Erosive reflux esophagitis treatment. Erosive reflux esophagitis

Reflux esophagitis is inflammation of the lining of the esophagus. It is formed due to the injection of pH from the stomach. It instantly begins to corrode the mucous membrane that protects the esophagus from an aggressive environment. In the absence of such protection, a person begins to feel pain. There are erosions, ulcers, complications.

The most common causes of reflux - esophagitis - are unhealthy diet, long-term alcohol consumption and very spicy food. With improper treatment or its absence, scars form on the walls of the esophagus. And also reflux can occur against the background of weakening of the muscles, when the valve begins to pass gastric juice.

The most common causes of esophagitis are:

• high pressure and bursting in the peritoneum;
• wrong diet;
• spicy, smoked and fatty foods;
• stress;
• chemical factors;
• obesity;
• ulcers;
• the period of bearing a child;
• excessive drinking;
• smoking.

Any of these factors can lead to an exacerbation and return of the disease. For this, even a simple tilt forward is enough.

Types of esophagitis

Classification of esophagitis is divided into 2 main forms - acute and chronic. They, in turn, are divided into:

• pseudomembranous;
• (otherwise superficial);
• necrotic;
• exfoliative;
• hydropic;
• phlegmonous (may be limited or diffuse).

Spicy esophagitis occurs in the lower esophagus, often combined with gastric diseases. Pathology occurs against the background of vitamin deficiency, gastrointestinal disorders, infections. Acute reflux causes soreness when eating or drinking liquids.

It appears as a separate disease or is formed as a complication after an acute form. Accompanied by a stable inflammation of the esophagus. Pain appears in the chest. Often the chronic form is supplemented by gastritis

Stages of development

Esophagitis develops in stages. In the first stage (A) of the disease, the affected area is 4-5 millimeters in diameter. There may be several such places on the mucosa. In this case, the affected zones do not touch.

In the second stage (B) of the disease, several defective areas expand and become more than 5 mm in diameter. At the same time, the affected areas begin to merge. Large defective areas are formed. However, they do not apply to the entire mucosa.

Her third is affected in the 3rd stage (C). The last stage - the fourth is accompanied by extensive ulcers on the mucosa. The sites of lesions occupy from 75 percent of the surface. Stenosis may be diagnosed.

Symptoms

The first signs are general malaise and fever. A person is tormented by pain behind the sternum, along the entire tube of the esophagus. An additional symptom of reflux esophagitis may be heartburn, vomiting, or.


Pathology can proceed secretly. Sometimes signs uncharacteristic for this disease join esophagitis. Each form has the same symptoms:

• lump in the throat;
• heartburn;
• burning or pain in the chest;
• nausea.

An hour and a half after eating, pain in the esophagus begins. This is already a pronounced inflammation. The symptoms are aggravated when the person lies down. Symptoms of reflux esophagitis may vary depending on the stage and type of disease:

1. Pulmonary caused by heartburn and unpleasant belching. Bronchial obstruction appears - a prolonged cough, nocturnal suffocating attacks, lack of air. This can trigger the formation of asthma.
2. cardinal accompanied by symptoms inherent in angina pectoris, due to the proximity of nerve endings. Pain always occurs after sour or spicy food, fried or fatty foods, overeating.
3. Otolaryngological, in addition to belching and heartburn, accompanied by sore throat, perspiration. Nasal congestion and discharge from it in the form of clear mucus may appear.
4. dental form is accompanied by the appearance of caries. This is facilitated by gastric juice, which corrodes tooth enamel.

Symptoms of subtypes of chronic reflux esophagitis

The hemorrhagic form is a type of acute esophagitis. It appears very rarely, against the background of severe erosive inflammation. Accompanied by bloody vomiting and chalky (tarry stool).

Note! Without timely treatment, the disease can last for years. Over time, the symptoms will intensify, and eventually irreversible changes in the mucosa occur, scars appear on it.

Diagnosis of the disease

When diagnosing esophagitis, the degree of mucosal damage and the form of the disease are determined. For this, an x-ray is used, the pictures of which clearly show whether the valve passes gastric juice. During endoscopy, the entire length of the esophagus is examined.

Before treating reflux, a scintigraphy is performed. It shows the presence or absence of abnormalities in the work of the gastrointestinal tract. A biopsy is taken for histological analysis. The pH-metry procedure determines the degree of acidity in the stomach.

Treatment

Treatment of esophagitis is always complex. The scheme includes medicines, diet, physiotherapy, exercise therapy and other methods. Initially, therapy is aimed at eliminating the causes of the disease.

General events

Treatment of gastric reflux begins with general measures aimed at correcting the quality of life. This greatly reduces muscle damage, which helps in a quick recovery:

1. Stop smoking, as nicotine increases acidity and relaxes the digestive muscles.
2. After eating food, you can’t immediately lie down, it’s better to sit quietly or go for a walk. Fast walking and running are excluded.
3. Restriction of physical activity helps to reduce the symptoms of the disease. You can not lift anything more than 3 kilograms.
4. A couple of hours before bedtime, food and alcohol are excluded.
5. It is necessary to sleep on a raised (15-20 cm) pillow.
6. Avoid wearing tight clothing.

If there are additional diseases (obesity, ulcers, etc.), you need to treat them. Otherwise, reflux esophagitis therapy will have no effect.

Medical

When making a diagnosis of reflux esophagitis, the treatment regimen is prescribed depending on the type of development of the disease:

1. To reduce the activity of AP-enzymes, "Pantoprazole", "Rabeprazole" is used.
2. After the 13th week of bearing a child, Lansoprazole is prescribed.
3. With bronchial asthma, "Omeprazole", "Esomeprazole" are indicated.
4. If liver function is impaired, any PPI (proton pump inhibitor) is used, but Rabeprazole is preferred.
5. For a quick and stable decrease in acidity, Pantoprazole or Lansoprazole is used.

If PPI therapy was ineffective, then histamine blockers are prescribed. However, they are used in large dosages, so they are used only when absolutely necessary - Nizatidine, Famotidine, Roxatidine and their analogues.

To reduce the aggressive effects of refluxes and their number, prokinetics are prescribed. They improve digestion and facilitate the passage of food. The most effective include:

• "Domperidone";
• "Cisapride";
• "Metoclopramide".

To quickly eliminate pain in the esophagus or heartburn, antacids are prescribed. They do not cure the disease, but partially alleviate the symptoms of reflux. Can be assigned:

• "Maalox";
• "Renny";
• "Gaviscon";
• "Megalac".

These drugs act quickly, retain their effect for a long time, and significantly reduce acidity. For the treatment of cardia insufficiency (incomplete closure of valves), Ranitidine, Omeprazole, Solpadein, Regidron are used. For complications, antibiotics are prescribed.

Diet Features

- one of the main directions in the treatment of esophagitis. Food can be cooked in only a few ways:

Attention! The likelihood of esophagitis increases due to malnutrition, smoking, drinking large doses of coffee, undiluted fruit juices and alcoholic beverages.

With intestinal esophagitis, the use of mayonnaise or oil in dishes is excluded, or they are added in minimal quantities. Do not use ketchups, hot sauces, horseradish and mustard for dressings. They will irritate the mucous membrane even more and increase the acidity of gastric juice. Too hot or cold food is prohibited.

When diagnosing reflux esophagitis, therapy includes strict dietary restrictions.

The menu includes vegetables and fruits, but it is not recommended to eat them raw, it is advisable to bake or stew. You need to eat every three hours, in small portions. The last dinner should be 4 hours before bedtime.

Physiotherapy

GERD can be treated with physical therapy. It is prescribed for severe symptoms, pain syndrome. Types of physiotherapy procedures for esophagitis:

• TCEA (transcranial electroanalgesia);
• aerotherapy;
• electrosleep therapy;
• electrophoresis with antispasmodics;
• baths with sodium chloride;
• galvanization;
• interference therapy;
• UHF (ultra high frequency inductothermy);
• cryotherapy in the epigastric region;
• magneto and laser therapy;
• coniferous and iodine baths;
• galvanization of the brain of the head.

Physiotherapy depends on the form of the disease, its severity, the presence or absence of complications. It helps to restore the functionality of the autonomic nervous system, partially relieves inflammation, and accelerates the healing process. Simultaneously improves the functioning of the digestive system and relieves spasms.

exercise therapy

With esophagitis, physical exercises help speed up the healing process, help strengthen the body.

Workouts and exercises are selected depending on. In this case, the maximum load tolerance should be taken into account. Exercise helps to get rid of heartburn, develops the muscular system, strengthens the sphincter, and promotes rapid healing of ulcers.

The main direction is breathing exercises. The main methods include diaphragmatic, according to Strelnikova. Separately, exercises for holding the breath are worked out, aerobic training is carried out.

Surgery

Surgical treatment of esophagitis is an extreme measure, used for serious complications. Surgical intervention may be prescribed for severe bleeding in the esophagus, persistent stricture, irreversible damage to the sphincter.

Also, the operation is prescribed in case of a precancerous condition of the mucosa, with active reproduction and degeneration of cells. Surgery is indicated for oncology of the 1st and 2nd degree. During surgery, a complete or partial removal of the esophageal tube is performed, the integrity of the organ is restored, and the tumor is excised.

Folk methods

The treatment regimen for reflux esophagitis includes as adjuvant therapy. In this case, decoctions of herbs, healing baths and teas are used.

One popular treatment for heartburn reflux is baking soda. However, this brings additional harm. During the first passage through the esophagus, the mucosa is irritated even more. In response to alkalization, a strong release of acid occurs, refluxes become even more aggressive. Therefore, instead of soda, it is desirable to use antacids.

Reflux esophagitis, caused by spicy, fatty or smoked foods, is initially treated with simple herbs. Herbal decoctions of motherwort, licorice, lemon balm and flax seeds help relieve inflammation.

Esophagitis in adults often causes. Rose hips, valerian, dandelion flowers and calamus powder save them from them. Plantain juice has a strong healing effect. However, it is contraindicated in people with acid reflux.

For the treatment of chronic esophagitis of the esophagus, decoctions of chamomile are made. They can be combined with flax seeds. The remedy is drunk three times a day. Flax seeds have at the same time an enveloping effect, reduce high acidity. This is a good prevention of cancer and reduce the symptoms of the disease.

Honey should be consumed a couple of hours before meals. It is desirable not in whole form, but diluted with a small amount of liquid. You can not use honey during an exacerbation of esophagitis. This will irritate the lining of the esophagus.

Sea buckthorn oil has a healing effect, improves secretory function and digestion. Potato juice envelops the mucous membrane, creating an additional protective film. It helps reduce heartburn and chest pain.

Can reflux esophagitis be completely cured?

It is possible in the early stages. However, despite the successful conservative therapy of reflux esophagitis, it is not completely cured. Any deviation from the diet and symptoms may return. This often leads to an exacerbation of the disease.

The exclusion of provoking factors from the life and diet helps to prevent serious complications in the form of perforation of the ulcer, oncology.

Reflux esophagitis is an inflammation of the esophageal mucosa that causes acid reflux (pathological reflux of contents from the stomach into the esophagus), ICD-10 code: K21.0 .: gastroesophageal reflux disease with esophagitis, GERD. There are two types of GERD: erosive and non-erosive. The form with esophagitis belongs to the first type.

When a person swallows food, the lower esophageal sphincter that separates the stomach and esophagus opens, allowing food and liquid to enter the stomach. Then he closes again. If this process is disturbed, then gastric juice flows back into the esophagus. The constant backlash of acid into the esophagus and throat due to reflux damages the lining, causing inflammation, leading to heartburn and nausea.

Often, gastroesophagitis is accompanied by a disease such as duodeno-gastric reflux (reflux of the contents of the duodenum and bile into the stomach), which aggravates the course of GERD. The following reasons lead to this:

• Increased intragastric pressure, which increases the likelihood of reflux esophagitis.
• An increase in the aggressiveness of gastric juice and acidity, which causes.

Clinical manifestations of the disease are divided into two groups: esophageal and extraesophageal. In adults, typical symptoms of the first group include heartburn, dyspepsia, sour taste, regurgitation, and chest pain that worsens when the person has eaten, lies prone, or leans forward. Extraphageal (atypical) include cough, lump in the throat, mucus in the mouth, reflux pharyngitis and hoarseness, with an acute course of the disease, the temperature rises. Signs in children and infants include recurring nausea, vomiting, and coughing.

Pain that occurs with esophagitis is often confused with heart pain, due to the proximity of the corresponding nerve endings. This phenomenon is called cardiac syndrome. Against the background of the underlying disease, non-obstructive bronchitis often develops.

Diagnostics

Daily pH monitoring. A special probe is inserted into the gastrointestinal tract through the nose with a device that measures acidity for 24 hours or more. During this time, the patient leads a normal life. pH-metry accurately detects the presence of reflux, the duration and frequency of episodes, helps to determine the impact of certain actions (eating, smoking, exercise, sleep) on changes in acidity. The results help to choose the method of treatment individually.

Radiography

An X-ray method that makes it possible to visualize the structure of the esophagus, stomach and duodenum. Before passing, the subject ingests a contrast agent (Barium sulfate BaSO4). Then the person is exposed to x-rays and pictures are taken. This is a proven and safe procedure that does not require internal intervention.

Gastroscopy

type of endoscopy. The doctor inserts an endoscope into the mouth, advancing it into the stomach. Then he carefully examines the condition of the mucous membranes of the studied organs. If necessary, a biopsy is performed (taking a tissue sample for detailed laboratory analysis).

Gastroscopy is the most detailed type of diagnostics, providing accuracy that other types of studies are not able to provide. Its characteristics allow you to quickly establish an accurate diagnosis.

Gastro esophagomanometry

Manometry - measurement of intraesophageal pressure during swallowing. A thin catheter with special sensors is inserted into the esophagus through the nose. The results of the study are used to determine the pressure in the esophageal sphincters and the work of peristalsis. Gastrointestinal motility problems and lower esophageal sphincter dysfunction play a key role in the development of reflux, making manometry an extremely important method.

Treatment

The patient needs to change his habits, diet. Various drugs are used to relieve symptoms and normalize the work of the gastric system. Various folk recipes are also used, which can replace many types of drugs in the early stages of the disease. For serious complications, surgical treatment is used.

Diet and diet

The following dietary rules should be followed:

1. It is necessary to switch to fractional nutrition, the diet is divided into 5-6 servings per day. The break between meals should not exceed 4 hours.
2. Avoid lying down for 3 hours after eating.
3. Minimize intake of fatty foods, caffeinated drinks, mint, spicy foods, citrus fruits, tomatoes and tomato paste, alcohol. These products weaken the tone of the cardiac sphincter and increase the secretion of hydrochloric acid.
4. Increase your intake of low-fat protein foods (white meat, low-fat cottage cheese, soy). Protein increases the regenerative capacity of the body and has a beneficial effect on digestion.

Taking medications

Antacids

These include drugs whose main task is to reduce the level of acidity by neutralizing hydrochloric acid and protecting the mucous membrane. Sold in the form of tablets and gels. Modern suspension antacids have an antireflux effect. The action occurs within 10-15 minutes after ingestion, therefore, it is often prescribed for the rapid relief of exacerbations in the initial stages of treatment. Many types of drugs are not contraindicated during pregnancy. A well-known household antacid is baking soda.

A significant drawback is the acid rebound syndrome associated with drugs (the response of the stomach to a rapid decrease in acidity, as a result of which the secretion of gastric juice increases). This group of drugs is popular due to its availability.

Antisecretory agents

The mechanism of these drugs is to reduce the secretion of hydrochloric acid and digestive enzymes. Unlike antacids, this type of medication is designed for long-term therapies and can increase the protective capacity of the stomach, but they have a wider range of side effects.

Alternative medicine

Using medicinal herbs and folk remedies, you can completely get rid of reflux, heartburn and other manifestations of the disease without resorting to the help of specialized pharmacological agents. It is worth remembering that this will not be enough to cure the advanced form of the disease.

Flax seed decoction

These seeds help to reduce the level of acidity and restore the mucous membrane. They can be taken in their pure form, but in this case they are more difficult for the body to absorb. To prepare a decoction, grind a tablespoon of seeds, place in a thermos, then pour boiling water over it. After that, the broth should stand for 10-12 hours.

Sea buckthorn oil

This remedy reduces the secretion of gastric juice, has an enveloping effect. Contains vitamins A, K and E. Accelerates the recovery processes of epithelial tissue, compensating for the harmful effects of esophagitis.

herbal teas

There are many plants and herbs that are useful in diseases of the digestive system. One of the most effective recipes is tea from the leaves of plants taken in equal proportions: chamomile, lemon balm and St. John's wort. To enhance the healing properties of this tea, you should add propolis, making sure that there is no allergy.

Complications

Lack of adequate treatment, non-compliance with recommendations during the period of exacerbation lead to various complications associated with reflux, which can be very life-threatening.

Barrett's esophagus

A precancerous condition of the esophagus, the main cause of which is chronic. Constant exposure to acidic contents causes changes in the structure of the lower part of the esophagus - metaplasia. Tens of times increases the risk of developing cancer. Diagnosis is complicated by the fact that this disease periodically passes without heartburn, which is due to the roughening of the walls of the esophagus.

In the early stages, this disease is treated by eliminating the manifestations of reflux and other indirect causes. With complications, laser therapy and surgical treatment are used. In the most severe cases, the following operation is applied -.

Acute erosive esophagitis

Also known as hemorrhagic esophagitis. Causes esophageal bleeding, which is caused by thinning of the mucous membrane and the occurrence of erosions and hemorrhages. Manifested in the form of bloody vomiting.

Erythematous form of gastritis

Usually erythematous esophagitis precedes erosive. It manifests itself in the form of red oval rashes on the mucous membrane.

Inflammation of the small intestine

Inflammatory process, which is accompanied by functional disorders of the small intestine. Medically known as enteritis. Manifested by rumbling and bloating, stool disorders.

Dysmetabolic nephropathy

An improperly functioning gastrointestinal tract can cause metabolic disorders. The load on the urinary system increases. This is fraught with the development of a disease such as dysmetabolic nephropathy - kidney damage caused by metabolic disorders.

Prevention

Extra pounds contribute to an increase in intra-abdominal pressure (for the same reason, it is necessary to abandon too-tight clothing and tight belts), increasing the reflux of hydrochloric acid into the esophagus. Therefore, with obesity, body weight should be normalized. It is undesirable to lose more than 0.5-1 kg. per week, as this is too high a load for the body.

You should also stop smoking, as nicotine irritates the mucous membrane and increases the level of acidity, which is unacceptable for reflux esophagitis. Many medications also aggravate the disease - their intake is agreed with the doctor.

Illness and sport are compatible, only gentle exercises are shown. Breathing exercises are recommended as they help reduce intra-abdominal pressure. You should avoid strenuous exercise after meals and stop training with weights.

Lifestyle changes and a correct diet help reduce the frequency of reflux, prevent new exacerbations and forget about this disease forever.

Almost any of the symptoms described in the article can be provoked by a banal overeating in a healthy person, but if any of them does not go away for a long time, then this is a good reason to see a doctor. Timely provided therapy will help to avoid complications with reflux esophagitis. This means that it is impossible to treat the disease and avoid diagnostics exclusively at home.

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 diseases, 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 esophageal mucosa 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 the changes, the appropriate treatment will be determined.

Reflux esophagitis is a chronic disease of the gastrointestinal tract, which is caused by the constant release of contents from the human stomach into the esophagus. According to statistics, about 50% of the total population suffer from such a disease, and the numbers have been actively increasing recently. Many people do not yet realize how potentially dangerous gastroesophageal reflux with esophagitis is, therefore they turn to doctors only at the very advanced stages, accompanied by serious complications.

Features of the digestive tract

To talk about GERD with esophagitis, the danger of reflux and their potential consequences, you first need to understand the features of the human esophagus and gastrointestinal tract (gastrointestinal tract).

The esophagus is a hollow organ located directly behind the trachea. In an average person, the length of the esophagus is about 24 cm or 25-30 cm in women and men, respectively. The esophagus has several layers - muscular, mucous, and also external. The main function of the esophagus is to carry food to our stomach. Up to a dozen folds are formed from the mucosa, which stimulate the esophagus to carry human food.

The esophagus also contains glands that secrete special mucus or mucous fluid. She participates in the processes of movement of food and does not allow the esophagus to be damaged from contact with it.

As for the muscle layer, it speeds up the process of passage of consumed products through our esophagus. The muscle layer has two valves - lower and upper. The lower valve is located directly between the human esophagus and directly his stomach. If a person does not eat food at the moment, this valve goes into a closed state until the next meal. When the swallowing process begins, the valve opens and allows food to pass through. If the work of the lower esophageal valve is disrupted, this will lead to symptoms of esophagitis reflux and the development of this unpleasant disease.

When people eat, the stomach begins to actively produce gastric juice. This is a mixture of various aggressive enzymes and hydrochloric acid, which are responsible for the digestion of our food. Stimulates the process of processing peristalsis, that is, the movements made by the stomach.

What is reflux or gastroesophageal reflux? This is the reflux of contents from our stomach into the esophagus. In a normal state, peristalsis advises about 20-30 refluxes, that is, it throws the contents from our stomach into the esophagus. At the same time, such refluxes do not cause any discomfort, because they are not a disease, but are a normal process of the gastrointestinal tract. But when the protective functions and mechanisms of the esophagus are violated, a person begins to feel pain with reflux esophagitis, since pathology is already developing.

Defense mechanisms of the esophagus

There are three in total. The first mechanism is the mucous membrane. It does not allow mechanical damage to the esophagus and protects against the effects of hydrochloric acid that enters as a result of reflux.

The second mechanism of the human esophagus is the sphincter, that is, the valve. Due to it, the contents from the stomach do not enter the esophagus too often.

The third mechanism is the blood supply. It stimulates the rapid recovery of the mucous layer, if it is damaged under one or another influence.

All of them together provide protection against such an ailment as gastroesophageal reflux disease or reflux esophagitis.

Types of disease

In many ways, the choice of treatment regimen depends on what type of disease the patient has encountered. GERD with esophagitis is of several types:

• Spicy. It is observed when gastroesophageal refluxes intensify and develop into pathology. It is characterized by inflammatory processes on the surface and in the depth of the esophagus. These are non-erosive refluxes of esophagitis, which can appear unexpectedly and, with proper treatment, pass without complications.
• Chronic. Chronic reflux esophagitis, caused by regular gastroesophageal reflux, is characterized by long-term inflammatory processes that occur on the walls of the stomach. This form can lead to irreversible consequences that can fully disrupt the entire work of the digestive tract.
• fibrinous. It's also pseudomembrane. At the beginning of the course of the disease, yellow effusions form, after which dense films appear on the mucous layer of the esophagus. They can be easily removed. In rare cases, the fibrinous type of the disease is accompanied by a severe course.
• Surface. The mildest form of the disease, since the damage is weak and the tissues are practically not destroyed.
• Biliary. It develops as a result of regular emissions from the stomach and duodenum. The inflammatory process of the tube through which food passes begins.

Forms

It is also worth noting several forms of the disease in which an ailment provoked by gastroesophageal reflux can occur.

Gastroesophageal refluxes are the norm for the digestive tract. But at the same time, certain disturbances in his work may occur, which entails a diagnosis of reflux esophagitis.

There are several forms of the course of the disease:

• Acute esophagitis. In such reflux esophagitis, the symptoms are accompanied by painful sensations when eating. Moreover, they are observed at the top of the chest and in the esophagus. Also a characteristic feature is a disturbed process of swallowing and weakness of the whole organism.
• catarrhal. If gastroesophageal refluxes, together with disturbances in the functioning of the esophagus, lead to a catarrhal form, then it is accompanied by swelling of the mucous layer of the esophagus. When swallowing, a person feels severe pain and the presence of a foreign object in the throat.
• The erosive form of reflux-esophagitis requires intervention in the treatment of a specialist. This is a complicated form, accompanied by the formation of ulcers, that is, erosion, on the mucous walls of the esophagus. This form is accompanied by increased symptoms of the previous forms. Unpleasant sensations intensify after each meal.

What is the danger of such a disease? The likelihood of transition to a chronic form and serious complications. The chronic form is characterized by a constant increase in unpleasant symptoms, which periodically go into a state of rest. Against the background of chronic esophagitis, gastritis develops.

Stages of the disease

If disturbed gastroesophageal refluxes provoked esophagitis, in the absence of appropriate treatment, the disease begins to progress and move from one stage to another.

The first stage or grade 1 reflux esophagitis is characterized by the presence of punctate erosions on the esophageal walls. And with reflux-esophagitis, 2 degrees of erosion merge, burning activity in the chest and heartburn increase. After meals in the chest, there is unpleasant discomfort and pain.

When the disease passes into the third stage or to the 3rd degree, extensive erosion is observed and the symptoms of the disease manifest themselves even in between meals.

The most dangerous stage is 4. It is characterized by a chronic ulcer of the esophagus and constant sensations of an unpleasant aftertaste. What it is? This stage is usually accompanied by complications, swallowing becomes an extremely difficult process. If the disease is not treated, a person may even face a malignant tumor.

Causes of the disorder

There can be many reasons for reflux esophagitis. This includes insufficiency of the cardia, and a hernia of the esophagus and a number of other reasons. Only a qualified specialist should determine the true causes and treatment. Do not self-diagnose and even more so independently treat the disease.

Insufficiency of the cardia or a cardiac defect, that is, impaired functioning of the cardiovascular system, is far from the only reason for the development of esophagitis reflux.

The main cause of the disease is a violation of the tone or normal operation of the esophageal valve. To provoke it and the development of the disease can:

• long-term medication;
• recent operations on the gastrointestinal tract;
• hiatal hernia;
• insufficiency of the cardia;
• overweight and obesity;
• an ulcer affecting the stomach or intestines;
• lifestyle, accompanied by low mobility;
• malnutrition;
• constant habit of eating before bed;
• gastritis;
• sedentary lifestyle, etc.

Symptoms

This article will not be complete if we do not tell you about the main symptoms and signs that may indicate the development of reflux esophagitis. If you notice these signs, be sure to contact a specialist immediately. Do not underestimate the potential danger of the disease. You already know what it is and what serious consequences esophagitis can lead to.

As the frequency of occurrence, the symptoms of reflux esophagitis can manifest themselves in the following:

• heartburn sensations when eating almost any food;
• constant heaviness in the stomach;
• feeling full even when eating a small portion of food;
• lump in the throat;
• frequent belching, accompanied by the release of air or a sour taste;
• bouts of nausea;
• pain in the epigastrium;
• problematic bowel movements;
• complications when swallowing food and even saliva;
• hoarse voice;
• pain in the region of the heart.

The disease can proceed and develop for many years. In this case, the symptoms increase gradually, if no measures are taken to eliminate them. Lack of treatment is accompanied by complications and increased manifestations of the disease.

It is important to note that reflux esophagitis is quite easy to treat if you strictly follow the doctor's recommendations and adjust your lifestyle. But after the completion of treatment and the return to a destructive lifestyle, the symptoms return, that is, there is a relapse of the disease.

If you do not pay attention to the symptoms of reflux-esophagitis in time, or at least do not visit a doctor to confirm or refute a possible diagnosis, the disease can lead to complications. But while malignant tumors are rare, complications such as esophageal ulcers, esophageal stenosis, and Barrett's esophagus are quite common problems that reflux esophagitis entails.

Therefore, be extremely attentive to the signals that your body gives you. Check any suspicions and treat the disease on the outskirts.

Many people, when they hear a diagnosis, think: erosive reflux esophagitis - what is it. This is a disease in which the mucous layers in the lower region of the esophagus become inflamed. Such an ailment develops due to the fact that food coma and other substances from the stomach are often and aggressively thrown into this part of the tubular organ.

Reasons for the development of the disease

This disease is considered one of the stages of gastroesophageal reflux disease. Gastric contents are food lumps, hydrochloric acid, mucus, enzymes for digestive processes, and sometimes also pancreatic juice and bile acid. The reflux of stomach contents into the esophagus is gastroesophageal reflux. Such a problem can occur even in a relatively healthy person. But usually during the day this happens no more than 2 times. The duration is up to 5 minutes. In the daytime, due to food intake, this phenomenon is observed more often. Most refluxes are not even felt.

To prevent such backcasting in a healthy body, several protective mechanisms are provided. This applies to the following events:

• the tone of the esophageal sphincters is at a sufficient level, both at the lower and at the upper (these are muscle valves that are located at the transition of the organ, at the top - into the pharynx and at the bottom - into the stomach);
• self-purification of the esophagus (at the same time, the reflux fluid that has entered the esophagus is neutralized);
• the integrity of the mucous membrane of the esophagus, it is strong enough and, most importantly, integral (in this case, there must be normal blood circulation so that the glands produce a sufficient amount of mucus, as well as substances such as prostaglandins and bicarbonates, the cells of the mucosa must be constantly updated);
• rapid removal of gastric contents that have entered the esophagus;
• regulation and control of acid formation in the stomach.

The causes of reflux esophagitis are very diverse. This pathology can be caused by various factors that will reduce the effect of protective factors or completely suppress them. For example, it could be smoking. The reason may also be excess weight. Excessive loads also adversely affect, especially when it comes to the abdominal muscles. So with a tendency to such a pathology, you should not carry heavy objects. Often the problem lies in the diet, or rather its improper use. Under no circumstances should you eat sour foods. It is very harmful to overeat before going to bed. Often the problem lies in addiction to alcoholic beverages. Stress and emotional stress also harm the human body. Do not wear tight clothing - corsets, bandages, etc. They compress the body and internal organs, harm the blood flow.

Erosive reflux esophagitis can also be caused by the consequences of surgery or bougienage. Also a common cause is a hernia in the opening of the esophagus. Due to the too wide lumen, the contents of the stomach back out through the sphincter. In addition, often such a pathology is provoked by medications that the patient has taken for too long and without medical supervision. This usually applies to drugs with anti-inflammatory properties, a group of medicines - calcium antagonists, antibiotics, nitrates, antidepressants, beta-blockers, theophyllines, quinidine, hormonal, sedative and narcotic drugs.

Often reflux esophagitis appears in pregnant women, but then, after childbirth, it disappears. In addition, in children, such a pathology also develops if there are abnormalities in the development of the muscular apparatus and the nervous system. It is also necessary to take into account constipation, which gradually becomes chronic. Another cause is scleroderma.

First, the enzymes of the stomach, lysolecithin and bile acid simply irritate the walls of the esophagus when thrown into it. As a result, the first symptoms appear. Then the inflammatory process develops. If reflux is regularly in contact with the mucous membrane, then erosion appears. They later become the cause of strictures (these are cicatricial-type deformations). The body often bleeds. In addition, inflammatory processes that are not controlled can cause precancerous type changes (Barrett's syndrome), and then they degenerate into malignant tumors. As a result, adenocarcinoma develops.

Symptoms of the disease

If a patient has reflux esophagitis, the symptoms will differ depending on the form of this disease. There are non-erosive and erosive forms. With a non-erosive type of disease, only swelling and redness of the walls will be detected during an endoscopic examination. With an erosive form, erosions with different lengths will be found. In this case, the degree is indicated - from the first to the fourth or a-d. Her doctor determines depending on the degree of damage to the organ and the prevalence of defects. In addition, it is necessary to determine the presence of complications - ulcers, Barrett's syndrome, strictures, shortening of the tubular organ.

Signs of reflux esophagitis will differ depending on the degree of damage to the organ. The disease can proceed in a latent form, so that the symptoms do not appear at all. But most often, erosive esophagitis greatly interferes with a person. All clinical manifestations are conditionally divided into extraesophageal and esophageal.

As a rule, symptoms of the esophageal type occur after overeating, eating late, dietary errors, drinking alcohol or carbonated drinks, stress and physical overexertion. Typically, symptoms appear when a person is lying down or lifting weights. Symptoms of the esophageal type are as follows:

• heartburn occurs in 75% of all cases;
• sometimes the intensity of salivation increases;
• nausea and vomiting attacks;
• belching - bitter or sour;
• in the morning in the oral cavity an unpleasant taste - sour or bitter;
• sometimes there are problems with swallowing food (this is due to the fact that the esophagus is reduced);
• when swallowing, discomfort or even pain may be felt.

There is a burning pain in the epigastric region. A person can easily be confused with pain in the heart, heart attack and angina pectoris. Then these sensations spread to the neck, chest, the area between the shoulder blades.

All of these esophageal symptoms are considered classic. They may appear all together, or only some of them appear.

As for the symptoms of the extraesophageal type, they are more difficult to associate with reflux esophagitis. For example, the voice becomes hoarse, there is a lump in the throat for a long time. Ulcers and granulomas appear on the vocal cords. For a long time, a person coughs with sputum and mucus. Sometimes there is suffocation. The gums may become inflamed. Rarely, damage to the tooth enamel occurs. Sometimes a person feels pain in the lower part of the mouth. Neck hurts from time to time. Rarely, papillomatosis of the larynx appears. It smells bad from the mouth. In some cases, the rhythm of heart contractions is disturbed.

Therapeutic measures

With erosive reflux esophagitis, treatment should be started as early as possible. It is recommended to carry out a lifestyle correction, eat right. Medicines are usually prescribed. In severe cases, surgery is required. Treatment is usually carried out on an outpatient basis. Hospitalization is required only when serious complications are detected.

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Erosive esophagitis appears due to the wrong lifestyle, so it is recommended to change it for the better. It is required to stop smoking and drinking alcohol. It is better not to lean on carbonated drinks. Be sure to monitor your own weight and get rid of extra pounds. The part of the bed where the head is located must be increased by 15 cm. Moreover, pillows cannot be placed - because of them, the pressure inside the abdominal cavity increases. You can not go to bed for 3 hours after eating. It is forbidden to wear tight clothing, especially belts, elastic bands, belts, bandages and corsets. You can't lift weights. Be sure to play sports, walk in the fresh air.

A diet for erosive reflux esophagitis is mandatory. It will help prevent the development of complications. A sparing diet is prescribed. You can’t overeat, but it’s also forbidden to starve yourself to death. Do not lean on fatty milk, cocoa, coffee, egg yolks, butter, margarine, peppers, garlic and onions, tomatoes, chocolate, mint, citrus fruits. All these products reduce the tone of the esophageal sphincters.

Medical therapy

Erosive esophagitis should be treated with medication. This treatment involves the use of two directions. First you need to use powerful drugs, and then the intensity of the drugs decreases. Then the second strategy should increase the pharmacological effect.

Be sure to prescribe drugs with antisecretory action. They reduce the intensity of secretion in the stomach. Since the level of acidity in the organ falls, the contents of the stomach do not affect the esophageal mucosa. These drugs include proton pump inhibitors. H2-blockers and M-anticholinergics are also required. The duration of the course will be determined by the doctor, but it lasts at least a month.

In the erosive form, prokinetics are required. For example, domperidone, metoclopramide, etc. They can improve motor skills. You will need alginates and antacids. They neutralize the action of hydrochloric acid.

Erosive and ulcerative esophagitis is a fairly common disease. With this disease, the mucous membranes of the esophagus in its lower part become inflamed. This is due to the fact that the gastric contents come back out of the organ. As a result, hydrochloric acid and enzymes harm the walls of the organ. If the disease is not treated, then in the future, erosion and ulcers appear in the places of inflammation.

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The symptoms and treatment of this disease is determined by the doctor, you should not self-medicate.

But in addition to medicines, you need to pay attention to the normalization of lifestyle, proper nutrition, and therapeutic exercises.