Mucosal elevation at 20 cm of esophagus may be caused by esophageal polyps, esophageal smooth muscle tumor and other factors, usually need surgery, but if it is caused by esophagitis, usually do not need surgery, can be treated with medication. 1. Esophageal polyps or esophagitis: usually due to improper diet, long-term smoking and other reasons, resulting in inflammation of the esophageal mucosa, which stimulates the mucosa to appear polyps or esophagitis, presenting the appearance of the mucosal bulge of the esophagus at the 20 cm point. When the esophageal polyp is large, surgical treatment is usually needed, such as laser resection surgery, high frequency electrocoagulation resection. Esophagitis can be treated with drugs such as omeprazole, rabeprazole, etc. Surgery is usually not needed. 2. Esophageal Smooth Muscle Tumor: It may be caused by heredity, frequent drinking and other factors, and during the examination, there will be an obvious mucosal bulge at 20 cm of the esophagus. It can be treated by surgery of partial resection or resection of the esophagus. 3. Esophageal cancer: Repeated stimulation of the esophagus by hot food and other factors can lead to localized cancer. This requires surgery, radiotherapy and other treatments. If there is mucous membrane bulge at 20 centimeters of esophagus, it is necessary to consult doctor in time and follow the doctor’s prescription after diagnosis.