Currently, a fairly common disease of the gastrointestinal tract is reflux esophagitis. Symptoms of this pathology make patients constantly take medicines, follow a diet and periodically seek medical attention from specialist doctors.
Definition of a concept
Reflux esophagitis is an inflammatory disease of the esophagus due to exposure to its mucous membrane of the gastric juice. This pathology is one of the most common. Today, about 3-4% of the world's population suffers from this disease. A huge amount of money is spent annually to combat a disease such as reflux esophagitis. Its treatment requires the use of both medicinal and non-drug methods.
Etiology
Few people know what reflux esophagitis is. In adults and children, the main factor in the development of this pathology is damage to the mucous membrane of the esophagus by gastric juice with the subsequent development of the inflammatory process. In this case, there may be several reasons for the reverse casting of gastric juice:
- Cardiac failure, especially in combination with abdominal obesity.
- Eating plenty of food, especially in the evening.
- Reducing the speed of food evacuation from the stomach (more often with diseases of the pylorus and duodenum).
- Work associated with constant torso forward, or a sedentary lifestyle.
Most often, in a patient suffering from reflux esophagitis, several provoking factors are detected at once.
The main clinical manifestations
Reflux esophagitis symptoms are quite characteristic. The main ones are the following:
- pain or discomfort in the sternum;
- heartburn;
- belching;
- difficulty swallowing;
- an increase in the amount of saliva secreted;
- shortness of breath, asthma attacks (with damage to the gastric juice of the bronchial tree and lung tissue).
Pain with reflux esophagitis is excruciating, practically not reducing its severity without treatment. At the same time, it can be amplified after eating, especially spicy, too salty, pickled. Also, it can be difficult for a person to be prone for a long time if he has reflux esophagitis. The reasons for this are that the gastric contents begin to be thrown back into the esophagus. In this case, the patient experiences severe heartburn, pain in the epigastrium and behind the sternum.
Heartburn is usually accompanied by belching. In this case, the patient can often experience a sour taste in the mouth. Heartburn is painful and especially active after a heavy meal or when a person is lying down.
Difficulties in swallowing usually develop in the presence of serious morphological changes in the esophagus (ulcer, sclerotherapy, tumor formation), which lead to a decrease in its lumen. Typically, this pathology develops in the case of a prolonged course of reflux esophagitis.
Shortness of breath and asthma attacks appear in cases where the thrown gastric juice enters not only the esophagus, but also the bronchial tree or lung tissue.
The severity of pathology
Clinical manifestations largely depend on the degree of development of the disease. Currently, the following stages of reflux esophagitis are distinguished:
- Stage 1 - there are separate foci of inflammation of the mucous membrane of the esophagus.
- Stage 2 - foci of inflammation often merge with each other, but there is no widespread damage to the mucous membrane of the esophagus.
- Stage 3 is characterized by more serious morphological changes with the formation of ulcers of the lower third of the esophagus.
- Stage 4 is determined in the case of narrowing of the lumen of the esophagus against the background of widespread ulcerative lesions of its mucous membrane.
Treatment for reflux esophagitis depends on how long and intensive the process is.
Diagnostic criteria
If a person has developed reflux esophagitis, treatment should be started as early as possible to avoid morphological changes in the esophagus. For this, it is necessary to timely diagnose this pathology. To this end, the following basic research methods are applied:
- History taking.
- Esophagofibrogastroduodenoscopy.
- Biopsy.
In the process of collecting an anamnesis, a specialist doctor tries to clarify the nature of the clinical manifestations, the timing of their first appearance, the relationship of the development of symptoms with food intake and the patient’s body position. In addition, the doctor clarifies the presence of diseases and pathological conditions that could lead to the development of reflux esophagitis.
EFGDS is the most important diagnostic method, due to which it is possible to clarify the presence of an inflammatory process in the mucous membrane of the esophagus. In the process of this study, the doctor introduces an endoscope into the patient’s digestive tract. In this case, the specialist has the opportunity to take a biological sample of pathologically altered tissue. In the future, the resulting material is sent for histological examination, which allows you to accurately verify the diagnosis.
General clinical trials are also usually performed. If there is a serious narrowing of the esophagus, fluoroscopy and magnetic resonance imaging can be performed.
Treatment
When reflux esophagitis develops, symptoms usually do not keep you waiting. This forces the patient in the early stages of the disease to consult a doctor who prescribes the following treatment options:
- Correction of the nature of nutrition and other non-drug methods.
- The use of drugs.
- Surgery.
Most often, the treatment of this pathology involves a combination of the first two approaches. Surgical treatment of reflux esophagitis is rarely used.
The basics of non-drug therapy of reflux esophagitis
After the diagnostic study and diagnosis, the patient is recommended to adjust his menu. With reflux esophagitis from the diet, it is necessary to exclude fried, excessively salty, marinades, sweet and spicy. It is also necessary to avoid eating large amounts of food at a time. It is recommended to eat in small portions 5-6 times a day. One serving should have a size approximately equal to the patient’s clenched fist.
Diet for reflux esophagitis involves eating no later than 2 hours before bedtime. Otherwise, the patient will experience discomfort, even if he adheres to the recommended diet exactly and takes the prescribed medications.
The diet for reflux esophagitis is very important, however, it is also not able to completely relieve the patient of unpleasant symptoms while ignoring other methods of combating the disease. A huge role in the prevention of reflux of gastric juice into the esophagus is played by the correct position of the body. A person is not recommended to lean forward too often. Also, you can not go to bed after eating for 1 hour.
Medications
With the development of a disease such as reflux esophagitis, medication is intended to neutralize hydrochloric acid that has entered the esophagus, or to reduce the volume of its initial production. As a result, drugs of the following groups are most often used:
- antacids;
- histamine H2 receptor blockers;
- antisecretory drugs;
- prokinetics.
If reflux esophagitis has developed, the patient most often begins treatment on his own even at the stage of excruciating heartburn. For this, he uses antacids. The most famous among them are the preparations "Rennie", "Phosphalugel", "Maalox" and "Almagel". The main mechanism of action of these drugs is the neutralization of hydrochloric acid. Some patients try to achieve the same results using mineral water for this. In this case, there is often an increase in the severity of heartburn several hours after its use.
Histamine H2 receptor blockers also reduce the amount of hydrochloric acid in the digestive tract. This is achieved by reducing the volume of its production by blocking the receptors responsible for controlling the concentration of acid in the gastric contents. The main drugs from this group are the following:
- "Famotidine";
- Ranitidine;
- Cimetidine.
As for antisecretory drugs, they reduce the production of hydrochloric acid by blocking the cells directly responsible for its production. The most popular products from this group are the following:
- Omeprazole;
- Lansoprazole;
- "Rabeprazole".
Another important group of drugs taken with reflux esophagitis are prokinetics. Among them, the most popular drugs are Domperidone, Motilium, Motilak, Metoclopramide and Passasix. The basis of their therapeutic effect is to increase the motility of the stomach and increase the tone of the esophagic sphincter.
If a person has developed reflux esophagitis, treatment with folk remedies is better not to use. This can lead to serious complications and the need for surgery.
Surgery
Surgical intervention is rarely used for this pathology. Usually, with timely correction of lifestyle and rational drug therapy, the disease can be transferred to the stage of remission. In case of neglect of this pathology or with the development of complications, as well as the ineffectiveness of the main drugs, it is recommended to undergo surgery.
Most often, surgical treatment of this disease refers to the strengthening of the esophageal sphincter, as well as the elimination of diaphragmatic hernia, if any. After the surgical intervention, the person is no longer bothered by heartburn, belching with acidic and other symptoms of a disease such as reflux esophagitis.
Each gastroenterologist with the ineffectiveness of therapeutic agents always recommends an operation. Naturally, even after it, a person must follow a diet.
Possible complications
There are several serious complications of reflux esophagitis that can bring many problems to anyone:
- Barrett's disease (develops when replacing the mucous membrane of the esophagus with stomach cells).
- Esophageal ulcer.
- Narrowing the lumen of the esophagus.
- Tumor masses.
- Esophageal bleeding.
Many of these complications require emergency treatment.
Preventive actions
Many diseases are easier to prevent than then treat. Reflux esophagitis is no exception. Treatment with folk remedies can do even more harm. In order to avoid the development of such a pathology, it is necessary:
- abandon a large number of spicy, overly salty, fried, pickled and smoked foods;
- do not consume large amounts of food at one time;
- lead an active lifestyle, maintaining your body in good shape.
So, we examined what is reflux esophagitis in adults. Subject to these simple rules, the likelihood of developing this pathology is significantly reduced.