Gastrointestinal diseases in the modern world are gradually becoming the most common. And this is not surprising - fast food, snacks on the go are popular, junk food is sold in supermarkets. Diseases such as gastritis or an ulcer are heard today. But the symptoms of reflux esophagitis are not less common. According to statistics, millions of people in the Russian Federation suffer from it.
This is the name for the release of bile into the oral cavity, esophagus, stomach. The disease progresses quickly enough and leads to dangerous complications if left untreated on time. Therefore, it is necessary to know the symptoms of this disease, its causes, the methodology of therapy.
The movement of bile in the body
The release of bile into the oral cavity is a physiologically abnormal phenomenon. But why is this happening?
Bile is produced by the liver. Then it rises into the gallbladder with the help of the sphincter of this organ due to the contraction of the bile ducts. Accordingly, bile accumulates in this bladder. As soon as a person begins to eat, she enters the stomach through the sphincter of Oddi. Juices, bile are mixed in the stomach, the digestion process begins.
But as a result of certain factors, the sphincter of Oddi relaxes. They can happen the following: removal of the gallbladder, impaired liver function, biliary dyskinesia. As a result, the discharge of bile into the stomach no longer depends on the impulses emanating from the brain. Sphincter begins to contract at random. Then the bile is released into the stomach and further into the esophagus, the oral cavity. Injuring the mucous membranes of these organs, not intended for contact with bile.
What is reflux?
The release of bile into the oral cavity is a pathological condition. But reflux alone is not. This is the name of the processes of moving the contents of one hollow organ to another, but in a direction opposite to the normal physiological. Hence, reflux can be observed not only in the digestive system, but also, for example, in the genitourinary.
However, most often people experience gastroesophageal reflux symptoms. What does it mean? The contents of the stomach are thrown back into the esophagus, and then into the oral cavity. With normal functioning of the body, this should not happen: food passes along the return path - from the oral cavity through the esophagus to the stomach.
To prevent gastroesophageal reflux, a special organ is arranged in our body - the lower esophageal sphincter. It shrinks after the food passes into the stomach, and does not let it back.
Pathological and non-pathological reflux
Reflux will not be pathological if some part of the contents of the stomach goes back into the esophagus. Here it is called burps. A person may encounter this phenomenon, for example, after a hearty meal. But if the release of bile or stomach contents into the oral cavity occurs regularly, this is a reason to beware.
The delicate mucous membranes of the esophagus and oral cavity are damaged by contact with bile and gastric juice. Systemically repeated reflux causes inflammatory processes in them. Such a syndrome, in which damage to the esophagus is observed by regular reflux of the contents of the stomach, duodenum into it, is called reflux esophagitis. Or GERD - gastroesophageal reflux disease, when bile, gastric juices cause ulcerative, erosive damage to the mucous membranes, the development of their inflammation.
To call this disease simply reflux is wrong. After all, it can be non-pathological - in the form of a rare belching. According to statistics, GERD affects more often than adults. Moreover, men suffer from reflux esophagitis more often than women, 2 times.
If treatment is not started on time, then as a result of such an aggressive effect on the esophagus, its functional epithelium begins to be replaced by a cylindrical analogue. The patient is diagnosed with Barrett's esophagus. And this is a dangerous precancerous condition.
Why is this harmful?
The release of bile into the oral cavity at night or in the afternoon is a physiologically abnormal phenomenon. After all, the mouth and esophagus are intended only for food intake, and not the contents of the duodenum or stomach.
The only exceptions are vomiting. By their nature, they are not reflux. This is an emergency measure when the stomach needs to clear itself of toxic contents. Thus, it saves the entire body, not allowing the intestines to absorb harmful substances from this mass into the blood.
Hydrochloric acid, bile, and pancreatic secretions are aggressive in nature. They need to break down food. Accordingly, only the mucous membranes of certain organs of the gastrointestinal tract can withstand their effects. In order not to damage other tissues of the body, the lower digestive sphincter works. It prevents the contents of the stomach from rising back. But for a number of reasons, he is not always able to fulfill his functions.
Non-pathological causes
As gastroenterologists giving advice to patients say, reflux of bile into the stomach is not always pathological. Consider the most common causes of this process that do not require treatment:
- Violation of the usual diet. The use of a large number of products that stimulate increased secretion of bile - fatty or smoked foods, strong tea or coffee.
- The abuse of highly carbonated drinks.
- A side effect of taking certain medications. In particular, relaxing the lower esophageal sphincter.
- Addiction to tobacco.
- Alcohol consumption.
- Severe stressful situation.
- Appeal to increased physical activity immediately after a snack.
- Overeating before bedtime.
- Pregnancy.
- Uncomfortable sleeping when you pinch your digestive tract. Therefore, reflux of bile into the esophagus often happens at night.
Pathological causes
What to do when ejecting bile into the oral cavity? If you suffer from this systematically, then you need to urgently consult a gastroenterologist. After all, this phenomenon causes quite serious pathological reasons:
- Obesity of the second or third degree.
- Enterocolitis of various origin, causing bloating.
- Dyskinesia of the bile ducts.
- Pyloric insufficiency.
- A hiatal hernia in the lower esophagus.
- Ascites with damage to the respiratory organs or cardiovascular system.
- Pathological processes affecting the duodenum 12.
- Diseases of the intestines, stomach, other organs of the digestive tract. Common causes here are gastritis and peptic ulcers (for example, a small intestine ulcer).
- Chronic constipation.
- Duodenal obstruction.
- Pathology of the vagus nerve.
- Benign and malignant tumors.
- Infectious diseases affecting the digestive tract.
- Chronic pancreatitis or cholecystitis.
- Hereditary predisposition.
Symptoms
The fact that inflammatory processes in the esophagus caused by the reflux of bile have begun can be found by the following characteristic symptoms:
- Heartburn. You get the feeling that behind the sternum, "under the pit" something is baking, burning. An unpleasant sensation rises from the bottom up. Most often appears at night, after a sharp movement.
- Bitterness in the mouth along with a burning sensation in the larynx. Again, the feeling increases after a sharp movement, tilt, when moving the body to a horizontal position from a vertical and vice versa.
- Gagging after eating. Bitter taste of vomit.
- Sensation of severe pain in the diaphragm.
- Hiccups after eating.
Possible complications
According to the advice of gastroenterologists, when throwing bile into the stomach, in no case should you wait for an exacerbation of this condition. The disease that caused it will not go away by itself, but will only continue to progress. This is fraught with the following:
- Attacks of angina pectoris and tachycardia.
- The appearance of adhesions on the walls of the esophagus due to its constant irritation with bile.
- Replacing the normal mucosa of the organ lining with scar tissue.
- All changes in the membranes of the esophagus can provoke the development of cancer in both himself and the stomach.
Diagnostics
If you constantly notice a reflux of bile into your esophagus, you should make an appointment with a therapist, gastroenterologist. To confirm the diagnosis of reflux esophagitis, the patient is prescribed FGS. In this diagnostic procedure, you can immediately establish the presence of bile in the stomach, take a fragment of the mucous membrane of the organ lining for biopsy for examination.
In some cases, an additional endoscopic examination is prescribed. The following diagnostic procedures may be needed:
- Sonography.
- Ultrasound examination.
- Ultrasonography.
- Radiography with a coloring substance.
Directions of treatment
In most cases, medication is conservative. The goals of reflux treatment are as follows:
- Protecting the mucous membranes of the esophagus from aggressive influences.
- Neutralization of the aggressive components of gastric juice, bile.
- An increase in the speed of passage through the esophagus of a lump of food.
- Increased tone of the pylorus of the stomach (lower esophageal sphincter).
- Increased activity of the cardiac gastric zone.
Surgical treatment is addressed only in complex cases:
- Correction of complex complications causing bile reflux. For example, esophageal hernia.
- Cases when the disease has reached the last stage. When diagnosing Barrett's esophagus.
Drug therapy
In most cases, the conservative treatment regimen consists of taking the following drugs:
- Proton pump inhibitors. These are drugs such as Omez, Gastrozole, Ranitidine, Pepticum.
- Antacids (protect the mucous membranes from damage, reduce secretion by the digestive tract). "Almagel", "Maalox", "Gastrofarm".
- Selective drugs that enhance evacuation functions, accelerate the flow of bile. This is Tsizaprid, Motilium.
- To eliminate bitter belching, normalize the secretion of bile, use "Ursosan", "Ursofalk", "Ursoliv".
- To save the patient from pain, doctors prescribe known antispasmodics (painkillers). This is Baralgin, No-shpa, Spazmalgon. In particular, they are prescribed as an injection to reduce the burden on the stomach.
Lifestyle recommendations
Non-drug treatment is also indicated. First of all, it is aimed at correcting the patient's diet. He should exclude the following from his menu:
- Spicy food.
- Carbonated drinks.
- Coffee and Cocoa.
- Alcohol.
- Fatty, fried foods.
- Spices.
- Too cold or too hot food.
- Mushrooms.
- Legumes
- Reducing the consumption of fresh fruits and berries.
On the contrary, it will be useful to increase the number of the following products in your menu:
- Low-fat cottage cheese.
- Crackers.
- Scrambled eggs.
- Compotes.
- Low-fat meatballs.
- Dairy products.
- Boiled, stewed food.
There are recommendations for diet:
- The patient switches to fractional nutrition - frequent, but in small portions.
- You must protect yourself from overeating, eating food just before bedtime.
- Between the last meal and going to bed, at least two hours should pass.
- After eating, you do not need to sit or lie down. It is better to take a leisurely stroll, do light housework.
In order for this disease not to return to you, you need to change your lifestyle. Get rid of excess weight, build the correct regimen "rest / wakefulness" (at least 8 hours of sleep per day), reduce the number of stressful situations. Refuse hard physical work, lifting large loads.
Try not to wear tight, tight clothes with belts, corsets. Set up a sleeping place too - the headboard should rise at least a few centimeters above the whole bed. Do not forget and timely treat diseases that cause reflux esophagitis.