How to treat reflux esophagitis with high acidity. Reflux esophagitis: symptoms and treatment. Reasons for the development of the disease

The disease reflux esophagitis is mainly chronic and is the reflux of gastric juice from the stomach into the esophagus. The diagnosis of reflux esophagitis occurs in 50% of the adult population, 20% of whom develop Barrett's esophagus. Our article will tell you about the symptoms of reflux esophagitis and what its treatment is based on.

Types of disease

This disease has different classifications, based on the course of the disease, it is divided into:

Acute, which has the following types of lesions: superficial, occurs without ulcers and erosions, edematous, characterized by ulcerative lesions of the mucous membrane, pathological leads to perforation of the submucosal membranes.
Chronic is characterized by hyperemia and erosive defects.

Based on the cause, the disease is divided into:

nutritional,
stagnant,
allergic,
infectious,
professional course.

Based on pathological changes, the disease is divided into erosive and non-erosive reflux esophagitis. The latter is divided into:

hydropic,
hemorrhagic,
pseudomembranous,
necrotic,
exfoliative,
necrotic.

Reasons for the development of the disease

Reflux esophagitis has different causes of development, they are divided into internal and external factors. Most often, this phenomenon occurs due to internal factors, which include:

excessive eating;
a hernia that has developed on the diaphragm;
cholelithiasis;
inflammation of the stomach;
stomach ulcer;
unhealthy diet based on frequent consumption of spicy, salty, pickled, fried foods;
tumor neoplasms;
scleroderma;
increased body weight;
the presence of frequent vomiting;
Esophagitis often occurs during pregnancy.

TO external factors pathology development include:

infections such as: herpes, candidiasis;
it often occurs in people with reduced immunity, in patients with AIDS;
medications taken for a long time cause this disease;
food burns caused by chemicals such as alkali, solvents;
regular consumption of alcoholic beverages;
allergic manifestations;
receiving radiation therapy.

Symptoms of the disease

With reflux-esophagitis, symptoms can be divided into 2 groups: food and non-food. Food symptoms include signs that arise as a result of the negative influence of food:

heartburn;
pain that occurs in the chest after eating;
nausea;
disruptions in the movement of food through the digestive tract;
reflux of gastric juice into the mouth.

This disease is sometimes difficult to recognize, since it also exhibits symptoms not related to the digestive system, these include:

sore throat, scratching, which are often mistaken for inflammation of the pharynx. This occurs due to the fact that the refluxed gastric juice enters the esophagus;
cough, shortness of breath, lack of air, attacks of suffocation, most often occurring at night, imitate inflammation of the upper respiratory tract;
tooth enamel is destroyed. Since hydrochloric acid destroys protective enamel;
Pain in the heart area is a frequent accompaniment of illnesses digestive system.

All of the above signs are conditionally combined into groups of signs by which this pathology can be determined.

Pain syndrome that manifests itself an hour after eating and from changing body position.
A burning sensation behind the sternum.
Spasms that occur during the advancement of food.

Diagnosis of the disease

Reflux esophagitis requires treatment. However, before you start taking the medicine, you need to consult a doctor who will identify the causes and treatment will be more effective. Before the examination, the attending physician collects anamnesis, finds out the medications and food products used. After which he will examine the oral cavity, since white coating on the tongue - a sign of this disease and palpates the abdomen to exclude gastritis, cholecystitis, pancreatitis. After which the specialist prescribes the following examination:

FEGDS. This method is able to detect problems in the esophagus and stomach, allows you to take a biopsy for research and rule out oncology.
An x-ray with the introduction of a dye allows one to see pathological reflux into the esophagus.
Daily study of pH levels. In a healthy person, the level should be within 4; if it is lower, this indicates that gastric juice can be thrown from the stomach into the esophagus.
Esophagomanometry allows you to examine the contractility of the sphincter.
An ECG is necessary to rule out angina.
A chest x-ray will help rule out pulmonary problems.

Treatment of the disease

Drug treatment of reflux esophagitis performs the following tasks:

Neutralization of the aggressive environment of gastric juice.
Strengthening the contractile function of the sphincter.
Increasing the speed of movement of products through the digestive tract.

Your doctor will tell you how to treat reflux esophagitis. Today, 2 therapeutic regimens are known in medicine. The first treatment regimen for reflux esophagitis includes taking antacids with simultaneous lifestyle changes and diet adjustments. If the method is not effective, then the doctor may prescribe more potent drugs.

The second scheme, on the contrary, involves taking stronger drugs first. If a person begins to recover, then their dosage is either gradually reduced or replaced with less strong ones. For treatment with medications, the following are usually prescribed:

antacids, Phosphalgel, Almagel, Maalox;
peptin blockers, for example, Fomotidine, Ranitidine;
drugs that block the proton pump - Esomeprazole, Omeprazole;
eliminating nausea, for example, Metaclopromide, Motilium.

Traditional medicine methods

Treatment in which drugs do not cause harm to the body is unrealistic. Since all medical products have a lot side effects. This is where it comes to the rescue ethnoscience, which affirmatively answers the question whether reflux esophagitis can be cured. However, it should not be forgotten that folk recipes can only be used in combination with methods traditional medicine. To the most effective means relate:

freshly squeezed potato juice;
juice from celery roots;
infusion of chamomile, wormwood, mint. Take 2 tsp. herbs, pour 1 liter of boiling water over them, leave for 2 hours, consume before meals;
dill infusion. 2 tbsp. l. dill seeds, pour 1 glass of boiling water, leave for 3 hours, drink before meals.

There are reviews from patients who claim that plants such as rowan, dandelion, plantain, and rowan increase the production of gastric secretions. In addition, honey and seeds have an irritating effect.

Often answering the question of how to cure reflux esophagitis, doctors claim that an effective remedy is the right attitude to nutrition. It is recommended to eat stewed, boiled, steamed dishes, mainly vegetables. When the exacerbation of reflux esophagitis passes, you can begin to slowly introduce your usual food. Doctors recommend adhering to the following rules regarding nutrition:

The usual portion should be divided in half, it is recommended to eat at least 5 times a day.
It is necessary to completely exclude foods that cause increased acidity such as tomatoes, coffee, smoked meats, chocolate, alcohol, onions, citrus fruits, garlic.
An effective method in treating the disease is hardening the body and performing feasible sports activities.
Regular intake of vitamins, correct mode days help improve the body's protective functions.
After eating, you should not lie down, and you should not eat at night. When sleeping at night, it is recommended to elevate your head higher, thus reducing the number of reflux events.
You need to wear loose clothing; a tight belt or tight underwear leads to a worsening of the disease.
Don't overeat. The body needs a break from digesting food and excess food.
You should eat in small pieces, chewing the food thoroughly, while avoiding trapping air.

Disease prevention

Prevention of reflux esophagitis with simultaneous treatment will allow you to forget about this unpleasant phenomenon forever. First of all, you should avoid those factors that contribute to the reflux of gastric juice.

It is also important to ensure that you wear the right clothes, which is important not only for women, but also for men, since they often wear a tight belt. Visit your doctor regularly and follow all his recommendations.

Reflux esophagitis is a rather unpleasant condition that often occurs in the adult population. If you address its symptoms in a timely manner, you can forget about this condition.

Widespread diseases of the gastrointestinal tract are observed in many countries, including Russia. Among them, gastritis, gastric ulcer and duodenum and various esophagitis. What is reflux esophagitis? This is a chronic inflammatory lesion of the wall of the esophagus as a result of the reflux of gastric juice with aggressive acid into it. This condition occurs much more often in adults than in children. Reflux esophagitis is not an independent disease, but, most often, occurs against the background of the above pathologies of the upper digestive system or as a result of congenital or acquired weakness of the sphincters at the junction of the esophagus with the stomach. Diagnosis of the disease is carried out using endoscopic examination of the esophagus and consultation with a gastroenterologist. Treatment has been successful using a combination of medications, along with lifestyle and dietary changes.

Reflux esophagitis is caused by the reflux of gastric contents into the esophagus

Causes

The causes of reflux esophagitis come down to disruption of the sphincter between the esophagus and the stomach, namely, its excessive relaxation, which allows gastric juice with high acidity to flow into the esophagus and the appearance of signs of the disease. In this case, a number of factors can be identified that lead to such a situation:

Chronic or acute stressful situations leading to disruption of the autonomic system nervous system and regulation of muscle sphincter tone;
Chemical factors, most often of a food nature, causing an increase in the acidity of the juice in the stomach and its aggressiveness;
An increase in intra-abdominal pressure leads to mechanical pressure on the stomach and promotes the backflow of gastric juice.

In addition to the immediate causes of reflux esophagitis, there are predisposing factors for its occurrence in the patient:

hiatal hernia, leading to incomplete closure of the sphincter and reflux of stomach contents;

overweight and obesity;
pregnancy, especially in the case of a large fetus or multiple births;
medications that relax smooth muscles (nitroglycerin, atenolol, etc.);
diseases of the gastrointestinal tract (peptic ulcer, gastroduodenitis, gastritis, pancreatitis, etc.).

All of these factors contribute or can cause the reflux of gastric juice into the esophagus, causing symptoms of reflux esophagitis.

Main manifestations

The symptoms of reflux esophagitis are varied, however, understanding what reflux esophagitis is, we can identify a number of general signs that allow us to quickly suspect the disease and prescribe appropriate diagnostic methods:

Heartburn is the most characteristic symptom of reflux esophagitis. It is characterized by a burning sensation or painful sensations along the esophagus behind the sternum, usually in its lower part. This is characterized by a sore throat and increased salivation. Heartburn occurs at any time of the day and may not be associated with food intake. The burning sensation intensifies when lying down or during physical activity.

Heartburn is one of the leading symptoms of reflux esophagitis

Sour belching and the development of dental caries are associated with the entry of acidic gastric juice into the oral cavity and its direct effect on tooth enamel.
With severe damage, dysphagia occurs, i.e. swallowing disorders. As a result of damage to the mucous membrane, food does not pass well through the esophagus and a feeling of a lump in the throat may occur.
Pain syndrome in chronic reflux esophagitis with exacerbations can mimic angina pain, radiating to the left half of the chest and arm, which can lead to an incorrect diagnosis.

As a rule, the patient’s complaints allow one to suspect a disease, prescribe rational methods of examination and treatment that reduces the acidity of gastric juice.

Examination and diagnosis

Qualitative collection of patient complaints, the time of their occurrence and the reasons that provoke them, as well as thorough examination allow us to identify characteristic symptoms diseases. However, to make a final diagnosis, it is recommended to use instrumental research methods:

Endoscopic examination of the stomach, or fibroesophagogastroduodenoscopy. This method of visual assessment of the condition of the mucous membrane of the stomach and esophagus is the gold standard in diagnosing and selecting treatment for reflux esophagitis. The examination is carried out using a special flexible endoscope with a camera inserted through the mouth, which allows the doctor to directly see the condition of the organs. When the disease occurs, redness of the mucous membrane, the formation of small erosions, ulcerative defects, as well as direct reflux of gastric juice are detected. Despite the patient's discomfort during fibroesophagogastroscopy, this method is recommended for all patients with suspected damage to the mucous membranes of the gastrointestinal tract.

Fibergastroscope

X-ray examination with contrast agents is used if a hiatal hernia or organic changes in the esophagus in the area of the sphincters (stenoses, deformities, etc.) are suspected. This method is based on the ability of a contrast agent passing through the esophagus to appear on serial x-rays.
Of utmost importance for the diagnosis and treatment of reflux esophagitis is the measurement of pH in the esophagus, which makes it possible to identify the reflux of gastric juice and the degree of its aggressiveness. For this purpose, daily pH-metry is used, based on the installation of a special sensor in the distal part of the esophagus, which constantly measures the level of acidity throughout the day.
Esophagomanometry is used to determine the level of pressure inside the esophagus, which makes it possible to identify achalasia and other movement disorders of the muscular layer of the organ.

Rational use of these methods allows you to quickly make the correct diagnosis with a minimum level of stress for the patient.

Only the attending physician should interpret the study data. Never try this on your own or make treatment decisions without medical advice.

Treatment of the disease

Treatment of reflux esophagitis is based on two related approaches: the use of medications and changes in lifestyle and diet. It is important to note that the use of medications alone or a change in diet alone will not lead to recovery.

Non-drug methods

Following the following recommendations is of great importance in the successful treatment of reflux esophagitis:

It is recommended to exclude from the diet all foods that stimulate the production of gastric juice - spicy, hot, salty, smoked, citrus fruits, tomatoes, etc.

In case of reflux esophagitis, it is necessary to exclude spicy foods from the diet.

All patients must stop drinking alcoholic beverages and smoking tobacco.
It is not recommended to eat legumes, cabbage, milk, as these products lead to increased gas formation and increased intra-abdominal pressure.
Confectionery products, coffee drinks, and strong tea help relax muscle sphincters and facilitate the reflux of gastric juice into the esophagus.
Meals must be fractional (small portions), but frequent - 5-6 times a day.
After a meal, you should not take a horizontal position and play sports for 1.5-2 hours.
It is recommended that the patient sleep with his head elevated.

Drug therapy

Treatment of reflux esophagitis is carried out using medications from several pharmacological groups. Most often, patients use antisecretory drugs to reduce the formation of hydrochloric acid in the stomach and significantly reduce its irritating effect. For this purpose, proton pump inhibitors (Rabeprazole, Omeprazole) and antihistamines (Ranitidine, etc.) are used in therapeutic dosages. The effect of the drugs, namely a lowered pH level, is observed a few days after the start of therapy.

Proton pump inhibitor

Protection of the delicate mucous membrane of the esophagus can be ensured by the use of enveloping drugs that can additionally neutralize hydrochloric acid. To such medicines include Maalox, Almagel and other products. Their use should be separate from food and other medications.

The use of prokinetics (Motilium, Domperidone, etc.), which accelerate the passage of the bolus of food through the esophagus and stomach, can have a great positive effect in treatment, which indirectly helps reduce acidity and improves the functioning of muscle sphincters.

Treatment of this disease is based on eliminating the causes of reflux esophagitis, therefore, along with medicines Non-drug treatment must also be carried out.

Surgery

Some causes of the disease can only be treated surgically. For example, hiatal hernias or deformations of the esophageal wall, leading to the reflux of gastric juice, can only be cured using surgery. This approach, when performed in a timely manner, ensures rapid restoration of the mucous membranes and the disappearance of all symptoms.

Currently, there are active discussions between scientists from different countries regarding 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 disease.

This is a disease of the esophagus that carries chronic course and manifested by degenerative changes in the wall of this body in the form of erosive damage.

So why are many doctors inclined 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 The occurrence 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 closure of the sphincter muscle apparatus 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 functioning of the endocrine system;
muscle ataxia, paralysis, paresis of sphincters, including the esophageal one.

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 sphincter incompetence. Disruption of its work is not systematic and regular, but occurs under certain conditions. These conditions are:

irrational food intake, periods of fasting are replaced by periods of overeating;
eating hard foods that can injure the internal membranes of organs;
drinking copious amounts of liquid in a short period of time.

3. “Non-reflux” causes. Among them, changes in other digestive organs are most often distinguished:

mechanical defects or formations in the gastric 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, depression;
taking certain medications: antibiotics, NSAIDs, hormones and others;
other related chronic diseases:, oncological processes, hepatitis, chronic pancreatitis, cholecystitis, food poisoning.

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

Stage I - single shallow erosions without signs of fusion or complications.
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 swollen and swollen.
Stage III – extensive damage by erosive elements, up to ulcerative defects, with signs of complications in the form of bleeding, perforation, and malignancy.

According to degrees of severity there are:

Mild degree – mild symptoms and clinical manifestations. The patient has virtually no complaints.
Moderate degree - the general condition suffers moderately, performance is impaired, the patient is bothered by the main complaints.
Severe degree - severe disruption 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 determine the disease

This cannot be done without the help of a qualified specialist. The doctor must collect all the necessary information about the complaints, detail them and prescribe the necessary medical examination methods.

The most informative way to find out 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 pH-metry method. This must be done to assess the acid-base composition of the esophagus and prevent aggressive effects on its wall from an acidic environment.
To exclude other diseases or to confirm concomitant diseases that could cause esophagitis, an ultrasound examination of the organs is prescribed abdominal cavity.
X-ray diagnostics of the esophagus with a contrast agent. Deep erosions can be visualized using this method.
Application high technology– computed tomography and magnetic resonance imaging. With the help of these studies, it is possible to examine the organ wall and its damage in volumetric form.

Symptoms and treatment of erosive reflux esophagitis

The symptoms of the disease are to some extent similar to the symptoms of gastroesophageal reflux disease; they are varied and can appear 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 pain in the chest area. Sometimes such signs can be disguised as diseases of the heart, lungs, or mediastinum.
Very characteristic feature– the sensation of food passing and moving through the esophagus and stomach. Due to the fact that the surface of erosions contains a large number of pain and sensitive receptors, this phenomenon occurs.
Difficulty swallowing a bolus of food. The process occurs in severe forms when the uppermost parts of the esophagus are affected.
Heartburn. The symptoms of this disease are more pronounced and painful than with GERD. It is permanent, regardless of what the patient ate or when it happened. Heartburn attacks can occur even at night. Any physical labor aggravates the symptoms.
Taste of blood in the mouth. A very important distinguishing feature. Appears with bleeding erosions. This is a serious symptom, after which you should definitely consult a doctor.
Belching gas or undigested food. Among other things, there may be belching of sour contents mixed with bile or hydrochloric acid.
Uncontrollable hiccups. Usually few people pay attention to this symptom. However, you should not forget about it. With the described pathology, this phenomenon may be the only sign of the disease.
Increased production of the salivary glands. A person notices an increase in the amount of saliva in the mouth.
Feeling of a lump in the throat. This symptom can masquerade as a throat disease.
Dry cough.
Decreased voice tone.

If you notice one of the listed symptoms, 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. Therapy is usually carried out on an outpatient basis.

Severe forms that require surgical interventions. When prescribing treatment, the doctor must comply with the following criteria:

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

First of all, it is important to explain to the patient that they should change their lifestyle and diet in a more correct direction.

A daily routine, a balanced diet, and a protective regime of work and rest must be observed. It is important to monitor your weight. If you have excess pounds, you need to gradually get rid of them.

If, on the contrary, there is not enough weight, you need to get it up to normal with a balanced diet. Clothing should be comfortable, loose, and compressions in the abdominal cavity should be avoided. You cannot wear tight clothes.

After eating, sit or stand for 40 minutes and do not engage in physical activity during this time. Your daily routine should include daily walks in nature.

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

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

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

Meals should be divided into 6 time periods in small portions. The last dose should be 2 hours before bedtime. If it is severe, you need to sleep with the head end raised.

Drug 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 existing ones. The most commonly prescribed drugs are Maalox and 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. Helps prevent complications and relapses.

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

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

In addition, if there are other pathologies of the gastrointestinal tract, they must also be treated. Enzymes may 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, in combination with drug therapy, herbs turn out to be a very important assistant. They enhance the effect of medications and have their own therapeutic properties.

Decoctions of chamomile and dill have an effect against this pathology.

Regular chamomile works very well. You can buy ready-made bagged collections or use the loose version. In any case, you need to pour hot boiled water over the herbal mixture and 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.

The dill solution is prepared in a similar way. It is better to brew in dried form.

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

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

At home, you can prepare your own collection from chamomile, mint, lemon balm and flax seeds. Tea is brewed from these herbs in equal proportions. Infuse in a teapot or thermos and drink before bed.

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

Reflux esophagitis is an inflammation of the mucous membrane of the esophagus, which 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, which separates the stomach and esophagus, opens, allowing food and liquid to enter the stomach. Then it closes again. If this process is disrupted, gastric juice flows back into the esophagus. The constant reflux of acid into the esophagus and throat caused by reflux damages the mucous membrane, causing inflammation, which leads to heartburn and nausea.

Gastroesophagitis is often accompanied by a disease such as duodenogastric reflux (reflux of duodenal contents 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, indigestion, sour taste, regurgitation and chest pain that worsens when the person has eaten, lies stomach down or bends forward. Extrophageal (atypical) symptoms include cough, lump in the throat, mucus in the mouth, reflux pharyngitis and hoarseness; in the acute course of the disease, the temperature rises. Children and infants may experience the following symptoms: repeated nausea, vomiting and cough.

The pain that occurs with esophagitis is often confused with heart pain, which is due to the close location 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 with a device that measures acidity for 24 hours or more is inserted into the gastrointestinal tract through the nose. At this time, the patient leads a normal lifestyle. pH-metry accurately detects the presence of reflux, the duration and frequency of episodes, and helps determine the effect of certain actions (eating, smoking, exercise, sleep) on changes in acidity levels. The results help to individually select a treatment method.

Radiography

A radiological research method that makes it possible to visualize the structure of the esophagus, stomach and duodenum. Before passing, the subject takes a contrast agent (Barium Sulfate BaSO4) orally. The person is then subjected to x-ray radiation and take pictures. This is a proven and safe procedure that does not require internal intervention.

Gastroscopy

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

Gastroscopy is the most detailed type of diagnosis, providing accuracy that other types of research cannot provide. Its characteristics allow you to quickly establish an accurate diagnosis.

Gastroesophagomanometry

Manometry is the 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 area of the esophageal sphincters and the work of peristalsis. Problems associated with gastrointestinal motility and impaired functioning of the lower esophageal sphincter play a key role in the development of reflux, which makes manometry an extremely important method.

Treatment

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

Diet and nutrition

The following dietary rules should be followed:

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

Taking medications

Antacids

This includes medications whose main task is to reduce acidity levels 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 effect occurs within 10-15 minutes after administration, therefore they are often prescribed for prompt relief of exacerbation of initial stages treatment. Many types of drugs are not contraindicated during pregnancy. A well-known household antacid is baking soda.

A significant drawback is the drug-associated acid rebound syndrome (the stomach's response 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 therapy and can increase the protective capabilities of the stomach, but they have a wider range of side effects.

Alternative medicine

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

Sea buckthorn oil

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

Herbal teas

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

Complications

Lack of adequate treatment and non-compliance with recommendations during an exacerbation period 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. Increases the risk of developing cancer tenfold. Diagnosis is complicated by the fact that this disease periodically passes without heartburn, which is due to the coarsening of the walls of the esophagus.

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

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. Manifests itself in the form of bloody vomiting.

Erythematous form of gastritis

Typically, erythematous esophagitis precedes erosive esophagitis. It appears as red oval rashes on the mucous membrane.

Inflammation of the small intestine

An inflammatory process that is accompanied by functional disorders of the small intestine. Known medically 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 dismetabolic 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, in case of obesity, body weight should be normalized. It is not advisable to lose more than 0.5-1 kg. per week, as this is too high a load for the body.

You should also quit 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 use must be agreed with the doctor.

Illness and sport are compatible; only gentle exercises are indicated. Breathing exercises are recommended as they help reduce intra-abdominal pressure. Must be avoided physical activity after meals and stop weight training.

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 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 consult a doctor. Timely treatment will help avoid complications with reflux esophagitis. This means that you cannot treat the disease and avoid diagnosis solely at home.

Regardless of the causes of inflammation of the esophagus, doctors define the disease with the general term “esophagitis.” The esophagus is the first section that belongs to the digestive tract. It is closely related to oral cavity, throat. Therefore, when diseases occur in the esophagus area, the functions of the respiratory system are often affected.

Concept

Esophagitis is a pathological disease affecting the mucous membrane of the esophagus. The process can be acute, subacute or chronic.

If left untreated, the disease affects not only the mucous membrane, but also the deeper layers.

The disease is common, but in 40% of cases clinical manifestations are not detected. As it progresses, life-threatening complications appear, including the formation.

The disease occurs in 20% of the population. In adults, the first sign is heartburn, but many people do not show up to see a doctor when such an unpleasant symptom is detected. Symptoms occur in equal numbers in men and women. The disease code according to ICD-10 is K20.

Classification

There are several types that are differentiated on various grounds. The most common are catarrhal and edematous. In this case, hyperemia of the mucous membrane and swelling occurs.

If an acute infectious process, chemical or thermal burns were observed, then the consequence may be, which is characterized by the appearance of erosions. If their formation does not occur, then doctors talk about a non-erosive form.

Photo of erosive reflux esophagitis

The following forms of esophagitis are distinguished:

. The mucous membranes are damaged by fungi of the genus Candida. The disease is rare, and the course is often similar to other ailments of the initial parts of the esophagus. If the inflammation is caused by other types of fungus, then they talk about fungal esophagitis or mycotic (mycotic).
Peptic. It occurs against the background of constantly repeated exposure to the mucous membrane from gastric or duodenal contents. In some cases, the mucous membrane is also influenced by the duodenum.
Eosinophilic. Occurs against the background of autoimmune diseases. This form is characterized by an increase in the number of eosinophils in the mucosa. Food or respiratory allergies are common causes.
Fibrous. It is usually a complication when proliferation of connective tissue fibers occurs. This leads to fibrous degeneration of the walls of the esophagus. It can be limited and diffuse, leading to narrowing of the lumen of the esophagus and shortening of the organ.
Terminal. In children it is associated with the work of fragile muscles of the digestive system. In adults, they form against the background of relaxation of the sphincter, which separates the esophagus from the stomach. The result is swelling of the organ membrane and hyperemia of some areas, which is expressed in the appearance of pinpoint hemorrhages.
Biliary. Inflammation of the mucous membrane occurs due to exposure to bile in the bolus of food. Constant exposure of the mucous membrane to bile and pancreatic enzymes leads to the development of inflammation. Because of this, histamine increases.
Post-radiation and radiation. Develop after undergoing radiation therapy to treat cancer of the esophagus, lungs and other organs. The frequency and severity of these forms depends on the increase in radiation dose, as well as the passage of drug therapy and radiation.
Atrophic. This form refers to precancerous diseases. Develops in advanced diseases of the esophagus. Under the influence of negative factors, mucosal cells atrophy and cease to perform their functions.
Erythematous. This form can be acute or chronic. It is characterized by a large accumulation of erosions that merge into a single erythema. There is a pronounced tendency to hemorrhage and bleeding.

Causes

The acute form most often appears due to some short-term factor. It can be:

infectious diseases,
physical impact (during insertion of a probe, burn),
damage from caustic chemicals,
allergic reactions to food products.

The most severe consequences arise from chemical damage. In case of infectious lesions, the cause is a decrease in the body’s immune forces.

Chronic forms appear due to consumption of alcohol or spicy foods. This impact must be permanent. If a person works with chemical vapors without respiratory protection, occupational esophagitis develops.

Chronic forms can be caused by:

for unknown reasons
vitamin deficiency,
prolonged intoxication,
disorders of the evacuation function of the esophagus.

If gastric contents reflux into the esophagus, peptic esophagitis develops.

Signs of reflux esophagitis in adults and children

The main symptom in adults is the appearance of heartburn. It can develop while eating, changing position, or lifting heavy objects. In advanced stages, this symptom is permanent.

Additional symptoms are:

sour belching,
nausea,
vomit,
pain while swallowing,
heaviness in the stomach.

Sometimes pain appears in the chest area. They may then be confused with symptoms of angina.

In young children, frequent belching is a cause of concern. As you get older, you may vomit frequently. Sometimes pain appears in the stomach area. This disease also has a bad effect on teeth. Since acidic gastric juice is refluxed, the proper formation of enamel is disrupted.

In children, esophagitis leads to bronchial hyperreactivity. Since the esophagus is short, the constant reflux of food from the stomach and hydrochloric acid when changing position not only leads to irritation of the mucous membrane. A small amount of juice can enter the respiratory tract, which leads to frequent bronchitis.

Acute symptoms

In the acute form, symptoms depend on the nature and extent of damage to the esophagus. If the disease is superficial, then there may simply be discomfort when eating sour or hot food.

In severe forms of the disease, severe pain, which radiate to the sternum, back, and neck.

In rare cases, difficulty swallowing and severe heartburn may occur. If the lesions of the esophagus are especially severe, then bloody vomiting and a state of shock appear.

Symptoms of the chronic form

The chronic form develops against the background of constant irritation of the esophagus or with an untreated acute form.

The symptoms are as follows:

Frequent belching of air and bad breath.
A white coating forms on the tongue, which almost never disappears.
An obsessive cough appears. The result is hoarseness and bronchitis.
Pain for chest may disappear and appear again.

There is a rapid development of caries. Due to gastric juice, the composition of saliva changes. Acidic components corrode tooth enamel.

Video on how to cope with symptoms of reflux esophagitis:

Features of the disease during pregnancy

During pregnancy, the cause of the development of the disease is impaired motility of the esophagus and stomach, as well as the aggressiveness of gastric contents. Develops more often in the 2-3 trimester.

Almost 75% of pregnant women suffer from heartburn, which occurs mainly when changing position, after eating fatty or spicy food. Heartburn can last from a couple of minutes to several hours.

During pregnancy, intra-abdominal pressure increases. At the same time, the muscles that close the passage from the stomach to the esophagus are in a relaxed state. This leads to the development of reflux, inflammation of the esophagus. During pregnancy, the only treatment is to relieve symptoms of heartburn with medication.

Degrees of development

In the acute form, there are 4 degrees of damage:

First. Usually of a superficial nature. The formation of ulcers and erosive defects does not occur. Hyperemia and swelling are noted. Symptoms at this stage are absent or mild.
Second. Extensive erosions form on the thickness of the mucosa, which may be accompanied by necrosis. The size of erosions is more than 5 mm. Heartburn appears when eating, a burning sensation in the chest after eating.
Third. The walls of the esophagus change as the lesion affects all layers. The ulcers begin to bleed and scars begin to form. Ulcers cover less than 75% of the esophagus. The stage is characterized by severe symptoms.
Fourth. Ulcers cover almost the entire esophagus. A sour taste appears in the mouth. Swallowing becomes painful, and discomfort spreads to the chest and abdomen. At this stage, the risk of developing stenosis and esophageal cancer increases.

Complications of esophageal disease

Complications include the appearance. They may bleed. To eliminate this pathology, endoscopic surgery is prescribed.

All treatment is aimed at:

elimination of the disease that caused esophagitis,
ensuring a reduction in the load on the diseased organ,
prescription of anti-inflammatory medications,
elimination of complications.

Typically, oral medications are reduced as much as possible or eliminated altogether. Therefore, patients receive the necessary chemical compounds through droppers or injections. In particularly severe conditions, food and water intake is excluded for 2-3 days. The body's needs are met through the use of parenteral nutrition.

Treatment of chronic pathology

As with treatment acute form a diet is prescribed and the factor causing the problem is eliminated. During exacerbations, moderate consumption of pureed food at room temperature is recommended.

It is necessary to exclude products that irritate the mucous membrane. It is also recommended to stop smoking and taking medications that affect sphincter tone.

Drug therapy includes:

, reducing the acidity of gastrointestinal juice.
Drugs that stimulate cardiac tone.

Additionally, physiotherapeutic methods may be prescribed, for example, amplipulse, electrophoresis. In extreme cases, surgery is prescribed, including resection and plasty of the esophagus.

Prognosis and prevention

If the course of the disease is without complications, then the prognosis is favorable. It is necessary to observe for a long time, adhere to the correct lifestyle.

As a preventative measure, it is recommended to avoid stress, not to smoke, and not to eat too spicy, smoked or sour foods. Food portions should be small. You should not lie down immediately after eating. At chronic form Regular visits to a gastroenterologist are required. In this case, annual spa treatment is indicated.