Heterotopic gastric mucosa in the proximal esophagus (inlet patch) : a clinical entity with increased recognition

Heterotopic gastric mucosa patch can be seen in various parts of the gastrointestinal system from mouth to anus. However, esophageal heterotopic gastric mucosa patch, also known as inlet patch (IP), has been increasingly reported. IP is seen as a flat island or islands of red mucosa in the proximal third of the esophagus in endoscopic examination (1). IP is often missed due to its location in the esophagus, just distal to the upper esophageal sphincter, making endoscopic evaluation difficult. Hence the condition is most likely to be under-reported. Nonspecific oropha- ryngeal symptoms are common and thought to be due to laryngopharyngeal reflux. Symptoms as well as morphologic changes associated with IP are regarded as a result of the damaging effect of acid, produced by parietal cells in the mostly fundic type of IP. In a recently published article, authors reported that dysphagia was related with the size of IP and speculated that this might be associated with larger IP causing more acid secretion (2).