Radial ulcers and hiatus hernia are observed. Many patients with GERD have a normal esophagus on endoscopy. The first sign of esophageal damage may be erythema. Appearance of erosions indicates more severe disease. Deep esophageal ulcers can occur in addition to the more common shallow erosions. As its severity increases, esophagitis can lead to obstruction through stricture formation. Severe esophagitis can also lead to cancer through the development of a columnar lining known as Barrett's Esophagus.
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