Reflux esophagitis is a pathology in which the lower part of the esophagus is damaged as a result of throwing the contents of the stomach into it. In the chronic form of this disease and the absence of therapy, stenosis or stricture is formed. In the future, this complicates the movement of food through the esophagus and requires prompt correction.
Causes
The most common etiological factor in the occurrence of esophagitis reflux is a decrease in the tone of the muscles of the lower sphincter in the esophagus, which leads to its complete or partial opening.
The following reasons can contribute to this violation:
- increased pressure in the abdominal cavity;
- psycho-emotional overload;
- exposure to chemicals;
- eating spicy or poor quality food;
- hernia of the diaphragm.
Many people ask what it is - reflux esophagitis 1 degree?
With motor disorders (dyskinesia) of the biliary tract, biliary reflux develops, which is associated with the irritating effect of bile, secreted outside the proper digestion process.
In addition, the factors leading to the occurrence of reflux are considered to be a long stay with the body leaning forward, being overweight, smoking, drinking coffee, spices, and alcoholic beverages. Often a similar pathology develops during pregnancy, in some cases it is a consequence of taking certain medications, for example, Nitroglycerin or Metoprolol.
Also, reflux esophagitis is often diagnosed in the presence of stomach ulcers, increased acidity, scleroderma, gastritis, which are caused by the bacterium Helicobacter pylori. Esophageal reflux is often found among people who are prone to overeating, eat fatty foods, have allergic reactions to any food.
Symptoms
The most common complaint in reflux esophagitis is heartburn (burning in the upper esophagus), which intensifies after eating, drinking alcohol, coffee, soda. Sour belching of the stomach contents may also be observed.
Esophageal reflux is characterized by dysphagia, which is manifested by difficulty in swallowing and impaired passage of food through the esophagus. With inflammatory processes in the mucosa, the intake of any food causes a rather pronounced pain syndrome. It should be noted that reflux esophagitis (ICD-10 - K21.0) is sometimes manifested by symptoms that mimic damage to other organs:
- Cardiac syndrome, when there is the appearance of pain in the sternum, which resemble the symptoms of angina pectoris. Such pain appears, as a rule, after overeating, taking sharp or acidic foods. All this is accompanied by heartburn with reflux esophagitis.
- Catarrhal syndrome, characterized by the development of inflammation in the larynx. The development of signs of pharyngitis can be explained by irritation of the throat mucosa with gastric juice as a result of reflux. Symptoms of reflux esophagitis may be different.
- Dental disorders that are caused by acid entering the oral cavity, which leads to tooth decay and provokes tooth decay.
- Pulmonary cider, in which a cough appears as a result of bronchial obstruction, which is often observed at night. The cause of the accumulation of sputum in the bronchi is microaspiration in the bronchi from the esophagus.
Stages of the disease
The severity of the pathology depends on how high the degree of damage to the esophagus:
- Reflux esophagitis 1 degree. What it is? It is characterized by erythema in the esophagus, as well as the occurrence of erosive lesions on its mucosa.
- 2 degree, in which erosion begins to merge with each other, but without total damage to the mucous surface.
- Grade 3 is characterized by a continuous, extensive ulcerative lesion in the lower part of the esophagus.
- Grade 4, when there is the presence of chronic ulcers and stenosis of the esophagus.
In addition, taking into account the depth of mucosal damage, superficial esophagitis is released when the inflammatory process covers only the outer layers and is manifested by hyperemia and edema, as well as erosive esophagitis, in which deeper lesions develop and erosive foci and ulcers appear on the mucosa.
Reflux esophagitis in children
It should be noted that reflux in childhood is considered by experts to be quite normal. In infants, this syndrome is called regurgitation and occurs in almost 90% of babies. The main reason for this is the weakness of the esophageal sphincter and overcrowding of the stomach with food, however, abundant and steady spitting up can be a sign of certain malformations or other disorders.
The main manifestations of this pathology in children are:
- the baby often cries, especially when feeding;
- belching and profuse belching is observed;
- vomiting after feeding;
- low body weight;
- nasal congestion in a child for a long time;
- troubled sleep.
In older children, reflux esophagitis manifests itself in the form of periodic vomiting at night, attacks of shortness of breath, dry cough, wheezing, which may resemble bronchial asthma.
Reflux in childhood can provoke the development of otitis media, sinusitis, pneumonia, decreased appetite, chest pain, the appearance of fetid odor in the mouth and early tooth decay. In adolescents, the symptoms of the disease are the same as in adults. To prescribe an effective treatment for reflux esophagitis, the doctor first conducts a comprehensive examination.
Pathology diagnostics
If you suspect the development of the disease, it is recommended that a number of certain examinations be carried out, which include:
- endoscopy with biopsy fence;
- bilimetry, which is performed with biliary reflux;
- X-ray examination;
- daily pH meter;
- omeprazole test;
- Bernstein test;
- scintigraphy.
The signs of this pathology may resemble the clinical picture that is characteristic of lung or heart damage, therefore, this disease in the absence of the correct therapeutic approach over time becomes lingering. In a chronic form, reflux esophagitis contributes to the development of esophageal stenosis and becomes the main cause of the so-called “Barrett syndrome”, in which epithelial cells are degenerated, which significantly increases the risk of esophageal cancer formation.
Symptoms, causes and treatment of reflux esophagitis are interrelated.
Treatment
For short-term attacks of reflux due to errors in nutrition, specific therapy is not required. To do this, it is enough to eliminate factors that irritate the stomach, for example, to exclude spicy dishes or alcohol from the diet.
With more frequent occurrence of reflux, patients need to adhere to a special diet. To alleviate clinical symptoms, you can use some medications that help neutralize gastric juice (antacids) or drugs that reduce the production of hydrochloric acid (for example, Ranitidine). These medications can be taken in cases where it is not possible to receive medical care immediately, but when normalizing the condition, one should not forget that it is only the doctor who can correctly determine which drugs to treat this pathology.
The treatment regimen is determined, as a rule, individually and depends on the clinical manifestations of the disease. It is extremely important for patients to avoid stressful situations, regulate the diet, do not overeat, do not use tightening clothes, lift weights and take medications that reduce the tone of the esophageal sphincter (Eufillin, sedative and sleeping pills).
Also prohibited are any activities and exercises that involve leaning forward or staying in a similar position for a long period of time.
Drug groups
Therapy of reflux esophagitis includes the use of the following groups of drugs:
- Prokinetics that increase the tone of the esophageal sphincter. The most commonly prescribed drugs are Motilak or Motilium, in which the active substance is dompiridone.
- Antacids are drugs that can reduce acidity in the stomach due to the fact that they neutralize hydrochloric acid. The main medicine from this group is Almagel.
- Antisecretory drugs that reduce acidity as a result of inhibition of the production of hydrochloric acid. The most common representatives of such drugs are Omez or Omeprazole.
Can reflux esophagitis be cured forever? This is a common question.
It should be noted that drug therapy should be carried out strictly as prescribed by the doctor and in accordance with the recommendations specified in the instructions. Such therapy is very long and lasts approximately 12 weeks. After the normalization of the condition, supportive treatment is carried out, which takes a few more months.
It is possible to cure reflux esophagitis with conservative methods, but this depends on the severity of the esophagus lesion, clinical manifestations and the course of this pathology. An operational solution to the problem, as a rule, is carried out among young patients who do not observe favorable dynamics after drug treatment. In addition, surgery is recommended in the presence of bronchial asthma, as well as some complications, the most dangerous of which are the development of esophageal strictures, bleeding and the formation of Burrett's syndrome. Nutrition for reflux esophagitis is of particular importance.
Nutrition Basics and Diet
Meals should be organized as follows:
- Fractional 6 meals a day, in which uncontrolled snacking and overeating are excluded, since when the stomach is full with food, its contents are more intensively thrown into the esophagus.
- The size of a single serving is reduced to 300 grams, and the nutritional value of the diet should not be reduced. A similar balance is achieved through a specially selected diet. Calorie intake per day for this disease should be 2000-2500 kcal.
- A certain time after eating can not take a horizontal position.
- It is strictly forbidden to eat at night.
What else does nutrition mean for reflux esophagitis? Fatty, spicy, coarse foods, as well as alcohol, citruses, soda, garlic, tomatoes, tea and coffee, are banned. Also, with reflux esophagitis, salt intake should be limited.
Food should only be processed by boiling, stewing or baking. Rigid products must be ground and ground before mashed. In addition, you need to chew enough food, during which it is better processed by enzymes contained in saliva.
Sweets are excluded from nutrition during exacerbations of reflux esophagitis. During remissions, the patient is recommended to focus more on their own feelings - if a certain sweetness in a small amount does not worsen the condition, then you can periodically use it.
It is important to observe the drinking regime, and drink at least 1.5 liters of clean water daily, which will significantly improve digestion.
Sample menu
An approximate menu for this pathology is made taking into account individual clinical manifestations and the stage of the disease. However, there are some options for the general menu, which should be followed by people suffering from throwing contents from the stomach into the esophagus.
Breakfast options:
- Pumpkin semolina puddings, steam omelettes, tea, cookies.
- Baked and boiled potatoes with sour cream sauce low fat, steam cutlet.
- Milk cereals with mashed berries, tea.
- Soft-boiled eggs, bread, a slice of boiled chicken.
- Porridge cooked on water, with the addition of chopped dried fruit, jelly.
Snacking Options:
- Potato casseroles, baked apples with honey, herbal tea.
- Cottage cheese casseroles, compotes.
- Cottage cheese with sour cream and dried fruits.
- Liver pate with boiled carrots.
- Fruit jellies, bananas.
Lunch Options:
- Vinaigrette, soup with meat and noodles, compote.
- Baked potatoes, boiled fish, herbal tea and cookies.
- Boiled vermicelli and steamed omelet with vegetables and herbs.
- Mashed potatoes, meatballs, low fat yogurt.
- Rice porridge, steamed cutlets, vegetable stew.
Dinner Options:
- Cauliflower puree, boiled chicken breasts, bread with tea.
- Pumpkin and applesauce, compote with cookies.
- Rice porridge, vegetable stew.
- Boiled or baked fish in sour cream, vegetable salad, compote.
- Kefir and crackers.
Such a diet helps eliminate the unpleasant symptoms of the disease and prolong the period of remission.
Omeprazole for Reflux Esophagitis
This drug is one of the main medicines prescribed for this pathology. Omeprazole is available in capsules, tablets, and powder for intravenous administration.
When the active substance of this drug penetrates the acidic environment of the stomach, it begins to act on the cells that are responsible for the production of gastric juice and enzymes, and begins to normalize these processes. A drug reduces the secretion of gastric juice, as well as its level of activity, has a damaging effect on the adverse bacteria, the presence of which is observed with this pathology.
We examined the symptoms, causes, and treatment of reflux esophagitis.