What does esophagitis mean? How is esophagitis treated with folk remedies? Good results are brought by a diet for reflux esophagitis, which includes such products

Having learned about such a diagnosis as reflux esophagitis of the 1st degree, most patients do not understand what it is.

Such a pathological process is not a separate disease, but only one of the main elements in the formation of gastric and duodenal ulcers.

It is damage to the esophagus caused by the reflux of gastric contents back. Eliminating the pathology at the preliminary stage is quite simple.

The reasons

A variety of factors are capable of provoking distal reflux esophagitis of the 1st degree, which can be eliminated independently by observing a balanced diet or with the mandatory use of medications.

The main causes of this disease include:

2nd and 3rd trimester of pregnancy, when the fetus begins to compress the digestive organs and provoke involuntary opening of the sphincter;
1 trimester of pregnancy, during which the contents are thrown due to toxicosis;
accumulation of a significant amount of fluid in the abdominal cavity;
increased body weight and obesity;
wearing tight clothing, in particular, tight belts and corsets are dangerous;
the use of medications - calcium channel blockers and nitrates often provoke pathology;
a hernia that develops in the opening of the diaphragm;
regular smoking and alcohol abuse;
stressful situations and physical stress after eating;
constant overeating;
congenital weakness of the food sphincter or its complete failure;
dry and recurrent cough.

Often, erosive reflux esophagitis of the 1st degree is provoked by diseases of the digestive organs of a chronic nature, which include ulcers, gastritis, pancreatitis, and gallstone disease.

In almost all cases, they are accompanied by the development of insolvency of the sphincter of the esophagus and stomach.

Symptoms

The clinical symptoms of this pathology are diverse. It is worth saying that the severity of all manifestations does not depend on changes inside the esophagus, which complicates proper diagnosis.

Symptoms of the disease are divided into 2 large subgroups:

Those associated with damage to the esophagus (heartburn, dysphagia, belching, pain in the retrosternal region and regurgitation).
Those that are not associated with the esophagus: cough, dryness in the larynx, hoarseness, shortness of breath, increased salivation, carious lesions, and others.

According to a patient survey, the most common symptoms are heartburn and sour belching, often occurring during sleep or when leaning forward.

No less common manifestation of pathology are pain in the retrosternal part, which mimic angina pectoris. Other symptoms do not appear very often.

Heartburn and belching. They are the most popular complaints in patients who have 1 degree reflux esophagitis. Heartburn is a burning sensation of varying intensity in the retrosternal area or near the shoulder blades. It is noted in 9 patients out of 10. The provoking factor of occurrence is the action of gastric contents with an extremely low pH on the mucosa of the lower esophagus. The specialist and the patient need to take into account that the intensity of heartburn does not reflect the severity of damage to the esophagus. At the same time, seizures are observed more often in violation of dietary nutrition, taking a variety of highly carbonated drinks and alcohol, during physical exertion and during sleep. Belching and regurgitation of food is noted in half of the patients. Most often, symptoms appear after eating.
Pain in the retrosternal region. Discomfort is concentrated behind the sternum, between the shoulder blades and is able to move to the cervical region, lower jaw, left side of the chest. Very often, the symptoms are similar to angina attacks, but they cannot be stopped by the use of nitroglycerin. In view of this, in order to exclude angina pectoris, myocardial infarction and other pathological processes, it is necessary to focus on the causes that provoked painful sensations. Retrosternal discomfort is often associated with a negative prognosis for the patient, in particular when combined with rapid weight loss and impaired swallowing.
Dysphagia. Impaired swallowing, which is observed less often than other signs, is interconnected with impaired movement of a lump of food through the esophagus. One of the rare manifestations of the pathological process, along with extraesophageal symptoms.

Diagnostics

To make a proper diagnosis, it is possible to use the following examination methods:

Radiography using CV. It makes it possible to assess the motor ability of the esophagus, to establish a wall diverticulum, various strictures and narrowing of the esophageal gap, indirect manifestations of inflammation in the wall (thickening, blurring of outlines).
Endoscopy with or without 24-hour intraesophageal pH monitoring. It is the best method of examination. In addition, directly endoscopic diagnosis makes it possible to properly establish the severity of the pathological process in question. Such a diagnosis helps to detect changes in the esophagus and to identify the intensity and frequency of reflux of stomach contents.
Assessment of esophageal motility. It makes it possible to assess the evacuation capacity of the organ and the functioning of antireflux mechanisms.
Morphological diagnosis of the esophageal wall. It is of key importance in the detection of Barrett's esophagus (a precancerous condition characterized by pathological changes in the esophageal wall) and adenocarcinoma.

It should be borne in mind that all the above methods of examination are supplemented by the history of the disease and the life of the patient, his complaints. None of the diagnostic methods will give accurate information.

Treatment of the disease

In the treatment of the pathological process under consideration, non-drug and medicinal methods of treatment are of key importance.

It must be remembered that the appointment of therapy is carried out by a specialist after a comprehensive examination of the patient, taking into account indications and contraindications.

Non-drug methods

Any patient with grade 1 reflux esophagitis is required to adhere to the following prescriptions:

Do not eat large meals and prevent overeating, in particular before bedtime. It is necessary to observe fractional nutrition with the consumption of small portions. Reduce the amount of fatty, spicy, sweet, the use of which serves as a provoking factor in the pathology. Use with caution drugs that contribute to the reflux of gastric contents into the esophagus (sedatives, theophylline, nitrates, verapamil and other calcium channel inhibitors).
Reduce the amount of physical activity that is associated with lifting weights and tension of the abdominal muscles.
Sleep with your head up.
Eliminate bad habits (smoking and alcohol abuse).
Reduce excess weight.

Medicinal methods

For the treatment of the disease in question, for a long time they use drugs that promote and reduce the acidity of pancreatic juice, and also accelerate the movement of food masses through the esophagus:

Medicines that reduce the acidity of pancreatic juice. Such treatment is aimed at increasing the pH of the gastric juice and lowering its ability to damage the esophageal mucosa. The most effective in this case will be proton pump inhibitors (omeprazole, rabeprazole, etc.), which inhibit the production of hydrochloric acid and increase the pH level. Less often used are H2-histamine receptor blockers (Ranitidine, Famotidine), which reduce acidity, but are less effective.
Means that accelerate the passage of food masses through the esophagus and prevent the reflux of gastric contents into the esophagus. These medications include Domperidone, Cerucal and others. They are also used as the only drug in combination with lifestyle changes in the pathology under consideration.

This disease is characterized by mild symptoms (heartburn, belching). Often it does not provoke anxiety in patients.

But, the progression of pathology without proper therapy can cause the formation of dangerous consequences, including cancer.

If the initial manifestations of the disease appear, it is required to immediately seek advice from a doctor in order to carry out timely diagnosis and prescribe appropriate therapy.

Medicines must be used under the supervision of a specialist, since it is necessary to draw up an optimal set of medicines for each patient, taking into account the provocative factor of the pathology in question.

When the patient simultaneously adheres to dietary nutrition and does not have diseases of the digestive organs of a chronic nature, it will be possible to completely get rid of the disease and prevent its progression.

Prevention

For the preventive purposes of the pathological process and its recurrence, it is required to remove all the factors that provoke the onset of the disease:

normalize the quality, quantity, calorie content of food;
control weight;
train the abdominal muscles;
eliminate bad habits;
adhere to the frequency of nutrition;
adjust sleep patterns.

Reflux esophagitis at the initial stage is a reversible condition. Therefore, it is necessary to consult a doctor in a timely manner for diagnosis and initiation of appropriate treatment.

Reflux esophagitis of the 1st degree is infrequently an independent disease. It is often provoked by pathologies of the digestive system.

In such a state, it is imperative to follow a diet and use prescribed medications.

With timely treatment, it will be possible to fully restore the esophageal mucosa and eliminate pain, heartburn and intestinal disorders.

Useful video

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:

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.
Professional- due to exposure to harmful substances in production (vapors of acids and alkalis, metal salts, etc.).
Allergic- Caused by the body's reaction to an allergen taken with food.
Infectious- due to infection with measles, scarlet fever, diphtheria and other infections. In this case, the most morphological varieties of pathology occur.
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.
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.)
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:

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.
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.
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).
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:

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.
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.
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.
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 the upper half of the body raised.

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 means;
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 brown 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.

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 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 appearance 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.

When gastric juice is released into the esophagus, a chronic disease of reflux esophagitis appears. The occurrence of pathology is associated with improper functioning of the sphincter of the lower part of the digestive organ. A healthy sphincter protects the esophagus from ingestion of stomach contents. Associate a violation of the functions of work with increased pressure in the stomach cavity.

Reasons for increased pressure in the stomach:

During pregnancy;
In the presence of excess weight (obesity), as well as the accumulation of fluid in the stomach (ascites);
Underdevelopment of the muscles of the lower esophagus in newborn babies;
Compression of the abdominal cavity with tight clothing;
When taking certain types of medications;
Specific foods (sweets, fatty foods, spicy foods);
The presence of bad habits, alcoholism, smoking;
Sedentary, inactive lifestyle;
Bouts of severe coughing;
Stress.

Most middle-aged people have symptoms of the disease.

Causes of reflux esophagitis:

Stenosis of the pyloroduodenal opening;
Operations and surgical interventions of the digestive tract or near them;
Alcohol abuse, smoking;
Drugs that reduce the tone of the esophageal sphincter;
Gastritis, bacterium Helicobacter Pylori;
Overweight, obesity;
peptic ulcers;
Hernia of the esophageal opening of the diaphragm;
Pregnancy;
Viral diseases, immunodeficiency;
Reflux of the gastroesophageal region.

Patients with gastroesophageal reflux esophagitis go to the hospital for three years from the onset of the disease. This factor makes it difficult to establish the exact cause of the disease.

Symptoms of reflux esophagitis:

The primary symptom is heartburn. Increases after eating, from overeating, increased physical activity.
Sour or bitter eructation. Gastric juice enters the mouth during reflux.
Profuse salivation.
Pain. Felt with esophagitis in the chest.
Bad breath.
Feeling of full stomach after eating.
Cough, hiccups.
Low husky voice.

Disease stages A, B, C, D:

Grade A. The mucous membrane is affected by 5 mm and is limited to folds;
Grade B. Mucosal pathologies occur;
Grade C. There are defects within the mucosal folds. The level of damage does not exceed 75% of the esophageal cavity;
Grade D. The cavity is more than 75% affected and has several defects.

Reflux esophagitis is classified into acute and chronic according to the form of the disease.

With improper treatment of the disease, scars remain on the mucous membranes of the esophagus. This form of esophagitis has periods of remission, as well as exacerbations.

Forms of esophagitis by morphological changes

Diet for reflux zzophagitis

The diet is observed without fail and is included in the complex of treatment for reflux. You need to eat small portions 5-6 times a day. You can have a snack before bed. To digest food, you need to do this a few hours before bedtime.

You can sleep after the final meal after some time (1-2 hours). So the food consumed is digested and sent to the intestines, which will make you feel better and prevent acid from entering the stomach cavity into the esophagus.

The diet is prescribed by the attending physician, with proper observance of which the treatment is easier. You should give up junk food: sweet, fatty, fried, spicy. Overeating exacerbates the situation. The accumulation of gases increases pressure in the intestinal area, and this will have a negative effect on the esophageal sphincter. It is also worth giving up food that increases gas formation (beans, carbonated drinks, cabbage, spicy dishes, brown bread, alcohol).

The patient is able to independently observe products that increase gas formation in him and remove them from his diet. Reflux esophagitis of the 1st degree is treated precisely by following a diet.

Vegetables and fruits containing many useful substances contribute to gas formation. In order not to exclude them from the diet, subject to heat treatment, cook compotes.

After eating, do not make sudden movements, tilts. Reduce physical activity for a while after eating to allow the food to be digested.

Products that are part of the diet for reflux esophagitis:

Dairy and sour-milk products;
Low-fat cottage cheese;
Baked apples or other fruits;
Soft-boiled eggs;
Steamed fish and meat.

acidic juices;
Carbonated water, drinks;
Cabbage in any form;
Alcohol;
Mushrooms;
smoked products;
Peas, beans and other legumes;
Spicy seasonings;
Chocolate and sweets;
Fatty and fried foods;
Black bread.

The composition of the diet necessarily includes cereals. More suitable cereals from millet and oats. Drink milk, rosehip broth, which you can cook yourself, dried fruit compotes.

For heartburn, eat a banana, plum, peach, or pear. To prevent air from entering the esophagus, do not speak while eating. In order not to heavily burden the digestive tract, food should be chewed thoroughly. Use traditional medicine. It is useful to drink a decoction of chamomile before going to bed, which has an anti-inflammatory effect.