Dysbiosis is a term that encompasses changes in the composition of the combined microbiota compared to that found in healthy individuals. When distinguishing the microbiota of a normal healthy esophagus from dysbiotic disease states such as reflux esophagitis, esophagitis, Barrett's esophagus, or esophageal adenocarcinoma, it is clear that dysbiosis may precede inflammation.

Acid-suppressing drugs are the first-line therapy for esophageal disorders such as reflux esophagitis, erosive esophagitis, and Barrett's esophagus. The primary mechanical action of PPIs is to reduce gastric acid production by inhibiting the hydrogen-potassium ATPase pump, a transmembrane protein responsible for the release of hydrochloric acid into the gastric lumen.