So-called “minimal changes” are not included in the LA Classification because endoscopists are unable to recognise these changes with acceptable agreement.
The extent of mucosal breaks due to either erosive or ulcerative esophagitis is the sole determinant of each of the four severity grades.
Extent is judged primarily by the radial pattern of mucosal breaks, using the longitudinal esophageal mucosal folds as landmarks, as shown in cartoons (see the LA Classification Poster).
LA Classification Poster
The LA Classification has been adopted widely and is the most commonly used esophagitis grading method in clinical practice and original research publications.