Background: Chronic kidney disease (CKD) is a global health problem associated with multi‑organ involvement, including upper gastrointestinal (GI) complications. Patients frequently present with anorexia, nausea, vomiting, dyspepsia, and upper GI bleeding, which significantly affect quality of life. The etiology of these manifestations is multifactorial, and endoscopic evaluation plays a key role in identifying mucosal lesions. Aims and Objectives: The aim of the study was to observe the prevalence of upper GI symptoms in patients with CKD, determine the prevalence of upper GI lesions by endoscopy, and evaluate the correlation between upper GI lesions and CKD stage. Materials and Methods: A prospective, observational study was conducted in the Departments of Gastroenterology and Nephrology at a tertiary care center. One hundred CKD patients (age ≥18 years, estimated glomerular filtration rate <60 mL/min/1.73 m2) were included after applying strict exclusion criteria. Detailed history, clinical examination, biochemical investigations, and fibreoptic esophagogastroduodenoscopy were performed. Statistical analysis was carried out using the Statistical Package for the Social Sciences version 21, with the Chi‑square test applied for correlation analysis. Results: The mean age was 63.67±11.23 years; 69 were males. Majority were in CKD stage V (69%). Upper GI symptoms were reported in 80% of patients, most commonly vomiting (38%) and anorexia (34%). Endoscopy revealed abnormal findings in 80% of patients, with gastritis (48%) as the most prevalent lesion, followed by reflux esophagitis (20%), gastric ulcer (10%), duodenitis (8%), hiatus hernia (6%), duodenal ulcer (2%), and esophageal candidiasis (4%). Positive endoscopic findings were significantly higher in CKD stage V (91.3%) compared to stages III–IV (54.8%) (P<0.05), particularly for gastritis and esophagitis. Conclusion: Upper GI symptoms are highly prevalent among CKD patients, with gastritis and esophagitis being the most common lesions. The severity of CKD correlates with increased prevalence of upper GI abnormalities. Early endoscopic evaluation and management are essential to reduce morbidity, improve nutritional status, and prevent life‑threatening complications such as upper GI bleeding.

Does modified peroral endoscopic myotomy really not reduce the incidence of postoperative reflux esophagitis?

Abstract Background Esophagogastrostomy (EG) after proximal gastrectomy (PG) is widely used but often complicated by reflux. Current anti-reflux procedures, such as double-tract and double-flap reconstructions, are effective but technically demanding. We developed a simplified, device-free anti-reflux EG that uses two sutures to approximate the angle of His, the gastric angle, and a neofundus-like contour. Methods We retrospectively analyzed 11 consecutive patients with upper-third gastric cancer who underwent laparoscopic PG followed by dual-suture fundoplication between May 2023 and November 2024. Surgical and clinical outcomes included operative time, blood loss, hospital stay, complications (Clavien–Dindo), reflux symptoms, endoscopic findings, and quality of life assessed using the Reflux Disease Questionnaire (RDQ) and the World Health Organization Quality of Life-BREF (WHOQOL-BREF). Continuous variables were summarized as mean ± standard deviation and range. Changes in RDQ and WHOQOL-BREF scores were compared using paired tests (paired t-test or Wilcoxon signed-rank test after normality assessment), with two-sided α = 0.05. Results All procedures were successfully completed without intraoperative or postoperative complications (Clavien–Dindo). The mean operative time was 189.9 min and the mean hospital stay was 7.4 days. During a median follow-up of 12 months, no patient required proton pump inhibitors, and no reflux esophagitis of Los Angeles grade B or higher was observed. RDQ scores remained stable, while WHOQOL-BREF scores were higher in the social and environmental domains, suggesting favorable postoperative function and quality of life. Conclusion This simplified dual-suture esophagogastrostomy appeared safe and feasible in this cohort and demonstrated reassuring early postoperative outcomes with respect to reflux. Its minimal technical demands and favorable postoperative recovery profile suggest potential suitability for broader clinical application, although larger comparative studies with extended follow-up are needed to clarify long-term outcomes.

Objective: To investigate the short-term efficacy of modified double muscle flap anastomosis with double barbed sutures (DDBS). Methods: A retrospective observational study was conducted. Clinical data of 112 patients with esophagogastric junction cancer or upper gastric cancer who underwent proximal gastrectomy combined with DDBS anastomosis at Changzhi People's Hospital Affiliated to Changzhi Medical College from November 2019 to September 2024 were collected. The cohort included 89 males and 23 females, with a mean age of (64.9±7.4) years. Surgical approaches consisted of 109 laparoscopic surgeries and 3 open surgeries. The main steps of DDBS anastomosis were as follows: (1) A "I"-shaped area measuring approximately 2.5 cm × 3.5 cm was marked on the anterior wall of the residual stomach, 1.5 cm from the stump. The seromuscular layer of the gastric wall was incised and dissected to create muscle flaps; (2) After muscle flap creation, the submucosal and mucosal layers were incised 0.5 cm above the lower edge of the muscle flap window to form the upper and lower lips of the residual gastric opening; (3) The residual stomach was returned to the abdominal cavity, and the posterior wall of the esophagus was marked with methylene blue 5 cm from the esophageal stump; (4) Barbed sutures were used for continuous suturing of 4 stitches to fix the residual stomach to the posterior esophageal wall; (5) The esophageal stump was opened using an ultrasonic scalpel; (6) The first barbed suture was used to continuously suture the full-thickness posterior wall of the esophageal stump to the upper lip of the residual gastric opening from left to right, exiting through the gastric serosa on the right side for later use; (7) The second barbed suture was used to continuously suture the full-thickness anterior wall of the esophageal stump to the lower lip of the residual gastric opening from right to left, exiting through the gastric serosa on the left side for later use; (8) The reserved barbed sutures on both sides were used to continuously suture the lower edge of the muscle flaps to the gastric wall, and then upward to suture the muscle flaps to the esophageal wall after meeting at the junction of the two muscle flaps; (9) A "Y"-shaped collar-like structure was finally formed. Surgery-related indicators and postoperative follow-up data of DDBS anastomosis were collected and analyzed. The incidence and severity of reflux esophagitis and its anti-reflux efficacy were evaluated based on postoperative endoscopic examinations, GerdQ scores, and multi-position upper gastrointestinal contrast imaging. Postoperative Visick classification, body mass index (BMI), albumin, total protein, and hemoglobin levels were also followed up to assess postoperative quality of life and nutritional status. Results: All 112 patients successfully underwent proximal gastrectomy plus DDBS anastomosis, achieving R0 resection. Intraoperative rapid frozen pathological examination of the surgical margins was negative in all cases, with no perioperative mortality. The median operative time was 205 (190, 224) minutes, the digestive tract reconstruction time was (53.4±5.9) minutes, the median intraoperative blood loss was 50 (40, 60) ml, and the number of lymph nodes dissected was (29.3±12.5). No unplanned readmissions occurred. A total of 6 cases (5.4%) had perioperative complications, including 1 case of anastomotic leakage complicated with pleural effusion and 5 cases of simple pleural effusion, all classified as Clavien-Dindo grade IIIa. No pancreatic fistula, anastomotic bleeding, or perioperative mortality occurred. Postoperatively, 10 patients developed anastomotic stenosis, including 8 cases of Clavien-Dindo grade IIIa and 2 cases of Clavien-Dindo grade I. The median time to oral intake was 3 (3, 4) days, and the median postoperative hospital stay was 9 (8, 12) days. With a median follow-up of 24 (6-36) months, no tumor recurrence or cancer-related deaths were observed. Reflux esophagitis was endoscopically detected in 4 patients; among them, 2 patients had a GerdQ score >8 points, and 2 patients showed reflux on multi-position gastrointestinal contrast imaging. Quality of life assessment revealed 102 cases with Visick grade I, 8 cases with grade II, and 2 cases with grade III, with no grade IV cases. Conclusion: DDBS anastomosis is safe and feasible, with definite anti-reflux efficacy. Patients achieve favorable postoperative quality of life and nutritional status.

Proximal gastrectomy (PG) for proximal gastric cancer (PGC) is associated with complications such as gastroesophageal reflux. The double-flap technique (DFT) has been proposed as an effective anti-reflux reconstruction method. This systematic review aims to compare the safety and short-term outcomes of DFT versus other reconstruction methods for proximal gastrectomy. The present meta-analysis was conducted, following PRISMA guidelines. Studies comparing DFT with other reconstruction methods for proximal gastric cancer were included. Outcomes assessed included surgical parameters (operative time and intraoperative blood loss), postoperative reflux incidence (subjective reflux symptoms, objective evaluation using endoscopy and proton pump inhibitor (PPI) intake), and other short-term postoperative indicators (postoperative complications and length of postoperative hospital stay). Data were extracted from PubMed, Web of Science, EMBASE, and the Cochrane Library through June 1st, 2025. Risk of bias was assessed using the Newcastle-Ottawa Scale. We performed meta-analyses using Review Manager 5.4, presenting mean differences (MD) and odds ratios (OR) with 95% confidence intervals (CI). A total of 11 retrospective studies were included in this meta-analysis. Qualitative analysis showed DFT had anastomotic leakage, stricture, and pancreatic fistula rates of 1.4%, 5.9%, and 1.8%, respectively. Postoperatively, 17.4% of patients took PPIs, and 3.4% reported subjective reflux symptoms. One year after surgery, during follow-up endoscopy, 5.1% of patients were found to have gastroesophageal reflux (Los Angeles classification grade B or higher). Meta-analysis results showed that the DFT group had significantly longer operative times but reduced intraoperative blood loss compared to the esophagojejunostomy (EJ) groups. Postoperative complication rates, including anastomotic leakage and stricture, were similar across the double tract reconstruction (DTR) group and other esophagogastrostomy (EG) groups. While no significant differences were found in reflux symptoms or esophagitis at the 1-year follow-up, DFT was associated with significantly reduced PPI usage, especially compared to the EG group. DFT is a safe and effective method for reconstructing the digestive tract following PG, offering a balance between surgical complexity and favorable short-term outcomes. Although it does not fully eliminate reflux, its reduced PPI dependency and acceptable complication profile make it a promising option. Further large-scale randomized trials are needed to confirm these findings. The protocol was prospectively registered on the PROSPERO website as CRD42025636187 on January 9th, 2025.

Interobserver agreement for the Los Angeles (LA) classification of erosive reflux esophagitis was good in validation studies, but limited agreement data exists from clinical trials (CTs). We conducted a post hoc evaluation of interobserver agreement between CT endoscopists and independent expert adjudicators in a multi-center, randomized controlled trial of a new acid suppression therapy. Trial endoscopists captured endoscopic images/videos and documented esophagitis severity using the LA classification. Adjudicators reviewed images/videos on a web-based platform. If the first two adjudicators disagreed and the third adjudicator did not produce a majority verdict, all three conferred to reach consensus. Cohen's kappa (κ) evaluated interobserver agreement. Cohen's weighted kappa (κw) evaluated agreement corrected for disagreement extent. Of 388 images/videos with adequate quality, trial endoscopists and adjudicators agreed on esophagitis severity in 168 (43.3%) cases, and assigned more severe grades than adjudicators for 185 (47.7%) cases. Agreement was fair between trial endoscopists and adjudicators (κ: 0.27; κw: 0.40), moderate between individual adjudicators (κ: 0.43 to 0.47), and good between adjudicators and final diagnosis (κ: 0.75 to 0.78). After adjusting for disagreement extent, agreement was good between individual adjudicators (κw: 0.63 to 0.66), and very good between adjudicators and final diagnosis (κw: 0.84 to 0.87). Interobserver agreement on esophagitis severity between CT endoscopists and adjudicators was fair. Initial agreement between adjudicators was moderate, but agreement between adjudicators and consensus diagnosis was very good. Accurate esophagitis grading for CTs requires further training on LA classification and a robust central reading protocol.

Comparison of the safety, efficacy, and rates of gastroesophageal reflux disease between full-thickness versus modified peroral endoscopic myotomy for achalasia: a systematic review and meta-analysis.

Peroral endoscopic myotomy (POEM) is a standard achalasia treatment, matching surgery in efficacy. However, myotomy length varies. Shorter myotomies are gaining attention for potential benefits. This study compares short versus long myotomies to identify the optimal approach. We conducted a systematic review and meta-analysis of Randomized Controlled Trials (RCTs) retrieved from PubMed (MEDLINE), Scopus, Web of Science (WoS), and Cochrane Central Register of Controlled Trials (CENTRAL) until November 28, 2024. Pooled results were calculated using risk ratios (RR) for binary outcomes and mean differences (MD) for continuous outcomes, with 95% CI (PROSPERO ID: CRD42024621638). Four RCTs with 419 patients were included. Clinical success (Eckardt score ≤3) showed no significant difference between short and long myotomy (97.4% vs. 95.9%, RR: 1.02 with 95% CI: 0.98-1.06, P =0.33), Reflux symptoms (RR: 0.93, 95% CI: 0.60-1.47, P =0.77), and reflux esophagitis (RR: 0.83, 95% CI: 0.55-1.27, P =0.39). However, short myotomy significantly reduced pathologic acid exposure (RR: 0.57, 95% CI: 0.36-0.91, P =0.02), procedural time (MD: -16.61min, 95% CI: -26.40 to -6.81, P <0.001), and hospital stay (MD: -2.37d, 95% CI: -4.67 to -0.06, P =0.04). Intraprocedural complications were similar ( P =0.73), as was integrated relaxation pressure ( P =0.95), indicating similar postoperative esophageal function. Short myotomy reduced acid exposure, procedure time, and hospital stay in POEM for achalasia without compromising clinical success or symptom improvement. It shows potential as an effective treatment, but large-scale RCTs are needed for definitive clinical endorsement.

To evaluate long-term postoperative outcomes in patients with reflux esophagitis, hiatal hernia and concomitant iron deficiency anemia. The study included 84 patients with hiatal hernia and concomitant iron deficiency anemia who underwent surgery in 2018-2022. All patients underwent original laparoscopic fundoplication. According to age criteria proposed by WHO, patients were divided into two groups. In long-term postoperative period, the authors assessed quality of life, physical and mental health, as well as recurrence rate. In both groups, the majority of patients demonstrated stable positive results after surgical treatment of GERD. The number of recurrences and QoL impairment did not demonstrate any significant differences in both groups. The authors obtained comparable results in both groups. This demonstrates safety and high efficiency of original laparoscopic fundoplication in patients of different age groups.

In recent years, the proportion of early gastric cancer and proximal gastric cancer has risen, and function-preserving gastrectomy has received increasing attention. Proximal gastrectomy has also been highly valued. Reflux esophagitis is an issue that cannot be ignored in the reconstruction of the digestive tract after proximal gastrectomy. For this reason, a series of anti-reflux surgical methods have emerged and been applied in clinical practice. Jejunal interstitial reconstruction is one of the widely used anti-reflux surgical methods in clinical practice at present, but there is a lack of standardized guidance in terms of application indications and operation procedures. This consensus was formulated based on the latest evidence-based medical evidence and after multiple expert discussions, aiming to provide reference and guidance for clinicians in choosing proximal gastrectomy and jejunal interstitial reconstruction.

We present a case of incidental PSMA uptake in the mid-esophagus on 99mTc-HYNIC-PSMA SPECT/CT in a 67-year-old man undergoing staging for high-grade prostate adenocarcinoma. While uptake in the prostate lesion was expected, unexpected focal avidity was noted in the esophagus. Given the rarity of esophageal metastases from prostate cancer, further evaluation was performed. Contrast-enhanced CT showed esophageal fluid levels, and endoscopy revealed linear ulcers in distal esophagus. Biopsy confirmed mild reflux esophagitis. This case underscores the potential for benign esophageal inflammation to mimic metastatic disease on PSMA imaging. Accurate interpretation requires careful clinical and pathologic correlation to avoid misdiagnosis.

Esophageal involvement is one of the most frequent visceral manifestations of systemic sclerosis (SSc), however, its association with the course of the disease has been insufficiently studied. Endoscopy is considered the most accessible instrumental method for examining the esophagogastroduodenal zone, and in combination with clinical symptoms forms the basis for diagnosing esophageal diseases. Objective : to investigate the frequency of clinical and endoscopic signs of esophageal disorders (ED) and their association with clinical manifestations of SSc. Material and methods . A total of 81 patients with SSc hospitalized at the Chelyabinsk Regional Clinical Hospital from December 2019 to September 2024 were examined. Results and discussion . In 40 (49.4%) patients, symptoms characteristic of ED were present: dysphagia (n=38, 46.9%) and heartburn (n=14, 17.3%). During esophagogastroduodenoscopy, erosive esophagitis (EE) was detected in 13 (16%) patients. In 5 (6.2%) cases, esophagitis grade B or higher was identified, and in 2 (2.5%) – grade D. Patients with EE more frequently had digital ulcers and scars, and treatment included sildenafil and cyclophosphamide (CYP) (p&lt;0.05). The frequency of esophageal erosions was 4.12 times higher in the presence of digital ulcers (95% confidence interval, CI 1.20–14.13; p&lt;0.05) and 9.48 times higher with CYP use (95% CI 1.81–49.45). The frequency of interstitial lung disease (ILD) did not depend on the presence of EE, but increased 4.33 times in the presence of esophageal atony according to radiography (95% CI 1.24–15.2). Conclusion . Patients with SSc report dysphagia or heartburn in half of the cases. EE is associated with more pronounced microcirculatory disturbances and treatment with CYP. ILD occurred more frequently when radiologic signs of esophageal atony were present.

O improve functional outcomes after surgical treatment of T1-2 gastric cancer. The study included 11 patients (5 males, 6 females; mean age 73±8.6 years) with T1-2N0M0 gastric cancer who underwent middle segmental gastrectomy with D2 lymphadenectomy. Selection criteria included tumor localization in gastric body, resection margins ≥6 cm, confirmed by intraoperative endoscopy. Proximal and distal gastric stumps were formed with anti-reflux fundoplication cuff. Quality of life (QoL) was assessed using EORTC QLQ-C30 and STO22 questionnaires. No postoperative complications or mortality were observed. Mean surgery time was 220.4±54.4 min, blood loss - 390±186.8 ml. All resections were radical (R0). In long-term period (24.2±17.5 months), recurrence occurred in 1 patient (T3N0M0). Reflux esophagitis was absent; mild dumping syndrome was detected in 1 patient. QoL scores after surgery (functional scale - 92.7; symptom scale - 23.8) surpassed those after gastrectomy, pylorus-preserving, and distal subtotal resections. Middle segmental gastrectomy demonstrates oncological adequacy and functional benefits (sphincter preservation, reduced reflux, and dumping syndrome). Further studies are required to confirm long-term outcomes.

Children with autism spectrum disorder and alterations in eating behavior: could it be gastroesophageal reflux disease?

BACKGROUND Hiatal hernia (HH) is a common condition that can present diagnostic challenges when accompanied by complex comorbidities. While HH is associated with obesity and elevated intra-abdominal pressure, its occurrence with eating disorders is not as well documented. We report a rare case of symptomatic HH in a patient with concurrent obesity and bulimia nervosa, a combination not previously reported in the literature. CASE REPORT A 39-year-old woman presented with 2 years of postprandial vomiting, chest pain, dyspnea, and heartburn. Her medical history revealed self-induced vomiting for weight control that progressed to bulimia nervosa, resulting in weight loss of 44 kg. Initial treatments with proton pump inhibitors provided minimal relief. Comprehensive evaluation revealed type III paraesophageal HH (5 cm hernial orifice), grade 2 reflux esophagitis, anemia, and a gallbladder polyp. The patient underwent laparoscopic cruroplasty with Toupet fundoplication and cholecystectomy, combined with psychiatric management including cognitive-behavioral therapy and fluoxetine. At 3-month follow-up, complete symptom resolution was achieved. CONCLUSIONS This case highlights the importance of thorough history-taking in patients with atypical gastrointestinal symptoms and demonstrates that bulimia nervosa can contribute to HH development through repeated increases in intra-abdominal pressure. A multidisciplinary approach integrating surgical and psychiatric interventions is essential for successful management of HH when associated with eating disorders and other complex comorbidities.

Abstract Cajuína, a traditional clarified beverage obtained from the cashew apple (Anacardium occidentale L.), holds ethnopharmacological relevance in Northeastern Brazil, particularly in Piauí, where it is recognised as intangible cultural heritage. This study evaluated its oesophagoprotective effects in a murine model of acute erosive oesophagitis and characterised its antioxidant and phytochemical profile. Cajuína contained phenolic compounds and high levels of vitamin C, which contributed to significant reductions in oesophageal lesion area, oedema, histopathological damage and biochemical markers of oxidative stress and inflammation. In vitro assays confirmed its antioxidant potential through ABTS and DPPH radical-scavenging activity. These findings provide the first experimental evidence that cajuína preserves mucosal integrity and attenuates injury in reflux-related oesophageal damage, supporting its potential as a culturally relevant nutraceutical and dietary adjunct in the management of gastro-oesophageal reflux disease (GERD).

Background:Eosinophilic esophagitis (EoE) is characterized by eosinophil infiltration into the esophageal tissue and esophageal dysfunction. In the United States, EoE has an estimated prevalence of 26–163 cases per 100,000 people. Real-world data concerning the clinical burden of EoE and treatment patterns in the United States are limited.Objectives:To describe the demographics, clinical characteristics, symptoms, comorbidities, treatment pathways, and healthcare resource utilization (HCRU) and costs among patients with EoE in the United States.Design:Retrospective analysis.Methods:A study of pediatric and adult patients diagnosed with incident EoE (full incident EoE cohort) using Merative™ MarketScan® health insurance claims data between January 1, 2017, and June 30, 2020. A subset of patients (matched incident EoE cohort) was matched with patients without EoE for age, sex, and payor (matched control cohort). Follow-up was 12 months after the EoE diagnosis date. All statistics are descriptive.Results:The full incident EoE cohort included 20,290 patients (62.61% were male; median (range) age was 38 (1–93) years); 13,710 patients (matched incident EoE cohort) were matched to 54,727 patients without EoE (matched control cohort). During baseline in the full incident EoE cohort, the most common comorbidities within the Charlson Comorbidity Index (CCI) were chronic pulmonary disease (19.79%), hypertension (15.77%), and depression (9.71%); the most common non-CCI comorbidities were reflux esophagitis (38.84%), allergic rhinitis (19.14%), and depression/anxiety (19.07%). During follow-up, the most frequently reported symptoms were acid reflux/heartburn (56.02%), dysphagia (51.89%), and abdominal pain (30.50%). The most common medications first observed were proton pump inhibitors (42.51%) and oral corticosteroids (12.26%). Overall, a larger proportion of the matched incident EoE cohort had visits to any healthcare setting during baseline and follow-up than the matched control cohort. Correspondingly, the annualized, all-cause healthcare costs per patient were higher in the matched incident EoE cohort than in the matched control cohort at baseline (mean (standard deviation), $10,185 ($29,455); median, $3248 vs $4906 ($20,601); $632) and during follow-up ($15,103 ($35,484); $6708 vs $5200 ($21,314); $651).Conclusion:Considerable disease burden is experienced by patients with EoE (before and after diagnosis), which contributes to a high level of HCRU and increased costs.

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.

Agarotetrol alleviates reflux esophagitis by regulating autophagy through the METTL14/FOXO3a pathway.

Background. Gastroesophageal reflux disease (GERD) is one of the most common diseases of the upper gastrointestinal tract. 24-hour intraesophageal pH-impedance measurement (IEP-IM) is generally recognized as the gold standard for diagnosing GERD. Obstructive sleep apnea syndrome (OSAS) is regarded as a comorbid condition accompanying GERD. Numerous studies demonstrate a high incidence of GERD among patients with OSAS. However, data on the prevalence of OSAS among patients with erosive esophagitis (EE) are less common, and therefore this issue is under investigation. Obective. To study the findings of IEP-IM in patients with erosive esophagitis associated with obstructive sleep apnea syndrome and to identify the correlation of the studied indices with the results of respiratory monitoring. Material and methods. For this purpose, 75 people with EE with/without OSAS who had signed a voluntary informed consent to participate in the study were examined. Instrumental diagnostics of EE was performed using EGD. The severity of EE was determined according to the Los Angeles classification (1999). OSAS was confirmed by respiratory monitoring taking into account the existing recommendations. 33 patients from this group additionally underwent 24-hour intraesophageal pH impedance monitoring with a single-night recording of breathing patterns to determine the severity and main parameters of OSAS. Statistical analysis of the data was performed using the program “jamovi 2.5”. The threshold value of the statistical significance level was assumed to be 0.05. Results. As compared with EE patients without sleep apnea in OSAS-associated EE patients the indices of 24-hour intraesophageal pH impedance testing shifted towards greater intra-esophageal «acidification» with an increase in the number of horizontal and proximal acid reflux events and with a decrease in the level of mean nocturnal baseline impedance (MNBI). Conclusion. 24-hour intraesophageal pH impedance testing findings have proved the negative effect of sleep apnea on EE course, with a shift of the studied indices towards greater "acidification" in OSAS-associated EE patients. A correlation was established between a decrease in the level of MNBI and an increase in the desaturation index, an increase in the desaturation time when blood oxygen saturation is less than 85% (tSpO2 &lt; 85%), an index of respiratory effort-related arousals and an autonomic arousal index. Therefore, these indices are significant in assessing the severity of esophageal mucosa damage in OSAS-associated EE patients.