Erosive reflux esophagitis. Chronic reflux esophagitis: what to do for patients with exacerbations of the disease Is there reflux esophagitis

One of the most common diseases of the gastrointestinal tract - reflux esophagitis, is recorded in almost half of the population. Appears as a result of inflammation of the mucous membrane of the esophagus, which develops due to the ingress of hydrochloric acid and other components of gastric juice into the esophagus.
According to numerous studies conducted in Europe, the USA, Russia, the prevalence of this disease among the adult population is 40-60%, and in recent years there has been a significant increase in this indicator.

However, patients often hesitate to contact a doctor when symptoms of reflux esophagitis appear, and treatment is delayed or requires more radical measures due to total damage to the esophagus and the occurrence of complications.

What is reflux esophagitis?

Reflux esophagitis is a disease of the esophagus, accompanied by the development of an inflammatory process on its mucosa. According to statistics, 2% of adults have reflux esophagitis, which is more often (2 times) detected in men. Often, the symptoms of this disease become habitual and are included in the daily norm. A person does not pay attention to a small after-dinner heartburn, which disappears after a tablet of Almagel or water with soda.

During the normal functioning of the digestive system, this sphincter opens only when food and water enters the stomach from the esophagus. Weakening of the muscular ring of the sphincter leads to the fact that the gastric contents:

• semi-digested food residues,
• hydrochloric acid,
• pepsin and other components of gastric juice,

enters back into the esophagus, irritates its mucosa and causes a lot of discomfort in the patient. It can provoke insufficiency of the sphincter: when the latter expands, the contents of the stomach are thrown.

Due to the sphincter, which is located at the junction of the stomach and esophagus, reflux esophagitis occurs very rarely and lasts no more than five minutes. This condition is considered quite normal. An abnormality is food reflux, repeated daily and lasting at least one hour.

Types of disease

Clinical forms:

1. Chronic reflux inflammation the esophagus is accompanied by periodic painful sensations behind the sternum. Signs increase when running, lifting weights, eating.
2. Acute reflux esophagitis characterized by inflammatory changes directly in the esophageal wall. When a person takes food, he feels that the movement of the food bolus stops behind the sternum. At the same time, the temperature rises, salivation increases, and swallowing disorders occur. Belching is observed at the final stage of the disease.

Nonerosive reflux esophagitis

What is non-erosive reflux esophagitis? This complex term refers to one of the varieties of GERD, characterized by specific clinical symptoms, in the absence of damage to the tissues of the esophagus. Usually no major therapy is needed. As a rule, patients recover after the normalization of nutrition and the exclusion of spicy, fatty and salty foods.

Erosive reflux esophagitis

The erosive form is one of the most dangerous, since with it the mucous membrane begins to become covered with ulcers. If left untreated, they can bleed or lead to more serious consequences. 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. The disease can proceed without symptoms for a long time or have the same symptoms as in.

If left untreated, this disease can affect not only the upper cells of the esophagus, but also the deeper layers. Therefore, treatment is carried out under the strict supervision of a doctor.

Causes

Any factors that reduce or completely eliminate the effectiveness of these protective mechanisms can lead to the occurrence of reflux esophagitis. They may be:

• Chemical, nutritional factors;
• Nervous tension;
• Increased pressure in the peritoneum.

Often reflux esophagitis accompanies such gastrointestinal diseases as:

• ulcer or;
• vagus nerve damage;
• violation of duodenal patency of the esophagus;
• chronic pancreatitis, cholecystitis;
• pyloroduodenal stenosis;
• hiatal hernia.

Symptoms of reflux esophagitis

With exacerbation of reflux esophagitis, inflammation of the walls of the esophagus and the occurrence of pain when eating and drinking are observed. Patients complain of a general deterioration in well-being, fever, retrosternal pain. Additionally, symptoms include heartburn, excessive salivation, impaired swallowing.

Common symptoms in adults:

• constant heartburn from almost all products,
• feeling of heaviness in the stomach,
• feeling of fullness
• overeating,
• feeling of a lump in the throat
• constant obsessive eructation of air or sour.

In addition, there is pain in the chest area, which is often perceived as cardiac. Sometimes these symptoms are completely absent, but there is a violation of the swallowing process.

Reflux esophagitis can be completely hidden, and can annoy the patient with many clinical manifestations. In this case, its symptoms are divided into:

• esophageal;
• extraesophageal.

In addition to the listed symptoms of reflux esophagitis, the patient may show signs of damage to the bronchi, lungs, vocal cords and trachea. Acid reflux can enter the respiratory tract and cause inflammation of these organs. As a result, a person can be treated for a long time and unsuccessfully for chronic bronchitis, asthma, recurrent pneumonia, etc.

Degrees

Symptoms of GERD () - their severity and impact on the general condition of the patient - directly depend on the degree of damage to the esophageal mucosa.

The disease goes through several stages, depending on which its manifestations change:

• 1 stage. The formation of separate small-sized erosions, as well as erytherms, localized in the distal esophagus.
• 2 stage. Erosions gradually increase and merge with each other, but do not cover the entire surface of the esophageal mucosa.
• 3 stage. The spread of erosion to the lower third of the esophagus, which leads to a complete lesion of the mucosa.
• 4 stage. It is characterized by chronic peptic ulcer and stenosis.

Diagnostics

In the presence of the above symptoms, the patient must certainly be examined, since the severity of clinical manifestations does not always correspond to the severity of mucosal damage. Therefore, even banal heartburn can be a formidable symptom.

To make an accurate diagnosis and determine the degree of damage to the mucous membrane, the patient is prescribed:

• X-ray diagnostics with contrast agents - this is necessary to detect ulcers, narrowing, inflammatory changes in the esophagus and assess its patency;
• Daily pH-metry, which allows you to study the esophagus throughout the day to identify the total time of manifestation of symptoms of reflux esophagitis and the maximum duration of the episode.
• Fibrogastroduadenoscopy - FGDS - one of the most informative methods, allows the specialist to see and assess the condition of the esophageal mucosa and the presence of erosion, inflammation and other changes.
• Esophagomanometry, a special catheter is inserted, which measures the pressure in the lumen of the esophagus, with reflux, the pressure is reduced.
• Acid perfusion test - Bernstein test for early detection of reflux esophagitis in children using a duodenal probe.

Treatment of reflux esophagitis

How to treat reflux esophagitis? The treatment regimen for reflux disease includes a complex effect aimed at eliminating its cause and symptoms. For a complete cure, long-term adherence to all points of the treatment regimen is necessary:

• lifestyle modification;
• drug treatment;
• surgery.

Lifestyle Correction

To prevent recurrence of the disease and alleviate the condition of the patient should:

• get rid of excess weight,
• observe the regime of work and rest,
• stop smoking,
• the use of alcohol or any psychoactive substances,
• avoid increased physical and neuropsychic stress
• adjust the intake of drugs that aggravate the manifestation of the disease.

You can independently alleviate the manifestations of reflux esophagitis and reduce the frequency of relapses (exacerbations) by performing the following manipulations:

• Sleep on a bed with a raised head end (10-15 cm);
• Do not wear tight clothing, belts, belts;
• Quit smoking, alcohol consumption;
• Get rid of excess weight;
• After eating, avoid physical activity, in particular bending over;
• Avoid drinking plenty of fluids;
• Avoid medications that cause reflux.
• Follow the right diet.

Medical treatment

For the treatment of reflux esophagitis, various groups of drugs can be used, but one of them is prescribed to almost all patients - these are proton pump inhibitors (abbreviated as PPIs). These drugs effectively reduce the acidity of gastric juice. Influencing the cells that produce hydrochloric acid, they reduce its concentration. Due to this effect, reflux of gastric contents damages the mucous membrane less.

Drug therapy for reflux esophagitis is carried out for at least 8-12 weeks, followed by maintenance therapy for 6-12 months.

Tablets used to treat reflux esophagitis:

1. Blockers of histamine H2 receptors (antisecretory drugs), with the help of which the flow of hydrochloric acid into the lumen of the stomach is reduced ("Ranitidine", "Fatomodin", "Omez"). "Ranitidine" is prescribed for adults and children under 12 years old 2 times a day, 150 mg. Treatment is carried out for 4 to 8 weeks.
2. Antacids that protect the gastric mucosa from hydrochloric acid:, almagel,.
3. Prokinetics increase pressure in the lower esophageal sphincter and reduce intragastric pressure. The following drugs increase the tone of the lower esophageal sphincter: motilium, genaton, motilak. Motilak, 10 mg: adults 20 mg 3-4 times a day, children over 5 years old, 2.5 mg / kg body weight, three times a day;

If symptoms of reflux esophagitis are detected, drug treatment is recommended to be carried out very carefully so as not to further irritate the esophageal mucosa.

Operation

In the absence of the effect of drug therapy, surgical treatment is indicated, the essence of which is to restore normal anatomical relationships in the esophagus and stomach.

Benefits of endoscopic surgery for complications of reflux esophagitis:

• invisible postoperative scars;
• minor blood loss;
• minimum postoperative pain;
• high accuracy of diagnostics and treatment;
• high organ-preserving principle.

Indications for radical surgery are:

• preservation of symptoms and endoscopic manifestations of esophagitis, subject to adequate drug treatment for six months;
• development of complications (repeated bleeding, narrowing, etc.);
• Barrett's esophagus with established severe dysplasia;
• frequent pneumonia developing due to aspiration of gastric acid contents;
• a combination of reflux esophagitis with bronchial asthma that does not respond to adequate treatment;
• patient's personal preference.

Diet

A diet for reflux esophagitis excludes all foods that can increase the acidity of the stomach and cause bloating. The diet of a patient with esophagitis is 4-5 times a day, in small portions. Evening intake should be no later than 2-4 hours before bedtime.

If reflux esophagitis is detected, the patient is recommended reduce consumption dairy and other products that cause bloating:

• fresh or sauerkraut;
• black bread;
• green peas;
• beans;
• mushrooms;
• fresh berries, fruits;
• carbonated drinks.

If discomfort occurs after eating, you need to pay attention to what foods were eaten and, accordingly, exclude them from the diet.

A diet for reflux esophagitis should include the following foods:

• Fat-free mashed cottage cheese
• Milk and sour cream with a low percentage of fat
• Fresh eggs (chicken or quail), soft-boiled
• Crackers
• All kinds of cereals
• Steam cutlets (preferably veal)
• Baked sweet apples
• baked vegetables
• Boiled and baked fish.

During the diet, you must adhere to the following recommendations:

1. Food can be diversified with products, after the use of which there is no discomfort.
2. Do not eat too cold or hot food, as this irritates the esophagus.
3. eliminate nervous overload at work, get enough sleep,
4. In addition, you need to pay attention to the diet. Eat 4-5 times a day (eat slowly, avoid rushing),
5. after a meal, it is recommended to walk or work while standing (you can not sit).

Folk remedies

There are many ways to treat reflux esophagitis even with folk remedies, but before using them, it is better to consult a doctor.

1. Take a tablespoon of oregano, calendula, calamus rhizomes, anise fruits, fireweed, white yasnitka, mint. Chop the ingredients. The broth is prepared, as in the previous recipe, but first insist and then boil. Drink the medicine 50 ml up to 6 times a day;
2. It is necessary to pour boiling water over 3 tbsp. tablespoons of flax seeds and wait 3 hours, strain, use 2 tbsp. spoons in 20 minutes. before eating. This jelly envelops the mucous membrane.
3. A good folk remedy for chronic reflux esophagitis. Medicinal mixture of herbs and juice from celery roots. In the treatment of reflux disease of the stomach, the juice of dandelion flowers with sugar for months will help. Drink 1 tbsp. a spoonful of juice from celery roots 30 minutes before a meal.
4. Papaya contains a special enzyme that helps treat reflux esophagitis naturally and effectively. Just consume this wonderful fruit every day. Additionally, you can use other folk remedies to combat this disease of the esophagus.
5. You can treat the disease with the help of a collection based on the root of marshmallow and linden. The collection also includes yarrow, licorice root, common chandra grass, common centaury grass, couch grass rhizome and St. John's wort. Pour a tablespoon of the mixture with a glass of boiling water and cover with a lid. Take the medicine twice a day for half a glass.

Forecast

Reflux esophagitis has, as a rule, a favorable prognosis for working capacity and life. If there are no complications, then it does not reduce its duration. But with inadequate treatment and non-compliance with the recommendations given by doctors, new relapses of esophagitis and its progression are possible.

Possible complications:

• the formation of Barrett's disease;
• a high risk of developing a malignant tumor;
• infringement and development of esophageal ulcers.

Attentive attitude to your health will help to avoid the dangerous consequences and complications of reflux esophagitis. It is not recommended to try to treat this disease on your own, its complications can be very serious.

This is all reflux esophagitis (reflux disease) in adults: what is it, what are the main causes, symptoms and signs, treatment features. Be healthy!

One of the most common diseases of the esophagus today is reflux esophagitis. Often it can be asymptomatic, so people do not even realize that they develop a pathology that is dangerous for normal digestion. Others feel pain and burning in the stomach due to this disease, their quality of life is significantly reduced. In our article, we will talk in detail about the causes of reflux esophagitis, its symptoms and treatment methods in adults and children.

Reflux esophagitis is an irritation of the esophageal mucosa that occurs as a result of exposure to the acidic contents of the stomach.

That is, the main reason due to which the disease can occur is a violation of the muscle tone of the lower part of the esophageal sphincter. Due to the fact that it is constantly in a slightly open state, its contents can easily enter the esophagus from the stomach. Now let's see what can cause such violations:

• Previous abdominal surgery
• Hernia of the esophagus
• stomach ulcer
• Duodenal ulcer
• Pylorospasm
• Pyloroduodenal stenosis
• scleroderma
• May cause reflux esophagitis and banal gastritis

The risk group for reflux esophagitis includes people who:

• Abuse alcohol and smoke a lot
• Drinking too much coffee per day
• suffer from obesity
• Taking medications that adversely affect the digestive system
• Are in a state of depression or a nervous breakdown

Pregnant women and even infants can experience esophagitis reflux.

Reflux esophagitis: symptoms

Reflux esophagitis manifests itself in an adult in this way:

1. The patient feels severe heartburn (this symptom occurs in 83% of cases). Increases after eating and sharp tilts of the body forward.
2. There is an eructation immediately after eating or a glass of carbonated water.
3. After exercise, regurgitation of food may occur. This is more typical for young children, but this symptom also occurs in adults.
4. The swallowing reflex may be impaired. The patient feels as if he has a lump in his throat.
5. In the region of the diaphragm, severe pain is felt, which intensifies after physical exertion.

Types of reflux esophagitis

Depending on how the inflammatory process proceeds in the esophagus, there are such types of esophagitis reflux:

1. catarrhal or edematous- These are the most common types in which the mucous membrane of the esophagus becomes covered with red spots and swells.
2. erosive- a type of esophagitis reflux, in which ulcers appear on the esophageal mucosa, increasing in size due to infection. This type occurs due to viral diseases of the nasopharynx or thermal burns of the esophagus.
3. Pseudomembranous or exfoliative - a type in which the inflammatory process extends not only to the mucosa of the esophagus, but also to other organs of the digestive tract.
4. Hemorrhagic - develops as a side effect of an infectious disease.

1. Necrotic - occurs due to scarlet fever, typhoid, measles and candidiasis, which can provoke the formation of deep ulcers in the esophagus.
2. Phlegmonous - develops due to the entry of a foreign body into the esophagus. Purulent inflammation occurs.
3. Alimentary - the type that occurs if you abuse the intake of too hot food or drinks.
4. Professional - occurs in people working in industrial enterprises. Chemical acids and heavy metals negatively affect the mucous membrane of the esophagus when inhaled.
5. stagnant - It is formed if food remains are on the walls of the esophagus for a long period of time.
6. Allergic - occurs due to exacerbation of food allergies.

Forms of reflux esophagitis

Reflux esophagitis can occur in two forms:

1. acute, which is characterized by a short-term negative effect of a factor irritating the mucous membrane of the esophagus, namely:

• Food or chemical burn
• food allergies

1. Chronic reflux esophagitis acquires if the mucosa of the esophagus is constantly negatively affected by the above factors. With this form reflux esophagitis worsens and can greatly impair the quality of human life.

Stages of reflux esophagitis

Doctors distinguish 4 degrees of reflux esophagitis:

• First– only 5 mm of the mucosal fold of the esophagus is affected
• Second- more than 5 mm of the mucosal fold of the esophagus is affected
• Third- 75% of the circumference of the esophagus is affected
• Fourth- the entire esophagus is affected

Diagnosis of reflux esophagitis

If there are any symptoms of esophagitis, it is recommended to visit the gastroenterologist's office, which, after examining the oral cavity (the tongue should be covered with a white coating) and palpation of the abdominal cavity, will refer the patient to such instrumental examinations:

• Fibroesophagogastroduodenoscopy- a procedure in which the patient needs to swallow a special probe. It is practically painless, but unpleasant. However, it should be noted that a person does not feel discomfort in the esophagus for a long time. The patient can feel pain only if the doctor deems it necessary to take a biopsy of the esophageal mucosa. This procedure also helps to determine the level of acidity in this organ.

• X-ray with contrast- the patient needs to drink a glass of white barium mixture before the chest and abdomen X-ray, which is very clearly visible on the image.
• Esophagomanometry - a procedure in which a doctor uses special catheters to measure pressure in the lower esophageal sphincter.
• Electrocardiogram - the necessary procedure that will exclude or confirm the presence of heart disease in the patient.

Based on the data obtained, the gastroenterologist will prescribe an effective course of treatment for the patient. We will describe each of the existing methods of treatment in more detail below.

Reflux esophagitis: treatment

The treatment process for reflux esophagitis is lengthy. A patient diagnosed with such a pathology needs to be prepared to take medications, physiotherapy and follow a strict diet.

Diet for reflux esophagitis

The very first thing a patient should do reflux esophagitis – change your diet and daily routine. You have to follow a special diet. Compose menu for reflux esophagitis necessary, considering the following rules:

1. The usual portion should be halved
2. You need to eat at least 5 times a day
3. Under no circumstances should you eat:

• Tomatoes
• Cabbage
• eggplant
• Garlic
• Oranges and lemons
• Chocolate products
• Smoked meats and canned food
• Alcoholic drinks
• muffin
• Meat broths
• Semi-finished products
• Pasta
• Barley porridge
• Fatty dairy products

1. All of the above products must be replaced with:

• Vegetarian soups
• Potato
• Carrot
• cucumbers
• beets
• Bananas
• Pears
• Buckwheat
• oatmeal

1. Do not eat hot or cold food
2. Dinner should be 4 hours before going to bed

How to treat reflux esophagitis with medication?

To speed up the healing process reflux esophagitis the doctor prescribes such drugs:

• Actovegin
• Liquiriton
• Sucralfate
• Almagel
• Tricardin
• Solcoseryl
• Drotaverine
• Omeprazole
• famotidine
• Motilium

In the case when taking pharmaceutical drugs is useless (this can happen when bleeding has opened in the esophagus, it has narrowed), the gastroenterologist conducts reflux esophagitis surgery.

Reflux esophagitis: treatment with folk remedies

In some cases, the gastroenterologist may recommend to the patient, in addition to medications, folk recipes for reflux esophagitis:

1. Brew herbal preparations:

• From lemon balm, chamomile, flax and motherwort
• From calamus, anise, oregano, mint and calendula
• From knotweed, plantain, shepherd's purse, yarrow and dandelion

1. Drink potato juice on an empty stomach and eat it with sugar
2. Drink charcoal solution
3. Chew fresh cabbage, raspberry and blackberry leaves
4. Take dill tincture several times a day
5. There is a mixture of Jerusalem artichoke and apple

According to reviews for reflux esophagitis alternative medicine can be very effective.

Complications of reflux esophagitis

If you neglect the treatment of reflux esophagitis, then life-threatening complications may occur:

1. An open ulcer is formed, accompanied by bleeding.
2. The lumen of the esophagus narrows, because of which a person simply cannot swallow. stenosis develops.
3. The epithelium of the esophagus may be replaced by the esophagus of the stomach. This phenomenon is called Barrett's esophagus.

Reflux esophagitis in a child

Children's reflux esophagitis is a problem that almost all new parents face, since babies have an immature esophagus.

The disease can occur for the following reasons:

• If the baby swallows a lot of air during feeding
• If the child eats too much
• If the baby was born with a congenital pathology of the esophagus

It will not be difficult for parents to guess about the development of reflux esophagitis in their crumbs, because it will manifest itself in this way:

• Baby vomits frequently
• He becomes moody and whiny
• The child is not growing well
• After eating, he begins to hurt in the diaphragm
• Baby has bad breath

With such symptoms, the pediatrician prescribes a special anti-reflux mixture to the child, taking special drugs and recommends doing the following:

• Feed your baby often and little
• Eat dinner 3 hours before bed
• Wear loose outerwear
• Rest for a few hours after eating

If you are attentive to your health and seek qualified help in a timely manner, you can avoid the unpleasant consequences that reflux esophagitis can lead to. Lead a healthy lifestyle, eat right, do not abuse bad habits. These simple rules are the key to good health and a high quality of life!

Video: "Reflux esophagitis"

At the present time, there are active discussions between scientists from different countries about the described disease. The thing is that, on the one hand, this disease is considered as an independent pathology, and on the other hand, as a complication or one of the forms of the course.

This is a disease of the esophagus, which has a chronic course and is manifested by degenerative changes in the wall of this organ in the form of erosive lesions.

So why do many doctors tend to believe that this is not an independent nosology, but a form of manifestation of GERD. This is explained by the fact that the most common cause of the disease is the reflux of acidic contents from the stomach cavity into the esophagus.

And this is directly related to reflux pathology. In addition, both of these concepts usually accompany each other.

Causes of the disease

The very first group of causes includes those that directly cause gastroesophageal reflux. These include:

1. Conditions under which the closing work of the muscular apparatus of the sphincter between the esophagus and stomach is damaged. As a rule, this is a pathological breakdown at the level of the nervous and hormonal systems. These conditions are:

• dysregulation of the central nervous system, with various injuries, bruises, poisoning with poisons and chemicals;
• hormonal imbalance, pathological changes in the endocrine system;
• muscle ataxia, paralysis, paresis of sphincters, including the esophageal.

As a result of these pathologies, the sequence of passage of food through the gastric tract is disrupted. Due to incomplete closure of the sphincter valves, the contents of the stomach flow back into the esophagus and cause a destructive effect on its wall.

2. Intermittent failure of the sphincter. Violation of its work is not systematic, regular, but occurs under certain conditions. These conditions are:

• irrational food intake, periods of fasting are replaced by periods of overeating;
• the use of hard foods in the diet that can injure the internal membranes of organs;
• drinking plenty of fluids in a short period of time.

3. "Non-reflux" causes. Among them, changes from other digestive organs are most often distinguished:

• mechanical defects or formations in the stomach cavity: stenosis, postoperative scars, tumors, polyps, diverticula, hernial protrusions, malformations.
• bad habits: smoking, drinking alcohol or psychotropic substances;
• eating raw fish or raw meat;
• thermally poorly processed food;
• prolonged fasting;
• prolonged stressful situations, shocks, depressions;
• taking certain drugs: antibiotics, NSAIDs, hormones and others;
• other concomitant chronic diseases: oncological processes, hepatitis, chronic pancreatitis, cholecystitis, food poisoning.

The disease is classified into stages depending on the spread of the erosive process:

1. Stage I - single shallow erosion without signs of confluence and complications.
2. Stage II - erosive lesions with a tendency to unite and merge. At the bottom of the erosions, full-blooded vessels are visible, their edges are edematous, swelling.
3. Stage III - extensive damage by erosive elements, up to ulcerative defects, with signs of complications in the form of bleeding, perforation, malignancy.

According to the severity are distinguished:

• Mild degree - mild symptoms and clinical manifestations. The patient practically does not complain.
• Medium degree - the general condition suffers moderately, performance is impaired, the patient is concerned about the main complaints.
• Severe degree - a pronounced violation of the organ, poor general condition of the patient, painful symptoms, damage to other organs and systems, the presence of complications in the form of bleeding, perforation, perforation.

How to identify a disease

You can't do it without the help of a qualified specialist. The doctor must collect all the necessary information about complaints, detail them and prescribe the necessary medical examination methods.

• The most informative way to learn about pathology is to conduct an endoscopic examination -. It will reveal the presence of erosions, their characteristics, complications or their absence. In addition, the degree and extent of the lesion is assessed. The endoscopist describes the visual picture, and the doctor, taking into account all complaints and examinations, makes a diagnosis.
• If necessary, resort to the method of pH-metry. This must be done to assess the acid-base composition of the esophagus and to prevent aggressive effects on its wall by an acidic environment.
• To exclude other diseases or to confirm concomitant diseases that could cause esophagitis, an ultrasound examination of the abdominal organs is prescribed.
• X-ray diagnostics of the esophagus with a contrast agent. Deep erosions can be visualized by this method.
• The use of high technologies - computed tomography and magnetic resonance imaging. With the help of these studies, it is possible to examine in a volumetric version the wall of the organ and its damage.

Symptoms and treatment of erosive reflux esophagitis

The symptoms of the disease are somewhat similar to those of gastroesophageal reflux disease, they are varied and can manifest in different combinations. But some signs have their own significant difference, which helps to identify this form of the disease.

• Pain and discomfort in the upper abdomen. Patients may report chest pain. Sometimes such signs can be masked as diseases of the heart, lungs, mediastinum.
• A very characteristic sign is the sensation of the passage and movement of food through the esophagus and stomach. Due to the fact that the erosion surface contains a large number of pain and sensory receptors, this phenomenon occurs.
• Difficulty swallowing food bolus. The process occurs in severe forms with damage to the uppermost parts of the esophagus.
• Heartburn. The symptom in this disease is more pronounced and painful than in GERD. It is permanent, regardless of what the patient ate when it was. Heartburn attacks can occur even at night. Any physical labor exacerbates the course of the symptom.
• The taste of blood in the mouth. A very important distinguishing feature. Appears with bleeding erosions. It is a formidable symptom, after which you should definitely consult a doctor.
• Belching of gas or undigested food. Among other things, there may be an eructation of acidic contents mixed with bile or hydrochloric acid.
• Indomitable hiccup. Usually, few people pay attention to this symptom. However, do not forget about it. With the described pathology, this phenomenon may be the only sign of the disease.
• Increased production of salivary glands. A person notices an increase in the amount of saliva in the oral cavity.
• Sensation of a lump in the throat. This symptom may masquerade as a sore throat.
• Dry cough.
• Decrease in the timbre of the voice.

If you notice one of these symptoms in yourself, you do not need to immediately become sure that you have esophagitis. Only a set of signs and a complete diagnostic examination by a doctor will give you reliable information about your health.

Treatment of the disease

When treating this type of esophagitis, it is important to take into account that the pathologies that contributed to its formation should also be treated. Usually therapy is carried out on an outpatient basis.

In the hospital, severe forms requiring surgical interventions are treated. When prescribing treatment, the doctor must comply with the following criteria:

• therapy should be complex;
• complete;
• correspond to the state, severity and course of the disease;
• there should be a minimum number of side effects;
• aimed at recovery, prevention of complications.

First of all, it is important for the patient to explain that he should change his lifestyle and nutrition in a more correct direction.

The regime of the day, rational nutrition, protective regime of work and rest must be observed. It's important to watch your weight. If there are excess kilograms, you need to gradually get rid of them.

If, on the contrary, the weight is not enough, it must be reached with a balanced diet to the norm. Clothing should be comfortable, loose, and pinching in the abdominal cavity should be avoided. Tight clothing should not be worn.

After eating for 40 minutes, be in a sitting or standing position, do not engage in physical activity during this time. Daily walks in nature should be included in the daily routine.

The diet should be balanced, rich in easily digestible components, correspond to the energy and plastic costs of the body.

We exclude from the diet alcohol, tobacco, bad habits, spicy, fried, raw meat, canned food, chocolate, coffee, soda, concentrated juices.

We add cereals, sour-milk products, boiled, steamed dishes, fish, chicken breast, fresh vegetables, fruits, except citrus fruits, compote, jelly, tea to the diet.

Meals should be divided into 6 time intervals in small portions. The last dose should be 2 hours before bedtime. When expressed, you need to sleep with a raised head end.

Medical therapy

antacid group. The drugs neutralize the acidic contents in the esophagus, reduce the risk of damage to the mucosa, prevent the appearance of new erosions, and promote the healing of the old ones. Most often prescribed maalox, phosphalugel.

Antisecretory drugs. Here the choice is between proton pump inhibitors and H-histamine receptor blockers. Blockers include omeprazole, emanera, lansoprazole and others.

Therapy is carried out for a long time. The course is at least three months. They help reduce acidity. Contribute to the prevention of complications and relapses.

The main group are prokinetics. They have an anti-reflective effect. Cerucal, metoclopramide, domperidone can be used.

They operate at the central level. Eliminate heartburn, nausea, vomiting, bitterness in the mouth. A group of drugs is especially effective when combined with gastroesophageal reflux disease.

In addition, if there are other pathologies from the gastrointestinal tract, it is necessary to treat them as well. Enzymes can be prescribed: mezim, pancreatin; probiotics: linex, normobact, adsorbents: activated carbon, hepatoprotectors: phosphaglyph and others.

Surgical treatment is indicated for severe forms and the course of the disease with complications.

Treatment with folk remedies

Patients do not always believe in the healing effect of medicinal herbs. However, when combined with drug therapy, herbs prove to be a very important helper. They enhance the effect of medicines and have their own therapeutic properties.

From this pathology, decoctions of chamomile and dill have an effect.

Ordinary pharmacy chamomile is very good. You can buy ready-made packaged fees or use the loose option. In any case, it is necessary to fill the phytocollection with hot boiled water, let it brew for two hours.

Drink 250 ml daily for at least two weeks. This simple recipe will help relieve pain and heal erosions.

Dill solution is prepared in a similar way. It is best to brew dry.

Sea buckthorn, nettle leaves, aloe, propolis have healing properties.

Many sources describe the healing effect of celery, or rather its juice. Freshly squeezed juice drink 1 tablespoon before meals.

At home, you can independently prepare a collection of chamomile, mint, lemon balm and flax seeds. In equal proportions, tea is brewed from these herbs. Insist in a teapot or thermos and use before going to bed.

Potato juice is effective in mild pathology. The potatoes are thoroughly washed, peeled, rubbed on a grater, squeezed and filtered through cheesecloth. If you get a thick consistency, you can dilute a little with boiled water. Take 1 tablespoon 3 times a day.

Erosive reflux esophagitis, also called peptic, distal or "", is an inflammatory disease of the mucous membrane of the distal esophagus.

The disease develops as a result of periodic reflux of the secret of the stomach or pancreas into the lower esophagus. The acids contained in the gastric juice adversely affect the mucous membrane of the esophageal tube.

Initially, hyperemia of the epithelium appears, but with further exposure of the secretion of the stomach to the mucosa erosions, ulcers, and after - scars are formed. These are single or multiple ulcerations and scarring.

The most common is distal erosive reflux esophagitis: what is it? This is a form of the disease in which erosion on the mucous membrane of the esophagus occurs in the distal, that is, the lowest part of it, close to the stomach.

The disease develops due to dysfunction of the sphincter of the lower esophagus.

If the muscle ring does not close tightly, then favorable conditions are created for the ingress (reverse reflux) of the secret of the stomach into the distal esophageal tube.

Patients should not expose the body to excessive physical exertion, do not wear tight clothing, especially in the abdominal area.

If a patient has a confirmed mucosal change that has a high risk of degeneration into cancer, then if heartburn occurs, they urgently need to contact their doctor.

In the presence of "Barrett's esophagus" it is necessary to conduct an endoscopic examination with obligatory sampling of material for histology once a year, and according to indications - even more often.

Summing up

A successful outcome of the disease depends on the timely start of therapy, as well as on how conscientiously the patient will follow the doctor's recommendations regarding diet, work and rest. In case of any undesirable manifestations, it is necessary to consult a specialist.

With reflux esophagitis, there is a pathological ejection of stomach contents into the esophagus. Erosive reflux esophagitis occurs due to chronic irritation of the esophagus with acid: ulcers and erosion appear on the mucous membranes. Reflux esophagitis is characterized by severe pain. Consider the features of the course of reflux esophagitis, the symptoms and treatment of this disease.

Causes

The main reason for this disease is that acidic contents enter from the stomach into the esophagus. This happens because the esophageal sphincter is in a relaxed state (which should not be normal).

In a healthy organ, the sphincter relaxes for only a few minutes to allow food to pass into the stomach. Further, it contracts, which prevents acid from getting back from the stomach.

Reflux esophagitis occurs in humans with such pathologies of the gastrointestinal tract:

• an ulcer in the stomach (it may appear due to excessive activity of the Helicobacter bacterium);
• cancerous tumors of the stomach;
• pathological conditions of the vagus nerve;
• pathology of the lumen of the duodenum;
• chronic inflammatory disease of the pancreas;
• prolonged inflammatory process in the gallbladder;
  pylorospasm;
• hernia of the esophagus.

Sometimes the reflux of the contents of the stomach into the esophagus occurs after surgical interventions on the stomach. Erosive esophagitis sometimes occurs in those patients who abuse strong alcoholic beverages, smoke a lot, drink excessive amounts of coffee.

In some people, part of the stomach may enter the chest (normally, the organ is entirely in the abdominal cavity). This anomaly occurs in obese individuals.

Pathogenesis

The human esophagus consists of mucous, muscular and external tissues. On the mucous membrane there are several folds that facilitate the process of getting food into the stomach. The muscular layer in the esophagus is necessary to facilitate this process. They form two sphincters, with the lower one located on the border between the two organs. They serve to prevent food from entering the esophagus from the stomach. It can only open when swallowed.

Normally, a person may have several dozen physiological reflux of food into the esophagus. But signs of pathology are not observed. And only when the sphincter system is disrupted, a person may experience symptoms of reflux esophagitis.

The appearance of esophagitis, reflux esophagitis is also associated with impaired functioning of the protective functions of the esophagus. Such conditions are most often created with poor nutrition, mechanical irritations, etc. I must say that a significant part of patients do not know what it is - reflux esophagitis, and do not pay enough attention to the normal process of chewing food. Frequent injuries of the mucosa and lead to disruption of the esophageal sphincter and the development of gastric diseases.

The erosive form is a complicated type of reflux esophagitis. In this case, small sores appear on the mucous membrane of the organ - erosion. Symptoms of reflux become pronounced, bring the patient some discomfort. Due to erosion, the pain increases significantly after eating, consuming Acetylsalicylic acid.

Stages and symptoms

This disease is characterized by several stages.

1. At the first stage, separate erosions form on the mucosa, which do not merge and do not capture a significant part of the esophagus.
2. The second stage is called confluent, because small ulcers and erosion areas become larger and larger. At the same time, they capture a small part of the esophagus.
3. In the third stage, the lower third of the organ is affected.
4. At the fourth stage of the disease, stenosis of the esophagus, a chronic ulcer is observed.

Note! Often in the third or fourth stage of the disease, the patient is recommended surgery. It is associated with certain risks and complications.

To prevent this from happening, you need to contact a specialist immediately after the appearance of unpleasant symptoms of diseases of the abdominal organs. It is especially difficult to treat advanced ulcerative esophagitis.

When esophagitis occurs in adults, there may be discomfort that occurs in the chest cavity. They give to the region of the heart and shoulder. Often, patients may not associate the appearance of such pain with the esophagus and take (most often uncontrolled) heart medications. Naturally, they do not give any result.

Reflux esophagitis has many manifestations. The most characteristic of them are:

• belching (it can be either air or stomach contents);
• painful heartburn;
• nausea turning into vomiting;

• frequent regurgitation (it often happens in children);
• acid taste in the mouth;
• dysphagia (in this case, the patient feels difficulty in the normal swallowing of food);
• a cough that lasts for a long time at night (it occurs due to the so-called microaspiration of small particles of food from the esophagus into the upper respiratory tract);
• damage to the teeth by caries due to the ingress of acid into the oral cavity;
• hiccups.

Important! Without treatment, esophagitis can last for years. His symptoms may get worse. This inevitably leads to the formation of scars on the mucosa of the esophagus.

All manifestations of reflux esophagitis increase significantly after a person lies down. In a standing or sitting position, pain, heartburn or hiccups almost do not bother.

Sometimes the patient may feel signs of pharyngitis, nasal congestion. These signs appear because the acidic contents of the stomach irritate the throat, which makes the patient tickle in the throat.

Features of diagnostics

If a patient is suspected of reflux esophagitis, his treatment is possible only after a correct diagnosis. Diagnosis occupies an important place, because it depends on how to further treat reflux esophagitis, what medications to prescribe to the patient.

Diagnostics consists of the following measures:

1. Interview with the patient. When collecting an anamnesis, the doctor identifies the characteristic complaints of the patient, the duration of the symptoms and the degree of their severity.
2. Examination of the oral cavity. The presence of affected teeth, inflammation of the mucous membranes suggests that the patient may develop reflux.
3. Palpation.
4. FEGDS is the main diagnostic method, on which further treatment will depend. In this case, a thin fiber optic probe is inserted through the patient's mouth. The state of the gastric and esophageal mucous membranes is being studied. Using the latest computer technology, the image is displayed on the screen. With reflux esophagitis, the mucosa is hyperemic and colored in red shades.
5. Radiography is performed using a special contrast agent (barium sulfate). Suspension does not have a pronounced taste, non-toxic to humans. With the pathology under consideration, the movement of barium suspension into the esophagus will be visible.
6. Examination of the acid index of the esophagus. In pathology, it will be reduced, since the penetration of gastric juice into the esophagus "acidifies" its membranes.
7. Esophagomanometry evaluates the normal contractile activity of the lower sphincter. This method clarifies the diagnosis.
8. The cardiogram is carried out for the purpose of differential diagnosis.
9. X-ray of the chest organs is performed to exclude pathologies of the lungs.

Remember that esophagitis can be cured when this disease is most accurately determined.

What is dangerous esophagitis

Do not assume that reflux esophagitis refers to "harmless" and "safe" pathologies. If left untreated, a person may develop the following dangerous diseases:

1. The appearance of ulcers on the esophageal mucosa may be in a patient if he suffers from the disease for a long time. For the treatment of hemorrhages, an endoscopic operation is used, which consists in the fact that with the help of a mini-electrocoagulator, cauterization of the vessel is done.
2. Esophageal stenosis develops in humans due to a chronic inflammatory process on its mucosa. The patient complains of pain during swallowing and the sensation of a lump in the throat. For treatment, a rather complicated surgical operation is performed.
3. Barrett's syndrome is a dangerous risk of developing a malignant neoplasm.

The sooner the patient sees a doctor for the treatment of reflux esophagitis, the easier his treatment will be.

Nutrition and lifestyle

For the treatment of such a disease, diet is very important. Practice shows that drugs to reduce the acidity of gastric juice and other pills will not be effective if the patient eats junk food. It will not bring a healing effect.

Can reflux esophagitis be cured with the right diet? In some cases, it is possible to cure esophagitis forever if you adhere to proper nutrition and take medications prescribed by your doctor.

The way of life of a patient with chronic reflux esophagitis should be like this.

1. It is necessary to completely eliminate all nervous overload.
2. Get enough sleep (at least 8 hours). Moreover, it is necessary to ensure that the head is slightly higher than the body. At the same time, the number of refluxes at night can be significantly reduced.
3. Five meals a day are necessary: ​​it will eliminate long breaks in eating and overeating.
4. In the treatment of erosive reflux esophagitis, it is very important not to lie down after eating. Again, avoiding overeating will not make the patient want to take a nap after dinner. But walking in such cases is useful.
5. To prevent the causes of reflux esophagitis, you do not need to wear tight clothing and belts.
6. It is forbidden to lift weights, because this increases the symptoms of reflux esophagitis.
7. It is necessary to exclude the use of drugs that cause relaxation of the esophageal sphincter.

The following foods and drinks are prohibited:

• alcohol;
• soda;
• coffee, black tea;
• chocolate products;
• seasonings;
• legumes;
• marinades, pickles, smoked products, canned foods;
• fatty food;
• sour juices;
• Rye bread;
• shop sauces, including mayonnaise;
• all snacks and fast food;
• chewing gum;
• all fried foods.

For a patient with reflux esophagitis, the following therapeutic diet is useful:

• sour cream and low-fat milk;
• soft-boiled eggs;
• cottage cheese (preferably low-fat);
• dried bread;
• cereals;
• steamed dishes;
• salads and vegetable stews;
• lean fish, meat.

Note! A diet with this pathology should be followed throughout life. This is the only way to prevent relapses and complications.

Of course, with chronic reflux esophagitis, nutrition is not limited to the above meals alone. There is a large amount of nutritious and tasty food that does not cause an exacerbation of the disease.

Treatment

How can reflux esophagitis be treated with medication?

First of all, we note that people, not knowing why there are exacerbations of reflux esophagitis and what it is, try to choose the “most suitable” medicine for themselves in the pharmacy. This is absolutely impossible to do, because this can only worsen the state of health. Only a doctor can choose a drug. Treatment of reflux esophagitis should not occur on its own.

The causes and treatment of this disease are interrelated: the doctor selects the right medicine only after finding out all the factors that led to it. As a rule, such drugs are prescribed:

1. Prokinetic drugs are needed to improve the tone of the lower esophageal sphincter. This is Motilium, Ganaton.
2. Antacids are needed to effectively reduce the acidity of gastric juice. Among them, many doctors pay attention to Almagel - he effectively fights the manifestations of hyperacidity of gastric juice.
3. Antisecretory agents are represented by hydrogen pump inhibitors (omeprazole or famotidine).

If the patient has symptoms of reflux esophagitis, treatment may continue for up to 6 weeks. It all depends on the severity and stage at which the disease is diagnosed.

Folk methods

How to cure reflux with unofficial remedies? Informal medicine knows many effective ways to treat the disease in question. Before treating reflux esophagitis, you need to contact a therapist: he will help you choose the most effective method for getting rid of the disease.

Consider some ways to treat the manifestations of reflux esophagitis in non-drug ways.

Reduces the intensity of inflammatory phenomena medicinal mixture of chamomile, flax, dog nettle, lemon balm leaf, licorice. To prepare a decoction, you need to take 2 tbsp. l. plants and brew in boiling water, evaporate in a water bath for 10 minutes. Drink a third of a glass, 4 times a day.

A mixture of calamus, anise, yasnitka, oregano, mint leaves, marigolds and fireweed (2 tablespoons) should be poured with water and heated in water. Drink half a cup 6 times a day.

Highlander root, plantain leaf, shepherd's purse, dandelion flowers, chamomile, yarrow grass, oregano are mixed, steamed in water. The decoction must also be consumed the same number of times in the same quantity.

This treatment should be combined with drug therapy.

Prevention

It is much easier to prevent this disease than to treat it. It is necessary to adhere to such recommendations:

• avoid emotional stress;
• do not abuse alcoholic beverages, and even better - completely abandon them;
  no smoking;
• avoid foods that irritate the esophageal mucosa;
• eat more often and in small portions;
• avoid hypodynamia, do exercises every day, play sports;
• after eating, you do not need to lie down, but walk a little.

So, reflux esophagitis should not be taken lightly. You need to start getting rid of it as soon as possible. Self-medication is extremely dangerous, because it can lead to relapses and complications. Only early and comprehensive diagnosis, a healthy diet will help keep the esophagus in good condition.