Reflux esophagitis. Symptoms and treatment of reflux esophagitis. What is reflux esophagitis in adults and children

Reflux esophagitis is inflammation of the lining of the esophagus. It is formed due to the release 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:

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.
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.
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.
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

Types of pathology	Symptoms
Catarrhal (otherwise superficial)	Difficulty swallowing food. After eating a person, dull pains in the esophagus, belching of mucus, and heartburn begin to torment. During eating behind the sternum there is a burning sensation, soreness. Pain can be given to the neck, shoulder blades and jaw. There is increased salivation.
exfoliative	Constant pain between the shoulder blades, aggravated by swallowing liquids or inhaling. General weakness, anemia, body temperature rises. When passing tests, a violation of the level of leukocytes is detected.
Hydropic	This form is a continuation of the catarrhal form. In addition to the symptoms inherent in it, an edema of the esophagus additionally occurs.
erosive	There are pains, "walking" along the entire length of the esophagus. Mostly during meals. There is a burning sensation in the chest, an eructation with blood appears and the remnants of undigested food come out. A person has severe fatigue, fainting, mild anemia. If an additional infection joins, bleeding occurs, cancer of the esophagus may occur.
pseudomembranous	Difficulty in swallowing. During this process, the pain behind the sternum increases. There is a cough with blood. A sign of recovery - exit to oral cavity pieces of fibrinous film.
Necrotic	Intense pain, dysphagia, frequent urge to vomit, in which pieces of mucous are visible. In a complicated form, bleeding occurs. This can provoke the appearance of purulent mediastinitis and abscess.
Phlegmonous	Pain when swallowing food, fever, dysphagia. A violation of the level of leukocytes is detected. Pain occurs when moving the neck. The same sensations during palpation of the abdominal muscles. A purulent abscess may begin. This is accompanied by vomiting with blood clots. The person is shivering, sweating profusely, and unbearable pain in the sternum is felt.

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 with a quick recovery:

Stop smoking, as nicotine increases acidity and relaxes the digestive muscles.
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.
Restriction of physical activity helps to reduce the symptoms of the disease. You can not lift anything more than 3 kilograms.
A couple of hours before bedtime, food and alcohol are excluded.
It is necessary to sleep on a raised (15-20 cm) pillow.
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:

To reduce the activity of AP-enzymes, "Pantoprazole", "Rabeprazole" is used.
After the 13th week of bearing a child, Lansoprazole is prescribed.
With bronchial asthma, "Omeprazole", "Esomeprazole" are indicated.
If liver function is impaired, any PPI (proton pump inhibitor) is used, but Rabeprazole is preferred.
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".

For fast elimination pain in the esophagus or heartburn are prescribed antacids. 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 acidity. gastric juice. Too hot or cold food is prohibited.

When diagnosing reflux esophagitis, therapy includes strict dietary restrictions.

Completely excluded	Allowed
natural juices; alcohol, soda and other drinks that increase the acidity of the stomach; · sweets; coffee, strong tea; black bread; · White cabbage; · fresh milk; legumes; marinades, smoked meats; spicy dishes, spices, pickles fruits (mainly citrus fruits); Fried and fatty foods rich broths and soups; · chewing gum.	crackers, unleavened bread; dairy products (low-fat cheese, cottage cheese, yogurt); soft-boiled eggs or in the form of a steamed omelet; porridge on the water (you can add a little milk); Boiled, stewed or steamed lean meat (can be baked in the oven).

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 exercise 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, develop muscular system, strengthen the sphincter, promote 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.

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

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

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

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

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

Causes of the disease

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

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

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

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

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

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

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

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

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

Stage I - single shallow erosion without signs of confluence and 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 edematous, swelling.
Stage III - extensive damage by erosive elements, up to ulcerative defects, with signs of complications in the form of bleeding, perforation, malignancy.

According to the severity are distinguished:

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

How to identify a disease

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

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

Symptoms and treatment of erosive reflux esophagitis

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

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

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

Treatment of the disease

During treatment of this type esophagitis, it is important to consider that the pathologies that contributed to its formation should also be treated. Usually therapy is carried out on an outpatient basis.

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

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

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

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

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

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

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

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

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

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

Medical therapy

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

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

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

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

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

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

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

Treatment with folk remedies

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

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

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

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

Dill solution is prepared the same way. It is best to brew dry.

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

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

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

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

The disease reflux esophagitis is mainly chronic and is the backfilling 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 talk about what reflux esophagitis has symptoms, 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, proceeds without ulcers and erosions, edematous, characterized by ulcerative lesions of the mucosa, pathological leads to perforation of the submucosal.
Chronic is characterized by hyperemia, erosive defects.

Based on the cause, the disease is divided into:

alimentary,
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 consumption of food;
hernia that developed on the diaphragm;
cholelithiasis;
inflammation of the stomach;
stomach ulcer;
malnutrition, based on the frequent use of spicy, salty, pickled, fried;
tumor neoplasms;
scleroderma;
increased body weight;
the presence of frequent vomiting;
Often there is esophagitis during pregnancy.

TO external factors development of pathology include:

infections such as: herpes, candidiasis;
often it occurs in people with reduced immunity, in patients with AIDS;
drugs taken for a long time cause this ailment;
food burn with chemicals such as alkali, solvents;
regular use of alcoholic beverages;
allergic manifestations;
receiving radiation therapy.

Symptoms of the disease

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

heartburn;
pain in the chest after eating;
nausea;
failure to move food through the digestive tract;
reflux of gastric juice into the mouth.

This disease is sometimes difficult to recognize because it also exhibits symptoms that are 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 thrown gastric juice enters the esophagus;
cough, shortness of breath, shortness of breath, asthma attacks, most often manifested at night, mimic inflammation of the upper respiratory tract;
tooth enamel is destroyed. Since hydrochloric acid destroys the protective enamel;
pain in the region of the heart are frequent companions of diseases of the digestive system.

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

Pain syndrome, which manifests itself an hour after eating and from a change in body position.
Burning sensation in the chest.
Spasms that occur during the promotion of food.

Diagnosis of the disease

Reflux esophagitis needs treatment. However, before you start taking the drug, you need to consult a doctor who will identify the causes and treatment will be more effective. Before the examination, the attending physician collects an anamnesis, finds out the medications and food used. Then he will examine the oral cavity, because white coating on the tongue - a sign of this disease and palpates the abdomen to exclude gastritis, cholecystitis, pancreatitis. After that, 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 the exclusion of oncology.
An x-ray with the introduction of a coloring substance allows you to see a pathological reflux into the esophagus.
Daily study of the pH level. In a healthy person, the level should be within 4, if it is lower, then this indicates that gastric juice can be thrown from the stomach into the esophagus.
Esophagomanometry allows you to explore the contractility of the sphincter.
An ECG is needed to rule out angina pectoris.
A chest x-ray can help rule out any lung 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.

How to treat reflux esophagitis, the doctor will tell you. To date, 2 therapeutic schemes are known in medicine. The first treatment regimen for esophagitis reflux involves taking antacids with simultaneous lifestyle changes and dietary adjustments. If the method is not effective, then the doctor may prescribe more potent drugs.

The second scheme, on the contrary, first implies the reception of more strong means. If a person begins to recover, then they either gradually reduce their dosage, or replace them with less strong ones. For the treatment of medications 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, drugs in which will not harm the body, is unrealistic. Since all medicines have a lot of side effects. It is here that traditional medicine comes to the rescue, which affirmatively answers the question of whether reflux esophagitis can be cured. However, one should not forget that folk recipes can only be used in combination with traditional medicine methods. The most effective means include:

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, insist for 2 hours, consume before meals;
dill infusion. 2 tbsp. l. dill seeds, pour 1 cup boiling water, insist for 3 hours, drink before meals.

There are reviews of patients who claim that plants such as mountain ash, dandelion, plantain, mountain ash 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 argue that an effective remedy is the right attitude to nutrition. It is recommended to use stewed, boiled, steamed dishes, mainly vegetables. When the exacerbation of reflux esophagitis passes, then you can begin to slowly introduce the usual food. Doctors recommend adhering to the following rules regarding the field of nutrition:

The usual portion should be divided by half, it is recommended to eat at least 5 times a day.
It is necessary to completely exclude foods that cause high acidity, such as tomatoes, coffee, smoked meats, chocolate, alcohol, onions, citrus fruits, garlic.
An effective method in the treatment of the disease is the hardening of the body, feasible sports loads.
Regular intake of vitamins, the correct daily routine help to improve the protective functions of the body.
After eating, you should not take a supine position, you can not eat at night. During nighttime sleep, it is recommended to raise your head higher, thus, fewer refluxes occur.
It is necessary to wear loose clothing, a tight belt or tight underwear leads to a worsening of the course of the disease.
You shouldn't overeat. The body needs to rest from the digestion of food and excess food.
It should be eaten in small pieces, chewing food thoroughly, while avoiding the capture of air.

Disease prevention

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

It is also important to follow 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. With timely treatment for its symptoms, you can forget about this condition.

Reflux esophagitis is a disease of a chronic nature, which consists in the pathological reflux of gastric contents into the esophagus.

Since there is no protection against such aggressive substances in the mucous membrane, epithelial damage occurs due to contact with them, with further inflammation and, accordingly, painful sensations.

When reflux esophagitis occurs, the acidity level of the esophagus drops markedly due to the mixing of the contents of the esophagus with acidic gastric reflux and digestive enzymes. The result of prolonged contact of the mucous membrane of the esophagus with such an irritant is its inflammation and trauma.

In this article, we will look at reflux esophagitis, its first symptoms and the basic principles of treatment, including at home.

Causes

Why does reflux esophagitis occur, and what is it? The cause of reflux esophagitis lies, as a rule, in the excessive relaxation of the esophageal sphincter at the entrance to the stomach. This muscle should be in a compressed state most of the time. A healthy esophagus only relaxes for 6-10 seconds to allow food or liquid to pass through. If the sphincter remains relaxed for longer (up to a minute for patients after each swallow), this causes a regression of the acidic contents of the stomach into the esophagus.

Often reflux esophagitis accompanies diseases of the gastrointestinal tract, such as:

or stomach cancer;
vagus nerve damage;
violation of duodenal patency of the esophagus;
pyloroduodenal stenosis;

It is not uncommon for reflux esophagitis to occur after stomach surgery. Also, the disease can be the result of smoking, drinking alcohol and drinking a lot of coffee. In some cases, sphincter relaxation occurs in people suffering from a hernia of the esophagus or from penetration of part of the stomach into the chest. This is seen in obese people, as a large belly increases pressure on the diaphragm.

Erosive reflux esophagitis

A complicated form of the disease, in which small ulcers (erosion) form on the esophageal mucosa. At erosive reflux esophagitis all of the above symptoms become more pronounced, bringing tangible discomfort to the patient. Manifestations of the disease are aggravated after eating, as well as certain drugs, such as aspirin.

Degrees

The course of the disease is characterized by several stages, and the symptoms gradually increase, and the erosive lesion of the esophagus becomes more pronounced.

degree - manifested by separate non-merging erosions and erythema of the distal esophagus;
degree - merging, but not capturing the entire surface of the mucous membrane of erosive lesions;
degree - manifested by ulcerative lesions of the lower third of the esophagus, which merge and cover the entire surface of the mucosa;
degree - chronic ulcer of the esophagus, as well as stenosis.

Symptoms of reflux esophagitis

If reflux esophagitis occurs, the symptoms of this disease may be pain behind the sternum, extending closer to the heart and even to the left shoulder, and can also suck in the pit of the stomach. Very often, the patient does not even associate these symptoms with problems with the esophagus at all, they are mistaken for an angina attack.

So, the main signs of reflux-esophagitis in adults are:

belching air or food;
heartburn;
nausea;
regurgitation;
sour taste in the mouth;
incessant hiccups.

Symptoms of reflux esophagitis often worsen when lying down (especially after eating) and disappear when sitting.

Chronic reflux esophagitis

Esophagitis in a chronic form, with a characteristic change in periods of exacerbation with periods of remission, can either be the result of acute undertreated reflux esophagitis, or develop against the background of alcoholism and the intake of coarse poor-quality food.

According to the types of changes, reflux esophagitis can be:

superficial (distal);
erosive;
hemorrhagic;
pseudomembranous, etc.

Signs of reflux esophagitis in the chronic stage, with a medical examination using X-rays, may be a violation of the mucous membranes of the esophagus, the appearance of ulcers and erosions.

Diagnostics

To detect gastroesophageal reflux today use enough different methods. Thanks to the x-ray of the esophagus, it is possible to fix the ingress of contrast from the stomach into the esophagus or to find a hernia of the esophageal opening of the diaphragm.

A more reliable method is long-term pH-metry of the esophagus (measurement of acidity in the lumen of the esophagus using a probe). This allows you to set the frequency, duration and severity of reflux. And yet the main method for diagnosing reflux esophagitis is endoscopic. With it, you can get confirmation of the presence of the disease, and determine the degree of its severity.

In general, the symptoms and treatment of reflux esophagitis depend on the severity of the disease, the age of the patient, and comorbidity. Some forms require no therapy, while others require surgery.

How to treat reflux esophagitis

When symptoms of reflux esophagitis appear, treatment consists in eliminating the disease that caused it (gastritis, neurosis, peptic ulcer or gastroduodenitis). Proper therapy will reduce the symptoms of reflux in adults, help reduce the harmful effects of gastric contents thrown into the esophagus, increase the resistance of the esophageal mucosa, and quickly clear the stomach after eating.

Conservative treatment shown to patients with uncomplicated disease. It includes general recommendations:

after eating, avoid bending forward and do not lie down for 1.5 hours
sleep with the head end of the bed raised by at least 15 cm,
do not wear tight clothing and tight belts,
limit the consumption of foods that are aggressive to the esophageal mucosa (fats, alcohol, coffee, chocolate, citrus fruits, etc.),
give up smoking.

drug therapy with reflux esophagitis, at least 8-12 weeks are carried out, followed by maintenance therapy for 6-12 months. Appoint:

proton pump inhibitors (omeprazole, lansoprazole, rabeprazole) in regular or double dosage,
antacids (almagel, phosphalugel, maalox, gelusil-lacquer, etc.) are usually prescribed 1.5-2 hours after meals and at night,
prokinetics - domperidone, metoclopramide.

To reduce the manifestation in the supine position of such symptoms like heartburn and pain in the sternum, you should take the correct posture - top part the torso should be slightly elevated, for which several pillows can be used.

Operation

This treatment is rarely used. Main indications for surgery:

Ineffectiveness of long-term drug treatment.
Development of Barrett's esophagus with the risk of malignancy (development of cancer of the esophagus).
Esophageal strictures.
Frequent esophageal bleeding.
Frequent aspiration pneumonia.

The main method of surgical treatment is the Nissen fundoplication, which restores the normal functioning of the cardiac sphincter.

Diet

With reflux esophagitis, the diet is quite strict and prohibits eating a certain amount of food. Among them:

alcoholic drinks, natural fruit juices, carbonated drinks;
pickled and smoked foods, pickles;
strong broths and soups cooked on them;
fatty and fried foods;
fruits (especially citrus fruits);
spices, sauces;
chewing gum;
products that increase gas formation (cabbage, black bread, milk, legumes, etc.);
products that relax the lower gastric sphincter and provoke stagnation of food masses in the stomach (sweets, strong tea, chocolate, etc.).

The diet of a person suffering from reflux should include the following foods:

soft-boiled eggs,
low-fat milk and mashed low-fat cottage cheese,
dairy products,
porridge,
meat and fish soufflé,
steamed cutlets and meatballs,
crackers soaked in water or stale bread,
baked apples.

nutrition of patients suffering from reflux disease should be fractional and include five to six meals a day, the last - four hours before bedtime.
portions should be small so that the stomach is filled with only a third of its volume.
Afternoon sleep is better to replace with a quiet walk. This contributes to the fact that food quickly gets from the stomach to the intestines, and the reflux of acidic contents into the esophagus will not occur.

To reduce gastroesophageal reflux, you must:

lose weight
sleep on a bed with a high headboard,
observe time intervals between meals and sleep,
stop smoking,
stop drinking alcohol, fatty foods, coffee, chocolate, citrus fruits,
break the habit of drinking water.

Folk remedies

Treatment of reflux esophagitis with folk remedies can only be carried out as an auxiliary procedure. Alternative treatment of reflux esophagitis is based on taking decoctions that soothe the mucous membrane of the esophagus, products that stimulate the tone of the sphincter, reduce acidity and fight heartburn.

Forecast

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

Inflammatory manifestations in the esophagus, which irritate the epithelium and develop against the background of ingestion of gastric juice and food, is called reflux esophagitis. If the irritating factor acts for a long time and the cause is not eliminated, the disease passes into the chronic stage and chronic reflux esophagitis appears.

What it is? The chronic course is characterized by periodic exacerbations of the disease, which alternate with periods of remission. During the lull of the disease, all signs disappear, and then make themselves felt again. Exacerbations occur most often in autumn and spring.

Food mixed with the acidic environment of the stomach has an irritating effect on the epithelial cells of the esophagus, causing discomfort and pain in the epigastric region to a person. Initially, the manifestations of reflux are characterized by heartburn and belching, but over time, pain is more pronounced, sometimes surgery is required. The clinic of the disease depends mainly on the stage and severity of the pathology.

The main role in the development of reflux esophagitis belongs to the sphincter between the esophagus and the entrance to the cardia of the stomach. In a healthy state, the muscular sphincter should be constantly contracted, it relaxes only for a few seconds for the passage of food or liquid.

If the sphincter is in relaxation for more than a minute after swallowing food, the gastric contents regress back into the esophagus - this gradually leads to weakening of the muscle fibers and weakness of the sphincter.

What provokes an exacerbation:

the use of hot spices, black coffee, alcoholic beverages, nicotine;
taking medications in large quantities;
frequent and prolonged stressful situations;
inflammatory diseases of the digestive system, hernia of the outlet of the esophagus;
surgical operations on the stomach;
increased intra-abdominal pressure, for example, when lifting weights, with an exhausting cough, during pregnancy, with accumulation of fluid in the abdomen, with excess weight.

But the most serious culprit in the transition of reflux to the chronic stage is the person himself. Often, patients ignore the primary blurred signs in the form of mild hunger pains, frequent belching, heartburn after eating, sour or bitter taste in the mouth. As a result, the disease develops further, the deep layers of the esophagus are affected, inflammation becomes chronic.

Important! When the first signs of the disease appear, you should not take heartburn remedies on your own, swallow baking soda. It is necessary to contact a local therapist, a qualified specialist should deal with the diagnosis and prescription of drugs.

Types of chronic reflux and stages of the disease

The inflammatory process can form at the beginning of the esophagus, in its lower section, or it can affect the organ along its entire length. In this regard, reflux is distinguished:

total- the entire inner surface of the esophagus is affected;
proximal– the process is localized in the upper part;
distal- the esophagus is affected at the junction with the stomach.

The most common type of reflux is distal. The insidiousness lies in the fact that it proceeds for a long time without any symptoms, patients begin to show concern only when the disease takes a chronic course, with sharp exacerbations and periods of calm.

In a complicated form of the disease, ulcers or erosions appear on the mucous membrane of the esophagus. With the erosive form of esophagitis, pain intensifies after eating, as well as when taking some medicines such as acetylsalicylic acid.

What are the stages?

I stage- in the lower part of the esophagus, capillaries expand, redness and friability of the mucosa appear, folds are smoothed out;
II stage- separate erosive foci are formed that do not merge with each other, they capture 10% of the mucosal surface;
III stage- erosive changes envelop more than 50% of the esophagus, the entire surface of the epithelium is affected, purulent contents appear on the ulcers with necrotic foci;
IV stage- a chronic ulcer is formed with severe necrosis and narrowing of the esophagus.

Chronic distal reflux esophagitis: what is it

In order to assign effective treatment it is necessary to accurately determine the type of disease and its form, for each variety certain medications. According to the ongoing changes, their nature, there are the following types of distal reflux:

catarrhal- original shape without erosion. It develops with mechanical injury by solid pieces of food, as well as as a result of a chemical burn from the abuse of alcohol, strong coffee, and spicy foods.

Hydropic- edema occurs when, at the first symptoms, the patient did not receive adequate therapy, while thickening is observed inner surface esophagus and consequently its narrowing.

Chronic erosive reflux esophagitis - the inflammatory process progresses, mucosal friability appears, on which an erosive surface forms.

exfoliative- is formed with diphtheria and scarlet fever, accompanied by a cough with an admixture of blood, the lining of the esophagus is destroyed, fibrin cells are partially rejected, severe complications are possible.

pseudomembranous- there is a rapid detachment of the fibrin film, an erosive surface appears at the site of rejection.

Phlegmonous- develops as a result of a complication after some infections or after mechanical damage, with scarring of the affected areas, the epithelium is replaced by connective tissue.

Necrotic- deep ulcers are formed, the inner layers of the esophagus are affected, it develops against the background of scarlet fever, typhoid fever, candidiasis.

Biliary - develops if the contents of the duodenum enter the esophagus, which first penetrates into the stomach, and then into the esophagus.

The main signs and diagnosis of reflux esophagitis

Often, pain in chronic reflux occurs behind the sternum, is given to the heart, to the left shoulder. Painful sucking in the pit of the stomach, the patient does not associate with the esophagus, takes pain for heart attacks. In adults, an attack of chronic reflux esophagitis is manifested by the following symptoms:

Sometimes swallowing is difficult, there is a burning sensation in the throat. All symptoms are aggravated by lying down, standing or sitting; signs decrease or disappear altogether.

Note! Belching and heartburn often appear before pathological changes in the esophagus. If you make the necessary adjustments to your diet and lifestyle, further complications and consequences may not arise at all. The intensity of symptoms increases as the disease progresses.

Irritation of the esophageal mucosa with gastric contents increases with bending over, especially after eating. Pain in the upper part of the epigastrium, heartburn, belching occur in some professions, often cleaners and nurses suffer from chronic esophagitis.

Diagnostics

At the initial stage of the disease, the symptoms of chronic reflux are blurred and mild. How is this diagnosed? To identify gastroesophageal reflux, different methods are used:

And yet, the main method for diagnosing reflux esophagitis is an endoscopic examination of the patient. With the help of a camera, which is located at the end of the endoscope, the doctor sees the entire inflammatory process, the presence of ulceration, erosion. In addition, an endoscope can take a piece of tissue for bacteriological and histological examination.

Treatment of the disease

Adequate treatment can only be prescribed by a specialist. You should not stop the attack of pain on your own, it threatens with serious complications. Treatment for the chronic form should be aimed at eliminating the symptoms of the disease and lengthening the period of remission.

Correct actions in the event of an attack of esophagitis:

Do not take any medications on the advice of friends, so as not to aggravate the disease and cause irreparable harm to yourself.

Useful video

This interesting video allows you to learn more about the topic "Non-traditional treatment of reflux".

The role of diet in treatment

With esophagitis, all patients are prescribed diet No. 1, regardless of the characteristics and type of disease. The dietary menu for any diseases of the gastrointestinal tract should be sparing to the maximum in order to avoid irritation of the epithelial membrane.

It is necessary to adhere to a diet with chronic reflux all the time: the more time a dietary diet is observed, the better tissue regeneration and scarring of ulcers will take place, exacerbations occur less frequently, and the remission period lengthens. In many patients, weight is reduced during the diet, the skin is cleansed of various rashes, hair and nails are strengthened.

Advice! It is necessary to eat such food that does not irritate the esophagus and throat circumference, is easy to chew and swallow. Very acidic foods should be avoided so as not to cause more inflammation.

Many berries contain too much acid, you should also not eat yogurt, nuts, tomatoes, chips, strong tea and coffee, of course, alcohol and cigarettes should be excluded.

Nutrition Features

You will have to give up fried and fatty foods, they enhance the relaxation of the lower sphincter, and also have an irritating effect on the mucous membrane. Typically, patients are offered a diet consisting of fruit salads, vegetable broths, baked fish, or chicken breast with vegetables. Useful steam cutlets, kefir, green tea, mashed potatoes or cauliflower.

Compliance with a strict diet will help get rid of discomfort and pain, while the entire digestive system directly normalizes. If the rules of nutrition are not observed, perforation of the esophageal ulcer or stenosis of its lumen may occur. Often, the inflammatory process drags on for many years, leading to the development of purulent complications.