Patient case (clinical description): A 48-year-old man comes to the office complaining of heartburn and acid reflux.  He has taken over-the-counter antacids but sees no relief.  Other medical history is unremarkable.  The patient does not use tobacco, alcohol, or illicit drugs.  Vital signs are within normal limits.  BMI is 31 kg/m2.  Physical examination is  positive for mild tenderness in upper stomach. Chest x-ray shows an air-fluid opacity behind the heart.  A barium swallow study reveals approximately 1/3 of the stomach herniating through the esophageal hiatus.

Patient's own account: I went to my doctor's office because of a non-stop heartburn and some acid reflux. I took over-the-counter medications, but it keeps going strong! I don't smoke, take drugs or drink alcohol, I'm healthy! The doctor took my vitals, which turned out normal. My BMI is 31, which might be a bit too much for a 48-year-old guy like me. They examined my stomach and found a mild tenderness in the upper part. I also did some X-rays, and they found out that I have an air-fluid opacity behind my heart. I did another X-ray, and it turns out that a part of my stomach went up my chest through a hole in my diaphragm!

Clinical trial: An Efficacy Study to Compare the Treatment Effects of Rabeprazole and Lansoprazole Depending on the Genotyping of CYP2C19 in Treating Reflux Esophagitis

Eligibility criteria:
Inclusion Criteria:

          -  Participants diagnosed with reflux esophagitis of Grade A or higher by Los Angeles
             (LA) classification based on the endoscopy among participants complaining of
             gastroesophageal reflux symptoms (such as: Heartburn, regurgitation, globus sensation,
             chronic [lasting a long time] cough [sudden, loud flow if air from the lungs],
             epigastric [area above the navel] pain, non-cardiac chest pain, hoarseness, or
             dysphagia), or those who diagnosed with reflux esophagitis of Grade B or higher
             without complaining of symptoms

          -  Participants without other serious disease except the study indication (reflux
             esophagitis)

          -  Participants with hematology (related to blood) panel, serum chemistry panel, or
             urinalysis result clinically within twice the normal range

          -  Female Participants of child-bearing potential who are using the appropriate
             contraceptive or with a negative urine pregnancy test

        Exclusion Criteria:

          -  Participants with other serious gastrointestinal disease except reflux esophagitis
             (example: digestive tract cancer [abnormal tissue that grows and spreads in the body
             until it kills], hepatic disease, pancreatic disease, and ulcer. However, the scar of
             an ulcer is included in study targets

          -  Participants with other serious concomitant disease(s) such as renal disorder,
             cerebrovascular disease, cardiovascular disease, hepatic disease, and severe
             respiratory disease

          -  Participants with medical history of upper gastrointestinal tract surgery,
             esophagostenosis, or a chalasia

          -  Participants with hematology panel, serum chemistry panel, or urinalysis result of
             above twice the normal range

          -  Participants who cannot discontinue proton pump inhibitors or Histamine 2 antagonist
             which may have influence on the study, 4 weeks before the start of this clinical study
No condition on gender to be admitted to the trial.
No healthy subjects accepted to join the trial.
Subject must be at least 18 Years old.
Subject must be at most 75 Years

Eligibility (NLI label): Contradiction