Early detection and treatment of grade 1 reflux esophagitis. Esophagitis - what is it? Esophagitis: symptoms and treatment Reflux esophagitis grade 1 treatment

Reflux esophagitis grade 1 what is it? A similar question interests a sufficient number of people who are often tormented by heartburn.

Description of the disease

Reflux esophagitis of the 1st degree is a rather difficult disease caused by dysfunction of the closing functions of the esophageal lower sphincter, after which inflammation of the mucous membrane of the organ occurs. Pathology begins due to obesity or wearing tight clothing that compresses the esophagus.

The reasons

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The main provocateur of the disease is the weakening of the neuromuscular esophageal region. Children suffer the most because of the pathology. Also the reasons are:

1. Strong internal pressure of the stomach suppresses the functioning of the gastrointestinal tract. Because of this, gastritis or peptic ulcer occurs.
2. Stressful situations suppress intestinal motility.
3. Poor nutrition provokes pathology. Abuse of sweets leads to the appearance of esophageal diseases.
4. Uncontrolled intake of drugs that have prostaglandins or nitrites as ingredients.
5. Smoking is a significant provocateur of reflux esophagitis.

Symptoms

GERD is classified as follows:

1. At grade 1, the area of ​​damage to the esophageal mucosa is small, it is limited by folds.
2. Reflux esophagitis of the 2nd degree is characterized by the presence of several defects or one, but exceeding 5 mm in diameter. All of them are limited by folds.
3. The third degree of pathology is characterized by the presence of several lesions, while up to 75% of the surface of the esophagus is affected.
4. At the fourth degree of the disease, the prevalence of defects exceeds 75% of the esophageal circumference of the esophagus.
5. 5 degree reflux esophagitis was not detected.

In the first stage of reflux esophagitis, the following clinical symptoms occur:

1. The whole esophagus is as if subject to burning.
2. A person often burps gastric contents or air. There is acid in the burp.
3. There is an unpleasant odor in the mouth.
4. Often there are diseases inside the oral cavity.
5. The patient feels pain behind the sternum and some burning. Sometimes these signs are given on the left.

Signs of chronic gastroesophageal disease:

1. Hacking cough. This cough rarely causes expectoration of sputum.
2. The voice becomes hoarse.
3. There is always a lump in the throat.
4. The headache is concentrated on the surface of the face.
5. The nose is often blocked.

The severity of symptoms is not always comparable with the stages that the disease has.

To confirm the diagnosis of catarrhal distal reflux esophagitis or to identify erosive reflux esophagitis, the following studies are used:

1. Endoscopy, since during the examination the condition of the mucosa is visually observed on the monitor, allowing you to confirm the changes, as well as determine the degree of pathology. At the same time, the endoscope allows you to take a biopsy.
2. With the help of daily monitoring of the pH of the esophagus, the severity, duration of exposure and frequency of reflux are determined.
3. Using a contrast agent and radiography, a hernia of the esophagus is detected, and the reflux of gastric chyme is monitored.

To cure first-degree reflux, drug therapy is rarely used. Enough lifestyle adjustments. Recommended:

• normalize the balance of leisure and work;
• streamline the diet;
• be treated with herbs.

The basis of a therapeutic diet for a similar disease of the esophagus is a ban on:

1. Sweets. Forget about chocolate and coffee.
2. Bad habits. It is undesirable to smoke and drink alcohol.
3. Fat containing products.
4. Spices. Any spicy seasonings must be removed from the diet.
5. Fast food, fast food.

Priority should be given to the following products:

• dried fruit compotes;
• low-fat dairy products;
• baked apples;
• boiled eggs.

Herbal treatment

The first treatment option is performed with herbs. To normalize the situation, it is recommended to use different plants for certain situations:

1. Improved digestion. Such herbs are suitable: anise, oats, oregano, St. John's wort, fragrant bison.
2. Constipation. Spicy amaranth, elder, highlander, watercress, medium clover will save.
3. Restoration of the mucosa. Highlander snake, tenacious, erect cinquefoil, sea buckthorn, smooth licorice will bring benefits.
4. Weak gastric peristalsis. The immortelle unifolia, the city gravel, the branched broomrape, the field toad will help.
5. Enveloping herbs. These include buckwheat, panicled mullein, paznik, common ragwort.

Medical therapy

For the treatment of the first stage of pathology, two types of drugs are used:

1. Antacids. They are taken every couple of hours. The main ingredients of the preparations are aluminum and magnesium. It is not recommended to use drugs for kidney failure. Then, instead of them, only those agents in which aluminum is present are prescribed. Therapy with antacids is long, however, very effective.
2. proton pump inhibitors. Blockers are used, which are prescribed to those patients who are diagnosed with the first stage of esophagitis. When ulcers have already affected the esophagus, there is no effect from inhibitors. Treatment with such drugs brings an effect only at the very initial stage of the pathology.

Estimated price tags for treatment in the main centers

Prevention

To prevent recurrence of the disease, it is required to exclude the factors provoking it:

1. The first requirement is to normalize nutrition.
2. The second step is to monitor your own weight. Obesity is a direct path to the onset of reflux esophagitis.
3. The third stage is to pump up the press.
4. The fourth rule is to quit smoking.
5. The fifth stage is to equip the sleeping place correctly. The head should be higher than the stomach.
6. The sixth requirement is to eat on time. make a clear meal schedule.
7. The seventh postulate is the normalization of sleep.

At the initial stage of reflux esophagitis, hoarseness sometimes occurs, a person often has a cough, he is prone to bronchitis or laryngitis. Other symptoms characteristic of reflux may not be observed at all.

Treatment in such a situation is selected carefully, they seek to eliminate the signs of both diseases at once. Active medication and diet therapy are the main directions of therapy. It is imperative for people suffering from reflux of food back into the esophagus to stop smoking forever.

Reflux esophagitis is a pathological condition in which the patient suffers from the constant reflux of stomach contents into the esophagus. There can be many reasons for the development of a disorder, the main of which are diseases of the gastrointestinal tract and weakness of the food sphincter. Due to the constant ingestion of acid on the neutral mucosa of the esophagus, the patient experiences unpleasant symptoms in the form of pain and burning. In the absence of therapy for this condition, erosion of the epithelial layer develops, which can grow and affect the entire esophagus.

The human stomach produces hydrochloric acid with its glands to digest food. Since it is useful only in the conditions of being in the gastric cavity, there are so-called locking devices in the digestive system, which are sphincters. The stomach contains two - one goes into the cavity of the esophagus, the second into the intestines.

When, under the influence of certain factors, the patient has a weakness of the first sphincter, part of the acid and products impregnated with it begin to enter the esophagus. The mucosa of this section of the intestine always has a neutral acidity and begins to suffer due to the slightest impact. After the first cast, small burns appear on it. With the systematic penetration of gastric juice, these erosions do not go away and are chronic.

With first-degree reflux esophagitis, burns are small, and with timely treatment and the transition to proper nutrition, they disappear. Usually, pathology in the initial stage without further progression occurs during pregnancy due to toxicosis and a growing fetus that presses on the gastrointestinal tract.

Attention! Reflux esophagitis of the 1st degree can be temporary and quickly eliminated after a slight overeating or vomiting due to poisoning. In this case, the burns disappear within a few days and do not become chronic.

Reasons for the development of the disease

Various factors can cause a violation, which are eliminated on their own while maintaining proper nutrition or with the mandatory use of medications. The main causes of grade 1 reflux esophagitis include:

Attention! Often, the process of formation of first-degree reflux esophagitis is triggered by chronic diseases of the gastrointestinal tract, including ulcers, gastritis, pancreatitis, and cholelithiasis. They are rarely solitary and are almost always accompanied by the development of weakness of the sphincter of the esophagus and stomach.

Symptoms of reflux esophagitis grade 1

The clinical picture of the disease at this stage is not pronounced. Primary symptoms occur only if the lumen of the esophagus narrows to 1 cm and multiple burns appear on it. In the initial stage, the patient is only concerned about heartburn, which patients associate with periodic overeating and do not pay appropriate attention to it.

With the first degree of reflux esophagitis, burning also appears after small loads on the abdominal cavity or at night. Given the exacerbation of the primary condition, patients may begin to complain of recurrent belching with a sour taste and a feeling of a foreign body in the throat. The following disorders in the patient's condition may also be noted:

• feeling of heaviness in the abdominal cavity;
• periodic bloating and flatulence;
• gases, which are especially disturbing at night and 2-3 hours after dinner;
• pain in the esophagus due to constant exposure to acid;
• the appearance of discomfort when swallowing.

Attention! Given the complications of the disease, problems may appear in the form of diarrhea, constipation, prolonged pain in the abdomen. Many patients begin to lose body weight due to decreased appetite and problems with swallowing.

Diagnosis of the disease

It is possible to confirm the pathology already at the first stage of its development with the help of appropriate diagnostic procedures. Face-to-face examination with reflux of the first degree does not give any result and requires mandatory instrumental methods.

Nutrition for the first degree of reflux esophagitis

The diet is not only health-improving in nature, but also allows the patient to maintain optimal body weight and becomes a prevention of possible chronic diseases. As with any gastrointestinal pathology, you should eat at least six times a day in small portions. Do not eat 2-3 hours before bed.

If the meal was late, you should not go to bed for half an hour after it. During this time, the stomach will be able to process part of the incoming food and give it to the small intestine. This will also reduce the load on the food sphincter and will not provoke the reflux of stomach contents into the esophagus. If the pathology has only the first degree of development, it quickly passes if these recommendations and diet are followed. During the treatment of reflux, the following products should be preferred:

In this case, it is required to completely exclude all products that can cause flatulence, containing acid, alcohol, fatty foods. Seasonings and a large amount of oil are harmful.

Attention! You should not drink a lot of coffee and tea with reflux esophagitis of the 1st degree. If it is difficult to refuse them, you need to prepare a weak brew and take only natural coffee, diluting it with milk.

Non-traditional methods of treatment

They are aimed at eliminating inflammation, healing wounds and restoring the epithelial layer. At the first stage of reflux, therapy with non-traditional methods is sometimes sufficient if the disease is not caused by pathological factors.

herbal collection

For treatment, you need to take chamomile, flax seeds, lemon balm grass, motherwort. All herbs are taken in the same amount and finely ground in a coffee grinder. For therapy, two tablespoons of the resulting powder is poured into 0.5 liters of cold water. The mixture is brought to a boil and kept on low heat for 15 minutes. After cooling, the grass is removed. Take 50 ml 3-4 times a day 15 minutes before meals. The duration of therapy is 7-15 days.

Chamomile and calendula

Herbs are taken at the rate of 2 tablespoons of chamomile flowers and 1 tablespoon of calendula. They are also mixed and ground in a coffee grinder. One part of the resulting amount of herbs is poured into 250 ml of boiling water and kept under the lid for 2-3 hours. After infusion, the mixture is removed through a sieve. Drink 50 ml three times a day 15 minutes before meals. The duration of therapy is up to three weeks.

Buckthorn

It treats not only the resulting burns, but also digestive problems in the form of flatulence, gas formation, heartburn and constipation. Two tablespoons of the substance are well crushed and steamed in 250 ml of boiling water for two hours. After that, the bark is removed through cheesecloth and 50 ml of the solution is taken in the morning and evening. Duration of therapy - no more than two weeks.

Rose hip

For treatment, it is required to boil a tablespoon of fruits in 500 ml of water for 15 minutes. They should be stirred and kept on low heat so that the dog rose gives the maximum amount of useful substances. After boiling, the fruits are left for 2-3 hours in water, after which they are filtered. It is required to take a decoction of 100 ml twice a day, if necessary, it is allowed to add a small amount of sugar. Treatment can be continued up to two weeks.

Preparations against reflux esophagitis of the 1st degree

Treatment is always complex and allows you to stop, including the progression of chronic ulcers, gastritis, pancreatitis. Courses of treatment are usually not long, since the disease is mild.

Prokinetics for reflux

Their impact is aimed at improving the motility of the gastrointestinal tract, strengthening the sphincter, eliminating flatulence and bloating.

"Damelum"

Tablets additionally relieve feelings of nausea and vomiting. It is recommended to take Damelium 10 mg three times a day. For the best effect, this should be done 30 minutes before meals, the duration of therapy is individual for each patient. With severe vomiting or nausea due to developing heartburn or simultaneous exacerbation of other pathologies of the gastrointestinal tract, you can take 20 mg of Damelium three times a day, also half an hour before meals.

Tablets "Damelium"

"Domstal"

You can take the medication at any age with the permission of your doctor. In the presence of kidney disease, the intake can only be a single dose; in severe conditions, no more than two doses are taken. If the patient does not suffer from renal failure, you can take 10-20 mg of Domstal, taking into account the condition, three times a day. To consolidate the result, the same dose of the active substance is taken at bedtime. Treatment is carried out individually selected course.

Tablets "Domstal"

Antacids and proton pump inhibitors

Neutralize the effect of hydrochloric acid and products impregnated with it on the walls of the esophagus. Quickly relieve heartburn, belching and possible pain.

"Agiflux"

If the patient does not have problems with ulcerative lesions, it is required to take 2-3 tablets an hour after eating. In the presence of peptic ulcer, in order to get rid of reflux, you should take Ajiflux 30 minutes before meals at a dose of 2-4 tablets. Duration of treatment - according to indications.

Tablets "Ajiflux"

"Maalox"

Quickly envelops the damaged mucosa and neutralizes the effects of hydrochloric acid. It is better to take the medication in the form of a suspension, it gives a faster and more lasting effect. A single dose of Maalox is 1-2 sachets of liquid. No more than 12 sachets of the drug are taken per day. It is better to drink the suspension one hour after a meal. Treatment can be continued up to 12 weeks.

Tablets "Maalox"

"Maalox" suspension

"Omeprazole"

A combined drug that protects the mucous membrane, normalizes motility, acidity and the overall functioning of the gastrointestinal tract. For the treatment of reflux esophagitis, one capsule of the active substance is prescribed, preferably in the morning. Treatment can last up to six months. If additional exposure to the Helicobacter bacterium is to be eliminated, the dose is 2 capsules of omeprazole for a week in combination with antibiotics.

Capsules "Omeprazole"

Antiulcer drugs

They are necessary to reduce the amount of hydrochloric acid and provide an antibacterial effect. They can be used in complex therapy with antibacterial agents to suppress Helicobacter pylori bacteria.

"Ranitidine"

In the first stage of reflux, the dose is usually 150 mg in the morning and evening, sometimes the entire daily dose is given at bedtime. If it is necessary to eliminate the symptoms of ulcers and gastritis, against which esophagitis has developed, the dose can be increased to 150 mg four times a day. Treatment, taking into account the degree of the patient's condition, can be continued for up to three months.

Tablets "Ranitidine"

"Atsilok"

Available in the form of a solution and tablets. With reflux esophagitis, including complicated by an ulcer or gastritis, it is taken only in solid form. The dose is 150 mg in the morning and evening, if necessary, if the symptoms bother the patient more in the evening and at night, you can take the entire dose once before going to bed. Treatment can be carried out up to three months.

Acilok solution in ampoules

"Ultop"

It is a stronger analogue of the classic Omeprazole. At the first stage of reflux esophagitis, 20 mg of the main component should be taken once in the morning. If necessary, the doctor may recommend taking the drug "Ultop" on demand with an increase in the symptoms of the pathology, the maximum dose of the active substance in this case is selected for each patient. Reception is carried out individually selected time.

Capsules "Ultop"

Auxiliary drugs

They are used in the presence of additional symptoms in the form of constipation, bloating, the presence of bacteria in the digestive tract. They allow you to enhance the impact of the main groups of medicines and speed up recovery.

"De-Nol"

It contains bismuth, which has the necessary astringent effect and prevents the spread of Helicobacter pylori. Tablets should be taken half an hour before meals, no more than one tablet at a time. The daily amount of the drug "De-Nol" is 4 doses. Therapy is carried out at an individually determined time.

Tablets "De-Nol"

"Espumizan"

It copes well with bloating and spasms, does not allow gases to linger in the digestive tract. You can take it in the form of an emulsion and in the form of tablets. Single dose 5-10 ml or 1-2 capsules. The daily dose, taking into account the patient's condition, is 25-50 ml of suspension or 5-10 capsules of espumizan. Take 30 minutes before meals.

Capsules "Espumizan"

"Rebagit"

Protects against the effects of hydrochloric acid, normalizing the work of the gastric glands. It is also used in therapy for the combined elimination of ulcers, gastritis and reflux esophagitis. Treatment involves taking 1 tablet "Rebagit" three times a day. The medication should be taken for 14-30 days, sometimes a longer course is required.

Tablets "Rebagit"

Attention! Medications should be taken under the supervision of a physician, since it is required to draw up an optimal set of drugs for a particular patient, taking into account the cause of reflux esophagitis. If the patient simultaneously follows a diet and does not have chronic pathologies of the gastrointestinal tract, it is possible to completely eliminate the problem and prevent its progression.

Reflux esophagitis of the first degree is rarely independent, more often provoked by diseases of the gastrointestinal tract. In this state, it is imperative to adhere to a diet and take prescribed medications. If the disease does not have pathological grounds, it is enough to eliminate the causes of the violation and, if necessary, undergo systematic therapy. With the timely start of treatment, it is possible to completely restore the esophageal mucosa and remove pain, heartburn and intestinal disorders.

Video - Reflux esophagitis grade 1: what is it

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.

The reasons

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. With 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.

1. degree - manifested by separate non-merging erosions and erythema of the distal esophagus;
2. degree - merging, but not capturing the entire surface of the mucosal erosive lesions;
3. degree - manifested by ulcerative lesions of the lower third of the esophagus, which merge and cover the entire surface of the mucosa;
4. 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

Today, quite different methods are used to detect gastroesophageal reflux. 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 comorbidities. 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 of symptoms such as heartburn and chest pain in the supine position, you should adopt the correct posture - the upper body 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.

Many people are concerned about the question, what is it - reflux esophagitis of the first degree? Reflux esophagitis is a type of gastroesophageal reflux disease, characterized by a constant reflux of gastric contents into the lumen of the esophagus and a negative effect on the mucous membrane of the latter.

GERD is characterized by regular episodes of acidic stomach contents back up into the esophagus.

Reflux esophagitis is an extremely common disease among the population, characterized by prolonged irritation of the esophagus by gastric juice. Despite this, there is some bias towards this condition among the population and doctors, associated with its underestimation as a possibility of developing serious conditions and complications. Therefore, each of us is recommended to know the main causes of reflux esophagitis, the first symptoms of the disease, as well as the basic principles of correct diagnosis and treatment.

Reflux esophagitis of the 1st degree is characterized by minimal symptoms (heartburn, belching, and others), which many people interpret as a consequence of eating poor-quality food. However, behind them is a serious disease, prone to constant progression and the development of a number of complications, up to cancer of the esophagus.

The prevalence of the disease in the population

The prevalence of reflux esophagitis in Russia is unknown, since a holistic record of the incidence is not kept. However, according to a recent social medical survey in Moscow, the main symptom of this disease, namely heartburn, is observed in 35% of women and 15% of men. Such figures indicate the occurrence of reflux esophagitis in every 8 people, which makes doctors sound a certain alarm. At the same time, no more than 10% of people with this symptom seek medical help.

A more complete picture of the prevalence of reflux esophagitis can be obtained by studying the statistics of the disease abroad. According to the US medical services, symptoms of reflux esophagitis are found in 30-50% of adults, and about 20% of people experience heartburn on a weekly basis. As in Russia, people with symptoms of the disease do not rush for medical help - only one in three people go to see their doctor.

GERD is a very common disease

Causes of reflux esophagitis

All causes of the disease can be divided into four large groups:

• Associated with a congenital or acquired decrease in the activity of the antireflux mechanism, which prevents the entry of gastric juice into the esophagus.
• Decrease in the rate of passage of food through the esophagus, which leads to its overstretching and disruption of the sphincters, which normally close the place where the esophagus passes into the stomach.
• Increased sensitivity of the inner lining of the esophagus to irritants, in particular, to gastric juice.
• Hypersecretion of hydrochloric acid and active enzymes in the stomach, which leads to an increase in the aggressiveness of gastric juice.

In most cases, in patients with reflux esophagitis of any stage, there is a combination of several factors leading to constant irritation of the esophageal mucosa and the appearance of symptoms of the disease. It should be noted that some of them may be congenital in nature (the nature of the antireflux mechanism, the sensitivity of the esophageal wall, and others).

Clinical manifestations of reflux esophagitis

Reflux esophagitis is often characterized by painful symptoms

The clinical symptoms of reflux esophagitis are varied. It should be noted that the severity of all symptoms does not depend on the nature and severity of changes in the inner lining of the esophagus, which makes it difficult to set the correct severity.

The manifestations of reflux esophagitis are divided into two large groups:

• Associated with damage to the esophagus, which includes heartburn, swallowing disorders, belching, retrosternal pain and regurgitation.
• Not related to the esophagus: cough, dry throat, hoarseness, shortness of breath, increased salivation, caries and others.

According to patient surveys, the most common symptoms are heartburn and belching of sour foods, most often occurring either during sleep or when leaning forward. The second most common symptom of reflux esophagitis is chest pain that mimics angina pectoris. The rest of these symptoms are not as common.

Heartburn and belching

The most common complaints in patients with reflux esophagitis. Heartburn is a burning sensation of varying strength behind the sternum (corresponding to the lower third of the esophagus) or in the region of the shoulder blades. It occurs in nine out of ten patients with the disease. The reason for the appearance is the effect of the contents of the stomach with a very low pH on the mucous membrane of the lower esophagus. Both the doctor and the patient must remember that the severity of heartburn does not reflect the severity of the esophageal lesion. At the same time, heartburn attacks occur more often when the diet is violated, the use of various carbonated and alcoholic beverages, during exercise and during sleep.

Chronic heartburn is the most common symptom of GERD.

Very often, heartburn is the first symptom of a disease that requires attention from a person and seeking medical help.

Belching and regurgitation of food are observed in half of the patients. The most typical occurrence of these symptoms after eating. Most often, regurgitation of acidic contents occurs.

Pain behind the sternum

Pain sensations are localized behind the sternum, between the shoulder blades and can move to the neck, lower jaw, left half of the chest. Very often similar to angina attacks, but not stopped by taking nitroglycerin. In this regard, in order to exclude angina pectoris, myocardial infarction and other diseases, it is necessary to pay attention to the factors that caused the pain syndrome. Retrosternal pain is often associated with a poor prognosis for the patient, especially when combined with rapid weight loss and impaired swallowing.

Swallowing disorder

Swallowing disorder, or dysphagia, is less common than other symptoms, and is associated with impaired progression of the food bolus through the esophagus. One of the rare signs of the disease, along with extraesophageal symptoms.

Feeling of food stuck in the esophagus

Diagnosis of reflux esophagitis

The following methods can be used to make a correct diagnosis:

• An X-ray examination using a contrast agent allows assessing the motor function of the esophagus, identifying a diverticulum of the organ wall, various strictures and narrowing of the lumen of the esophagus, as well as indirect signs of an inflammatory process in the wall (its thickening, changes in the nature of folding, unevenness of the contour).
• Endoscopy with or without 24-hour esophageal pH monitoring is considered the gold standard for diagnosis. In addition, it is endoscopic examination that allows you to correctly set the severity of reflux esophagitis. Daily monitoring of pH in the esophagus allows you to identify its changes and detect the strength and frequency of reflux of gastric contents.
• Evaluation of the motor activity of the esophagus allows you to evaluate the evacuation function of the organ and the work of antireflux mechanisms.
• Morphological examination of the esophageal wall plays an important role in the diagnosis of Barrett's esophagus and esophageal adenocarcinoma. Barrett's esophagus is a precancerous condition characterized by changes in the wall of the organ with the replacement of the esophageal type of the mucosa with the gastric type.

It is important to remember that all these diagnostic methods should be supplemented by the history of the patient's illness and life, as well as his complaints. None of the diagnostic methods guarantees 100% accuracy of the result.

Treatment of the disease

In the treatment of reflux esophagitis of the first degree, non-drug and drug therapies play an important role. Remember that the appointment of treatment should be carried out by the attending physician after a complete examination of the patient, taking into account all indications and contraindications.

Non-drug methods

Any patient with a diagnosis should follow a number of recommendations:

• Do not eat large portions of food and do not overeat, especially before bedtime. It is important to adhere to fractional nutrition with the use of small portions. Reduce the amount of fatty, spicy, sweet foods, which in themselves can serve as an irritant. Carefully use drugs that promote the reflux of stomach contents into the esophagus (sedatives, theophylline, nitrates, verapamil and other calcium channel inhibitors).
• Reduce the amount of physical activity associated with lifting heavy weights and tension in the abdominal muscles.
• Raise the head of the bed and sleep with your head elevated.
• Give up bad habits (smoking and drinking alcohol).
• Reduce body weight in case of its excess.

Medical methods

For the treatment of reflux esophagitis of the first degree, drugs are used for a long time that help reduce the acidity of gastric juice and accelerate the movement of food through the esophagus:

• Drugs that reduce the acidity of gastric juice. This therapy is aimed at increasing the pH of the gastric juice and, thereby, at reducing its ability to damage the mucosa of the esophagus. The most effective in this respect are proton pump inhibitors (omeprazole, rabeprazole and others), which inhibit the production of hydrochloric acid and increase the pH level. Less often, blockers of H2-histamine receptors (Ranitidine, Famotidine) are used, which also reduce acidity, but are less effective.

proton pump inhibitor

• Drugs that speed up the passage of food through the esophagus and prevent the reflux of stomach contents into the esophagus. This group of medicines includes Domperidone, Cerucal and others. Can be used as the sole drug in combination with lifestyle changes for grade 1 reflux esophagitis.

Reflux esophagitis of the first degree is characterized by mild symptoms (heartburn, belching) and most often does not cause concern in patients. However, the progression of the disease without appropriate treatment can lead to the development of severe complications, up to oncopathology.

In the event of the first symptoms of the disease, it is necessary to immediately seek medical help for timely diagnostic measures and the appointment of the necessary treatment.

Reflux esophagitis is an inflammatory pathology that provokes gastric contents thrown into the esophagus due to insufficiency of the lower sphincter of the latter. Aggressive substances contained in gastric juice negatively affect the mucous membrane, causing pain.

Causes of reflux esophagitis

Often this disease occurs due to a weakening of the muscle tone of the lower esophageal sphincter. As a result, the latter is partially or completely open, which allows the contents of the stomach to enter the esophagus.

In turn, sphincter insufficiency occurs due to nerve stress, chemical / nutritional factors, and increased pressure in the peritoneum.

A hernia of the esophageal opening of the diaphragm can provoke insufficiency of the sphincter: when the latter expands, the contents of the stomach are thrown.

Provoking factors:

• Obesity;
• Smoking, alcoholism;
• Taking a number of medications (eg nitroglycerin, metoprolol);
• Excessive passion for coffee, chocolate, spices;
• Pregnancy;
• Ulcer disease.

Degrees and forms of the disease

This pathology can be acute and chronic. In the first case, the symptoms include soreness after a meal, discomfort behind the sternum along the esophagus, general malaise, slight fever, burning sensation in the neck, profuse salivation.

The chronic form of inflammation manifests itself primarily in pain localized behind the sternum, often accompanied by gastritis. There is heartburn, difficulty breathing, hiccups, vomiting.

What is it - reflux esophagitis 1, 2, 3 and 4 degrees?

• The first degree indicates that there are several erosions on the mucosa that do not merge, as well as erythema in the distal organ;
• The second degree - erosion is already merging, but does not affect the entire mucosa.
• Third - ulcerative lesions form in the lower third of the esophagus.
• The fourth degree is a chronic ulcer and stenosis.

Symptoms and treatment strategy for reflux esophagitis

The first warning sign is heartburn. The latter can occur regardless of the time of day, after eating, when the body is in a horizontal position.

In addition, there is pain in the chest area, which is often perceived as cardiac. Sometimes these symptoms are completely absent, but there is a violation of the swallowing process. The latter indicates the development of cicatricial narrowing and the progression of pathology.

Other symptoms of the disease:

• Sour or belching air;
• Failures of the swallowing reflex, violation of the passage of food;
• Chronic cough, obstruction of the bronchi with a viscous secret;
• Rhinitis and pharyngitis. The mucous membrane of the pharynx and nose becomes inflamed due to frequent contact with the contents of the stomach;
• Destruction of tooth enamel by acidic gastric juice.

Sometimes even an experienced doctor can find it difficult to determine this disease, since it has a similar clinical picture with many pathologies of the gastrointestinal tract.

In order to detect the disease in time, it is necessary to conduct a series of studies. Typically, a set of diagnostic procedures includes esophagoscopy (examination of the esophagus using endoscopic equipment), X-ray, mucosal biopsy, esophageal pH-metry (to determine the level of acidity).

What is catarrhal and erosive reflux esophagitis?

The catarrhal form of the disease is most often diagnosed. In addition to the main symptoms listed above, the doctor, during a diagnostic examination, detects swelling and hyperemia of the esophageal mucosa. Catarrhal esophagitis occurs due to insufficient function of the cardiac sphincter of the esophagus.

Erosive reflux esophagitis is characterized by a stronger and deeper lesion of the mucosa. This form of pathology is less common than the previous one, but much more often leads to various complications. So, the disease is accompanied by the formation of ulcers and erosions on the mucous membrane of the esophagus.

There are 3 degrees of pathology:

• I - a single formation of small erosions;
• ІІ – increase in the affected area;
• ІІІ – formation of a chronic ulcer.

How to stop the symptoms and treatment of the disease, diet for reflux esophagitis?

As with any other diseases, therapy in this case begins with the exclusion of possible causes of the development of pathology, for example, smoking, stress, obesity.

Medications are mandatory. First of all, these are antacids - drugs that reduce the acidity of gastric juice by neutralizing it.

One of the most famous antacids is Almagel. The latter is taken for several days in a row, 5-10 mg three times a day before a meal.

In addition to antacids, treatment includes prokinetics - substances that increase the muscle tone of the lower sphincter. These include Motilium and Motilak.

It is also necessary to take antisecretory drugs that reduce acidity by inhibiting the production of the latter. These include Famotidine and Omeprazole.

Diet for reflux esophagitis

Diet modification is a mandatory component of the treatment complex. From the menu, first of all, you need to exclude the following products:

• alcohol (increases acidity, relaxes the sphincter);
• strong tea, coffee, soda;
• chocolate (promotes relaxation);
• mushrooms;
• mayonnaise, ketchup, hot spices;
• smoked meats;
• marinades;
• legumes, especially peas and beans (increase intra-abdominal pressure);
• canned food;
• sour juices;
• fresh and sauerkraut;
• fatty;
• black bread;
• fast food, chips, chewing gum;
• fried meals.

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

The diet necessarily includes the following products:

• mashed cottage cheese (fat-free);
• sour cream and milk (with a low% fat content);
• fresh and soft-boiled chicken and quail eggs;
• homemade crackers;
• any cereals;
• steam cutlets;
• baked apples of sweet varieties;
• baked vegetables;
• baked and boiled fish.

Food can be diversified with products, after the use of which there is no discomfort. In addition, you need to pay attention to the diet. It is necessary to exclude nervous overload at work, get enough sleep, eat 4-5 times a day (eat slowly, avoid haste), after a meal it is recommended to walk or work while standing (you can not sit).

Symptoms and treatment of reflux esophagitis: therapy with folk remedies

Alternative medicine, of course, can be used and at the same time very effectively. However, various recipes can only supplement the main, drug treatment.

In addition, therapy with folk remedies lasts quite a long time - about two months.

1. To reduce acidity, stop pain, relieve inflammation, a collection of chamomile flowers and flax seeds (2 tablespoons each), lemon balm leaves, licorice root, motherwort (1 tablespoon each) will help. Herbs are poured with boiling water and boiled in a water bath for 10 minutes, then the broth is kept for 2 hours and after filtering they drink a third of a glass up to 4 times a day;
2. Take a tablespoon of oregano, calendula, calamus rhizomes, anise fruits, fireweed, white yasnitka, mint. Chop the ingredients. The broth is prepared, as in the previous recipe, but first insist and then boil. Drink the medicine 50 ml up to 6 times a day;
3. Mix 2 tbsp. l .: plantain leaves, dandelion, chamomile flowers, mountaineer roots, oregano, yarrow and shepherd's purse grass. Pour the collection with hot water and insist. After straining, drink warm up to 6 times a day.

You can fight heartburn with folk remedies such as juices, for example, potato. It is necessary after eating to drink 1/2 cup of freshly squeezed juice and seize it with sugar. Sweet water works in a similar way (prepare in the evening, drink in the morning). Chamomile and mint tea will also help, you can chew raspberry or blackberry leaves.