What is reflux esophagitis in adults: causes, symptoms, treatment. Symptoms and treatment of erosive reflux esophagitis Reflux esophagitis symptoms causes and treatment nutrition

Esophagitis reflux is a disease of the digestive system, in which the esophagus receives the main blow. The disease manifests itself when there is a violation of the proper functioning of the stomach and its contents rise to the esophagus. This contact is unfavorable, since the walls of the esophagus are not adapted to such a concentration of acids, and causes irritation, and eventually inflammation.

Treatment of esophagitis reflux gastritis is carried out after a complete examination.

The disease is accompanied by a jump in secretion (high acidity), which means that pain in the lower part of the esophagus and almost constant heartburn will be characteristic. You should not delay and endure this ailment, as it can worsen and lead to even greater discomfort, pain, and eventually to exacerbation.

Causes and consequences of the disease

The disease is bad because at the initial stages of development it is hardly noticeable, and the symptoms are barely felt. Because of this, few people immediately go to the doctor only with the appearance of the first symptoms, and the disease, meanwhile, is gaining momentum. As practice shows, patients seek help from specialists already at the stage of development of inflammation and.

Esophagitis reflux gastritis in its advanced form leads to ulcers of the lower esophagus, causing acute pain and bleeding. According to research, the disease can be the cause of the hiatal hernia in the diaphragm. This hernia is a part of the stomach that has fallen into the esophageal opening, which clearly does not belong there.

The cause of the appearance is the overeating of certain foods, which provokes the entry of stomach contents into the esophagus. These foods include heavy sweets, citrus fruits, tomatoes, and foods high in fat. In adults, alcohol or nicotine (smoking) often becomes the cause of the appearance, however, it has long been known to everyone that excessive use of these substances leads not only to problems of the digestive system ...

Symptoms of the disease

Esophagitis reflux gastritis is a very unpleasant disease just because it can affect people of all ages, even children. However, each age has its own symptoms.

The course of the disease in children

In young children, the disease manifests itself in frequent belching and excessive milky vomiting. Symptoms worsen after feeding, and the child may also feel discomfort, which often causes crying. Before putting to bed, you need to make sure that the child is in an upright position for some time, otherwise symptoms will appear, and the baby’s sleep will be disturbed by the same burping and vomiting.

In a little older baby, gastritis also enhances manifestations at night (namely, when a person is in a horizontal position) or after a meal. Of the symptoms and sour belching, which in itself means increased acidity, and sometimes a slight and burning pain inside, in the chest area.

The course of the disease in adults

In adults, as well as in children, the main symptoms will be accompanied by increased acidity. There is pain in the lower part of the esophagus (approximately in the lower part of the chest) and poor patency of food in the esophagus.

From patient stories: Belching was also noticed, in which part of the contents of the stomach fell into the oral cavity. Most often, this then led to vomiting.

Adults may experience symptoms that are not similar to those of a digestive disorder. For example, there may be discomfort in the throat (approximately the same as the people say “a lump in the throat has become ...”), accompanied by frequent coughing and deterioration of tooth enamel (teeth may turn a little yellow).

It is worth paying attention to the fact that, according to the indicators of doctors, in most patients, a slowdown in the emptying of the stomach (slow transition of food from the stomach to the intestines) was noticed, the reason for this may be a distended stomach, which is far from uncommon in our time. Doctors think that this may be one of the causes of esophagitis reflux gastritis.

Disease severity

The severity of esophagitis reflux gastritis can be divided into several phases:

1. Separate small erosive spots and pronounced redness of the tissue in the lower part of the esophagus.
2. When erosive spots are combined into a general erosion without affecting the entire cavity of the esophagus.
3. Covering by erosion of the entire mucous membrane and the appearance of ulcers in the lower part of the esophagus.
4. The appearance of a chronic ulcer of the esophagus and a clear narrowing of the cavity of the esophagus.

Starting from the second phase, persistent heartburn and sour belching were noticed, no matter how long ago the food was taken. Therefore, pain begins to accompany the patient almost constantly, causing discomfort both day and night. Doctors say - if the symptoms begin to torment you constantly, then the disease has worsened. And even eating according to the prescribed diet will not eliminate all the symptoms of the disease.

Forms of the disease

Just like any gastritis, there are two forms of the course of the disease:

1. Acute inflammation is an exacerbation of the inflammatory process of the mucous membrane of the esophagus. It is characterized by acute pain when eating or drinking. As with any inflammatory process, it is accompanied by the presence. Inflammation may have other symptoms, namely: entail pain when swallowing, pain in the neck, impaired salivation function. In case of exacerbation, it is desirable to immediately contact a specialist to confirm the diagnosis, because it is better not to delay the inflammatory processes.
2. Chronic leakage is a prolonged inflammation of the walls of the esophagus. May be due to poor or incorrect treatment of acute inflammation (or neglect by the patient of the severity of the disease). Feels like constant internal pain in the lower region of the chest. There is also discomfort in the esophagus during active movement (running, sporing, swimming), which is accompanied by hiccups, sour belching, and sometimes even vomiting. Chronic esophagitis can also cause apparent breathing discomfort (it seems to the victim that it is difficult for him to breathe) with pain in the esophagus.

Treatment of esophagitis reflux gastritis

The treatment of this disease is long, the disease does not go away within one or two weeks. During the treatment of the disease, diet is also important, because what we eat affects the performance of our digestive system, especially in diseases.

Diet and nutrition rules

During the examination by the doctor and the diagnosis, be sure to consult with him about the diet. For each stage of the development of the disease, different foods may be prohibited, but in general it is worth giving preference to boiled foods (or steamed), avoiding heavy fatty foods.

The main rules we follow are:

1. We reduce portions of food. Just like with gastritis, it is recommended to eat in small portions, but more often (about 5-6 times a day);
2. We refuse products that can weaken the tissues of the esophageal sphincter. Often these are spicy foods (onions, garlic, peppers), coffee, fruits, especially citrus fruits with a high content of vitamin C. It is strictly forbidden!
3. General hardening of the body's immunity. The very first thing to do is get enough sleep, healthy sleep will help you recover. Organize the intake of vitamins to strengthen immunity (but first we consult a doctor). It is simple and trite to strengthen the body by playing sports.
4. It is undesirable to take a horizontal position after eating. At least until it's digested. When sleeping, it is best to raise the pillow under the head so that the body is tilted, which will reduce the chances of gastric substance entering the esophagus.
5. Light clothing is encouraged. The outfit should not be tight (have tight elastic bands or belts), this exacerbates the disease and increases heartburn.

Medication treatment

Medical treatment of esophagitis is the most important step in the recovery process. After all, correctly selected drugs and a well-designed course of treatment always mean a quick recovery without consequences and complications.

The main prescribed drugs:

1. First of all, treatment should suppress the inflammatory process. Therefore, the most important role in the treatment is played by drugs that reduce inflammation of the esophageal mucosa. Actovegin or Sucralfat are the most famous assistants in this matter (the doctor can prescribe newer drugs, medicine never stands still).
2. The next step is to reduce acidity and increase tissue resistance to acid. In the main composition, these are H2-blockers of histamine, antacids, inhibitors.
3. In an advanced case, preparations for the healing of erosions and tissues affected by ulcers are necessarily added to the main shock group. As well as drugs with an analgesic effect, such as Solcoseryl.
4. Conduct a small course of prokinetics to get rid of nausea and belching.

From folk medicines, you can use decoctions and teas, which are used to speed up the recovery of the digestive system. Decoctions of flax seeds and chamomile, rose hips and lemon balm have long been used. These herbs will not cure us of this ailment, but will greatly help to fight its symptoms.

In conclusion, we still recall that it is necessary to treat the disease in a timely manner, and even better - not to get sick at all. Therefore, we strengthen our body, eat right and do not abuse alcohol, and then we are not afraid of any gastritis and esophagitis.

Reflux esophagitis is an inflammatory disease of the tunicae mucosae (mucosa) of the distal esophagus caused by exposure to gastric or duodenal peptic reflux. The distal esophagus is the part of the esophagus that is adjacent to the stomach. Cm. .

Manifestations in adults are esophageal (heartburn, belching, dysphagia, retrosternal pain and burning), and extraesophageal (dry cough, hoarseness, pain in the tongue, bitterness in the mouth) symptoms.

Causes

In pathogenesis, there are 3 main causes of reflux esophagitis:

1. Insufficiency of the lower esophageal sphincter (LES), which is divided into relative (the result of excessive gastric motility with a normally functioning LES) and absolute - the result of impaired functioning of the NES. This can be facilitated by:
   • axial hernia;
   • , duodenitis; ;
   • hypertrophic,;
   • gastric and duodenal ulcerogenic lesions, especially with;
   • conditions after resection of the stomach;
   • c, conditions with low acidity of gastric juice;
   • abuse of drugs that relax smooth muscles (nitrates, beta-blockers, tranquilizers).
   • alcohol and smoking abuse,
   • stressful situations;
   • starvation.
2. Violation of the rate of emptying and cleansing the esophagus (esophageal clearance).
3. Violation of the mechanisms that protect the mucosa from damage.

Based on the causes of the disease, it is clear that for effective drug treatment it is necessary not only to act on the symptoms caused by the disease of the esophagus, but also to cure the diseases that caused this condition.

Classification

RE has two main forms - acute and chronic.

The causes of acute reflux esophagitis can be:

• allergic diseases;
• exacerbation of chronic diseases of the stomach (condition after gastrectomy, HH, subatrophic gastritis, gastric ulcer);
• infection (, septic esophagitis).

Acute reflux esophagitis is manifested by the following symptoms:

• general malaise;
• rise in temperature;
• dysphagia;
• heartburn;
• belching;
• pain along the esophagus while eating.

Chronic reflux esophagitis can develop as an outcome of a poorly treated acute form, and as a primary chronic disease. This form of the disease is often accompanied by gastrointestinal diseases, it is characterized by both esophageal and extraesophageal symptoms of RE.

• Depending on the prevalence of the pathological process, there are:
  • focal reflux esophagitis - the pathological process occupies one or more foci on the back or side wall of the organ in the distal (adjacent to the stomach) section;
  • diffuse EC - a pathological process occupies the entire or most of the organ.

Depending on the depth of the wall lesion, there are: non-erosive reflux esophagitis (superficial) and.

Non-erosive forms of pathology

Non-erosive forms are divided into catarrhal and edematous. Distal non-erosive reflux esophagitis is a mild superficial form of the disease. Symptoms are usually mild, patients complain of a small in the retrosternal region, at times, belching (more often after overeating or sharp torso bends). Sometimes the pathological condition proceeds without heartburn at all.

Treatment mainly includes:

• diet
• herbal medicine (various decoctions and herbal tinctures);
• physiotherapy.

Signs of erosive reflux esophagitis are:

• heartburn;
• belching;
• chest pain.

The uncomplicated form is treated conservatively: diet therapy, drug therapy, traditional medicine methods. If complications occur, surgical treatment is possible.

Rarely, the disease proceeds with moderately severe symptoms or is completely asymptomatic. More often, the symptoms of reflux esophagitis in adults are pronounced. Allocate symptoms from the esophagus and symptoms from neighboring organs.

Symptoms from the esophagus:

• heartburn;
• belching
• pain in the retrosternal region ("tightening behind the sternum"), often radiating to the neck and back, relieved by antacids;
• dysphagia, of varying severity, of a transient nature;
• with a severe current disease, vomiting with an admixture of blood is possible.

Symptoms from other systems and organs:

• from the side of the cardiac system: extrasystoles, conduction disturbance, cardialgia;
• from the pulmonary system: dry cough (sputum appears when a secondary infection is attached), shortness of breath, shortness of breath, sleep apnea;
• on the part of otorhinolaryngological organs: pharyngitis phenomena (pain and mucus in the throat, redness of the throat is possible), the onset of symptoms of acute laryngitis due to reflux disease (hoarseness, severe pain when swallowing, sore throat);
• on the part of the dental organs: glossitis phenomena (feeling that the tongue is burning, pain in the tongue), damage to tooth enamel, stomatitis;
• on the part of the blood: the phenomena of anemia.

Cough

The cough with reflux esophagitis is dry, often painful. Droplet infections that occur against this background are difficult and can be complicated by the development of bronchial asthma.

There are two mechanisms for the development of cough syndrome:

1. Refluxate particles, with severe damage to the esophagus, enter the pharynx, and from there into the nasopharynx and trachea, where they irritate the cough mucosal receptors.
2. If the reflux reflux is low, and the process is localized only in the distal esophagus, irritation of the vagal centers located in the lower part of the esophagus, which activate the cough center of the brain, is possible.

In order to properly treat cough with reflux esophagitis, it is necessary, first of all, to increase the pH of gastric juice in order to remove its cause (antacids, IGR, PPIs). With frequent aspiration pneumonia, surgical treatment is required. To make it easier to endure attacks, you can take cough remedies recommended by alternative medicine (honey, aloe, propolis). Breathing exercises are often used.

Extrasystoles

Extrasystole (extraordinary contractions of the heart muscle) is a common complaint in diseases of the stomach and gastrointestinal tract in general. Extrasystoles arise due to viscerocardial reflexes, are functional in nature. Special antiarrhythmic treatment is not required, especially with moderate extrasystole.

Another reason for the occurrence of extrasystole is the long-term effect of reflux on the vagal centers located in the lower part of the esophagus. The consequence of which is the development of vegetative-vascular dystonia with psychosomatic manifestations.

Treatment should be aimed at eliminating the pathology that caused extrasystole.

When patients do not tolerate extrasystole, especially if it is accompanied by increased excitability (fear, insomnia), of course, a correction of the condition is required. But before treating extrasystole, it is necessary to consult a psychoneurologist, since substances usually prescribed for neurosis (antidepressants, tranquilizers, neuroleptics) can worsen the condition of the lower esophageal sphincter.

Symptoms of chronic forms of reflux esophagitis

Clinical manifestations of RE depending on the morphological form of the process.

Table 1. Symptoms of chronic reflux esophagitis

Types of reflux esophagitis	Symptoms
catarrhal and edematous	The most mild forms of the disease, accompanied by inflammation of the mucosa. The clinical picture is expressed moderately or weakly. Patients complain of slight discomfort in the retrosternal region and epigastrium, recurrent heartburn, and belching. All symptoms are aggravated by overeating and physical activity. The course is usually benign, with proper treatment ends in complete recovery.
	The general condition is not broken. In patients over 60 years of age, endoscopic examination often reveals whitish spots in the thoracic esophagus - this is an intracellular deposition of glycogen (esophageal acanthosis). Complaints of retrosternal burning pain that occurs both during meals and outside meals, heartburn, which provokes constant intake of soda, belching, hypersalivation. The disease is often accompanied by extraesophageal symptoms. In severe cases, complications are possible.
fibrinous	Complaints of difficulty swallowing, heartburn, belching, sharp retrosternal pain radiating to the back and pericardial region, the appearance of gray films in the mouth.
erythematous	The general condition is broken. Patients complain of dysphagia, vomiting, regurgitation of mucus, heartburn, burning sensation in the chest, retrosternal pain. The clinic is dominated by regurgitation of bloody mucus, vomiting with an admixture of blood, severe dysphagia, odynophagia - a feeling of pain during the passage of food through the esophagus, chest pain, melena - stool with an admixture of blood.
Necrotic	It develops against the background of serious diseases (uremia, agranulocytosis, sepsis); the disease is manifested by dysphagia, odynophagia, repeated vomiting, sharp retrosternal pain, aggravated by swallowing.

Degrees of reflux esophagitis

During the pathology, 4 degrees of severity are distinguished.

Table 2. Reflux esophagitis and severity

Reflux esophagitis	Symptoms	Treatment
1 degree	Heartburn that occurs when the diet is violated and when overeating, discomfort in the retrosternal region, belching.	Medical treatment is usually not required.
2 degree	Heartburn dominates in the clinic. The burning sensation is aggravated by physical activity, especially when bending over. Patients complain of: belching, retrosternal pain, bad breath, white coating on the tongue, feeling of a lump in the throat.	Strict adherence to the diet. Taking drugs that reduce the concentration of H + ions in the refluxate (antacids, IGRs, PPIs), prokinetics.
3 degree	Heartburn, belching, retrosternal pain disturb almost constantly. Extraesophageal signs of the disease appear: dry, hysterical cough, palpitations, arrhythmias, pain in the mouth, hoarseness.	This degree requires massive therapy, lasting at least 8 weeks. PPIs, antacids, prokinetics, reparants are used.
4 degree	This is the stage of complications: stricture of the esophagus; diseases that often lead to cancer ().	Drug treatment, as in grade 3 + treatment of complications. Operation is possible.

Diagnostic methods

RE is diagnosed using endoscopy (with biopsy), x-ray examination of the esophagus and stomach, intraesophageal pH-metry and manometry.

1. Esophagoscopy allows you to carefully examine the mucosa of the esophagus, determine the degree of damage to the organ according to the Los Angeles classification (a, b, c, d), take a biopsy for histological examination.
2. allows you to identify the lesion, the degree of narrowing of the lumen of the body.
3. Long-term measurement of the acidity of the esophagus allows us to ascertain the presence of gastroesophageal reflux.
4. Esophageal manometry - allows you to assess the motility of the organ, determine the clearance of the esophagus.

After the examination, a diagnosis is made and drug treatment is prescribed.

Reflux esophagitis and drug treatment

For rational treatment of the disease, it is necessary:

• change your lifestyle to eliminate those negative influences that led to the disease;
• take all medications prescribed by the doctor;
• if necessary, supplement drug therapy with traditional medicine.

Drug therapy is prescribed in accordance with the severity of the inflammatory process and the severity of the pathological process. How long and in what dosage to take the pills is determined by the doctor.

Pathogenic drugs are:

• antacids and alginates - drugs increase the pH of gastric juice, thereby reducing acid aggression on the esophageal mucosa, in addition, they envelop the mucosa, providing cytoprotection (cell protection).
• antisecretory agents (IGR, PPI) - reduce the concentration of H + ions in gastric juice;
• prokinetics - drugs that accelerate the movement of food from the stomach into the intestines, thereby eliminating congestion in the stomach, increasing the tone of the lower sphincter.

Table 3. The most effective drugs for the treatment of reflux esophagitis in adults

A drug	How to use
Antacids
Phosphalugel	The dose of the drug is prescribed individually. The drug is prescribed immediately after meals and at night.
Almagel	5-10 ml (1-2 measuring spoons) 3-4 times a day after meals
Maalox	1-2 packets one hour after a meal or when heartburn occurs
Prokinetics
Trimedat	The daily dose for oral administration is 300 mg, rectally 100-200 mg, parenterally 50 mg. The duration of use depends on the clinical situation.
domperidone (Motilium)	1 tablet (10 mg) three times a day. Max dose 30 mg
Ganaton	Take 50 mg 3 times a day
Itomed	1 tablet (50 mg) three times a day
Iberogast	20 drops 3 times a day before meals with a little water
Cerucal	5-10 mg three times a day
H2 histaminolytics
Ranitidine	150 mg twice a day
proton pump inhibitors
Lansoprazole	1 capsule per day
Omeprazole	20 mg twice a day
Rabeprazole	20 mg per day (1 tab.)
Pantoprazole (Nolpaza)	1 tab. (40 mg) per day
Antiulcer agents with bactericidal activity against Helicobacter pylori
	1 tab. 2-3 times a day for half an hour before meals
Reparants
Ursosan	1 capsule 1 time per night
Venter	1 gr. in the morning and before bed
Hepatoprotectors
Ursofalk	The dose is prescribed individually
Cholagogue
Hofitol	2 tab. three times a day before meals
Allochol	2 tab. three times a day
Odeston	1-2 tab. (200-400 mg) three times a day
Antispasmodics
Duspatalin	135 mg 3 times a day
Enzymatic preparations
Creon	1-2 capsules during meals
Antipsychotics
Eglonil	50-150 mg per day

Attention! Patients should know which medicines to take at night for severe nocturnal heartburn - the so-called "nocturnal acid breakthrough". These are Phosphalugel (antacid), Omez Insta (a special form of PPI), chamomile tea (1 cup).

But even the most effective drugs will not help if the patient does not change his lifestyle, does not eliminate the causes that caused the disease, and does not follow a diet.

What to do if the disease does not go away? First of all, you should know that the treatment of reflux esophagitis is a long process. How long the treatment will take depends on the severity of the disease, in any case not less than 6-8 months. You need to get emotional. If the disease is really difficult to treat, a second examination is prescribed, especially if there are complaints (yellow coating on the tongue, constant bitterness in the mouth) to exclude biliary reflux esophagitis, pancreatic pathology. If the examination reveals nothing, the question arises about the operation.

Lifestyle with reflux esophagitis

Before proceeding with the treatment of reflux esophagitis, it is necessary to get rid of those addictions and habits that led to cardia insufficiency. This means that you need to listen to simple recommendations and strictly follow all medical advice:

1. Diet therapy is one of the main components in the treatment of patients with the gastrointestinal tract. Patients must strictly adhere to the recommended diet, excluding all prohibited foods from the menu. Food should be warm, boiled (or steamed), soft. You need to eat regularly, often, in small portions.
2. A patient with RE needs to avoid physical and mental overstrain and stressful situations in every possible way. However, it is impossible to completely abandon physical activity (you can visit the pool, take walks).
3. It is necessary to ensure a full 8-hour night's sleep. It is better to sleep on a special wedge-shaped pillow from GERD, one end of which is raised twenty centimeters above the level of the bed, which prevents the backflow of gastric contents and allows you to sleep properly.
4. Give up alcohol and smoking.

All these tips must be followed after the subsidence of clinical manifestations, as they are the prevention of repeated exacerbations.

Surgical treatment

Surgery for reflux esophagitis is a last resort. It is resorted to only if the consequences of refusing the operation are much more difficult than the operation itself and the risks of its complications.

Indications for surgical treatment:

• complex, prescribed in maximum doses, drug therapy, carried out for more than six months, did not give results;
• the patient has frequent, threatening severe pulmonary pathology, aspiration pneumonia;
• developed severe complications of chronic reflux esophagitis (cicatricial, severe ulcerative pathology, Barrett's esophagus, bleeding);
• The patient has a hernia of the esophageal opening of the diaphragm.

Is reflux esophagitis dangerous?

Symptoms of an uncomplicated course of the disease are very unpleasant. But what is dangerous about reflux esophagitis is its complications. The most dangerous consequences include:

1. Stenosis of the esophagus that occurs with prolonged chronic inflammation. The normal mucosa is replaced by scar tissue that narrows the lumen of the organ.
2. . If the inflammation exists for a long time, then not only the superficial, but also the deep layers of the esophageal wall are affected. Ulcers are often complicated by bleeding, requiring emergency surgical treatment.
3. . This . With this pathology, the likelihood of development is very high.

Effective traditional medicine for the treatment of reflux esophagitis

Table 3. Traditional medicine

Means	Action	Prescription (and how to take)
Sea buckthorn oil	Normalizes the production of digestive juices. Antitumor activity Enhances regenerative processes	Buy at the pharmacy Dessert spoon after meals 3 times a day (2 weeks)
potato juice	Has an enveloping effect, reduces symptoms - heartburn and retrosternal pain	Squeeze juice from 1 potato tuber. Freshly squeezed juice is drunk before meals 3 times a day (for 2 weeks)
Honey	Anti-inflammatory action	25 grams 2 times a day 1 hour after meals
Linseed oil	Accelerates the regeneration of damaged mucosa, which is important for the treatment of reflux esophagitis	Drink a teaspoon 2 times a day an hour before meals (10 days)
Flax seeds	Has an enveloping property, reduces the concentration of H + ions	At night, pour flax seed with boiling water in a ratio of 1: 5, take it in the morning before meals. Drink weekly courses with a 10-day break
Herbs	Reducing the concentration of H+ ions in the refluxate. Acceleration of mucosal regeneration. Strengthening the motility of the stomach and the tone of the NSP. Decreased fermentation processes in the intestines, reduced flatulence	Collection: chamomile flowers, flax seeds, licorice rhizomes, lemon balm leaves, taken in a ratio of 2:2:1:1. The ingredients are crushed and poured into 1000 ml of boiling water. A mixture of herbs is boiled in a water bath. Leave for 2 hours, the broth is filtered. Drink the drink should be four times a day in an amount of 50 ml
chamomile	Anti-inflammatory	1 sachet of chamomile is brewed with boiling water. Drink as tea 2 times a day after meals
Aloe	Juice has regenerative and anti-inflammatory properties, helps to reduce the concentration of H+ ions	The juice of freshly squeezed aloe vera is diluted with water (0.060–0.030), aloe is drunk before meals
oatmeal jelly	It is used as a component of dietary nutrition for reflux esophagitis and gastritis.	Hercules flakes are poured with cold water in a ratio of 1: 3. Leave overnight. In the morning, strain and simmer until the liquid thickens. Used as breakfast
Mint	Menthol oil has an antispasmodic, prokinetic effect. Reduces the activity of Helicobacter pylori. An improperly prepared mint solution can cause an exacerbation	3 fresh mint leaves pour 0.25 liters of boiling water. Drink 1 time per day 0.5 hours before meals
Rose hip	It has an anti-inflammatory effect. Accelerates regeneration. Normalizes the work of the gastrointestinal tract, reduces the concentration of H + ions in gastric juice	60 grams of dry berries are poured into 1000 ml of boiling water, insisted for 6 hours. Drink instead of tea 3 times a day
Chicory	Blocks nausea, heartburn and discomfort after eating	Brew like coffee, take after meals
Goat milk	A symptomatic remedy that allows you to quickly relieve inflammation and such unpleasant symptoms as heartburn and belching	1 glass daily in the morning before meals
plantain herb	Relieves pain, reduces the severity of symptoms, inflammatory response, reduces the concentration of H + ions	Squeeze juice from plantain leaves, dilute in 250 ml of water, drink throughout the day
Calendula	Has analgesic, anti-inflammatory, antiseptic and antispasmodic properties	5 g of dried flowers are brewed with 1 cup of boiling water. Drink like tea after meals
Dandelion	The agent reduces the severity of the inflammatory reaction and the severity of the main symptoms	Dandelion flowers are tightly filled with a container, sprinkled with sugar. A teaspoon of the resulting syrup is dissolved in a glass of water. Drink before every meal

Mineral waters for reflux esophagitis

Mineral alkaline waters are used for reflux esophagitis and gastritis during remission. Apply low-mineralized medical-table water. They normalize the motor and secretory functions of the stomach. Beneficial effect on the function of the sphincters of the esophagus.

"Borjomi"

Course treatment of RE with mineral water "Borjomi" against the background of diet therapy significantly reduces the number of complaints, significantly reduces the acidity of gastric juice, improves its enzymatic properties, cleanses the walls of the esophagus. The course of treatment is 21 days (drink 150 ml without gas three times a day 40 minutes before meals).

Resort Borjomi

"Essentuki No. 4"

Mineral water "Essentuki No. 4" reduces the secretion of H + ions in the stomach, improves the functioning of the LES. With hyperacid gastritis and reflux esophagitis, water is taken one hour before meals in a heated state, quickly, in large sips. Start taking "Essentuki No. 4" with 100 ml, gradually increasing the dose.

Can reflux esophagitis be cured permanently?

It all depends on the severity of the disease. With reflux esophagitis of the 1st degree, for a complete remission, it is quite enough to eliminate the causes of the disease, follow a diet, use alternative medicine that has an anti-inflammatory, enveloping effect.

If the course is severe, then complex medical treatment is necessary here in order to prevent complications.

If complications do arise, then it is likely that surgical treatment will be required.

Reflux esophagitis is one of the most common esophageal diseases. It occurs as a result of direct contact between the mucosa of the esophagus and the contents of the intestine. Due to the characteristic increased acidity, damage to the lower esophagus occurs, due to which symptoms are characteristic of reflux esophagitis in the form of heartburn, pain, and similar disorders of the digestive system.

Features of the disease

Tracking the incidence rate according to real indicators is not possible, because reflux esophagitis occurs with mild symptoms, in which, as a rule, there is no appeal to specialists. Meanwhile, going to the doctor is almost mandatory, even as a symptom or. The occurrence of reflux esophagitis, in addition, can act as a symptom of the occurrence of a diaphragmatic septum. In this case, we are talking about getting into the hole of the part of the stomach, in the normal state of which there should not be there in principle. There are also a number of specific types of foods that cause stomach contents to enter the esophagus. This includes, in particular, chocolate and citrus fruits, tomatoes and fatty foods. Additionally, for adults, coffee, alcohol, and smoking act as concomitant products of getting into the esophagus.

Reflux esophagitis: symptoms

Each age category has its own characteristic signs of this disease. So, reflux esophagitis, the symptoms of which occur in children, manifests itself in the form of belching and frequent regurgitation, vomiting of milk and belching of air. When the child is raised in a vertical position, a decrease in the isolated phenomena is observed, meanwhile, after the next feeding, they appear again. If you continue to be in a horizontal position, reflux esophagitis intensifies in manifestations, and therefore the head end of the child's bed should be slightly raised or a pillow should be placed higher - this will remove the characteristic symptoms.

For older children, a characteristic feature is the presence of complaints of frequent heartburn, sour belching, often there is a burning sensation in the area behind the sternum. The listed symptoms are most often relevant after eating, with body tilts, at night.

As for adults, pain is most often noted in the area behind the sternum, and the most common of the symptoms occurs, which has the character of a “coma” sensation in the throat. In addition, the symptoms characteristic of reflux esophagitis may also correspond to symptoms of a completely non-esophageal nature, expressed in a constant cough, hoarse voice, dental disease, etc.

Increased reflux of stomach contents into the esophagus can be increased for a number of different reasons. So, this, first of all, may be associated with a violation that occurs in the motility of the gastroduodenal zone, which is most often relevant in the presence of various types of pathology in the digestive organs. It is also associated with a slowdown in gastric emptying. It is noteworthy that delayed gastric emptying is observed in about 50% of the total number of patients diagnosed with reflux esophagitis. By stretching the stomach, the volume of contents in the stomach increases, which, in turn, contributes to the occurrence and development of reflux. Due to the disturbance in pyloroduodenal motility, duodenogastric reflux is formed. In this case, we are talking not only about an increase in the volume of the contents of the stomach, but also the formation of an additional factor that contributes to damage to the mucosa as a whole.

Degrees of reflux esophagitis

This disease has its own degrees characterizing it.

• I degree - manifestations are in a separate type of erosion that does not merge with each other, as well as in erythema that occurs in the distal esophagus;
• II degree - erosive lesions are confluent, but without capturing the entire surface of the mucosa;
• III degree - the manifestation of ulcerative lesions in the esophagus in the lower third of its part. In this case, they merge when capturing the surface of the mucosa in the complex;
• IV degree - is expressed in a chronic ulcer of the esophagus and in stenosis.

It is noteworthy that the moderate severity of reflux esophagitis is characterized by the manifestation of heartburn not only after eating. So, the pains become more intense and frequent, disturbing the patient even if he takes dietary food. The manifestations in the form of belching with air, the lining of the tongue and an unpleasant aftertaste in the oral cavity are also frequent.

Forms of reflux esophagitis

This disease is characterized by acute and chronic manifestations.

• Acute reflux esophagitis manifests itself in inflammation of the walls of the esophagus with the simultaneous presence of painful sensations that are relevant when eating, as well as liquids. Characteristic for him is an increase in temperature with general malaise, behind the sternum, the patient experiences discomfort along the esophagus. There is also a burning sensation and pain in the neck, profuse salivation, belching, a violation in the function of swallowing.
• Reflux esophagitis, chronic manifests itself in chronic inflammation of the walls of the esophagus, which is accompanied by the occurrence of pain in the area behind the sternum. Often, the chronic form of reflux is also accompanied by gastritis. Rawness behind the sternum can also occur when running, in addition, there may be difficulty in breathing, hiccups, heartburn, and even vomiting.

Esophagitis also occurs catarrhal, characterized by swelling that occurs in the mucosa of the esophagus and hyperemia, as well as erosive, the nature of the development of which is determined by acute infections.

Biliary reflux esophagitis: symptoms

A violation of the process of digestion of food, in which the contents of the stomach are in the intestines when causing inflammation and irritation in it, as well as the flow of intestinal contents into the stomach determines reflux. Accordingly, the gastritis formed against the background of this process is defined as reflux gastritis. The reasons that provoked reflux determine its type, which can be duodenal or biliary.

Let us dwell on such a form as biliary reflux esophagitis, the symptoms of which are expressed in a feeling of heaviness and fullness in the stomach, which is important in the process of eating, as well as immediately after it. Additionally, we note bitterness and belching, an unpleasant aftertaste felt in the mouth, nausea, various kinds of stool disorders (alternating with diarrhea, as well as bloating). Mostly biliary reflux gastritis is not expressed as a pain symptom. When pain occurs, it is aching and dull in nature, aggravated after eating. It is noteworthy that this disease leads to violations of the body's absorption of nutrients obtained through food. For this reason, there is an impressive weight loss, the formation of "jam" on the lips, general weakness, as well as dry skin.

Causes of biliary reflux esophagitis

This type of disease is associated with the presence of disorders of the biliary system, as well as disorders in motor skills (that is, with dyskinesia), and the lack of coherence in the work of sphincters. Thus, violations provoke a failure in the sequence and in the force of pressure that occurs in the intestines and in the bile ducts. Further, at the reflex level, failures occur in the compression of the ducts of the stomach and pancreas. Due to the occurrence of the biliary type of disorders, impregnated with bile and pancreatic enzymes, the contents from the duodenum end up in the stomach, burning it and thereby forming gastritis. Often, biliary reflux esophagitis is combined with a diagnosis such as biliary duodenitis (or inflammation of the duodenum). This combination is explained by the irritation produced by bile, which is secreted outside the process of normal digestion.

Erosive reflux esophagitis: symptoms

Esophagitis in its form, in which the mucosa of the esophagus is deeply affected, is defined as erosive reflux esophagitis, the symptoms of which are manifested in the form of heartburn and belching, nausea (occasionally vomiting), pain in the area behind the sternum, sensations of swallowing pain and the presence of "coma " in the throat. Despite the fact that these manifestations are generally characteristic of esophagitis, in this case they are more pronounced, respectively, bringing more anxiety and discomfort to the patient.

The aggravation of the course of the disease is provoked by errors in nutrition, which consist in the use of acidic foods of various types, caffeine and alcohol. Often, the course of the disease is aggravated by drugs, even such harmless, at first glance, as paracetamol, analgin, aspirin, etc.

Treatment of reflux esophagitis

For the treatment of reflux esophagitis in any form, it is natural that the root cause, that is, the disease that provoked its occurrence, should be eliminated. These include gastritis and neurosis, or peptic ulcer. When the correct therapy is determined, the symptoms of reflux esophagitis may subsequently be less pronounced, while with its help it will be possible to reduce the harmful effects of gastric contents that enter the esophagus. Also, therapy in its correct form will increase the overall resistance of the esophageal mucosa, contributing to the rapid cleansing of the stomach after eating.

The first step in the treatment of esophagitis is nothing more than a diet, in which spicy and fatty foods, chocolate, tomatoes, citrus fruits, caffeine and, if possible, smoking should be excluded.

Additionally, the specialist prescribes drugs that reduce the acidity of the stomach, in particular, these include antacids. Peptic ulcer disease, as well as erosion, involve taking antisecretory drugs (proton pump inhibitors or H2-blockers). Due to this, intragastric pressure decreases, which ensures the overall resistance of the stomach to food intake. Additionally, due to this, intestinal motility is normalized, and all symptoms characteristic of reflux esophagitis are eliminated. To avoid exacerbating the symptoms that occur when lying down, additional pillows are placed to elevate the upper body - this measure will help reduce heartburn, as well as pain that occurs in the sternum.

To diagnose reflux esophagitis, as well as its accompanying diseases, you should contact a gastroenterologist. Based on the patient's complaints, the duration and severity of the disease, as well as the morphological and endoscopic assessment of changes, the appropriate treatment will be determined.

It is known that a disease such as erosive reflux esophagitis is characterized by the presence of small areas on the esophageal membrane that have undergone pathological changes. This is a complicated form of esophagitis, in which the signs of the disease become aggravated, and bring the patient severe discomfort. Symptoms are aggravated after eating and taking pharmaceutical drugs, such as salicylates.

The eroded areas become very thin, due to which the esophagus loses its ability to fully function. In the absence of treatment and adherence to dietary recommendations, there is a risk of developing an ulcerative form of the disease.

Course of the disease

This is a rather rare type of disease that occurs if the pathology exists for a long time and is not subjected to any therapeutic effect. At the same time, the superficial form of the disease, which is characterized by a slight hyperemia and swelling, due to the incessant exposure to an aggressive environment, gradually transforms into an erosive one, while the mucosa of the esophagus changes its structure.

Prolonged exposure to gastric juice when it is ejected from the stomach leads to thinning of the walls of the esophagus and damage to the deeper (muscular and submucosal) layers. The walls are covered with fibrinous plaque. An erosive-ulcerative defect of the esophageal membrane is formed.

The course of the disease is characterized by several successive stages of development, as the erosive lesion progresses:

• Erosive reflux esophagitis of the 1st degree is manifested by focal erosions that do not merge together and erythema of the lower esophagus.
• The second degree is characterized by erosive areas, which do not occupy the entire area of ​​the mucosa.
• Esophagitis of the 3rd degree has the form of ulcerative defects of the distal organ, which are confluent in nature and capture the entire surface of the esophageal membrane.
• Erosive esophagitis grade 4 is an ulcer of the esophagus with stenosis.

Classification of reflux esophagitis according to the severity of the disease, taking into account the condition of the organ and symptoms, makes it possible to establish an accurate diagnosis and determine the tactics of treatment.

Symptoms of the disease

Characteristic signs of the disease are pain behind the sternum, which can radiate to the region of the heart and shoulder. This symptom is sometimes quite difficult to differentiate from heart pain in angina pectoris.

In addition, signs of erosive reflux esophagitis are:

• belching;
• constant heartburn;
• unpleasant taste in the mouth;
• nausea;
• night cough;
• cutting pain when swallowing;
• obsessive hiccups.

The sensations tend to be worse in the horizontal position, especially immediately after eating. When the patient sits down, his state of health improves a little.

Diagnostics

To determine the condition of the mucosa and the level of acidity of the esophagus, as well as violations in the valve and the presence of a diaphragmatic hernia, modern research methods are used. The erosive form of the disease requires the following diagnosis:

• esophagoscopy (the method makes it possible to determine areas of hyperemia and hemorrhage, tissue edema, erosive defects).
• X-ray of the esophagus helps to diagnose hiatal hernia and to fix gastric reflux with the help of a radiopaque substance.
• daily pH-metry of the esophagus, which is a measurement of the acidity of the esophagus using a probe, is recognized as a highly informative method. The method allows you to fix the duration, frequency and intensity of reflux.
• esophagography is an additional diagnostic method and is carried out in conjunction with esophagoscopy. Allows you to determine the unevenness of the contours and hypertrophy of the mucosal folds. The method is completely safe and can be used repeatedly.
• analysis of feces for hidden hemorrhage.
• general blood analysis.

Therapy depends on the severity of the pathology and general diseases. With the first degree of reflux esophagitis, it is enough to follow a diet, the second is effectively treated with drugs, and in the last stages, pharmacotherapy may not work, and the disease requires surgical intervention.

Acute treatment

If the cause of esophagitis is a chemical burn of the mucous membrane, then the treatment of such a disease should begin with urgent gastric lavage in order to immediately free the organ from the aggressive substance. During the treatment of an acute form of reflux esophagitis, the patient should refrain from eating on the first day of the disease. Further treatment involves the use of PPIs or histamine H2 receptor blockers to reduce the secretory activity of the stomach.

The severe course of the disease includes the most sparing diet or parenteral administration of saline solutions in order to detoxify and maintain the patient's life. To suppress the bacterial flora, antibiotic therapy and gel antacids are needed.

With ulcerative reflux esophagitis, which is accompanied by a pronounced pain syndrome, it is necessary to administer myotropic antispasmodics (No-shpa, Papaverine, Drotaverine) and painkillers. In this case, gastric lavage is contraindicated. If the erosive necrotic focus is not treatable, then surgical debridement of the mucosal area should be performed. Also, indications for surgical treatment of erosive reflux esophagitis are strictures of the esophagus, if bougienage or balloon dilatation does not work.

Treatment of the chronic form

Treatment of the chronic form of esophagitis is to eliminate the factors of its occurrence. The main components of the treatment of the disease are measures such as changing the diet, menu composition, and eliminating bad habits. The diet involves the use of crushed food of a mushy consistency, the temperature of which should be in the range of 35-37 degrees.

The patient should exclude the use of pharmacological agents that affect the tone of the esophageal sphincter (prostaglandins, theophylline, tranquilizers and sedatives).

Drug therapy consists of the following drugs:

• proton pump inhibitors;
• myotropic antispasmodics;
• gel antacids with anesthetic components;
• prokinetics;
• antibacterial drugs (if necessary);
• blockers of H2 histamine receptors.

Physiotherapeutic measures that complement drug treatment:

• electrophoresis;
• amplipulse therapy;
• balneotherapy;
• mud treatment.

Physiotherapy procedures are not recommended for 3-4 degrees of reflux esophagitis. In this case, surgical treatment is indicated, which consists in dilatation or bougienage, as well as endoscopic dissection of strictures. If necessary, surgical plastic surgery and resection of the esophagus are used.

Diet food

It is possible to treat such a disease only with the unconditional observance of dietary nutrition, which includes easily digestible food of a semi-liquid consistency. Foods that irritate the inner lining of the esophagus and stomach should be completely eliminated in order to help eliminate the inflammatory process and exclude the release of gastric juice.

The nutrition of the patient must meet the following conditions:

• Porridges, meat soufflés and vegetable purees, mashed soups are recommended. At the time of treatment, fresh fruits and vegetables are excluded so that the coarse fiber contained in them does not irritate the surface of the diseased esophagus.
• Food should be home-cooked, canned food, convenience foods, fast food, spicy and spicy dishes, marinades and pickles are excluded.
• Confectionery and flour products, coffee and carbonated drinks are contraindicated.
• Cooking food should be steamed or boiled, stewed without adding fat. Fried and baked foods are prohibited.
• The consistency of the food should be semi-liquid so as not to injure the inflamed mucosa of the esophagus.
• Dinner should be done long before going to bed, after eating food, you should not take a horizontal position, lift weights and bend over. It is desirable to sleep with a raised headboard. In addition, you should not wear tight clothing that squeezes the stomach and chest.

Non-traditional methods

Phytotherapy involves the use of herbal decoctions and infusions that promote the regeneration of damaged tissues of the esophagus, improve the tone of the sphincter muscles, which have an anti-inflammatory effect.

The most suitable herbs for making decoctions (0.030–0.500) are:

• motherwort;
• chamomile;
• plantain;
• Melissa;
• flax seed;
• liquorice root.

Before using herbal medicine, you need to discuss it with your doctor, who will confirm the absence of contraindications and prescribe safe doses of herbal decoctions. Erosive reflux esophagitis is a serious form of the disease, in which the doctor can very rarely advise treatment with herbal decoctions, in order to avoid bleeding and worsening the patient's condition.

Due to the constant reflux of gastric contents (sometimes along with the contents of the duodenum), the mucous membrane of the esophagus is injured. A serious disease develops - reflux esophagitis. It is dangerous with severe bleeding from and erosion, degeneration into Barrett's esophagus,. With reflux esophagitis, treatment is long, since it is necessary to eliminate not only the symptoms, but also the cause of gastroesophageal reflux.

Symptoms of reflux esophagitis

One of the characteristic symptoms of reflux esophagitis is heartburn.

Inflammation of the esophagus, caused by irritation of the mucous membrane with the acidic contents of the stomach, is manifested by esophageal dyspepsia. The most characteristic symptoms for reflux esophagitis are:

1. . Describing this condition, patients put their hand on the sternum, indicating the location of the burning sensation. Sometimes it radiates to the neck, shoulder blade. If the heartburn is mild, it goes away 3 to 5 minutes after taking antacids. It is possible to eliminate it by drinking a glass of milk. Increases with overeating, bending over, after taking alcohol, carbonated drinks.
2. Belching. Patients complain of regurgitation. An unpleasant sour or bitter taste appears in the mouth. Belching indicates the development of stenosis of the esophagus. Especially dangerous is nocturnal regurgitation during sleep (the contents of the esophagus enter the respiratory tract).
3. Pain behind the sternum. It is burning, intense, aggravated in the lying position, with the torso leaning forward. Irradiates to the interscapular region, neck, lower jaw. According to the clinical manifestation, pain with reflux esophagitis is similar to.
4. Dysphagia. At the initial stages, patients complain of difficulty swallowing solid food (bread, meat). If the disease progresses, the lumen of the esophagus narrows significantly (becomes less than 13 mm), then even saliva is difficult to swallow.
5. Esophageal bleeding. This is an extremely dangerous symptom that requires urgent surgical intervention.
6. The appearance of foam in the mouth. An extremely rare sign of reflux esophagitis. It occurs due to the intensive production of secretions by the salivary glands (up to 10 ml per minute), in response to the esophago-salivary reflex.

In addition to the standard clinical esophageal manifestations, patients complain of other symptoms. Sometimes a completely different disease is treated for a long time and persistently, since dysphagia, heartburn are less pronounced than extraesophageal symptoms:

1. Dental. Due to the ingress of gastric juice into the mouth, erosions appear on the tongue, teeth are destroyed, develops,. Patients complain of salivation.
2. The ENT organs become inflamed (nasopharyngitis, rhinitis, etc. develop). Patients are concerned about the feeling of a lump, spasm in the throat. Ulcers, granulomas, polyps appear on the vocal cords. The patient's voice becomes hoarse, rougher. Reflux esophagitis contributes to the development of cancerous lesions of the pharynx, vocal cords, and larynx.
3. bronchopulmonary symptoms. With reflux esophagitis in 6–10% of patients, the disease manifests itself with an exceptionally persistent cough, asthma attacks, which occur mainly at night.
4. Pseudocardial. Pain behind the sternum with reflux esophagitis is difficult to distinguish from "angina pectoris". It even irradiates in the same way as with angina pectoris. This is due to the innervation of the esophagus and the heart by the same nerve. These symptoms occur in 70% of patients. They initially turn to a cardiologist, but do not show deviations.
5. Cardiac symptoms. Patients, especially the elderly, complain of tachycardia, with attacks of pain caused by reflux. Due to the pathology of the esophagus, reflex angina pectoris, myocardial ischemia develops.
6. Signs of damage to the stomach. Patients complain of pain and heaviness in the abdomen, aggravated after eating, rapid satiety, nausea.

People with reflux esophagitis often have hiccups. They even complain about and unsuccessfully treat the spine.

Diagnostics

The doctor makes the final diagnosis based on the results of FGDS.

It is possible to identify the entry of bile into the esophagus according to the patient's complaints of a bitter taste in the mouth, especially in the morning, a yellowish coating on the tongue. Duodenal reflux is finally determined by analyzing the scraping of the tongue for the presence of bile acids.

Some clinical manifestations are not enough to establish the diagnosis of "reflux esophagitis". This disease is accompanied by serious changes in the mucous membrane of the esophagus. Therefore, before treating reflux esophagitis, it is necessary to differentiate it from other diseases. The doctor prescribes such additional studies:

• , esophagus, stomach;
• test with proton pump inhibitors.

The final diagnosis is made after the procedure, if appropriate histological and morphological changes in the esophageal mucosa are detected. In the presence of ulcers, erosion, a biopsy is necessary.

Treatment

Medicines

If the disease is not started, complications (bleeding, ulcers, etc.) are not detected, conservative treatment is carried out. Prescribe medications:

• prokinetics;
• antisecretory agents;
• antacids.

Prokinetics improve the functioning of the lower esophageal sphincter, reduce the number of refluxes.

Among antisecretory drugs for healing erosions, proton pump inhibitors (PPIs) are preferable. Only they must be taken correctly (half an hour before meals), otherwise the effect of their use will be minimal.

With resistance of patients to PPIs, monotherapy with antacids is carried out. In severe cases, a complex is prescribed:

• blockers of H 2 -histamine receptors;
• antacids.

Occasionally, PPI resistance occurs in patients with esophageal hypersensitivity. Therefore, proton pump inhibitors are prescribed with drugs that reduce sensitivity:

• tricyclic antidepressants (amitriptyline);
• selective serotonin reuptake inhibitors (fluoxetine, paroxetine).

Antacids reduce the effect of hydrochloric acid and other components of the reflux on the mucosa of the esophagus.

If it is found that, in addition to gastric juice, the contents of the duodenum enter the esophagus, drugs that neutralize bile acids are prescribed:

• ursodeoxycholic acid;
• antacids;
• cholestyramine.

Tablets, so as not to damage the esophagus even more, should be taken sitting or standing, washed down with plenty of water (100-150 ml).

Diet and lifestyle

In addition to medication, patients with reflux esophagitis must definitely change their lifestyle. There are certain rules that must be followed in order to reduce the number of refluxes:

1. Skip the afternoon break. Do not eat 3 hours before bedtime. After eating, it is better not to take a horizontal position, but to take a walk in the fresh air or just sit, walk around the room for half an hour.
2. Do not wear tight clothing. Underwear that tightens the stomach is strictly contraindicated. No pulling belts, tight belts, corsets.
3. You need to go to bed so that the head of the bed is raised by 15 cm.
4. Reduce the load on the abdominal muscles, especially after eating. It is impossible to destroy the extra calories eaten instantly by pumping the press, making forward bends. Set aside these exercises for 2 hours.

Mandatory for reflux esophagitis diet. With an exacerbation of the disease, treatment table No. 4 is shown. As you recover, most of the restrictions are removed, but the following remain banned:

• alcohol;
• carbonated drinks;
• strong tea with coffee;
• spicy, salty.

Sometimes patients with reflux esophagitis do not tolerate citrus fruits, tomatoes, apples - they cause heartburn. It is also better to refuse these products.

Surgery

Surgical treatment is necessary for:

• strictures of the esophagus;
• frequent bleeding;
• relapses of aspiration pneumonia;
• transformation of the disease into Barrett's esophagus;
• ineffectiveness of drug therapy.

For surgical treatment, they resort to fundoplication - circular suturing of the bottom of the stomach to the esophagus. This method is necessary so that in the future food from the stomach does not fall back into the esophagus.