The gastroesophageal reflux disease

A 50-year-old man came to your clinic with a 15-year history of chest pain that occurs at night and after eating heavy meals, the patient is a smoker and eats plenty of foods, you diagnosed him with gastroesophageal reflux disease and decided to do a biopsy from the lower esophageal mucosa, biopsy results are shown in the image, what is the cause of cellular stress here and what is a type of adaptation, respectively?
Esophagus: Stratified squamous epithelium
a. smoking, cellular atrophy
b. Low ��, intestinal metaplasia
c. vitA deficiency, cells

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