Reflux esophagitis: symptoms and treatment with pills, diet and folk remedies. What is reflux esophagitis of the first degree Distal reflux esophagitis of the 1st degree

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 an inflammation of the lower esophagus, which is caused due to damage to its walls by the contents thrown from the stomach or intestines. This inflammation is a dependent disease, most often, it is a symptom of an ulcerative lesion of the digestive tract or a complication of gastroesophageal reflux disease.

Reflux esophagitis has no specific symptoms. Its first symptom is heartburn. It is also manifested by such digestive disorders as dysphagia, belching sour, especially after eating. There is pain in the epigastrium, which radiates to the area between the shoulder blades, neck, lower jaw, left side of the chest. There are also extraesophageal manifestations of the disease, which include cough, shortness of breath in a horizontal position, hoarseness, dry throat, inflammation of the tonsils or paranasal sinuses, white coating on the tongue, bloating, nausea, vomiting, and rapid satiety.

The medical classification of reflux esophagitis divides it into degrees (A, B, C, D), they are also called stages (1, 2, 3, 4). Also, depending on the predominance of certain changes, catarrhal, exfoliative, edematous, erosive, pseudomembranous, necrotic and phlegmonous reflux esophagitis are distinguished.

Causes and diagnosis of the problem

The reasons for the development of pathology can be:

• weakness of the muscular system of the lower esophageal sphincter;
• spontaneous relaxation of the gastroesophageal sphincter;
• hiatal (diaphragmatic) hernia;
• the use of sedatives and antispasmodics;
• a decrease in the body's ability to self-cleanse;
• strengthening the damaging properties of the contents thrown from the stomach or intestines;
• reducing the resistance of the mucous membrane to the damaging effects of the food thrown back;
• stomach emptying disorder;
• intra-abdominal hypertension (i.e., high blood pressure), often developing with obesity, ascites, overeating, severe intestinal distention.

Methods for diagnosing reflux esophagitis:

• To make a diagnosis of reflux esophagitis, an instrumental examination of the esophagus is prescribed using an endoscope. As a result, it reveals the presence of inflammation, erosive changes, ulcerative lesions, replacement of squamous stratified epithelium with a cylindrical one.
• Another type of diagnosis of food reflux into the esophagus is daily pH-metry of the esophagus. A decrease in pH (that is, a pH value) less than 4, or, conversely, an increase in more than 7, indicates the presence of reflux. At the same time, a decrease in the pH indicator reveals the reflux of gastric contents, and an increase - intestinal. The normal pH is 6.0. This type of study determines the number and duration of episodes of reflux in the lower esophagus. It is daily pH-metry that makes it possible to choose individual treatment and monitor the effectiveness of prescribed drugs.
• Manometry of the esophageal sphincters allows you to determine the change in valve tone.
• pH-metry combined with impedancemetry. The study is called impedance-pH-metry. This method allows you to evaluate the peristalsis of the esophagus and gastroesophageal reflux.

Mild variant of the disease

The disease begins with stage 1 - reflux esophagitis 1 (A) degree. What it is will help to understand the fact that stage 1 is characterized only by intense redness of the esophageal mucosa and the formation of point erosions.

At the first stage of the disease, drug treatment is usually not required. Sufficient is the observance of certain conditions, the maintenance of a dietary diet. Adherents of traditional medicine can use decoctions and teas from medicinal herbs as therapy.

To eliminate stage 1 reflux esophagitis, you must:

• do not abuse food, eat in small portions and only warm food;
• eat every 2-3 hours;
• do not eat fried, pickled, spicy and sour foods and dishes;
• stop drinking alcohol and smoking;
• eat at least two hours before bedtime;
• normalize weight;
• wear comfortable clothes, avoid tight belts;
• eliminate bending after eating;
• stop taking medicines that can provoke relaxation of the gastroesophageal sphincter.

As a folk therapy, you can take dandelion flower syrup. To obtain it, you need to cut dandelion flowers and, placing layers in a jar, sprinkle them with sugar. The resulting mixture is well crushed and infused until juice is formed. After that, dilute 1 teaspoon of juice in half a glass of water and take it before meals 3 times a day. You can also brew a mixture of marigold, lemon balm, oregano and plantain in the form of tea. Before use, dilute 1 tablespoon of the resulting concentrate in 200 ml of water. Take 1/3 cup before meals.

Deterioration of the situation

Reflux esophagitis of the 2nd degree is characterized by the development of erosions and ulcerative changes on the mucous membrane of the esophagus, which tend to merge into a single whole, thus increasing the area of ​​the lesion. In this case, the percentage of damage is at least 40% of the entire organ.

On examination, scarlet erosions with numerous bruises, swelling and thickening are visible. On the upper layer of the mucous membrane, purulent, serous and bloody discharges are observed. With vomiting, the exfoliated mucosa can come out along with the vomit. This stage already needs to be treated with medications:

• Prokinetics - a group of drugs (Dimelium, Motilium, Domstal, etc.), which is aimed at stimulating the motor function of the digestive tract. As a result of their use, there is stimulation of the tone of the lower esophageal sphincter, the rapid passage of the food bolus through the esophagus, and accelerated emptying of the stomach from digested food.
• Antacids (Almagel, Ajiflux, Maalox) are used to neutralize excess hydrochloric acid in the stomach, normalize the acidity of gastric juice and protect the walls of the stomach due to the enveloping effect.
• Antiulcer drugs such as Ranitidine, Omeprazole, Lansoprozol and others reduce the formation of hydrochloric acid and have a bactericidal effect against Helicobacter pylori.

With the progression of the disease to grade 3-4 reflux esophagitis, one or more esophageal folds are affected. The mucous membrane is affected up to 75% around the circumference. The symptoms and disorders of the functioning of the organ are aggravated. Because of this, there is a violation in the work of neighboring organs involved in digestion (intestines, stomach, gallbladder, liver).

In the absence of adequate treatment, the process of transformation of organ cells into necrotic fibers starts, decay is observed, and oncopathology is formed.

At these stages, complex therapy of the condition is necessary, which includes a diet, compliance with the recommended rules, taking the above medicines, as well as the use of drugs from the group of gastroprotectors and reparants. These include: Venter, Solcoseryl, Actovegin and others.

At the first symptoms of the disease, you should consult a specialist. All drugs and dosages are selected individually by the attending physician based on the results of tests and studies. In the case of a neglected form, surgical treatment of the disease is possible.

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Frequent heartburn is a sign of the development of chronic distal esophagitis. Acute attacks of this disease usually pass quickly, but if inflammation of the esophagus is a frequent concern, it is necessary to undergo a diagnosis and start treatment in order to avoid complications of the pathology. There are several types of distal esophagitis, each of which has its own characteristics of the course.

Distal esophagitis is a disease of the esophagus characterized by an inflammatory process on the mucous membrane of its lower section, located near the stomach. Such inflammation is not always a pathology - in the normal state, it indicates that too aggressive food has entered the body. The process becomes permanent when the defense mechanisms are weakened and under the influence of a number of other factors.

Causes of pathology

According to the etiological sign (reasons), several types of distal esophagitis are distinguished:

1. Alimentary- due to mechanical, chemical, thermal and other effects on the esophagus. It is a natural reaction to hot, spicy, poorly chewed food, strong alcohol, cigarette smoke.
2. Professional- due to exposure to harmful substances in production (vapors of acids and alkalis, metal salts, etc.).
3. Allergic- Caused by the body's reaction to an allergen taken with food.
4. Infectious- due to infection with measles, scarlet fever, diphtheria and other infections. In this case, the most morphological varieties of pathology occur.
5. Reflux esophagitis- due to ingestion of digested food from the stomach into the esophagus. This may be due to the weakness of the lower sphincter, located on the border of the two sections of the gastrointestinal tract, hernia - a protrusion of the stomach into the esophagus, and some diseases. Symptoms are more pronounced if the pathology is combined with factors that cause increased secretion of hydrochloric acid in the stomach.
6. stagnant- Irritation of the esophagus with food debris stuck in it. Food may not pass into the stomach due to insufficient relaxation of the sphincter, congenital or stenotic reduction in the lumen of the esophagus, protrusion of its wall (congenital, caused by a benign or cancerous tumor, etc.)
7. candida- occurs when the fungus of the genus Candida, which causes thrush in the oral cavity, spreads to the mucous membrane of the esophagus. It is rare, because for this, candidiasis must be very neglected.

Important! Distal esophagitis is often not an independent disease, but a symptom of other problems with the body.

Because of this, frequent heartburn cannot be ignored - you need to contact a gastroenterologist for an examination.

Morphological forms of esophagitis

One of the main classifications of distal esophagitis is based on the nature of morphological changes occurring in the tissues of the esophageal mucosa. On this basis, the following main forms of pathology are distinguished:

• Catarrhal (superficial) - the most common, characterized by redness and swelling of the mucous membrane. At the same time, tissues are not destroyed, therefore, with timely treatment, inflammation disappears without health consequences. Most often, this form occurs when the mucous membrane comes into contact with hydrochloric acid from the stomach. Less often - with esophagitis of an infectious nature.
• Erosive. It is characterized by the formation of bleeding erosions and ulcers on the wall of the esophagus. It occurs with mechanical or chemical tissue damage (sometimes due to prolonged use of glucocorticoid drugs) and with infectious esophagitis.

Erosive distal esophagitis can be additionally divided into several types:

1. Hemorrhagic esophagitis is not always isolated in a separate form; differs in some features of the inflammatory process, which can only be determined by histological examination. It is characterized by a severe course with a high probability of exfoliation of the mucous membrane, hematemesis.
2. The fibrinous type of pathology occurs in childhood infectious diseases, as well as in adults as a side effect of radiation therapy and in hematological diseases. It is distinguished by the formation of a grayish-yellow film over the inflamed areas of the mucous membrane, which can exfoliate, revealing bleeding erosions and ulcers. The film consists of fibrin, which is why this form is also called pseudomembranous - a real membrane is formed from epithelial tissue. Clinically, fibrinous esophagitis does not differ from acute erosive pathology.
3. Exfoliative (membranous) esophagitis is characterized by delamination of the mucous membrane of the esophagus - the membrane in this case is a thin layer of detached epithelial tissue. In severe cases of pathology, flaps of deep-lying tissues can exfoliate, which leads to the formation of perforations, bleeding, which sometimes results in death. The reason for the development of this form of pathology are severe chemical burns, infectious diseases (smallpox, shingles).
4. In the rarest cases, necrotizing distal esophagitis occurs. It occurs with a critical weakening of the immune system, combined with severe infectious diseases (typhoid, sepsis, etc.). Morphologically manifested in tissue necrosis.

A complication of any form of pathology can be phlegmonous esophagitis, which occurs as an independent disease in cases of mechanical damage to the mucous membrane by foreign bodies and burns. In this case, purulent edema and abscesses form on the wall of the esophagus, which can spill and melt the mucous membrane.

A separate form is chronic esophagitis, which develops as a result of prolonged exposure to the mucous membrane of the esophagus. Its most common type is peptic esophagitis, caused by the systematic ingress of gastric juice into the lower esophagus. Its complication is peptic ulcer.

Degrees of the disease

Based on changes in the tissues of the mucous membrane, identified during the endoscopic examination of the esophagus, the severity of the pathology is determined:

1. I degree- inflammation is focal, mild. There is friability of the mucosa at the junction of the esophagus with the stomach. The folds are slightly smoothed out.
2. II degree- the occurrence of separate elongated erosions, capturing only the upper layers of the mucous membrane and extending to no more than 10% of the surface of the wall of the lower third of the esophagus. Possible exudate.
3. III degree- single erosions merge with each other, exudate is abundantly secreted, tissue necrosis begins. The area of ​​the affected surface is not more than 50% of the total.
4. IV degree- erosions that are completely merged, affect the esophagus in a circle, spreading more than 5 cm from the entrance to the stomach. Necrosis intensifies, ulcers form, affecting the deep layers of the epithelial tissue. The lumen of the esophagus narrows.

Narrowing of the esophagus interferes with the passage of food into the stomach. If left untreated, the ulcer can go into perforation of the esophageal wall, which is fraught with death. A serious complication of esophagitis can be cancer associated with the fact that the cells of the mucous membrane of the esophagus degenerate into cells of the gastric epithelium.

Clinical manifestations

The main symptom of most forms of esophagitis is severe heartburn that occurs immediately after eating. It is usually observed in a horizontal position of the body, disappearing when taking a vertical posture. It also increases with active physical activity and overeating.

In the early stages of the development of the disease, the following symptoms are also observed:

• belching with a sour or bitter taste, which occurs with reflux esophagitis, when the contents of the stomach rise into the oral cavity;
• increased secretion of saliva;
• difficulty and pain in swallowing.

These symptoms disappear or weaken after taking antacids - drugs that neutralize the acid component of gastric juice.

As the pathology develops, the following clinical signs of esophagitis appear:

• hoarseness and cough, sore throat;
• hiccups that appear after belching;
• heaviness in the abdomen;
• chest pain;
• isolation with cough and vomiting of exfoliated flaps of epithelial tissue lining the wall of the esophagus.

Acute esophagitis is sometimes accompanied by fever, weakness, and nervousness.

Methods for eliminating pathology

First of all, the cause of the inflammation must be eliminated. With the infectious nature of the disease, the basis of treatment will be a course of antibacterial or antiviral drugs. Fungal inflammation is treated with fungicidal preparations. If distal esophagitis is idiopathic (of unclear origin) or caused by a single mucosal lesion, therapy will be based on symptomatic relief.

Diet

In most cases, the inflammatory process stops on its own as soon as the patient's nutrition returns to normal. It is necessary to limit the irritating effect on the mucous membrane of the esophagus by excluding fried, spicy, smoked foods and too hot dishes from the diet. To avoid mechanical damage to inflamed tissues, food should be crushed before use and chewed thoroughly. You also need to limit the use of strong alcohol, juicy fruits and vegetables, smoking.

The patient's diet should consist of dietary meat and fish, non-acidic juices, mineral water, steamed vegetables, cereals, low-fat dairy products. Enveloping products are recommended - for example, vegetable oil. If reflux esophagitis is diagnosed, you should not take a horizontal position: within two hours after eating it is better not to go to bed at all, but you need to sleep with your upper half of your body elevated.

Medical therapy

Drugs are prescribed if the pathology has reached the late stages of development and with complications. In addition to drugs that help fight the cause of esophagitis, the following medications are used:

• antacids - omeprazole, as well as acidity stabilizers;
• prokinetics (stimulators of gastrointestinal motility) - domperidone;
• antispasmodics;
• enveloping agents;
• analgesics.

In the chronic form of the disease, specific drugs are needed that reduce acidity, but are not absorbed into the mucous membrane. These include medicines based on alginic acid.

Folk remedies

From heartburn with distal esophagitis, herbal decoctions help. Plant components have an antacid, enveloping, anti-inflammatory effect, they can be used in various combinations. It is recommended to change the decoction recipe every two weeks for better treatment effectiveness.

The following means are applied:

• flax seeds are a good antacid;
• chamomile has an anti-inflammatory effect;
• lemon balm leaves soothe inflamed tissues;
• rose hips accelerate the regeneration of the epithelium.

From these components, it is easy to collect a decoction that will help relieve almost all the symptoms of acute distal esophagitis. For example, to relieve pain, inflammation and reduce acidity, the following collection is used: 2 tbsp. chamomile and flax seeds are mixed with 1 tbsp. l. motherwort, lemon balm leaves and licorice root. The mixture is poured into 0.5 liters of boiling water and infused for 10 minutes. The tincture is filtered and consumed in the amount of 1/3 cup 4 times a day.

Potato juice, sweet water, mint or chamomile tea, dry raspberry leaves will help get rid of heartburn.

Inflammation relieves decoction of dill. Ground seeds of the plant in the amount of 2 tsp. pour a glass of boiling water and infuse for several hours. A decoction is used before meals, 1 tbsp. l.

Important! Decoctions should be insisted on water - alcohol tinctures will aggravate the inflammatory process in the esophagus.

In addition to decoctions, the following herbal remedies can be used:

• aloe juice - envelops the mucous membrane of the esophagus, preventing food from irritating it;
• sea ​​buckthorn oil - analgesic.

Esophagitis complicated by recurrent bleeding or perforation of the esophagus is treated with surgery.

Diagnostics

The main methods for diagnosing esophagitis are x-rays of the esophagus and endoscopic examination, which helps to assess the degree of damage to the mucous membrane. With the help of these procedures, the degree of development of the pathology is also established and the cause of the disease is determined.

Diagnosis can be supplemented by esophagomanometry - a procedure that assesses esophageal motility disorders. Daily monitoring of esophageal pH is also used.

Features of prevention

Prevention of acute distal esophagitis is:

• avoidance of mechanical, thermal and chemical damage to the esophagus;

Heartburn and a feeling of discomfort in the throat are among the main signs of inflammatory processes in the esophageal mucosa, and they need to be treated by qualified specialists. Moreover, the symptoms and treatment of reflux esophagitis should be constantly monitored by doctors. This is the only way to avoid irreversible changes in the tissues of the esophagus, and the development of complications requiring surgical intervention.

Let's try to figure out what reflux esophagitis is. "Esophagitis" is an ancient Greek word meaning esophagus. The term "reflux" is borrowed from Latin and translates as "flow back".

Thus, both concepts reflect the process that occurs during the development of the disease - food masses, gastric juice and enzymes move backward from the stomach or intestines, penetrate into the esophagus, irritating the mucous membrane and causing inflammation.

At the same time, the lower esophageal sphincter, which separates the esophagus and stomach, does not properly prevent the movement of acidic masses.

In official medicine, reflux esophagitis is a complication of gastroesophageal reflux disease, which is characterized by the reflux of acidic contents of the stomach or intestines into the esophagus.

Periodically repeated aggressive action gradually destroys the mucosa and epithelium of the esophagus, contributing to the formation of erosive foci and ulcers - potentially dangerous pathological formations that threaten to degenerate into malignant tumors.

Causes

Under certain circumstances, gastroesophageal reflux can also occur in healthy people. Frequent cases of the onset of the disease indicate the development of inflammatory processes in the gastroduodenal region.

Among the possible causes of reflux, gastroenterologists distinguish the following pathological changes in the structure and functionality of the digestive tract:

• decreased tone and barrier potential of the lower esophageal sphincter;
• violation of esophageal cleansing, redistribution and withdrawal of biological fluids from the intestine;
• violation of the acid-forming mechanism of the stomach;
• decrease in mucosal resistance;
• narrowing of the lumen of the esophagus (stenosis);
• an increase in the size of the esophageal opening of the diaphragm (hernia);
• violation of gastric emptying;
• high level of intra-abdominal pressure.

Most often, reflux esophagitis occurs as a result of weakening the tone of the muscles of the esophagus against the background of a full stomach.

Provoking factors

There are several etiological varieties of factors that provoke the reflux of acidic masses into the esophagus: physiological characteristics of the body, pathological conditions, lifestyle.

Reflux is promoted by:

• pregnancy;
• allergies to certain types of products;
• binge eating;
• obesity;
• smoking and alcohol;
• poisoning;
• unbalanced diet;
• stress;
• work associated with frequent torso bending;
• autoimmune diseases;
• taking medications that weaken the muscles of the cardiac sphincter.

In addition, reflux disease can occur as a result of prolonged use of a nosogastric tube.

In men, gastroesophageal reflux is observed more often than in women, although science has not established a direct relationship between the disease and the gender of a person.

Symptoms and signs of the disease

When gastric masses get on the surface of the mucosa, a burning sensation occurs in the esophagus, since exposure to acid causes tissue burns.

With a long course of the disease, the symptoms of esophagitis reflux become more pronounced, and other pathological manifestations are added to heartburn:

• belching sour. May indicate the development of stenosis of the esophagus against the background of erosive and ulcerative lesions of the mucosa. The appearance of belching at night is fraught with acidic masses entering the respiratory tract;
• pain in the sternum, often radiating to the neck and the area between the shoulder blades. Usually occurs when bending forward. According to clinical characteristics, it resembles the symptoms of angina pectoris;
• difficulty swallowing solid foods. In most cases, the problem occurs against the background of a narrowing of the lumen of the esophagus (stenosis), which is considered as a complication of the disease;
• bleeding is a sign of an extreme degree of development of the disease, requiring urgent surgical intervention;
• foam in the mouth is the result of increased productivity of the salivary glands. Rarely observed.

In addition to the standard clinical signs, extraesophageal symptoms may indicate the development of the disease.

Signs of an extraesophageal nature

The occurrence of pathological processes in areas of the body that are not directly related to the gastrointestinal tract is not always associated with pathological processes in the esophagus - especially in the absence of severe heartburn.

In the absence of full-fledged diagnostic studies, adequate treatment of reflux esophagitis is not possible.

Extraesophageal symptoms of inflammatory processes on the esophageal mucosa differ not only in the nature of severity, but also in localization:

• ENT organs. In the early stages of the disease, rhinitis, laryngitis and pharyngitis develop, there is a feeling of a lump or spasms in the throat. As the pathology develops, it is possible to develop ulcers, granulomas and polyps in the area of ​​the vocal cords, as a result of which the patient's voice changes, becomes hoarse and rough. In the later stages of the disease, a cancerous lesion of the ENT organs is possible;
• oral cavity. Erosive foci appear on the tissues of the oral cavity when gastric juice enters, periodontitis, caries and salivation develop. Pathological processes are accompanied by bad breath;
• bronchi. There may be nocturnal attacks of suffocation or severe coughing;
• chest, heart. Pain in the sternum is identical to the manifestations of coronary heart disease. There may be additional signs indicating cardiac pathology - hypertension, tachycardia. Without special diagnostic studies, it is almost impossible to establish the cause of the disease;
• back. Back pain is caused by innervation with the gastrointestinal tract, the source of which is located in the sternal spine.

In addition, symptoms may appear that indicate a violation of the functionality of the stomach - nausea, vomiting, bloating, a quick feeling of fullness.

Degrees of reflux esophagitis

The level of complexity of the course of the disease is determined by the stages of its development. In most cases, the development of gastroesophageal reflux disease takes about three years, during which the pathology acquires one of the four forms classified by WHO.

Reflux esophagitis of the 1st degree is characterized by intense reddening of the epithelium of the esophagus and a relatively small, up to 5 mm, area of ​​the mucosal lesion zone with point erosions.

The second degree of the disease is diagnosed in the presence of erosions and ulcerative areas against the background of edema, thickening and bruising of the mucosa. With vomiting, partial rejection of minor fragments of the mucosa is possible. The total area of ​​lesions occupies about 40% of the surface of the esophagus.

For the third degree of reflux esophagitis is characterized by an increase in the area of ​​the lesion up to 75% of the surface of the esophagus. In this case, ulcerative formations gradually merge into one.

The development of the fourth degree of the disease is accompanied by an increase in the size of ulcerative areas. Pathological formations occupy more than 75% of the mucosal surface and affect the esophageal folds.

In the absence of treatment, necrotic processes develop in the tissues of the esophagus, leading to the degeneration of cells into malignant ones.

Types of disease

The development of reflux esophagitis can take place in acute or chronic form.

The acute form of reflux is the result of a mucosal burn under the influence of gastric juice. It is most commonly seen in the lower esophagus and responds well to treatment.

The chronic form can occur both against the background of an untreated exacerbation, and as an independent primary process. The chronic course of the disease is characterized by periodic exacerbations and remissions.

Diagnostic measures

Despite the possible severity of the clinical manifestations of reflux esophagitis, additional information is needed to make an accurate diagnosis, which is obtained through examination.

The most informative are such studies as:

• blood analysis;
• Analysis of urine;
• radiography of the organs of the sternum;
• endoscopy - a procedure that allows you to identify erosive and ulcerative formations, as well as other pathological changes in the condition of the esophagus;
• biopsy;
• manometric analysis of the state of sphincters;
• scintigraphy - a method for assessing esophageal self-purification;
• pH-metry and impedance pH-metry of the esophagus - methods to assess the level of normal and retrograde peristalsis of the esophagus;
• daily monitoring of the level of acidity in the lower esophagus.

Reflux esophagitis is diagnosed in the presence of histological and morphological changes in the esophageal mucosa.

Treatment of reflux esophagitis

Successful treatment of reflux esophagitis involves an integrated approach - the use of drug therapy against the backdrop of changing the patient's lifestyle.

Drug treatment with drugs

The prescription of medications for gastroesophageal reflux disease has several objectives - improving the self-purification of the esophagus, eliminating the aggressive effects of gastric masses, and protecting the mucosa.

The following drugs are most effective for treating reflux:

• antacids - Phosphalugel, Gaviscon, Maalox;
• antisecretory agents - Omeprazole, Esomeprazole, Rabeprazole;
• prokinetics - Domperidone, Motilium, Metoclopramide.

In addition, the intake of vitamin preparations is shown - pantothenic acid, which stimulates peristalsis and contributes to the restoration of the mucosa, as well as methylmethionine sulfonium chloride, which reduces the production of gastric secretion.

Surgical intervention

With the development of reflux esophagitis of the third and fourth degree, surgical methods of treatment are indicated - an operation that restores the natural state of the stomach, as well as putting on a magnetic bracelet on the esophagus that prevents the reflux of acidic masses.

Folk remedies

For the treatment of reflux with folk remedies, it is recommended to use decoctions and infusions from plant materials.

A teaspoon of crushed dill seeds brewed with boiling water effectively eliminates heartburn and stops inflammation in the esophagus.

During the day, you should take decoctions of herbal preparations from the rhizomes of the mountaineer, plantain leaves, yarrow, oregano and chamomile. Before going to bed, teas from mint leaves, fireweed, calendula flowers and calamus root are shown to be taken.

The rule for preparing decoctions is to pour one tablespoon of the plant mixture with a glass of boiling water and incubate in a water bath for 15 minutes.

Diet for sickness

Therapeutic nutrition is designed to eliminate from the diet products that have an irritating effect on the mucous membrane, as well as enhance the production of gastric secretion.

Good results are brought by a diet for reflux esophagitis, which includes the following products:

• soft-boiled eggs;
• low-fat dairy products;
• liquid and semi-liquid cereals;
• steam fish and meat;
• baked apples;
• white bread crumbs.

Under the ban - coffee, alcohol, soda, any acidic drinks, beans and peas, spicy, fried, smoked and salty foods, chocolate and black bread.

Prevention

Of great importance for recovery and prevention of relapse of reflux is the correct lifestyle. Patients are advised to maintain physical activity, monitor weight, do not overeat, and after eating take walks in the fresh air.

In addition, any load on the stomach area, including tight clothing and tight belts, should be avoided. Bending after eating is not allowed. The head of the bed for a night's rest must be raised by 10-15 cm.

And most importantly - you need to regularly visit a gastroenterologist and pass all the scheduled examinations in a timely manner.

This is a lesion of the esophagus caused by the reflux of the contents of the stomach in the opposite direction. Reflux esophagitis is not a separate disease, but one of the components of the development of peptic ulcer of the stomach and duodenum.

Causes of reflux esophagitis

As a result of disturbed nerve connections between the sections of the gastrointestinal tract, gastric juice with hydrochloric acid, as well as bile, appear in the lower sections of the esophagus. There is a so-called. The mucous membrane of the esophagus is not adapted to the effects of acidic contents and enzymes, therefore it reacts with inflammation.

The cause of reflux can be called mechanical pressure from the peritoneum through the diaphragm. This phenomenon occurs with overeating, a large abdomen (obesity, ascites), hernia of the esophageal part of the diaphragm, flatulence (bloating).

Taking drugs containing sedatives and antispasmodics (papaverine, platifillin, spasmalgon and others), which women are fond of with menstrual pain, migraine, can also cause reflux with subsequent inflammation.

Antispasmodics are included in many over-the-counter pain relievers.

Symptoms of reflux esophagitis in the initial stages

The classic manifestations are pain in the epigastric region, heartburn, belching with sour or bitterness, a feeling of "coma" in the esophagus when swallowing. Often, patients themselves associate symptoms with the intake of plentiful food, hard physical work in the forward bending position.

Sometimes there is hiccups, salivation, nausea.

If symptoms occur once a month, then functional disorders quickly recover on their own. With more frequent complaints, it is necessary to undergo an examination by a gastroenterologist.

Diagnosis of reflux esophagitis 1 degree

Inflammation of the esophagus is visually detected by a doctor conducting esophagogastroscopy.

The method is based on the introduction of a thin tube with an optical device at the end into the stomach and upper part of the duodenum. It allows you to examine all parts of the esophagus.

In the first stage of esophagitis, the esophageal mucosa is intensely red in color with erosion (crack or scratch).

Treatment of reflux esophagitis of the first degree

To eliminate the initial stages of esophagitis does not require special medicines.

It is enough to comply with some conditions:

• do not overeat, provide six meals with small amounts of food;
• stop drinking alcohol, carbonated drinks;
• do not eat at night;
• get rid of excess weight;
• do not lean forward after eating;
• do not wear tight belts and clothes;
• stop taking antispasmodics and sedatives;
• Do not smoke.

A good effect is provided by folk remedies in the form of decoctions of herbs, medicinal teas.

Children love dandelion flower syrup: pour dandelion flowers and granulated sugar in layers in a glass jar, crush on top. Steep until juice is formed. One teaspoon of juice is diluted in half a glass of water, taken before meals three times a day.

Brew marigold flowers, lemon balm leaves, oregano, plantain as tea in a tablespoon per glass, take 1/3 before meals.