscopic and ultrasonographic observation of reflux, esophageal manometery and gastric emptying study are useful for evaluation of pathophysiological state of gastroesophageal reflux disease, particularly in patients lacking evident endoscopic esophagitis. Symptom evaluation, either by acid suppression or acid load, shows relationship analysis is also the important diagnostic approach to acid reflux. Changes in symptoms by acid suppression and acid perfusion of the esophagus suggest the link between acid irritation and symptomatogenesis. Health-related quality of life evaluation seems to be another important diagnostic toll in near future.