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CLASSIFICATION
Classification
Los Angeles classification (reflux esophagitis)
Grades A–D of reflux esophagitis by the extent of mucosal breaks. So-called minimal changes are not included.
Classification overview
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Mild
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Grade A · Mucosal break ≤5 mm, not bridging folds
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Grade B · Mucosal break >5 mm, not bridging folds
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Severe
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Grade C · Breaks bridging folds, <75% circumference
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Grade D · Breaks involving ≥75% circumference
Mild
Grade A
Mucosal break ≤5 mm, not bridging folds
Jung 2025, Fig. 1A, Not original, CC BY-NC
Definition
One (or more) mucosal break no longer than 5 mm that does not extend between the tops of two mucosal folds
Grade B
Mucosal break >5 mm, not bridging folds
Jung 2025, Fig. 1B, Not original, CC BY-NC
Definition
One (or more) mucosal break more than 5 mm long that does not extend between the tops of two mucosal folds
Severe
Grade C
Breaks bridging folds, <75% circumference
Jung 2025, Fig. 1C, Not original, CC BY-NC
Definition
One (or more) mucosal break that is continuous between the tops of two or more mucosal folds but which involves less than 75% of the circumference
Note: Many guidelines treat A/B as mild and C/D as severe.
Grade D
Breaks involving ≥75% circumference
Jung 2025, Fig. 1D, Not original, CC BY-NC
Definition
One (or more) mucosal break which involves at least 75% of the esophageal circumference
Jung 2025, Fig. 1, Not original, CC BY-NC
Reference
Original article
Lundell LR et al. Gut 1999;45:172-180
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Decision support only. Follow current guidelines and local protocols. Classification definitions and terminology follow the original publication language.