What does GERD cause in the esophageal wall?

Gastroesophageal reflux disease (GERD) is characterized by the backflow of stomach contents into the esophagus, which can lead to several damaging effects on the esophageal wall. One of the primary consequences of GERD is the erosion and ulceration of the epithelial layer due to the acidic content of the stomach damaging the tissues. This chronic exposure can create painful sores and inflammation in the esophagus.

Additionally, the tissue can become fragile as repeated exposure to acid weakens the esophageal lining, making it more susceptible to injury and less capable of withstanding future episodes of reflux. This fragility can further exacerbate the risk of damage.

Hyperemia, or increased blood flow to the affected area, can also occur in response to inflammation. An inflamed esophagus may exhibit signs of hyperemia as the body responds to the injury by increasing blood supply to promote healing and deliver immune cells to the site of damage.

Considering this information, all of these manifestations—erosion and ulcerations, tissue fragility, and hyperemia—are typical effects of GERD on the esophageal wall, thus making the option that includes all of them the most comprehensive and accurate choice.