Los Angeles (LA) Grading of Reflux Esophagitis
Endoscopic grading of reflux esophagitis based on mucosal break size and extent. Used to guide therapy and monitor GERD treatment response.
Score interpretation
No erosive oesophagitis — may still have NERD (non-erosive reflux disease)
→ Trial PPI therapy; pH-impedance study if symptoms persist; consider functional heartburn
Grade A or B — mild erosive oesophagitis
→ PPI once daily for 4–8 weeks; high healing rate; consider long-term therapy if relapse
Grade C or D — severe erosive oesophagitis. Grade D — risk of stricture/Barrett's.
→ High-dose PPI twice daily for 8 weeks; repeat endoscopy at 8–12 weeks to confirm healing; consider anti-reflux surgery; Barrett's surveillance if grade C/D
Interpretation bands for the LA Grade Esophagitis. Apply clinical judgement and local guidance.
References
- Armstrong D et al. The endoscopic assessment of esophagitis: a progress report on observer agreement. Gastroenterology. 1996;111(1):85–92.
Related
Curated clinical cross-links plus same-class fallbacks.
- Methotrexate (Dermatology — Psoriasis) · Disease-Modifying Antirheumatic / Immunosuppressant
- Acetazolamide (Ménière's Disease) · Carbonic Anhydrase Inhibitor (Diuretic)
- Zinc acetate · Zinc salt (Wilson's disease)
- Sulfasalazine · Aminosalicylate / Disease-Modifying Antirheumatic Drug (DMARD)
- Sodium alginate with calcium carbonate and sodium bicarbonate · Reflux suppressant (alginate raft + antacid)
- Sodium alginate with potassium bicarbonate · Reflux suppressant (low-sodium)
Decision support only — verify against a current formulary, NICE, or your local guideline before clinical use.