When acid from the stomach bathes the lower esophagus, a feeling of heartburn occurs. In some people, actual tissue damage occurs. This can cause mild inflammation or reddening of the lower esophagus, as seen in Image 1, or a slight erosion having a whitish center surrounded by inflamed red tissue, as seen in Image 2. In severe cases, extensive deep ulcerations occur. Images 3 and 4 show these ulcers.