Prolapse of the gastric mucosa into the esophagus is a fairly common disease, especially among patients older than 50 years. They regularly begin to suffer from such dangerous and unpleasant symptoms as belching, nausea after eating, heartburn. These pathological manifestations in official medical terminology are called gastroesophageal reflux. In fact, this is the reverse casting of food into the esophagus from the stomach. In this article we will talk about the causes, symptoms, treatment and consequences of this disease.
Features of the disease
One of the most common mistakes in the occurrence of prolapse of the gastric mucosa into the esophagus is that patients try to fight the disease on their own. Moreover, as a rule, they try to eliminate only the symptoms themselves, without thinking about what could cause this pathology. In fact, the same gastroesophageal reflux, which is also called a hernia of the esophageal opening of the diaphragm, brings them suffering. To understand the danger and insidiousness of this ailment, we will get to know him better.
In fact, prolapse of the gastric mucosa into the esophagus is a protrusion or loss of part of the stomach into the esophagus that occurs through the diaphragm. This pathology can be of two types - paraesophageal and moving.
The paraesophageal view is characterized by a shift to the thoracic esophagus only part of the stomach. But with a sliding prolapse of the gastric mucosa into the esophagus, which is diagnosed in most cases, the entire digestive organ freely begins to pass through the esophagus in one direction and the other.
Causes
Surprisingly, the exact cause of this pathological condition has not yet been established. Some medical professionals believe that in some patients it develops as a result of weakening of the diaphragmatic muscle tissue, which occurs due to any damage to the internal organs.
A prolapse of the gastric mucosa also contributes to a sharp increase in intra-abdominal pressure, which begins to strongly pressure the muscles located around the stomach. This condition, most often, is provoked by excessive physical activity, weight lifting, breakthrough and prolonged vomiting, regular constipation, severe coughing, even pregnancy.
It is worth noting that there are factors that increase the likelihood of a patient having a prolapse of the gastric mucosa into the lumen of the esophagus. They contribute to the general weakening of the muscles of the diaphragm, their loss of elasticity, which ends with the development of this pathological condition. In most cases, this process is affected by abdominal ascites, frequent and prolonged smoking, obesity, and aging of the whole organism.
People who fall into one, and especially several risk groups, are advised to be as attentive to their health as possible, and if the first signs of gastroesophageal reflux occur, which most often indicates impending prolapse, undergo a full diagnostic examination to determine the causes of this symptom in a timely manner. .
Symptoms
One of the main dangers of this disease is that it is not always possible to independently understand that prolapse began to develop. In most cases, the classic symptomatology in a person may simply be absent. The pathology of the sphincter, which occurs between the esophagus and the stomach, is often discovered by chance, conducting a planned or preventive examination of the organs of the gastrointestinal tract.
In this case, the disease is often accompanied by obvious symptoms, and there are very severe clinical manifestations that clearly indicate this ailment. Specialists-gastroenterologists note what symptoms of prolapse of the gastric mucosa into the esophagus should pay attention in the first place:
- Sharp pain behind the sternum of a cutting or stitching nature, which occurs spontaneously with food or during physical exertion. It is provoked by the fact that the protrusion of the folds of the gastric mucosa occurs. It is characteristic that the pain disappears as suddenly as it appeared.
- At the peak of pain, there is a feeling of severe nausea, vomiting may appear, in which just eaten food will be present.
- Heartburn worsens with torso and lying down.
- There are problems with the swallowing reflex.
- Against the background of prolapse of reflux disease, the patient appears extremely unpleasant and dangerous signs, for example, regurgitation of food. After that, a feeling of acid and bitterness remains in the mouth.
Be attentive to any unpleasant painful symptoms. When they appear, immediately seek help from a doctor. This disease is very insidious, since the pain behind the sternum is easily confused with an attack of angina pectoris or a violation of the heart rhythm. In such a situation, only electrocardiography will help to diagnose.
Treatment methods
Note that in most cases, specialized treatment of prolapse of the gastric mucosa into the esophagus is not required. The list of certain therapeutic measures is determined by the presence of a specific list of symptoms in the patient. With the regular occurrence of acid reflux and constant heartburn, medication is prescribed. It is based on taking drugs that block secretions and neutralize the acid in the gastric juice. In fact, they are intended to eliminate the symptoms of heartburn.
In the treatment of prolapse of the gastric mucosa, surgical intervention is required only when conservative therapy does not bring any results. However, he admits that in the vast majority of cases, resorting to extreme measures is not necessary.
Sometimes it is advisable to treat excessive elasticity of the folds of the mucosa of the main digestive organ, as well as lowering the strength of the diaphragm. This approach is considered reasonable only if the patient experiences severe discomfort.
The list of therapeutic measures in this case is based on taking certain medications. These are proton pump inhibitors (Rabeprazole), antispasmodics (Drotaverinum), antacids (Phosphalugel), prokinetics (Domperidone).
To stop some unpleasant sensations that can cause severe discomfort to the patient, as a rule, it is enough to use one of the means. To completely get rid of this pathology, a surgical operation is required. Only thanks to her, the patient will be able to restore the originally existing anatomical position of the organs. However, the operation is not always considered appropriate, it is carried out only in the absence of a reaction to drug treatment, and also when the hernial sac grows to too large a size.
Retrograde prolapse
Let us dwell in more detail on the varieties of the disease under study that may occur at present. With retrograde prolapse of the gastric mucosa into the esophagus, the cardial part of the stomach passes into the abdominal segment. In this case, a scalloped formation may appear, but it will not be in the stomach itself, but on its eve.
A layer of contrast medium is formed between the precipitated mucous membrane and the walls of the esophagus, which in the picture resembles a narrow ring in appearance. If at this time the esophagus is introduced into the cardiac part of the stomach, its corolla becomes as sharp as possible in the pictures.
Typical for retrograde prolapse of the gastric mucosa is the variability of x-rays. Note that such changes should not be confused with a hernia in the esophagus of the diaphragm.
Hernia
One of the common causes of this pathological condition is a hiatal hernia. This condition in everyday life is called a short internal esophagus. It is believed that this is an abnormal development of the mucous membrane of the esophagus. At the same time, a gag reflex is often taken for such a pathology in patients. According to most experts, this picture indicates an abnormal development of the submucosal layer.
To make the correct diagnosis, it is necessary to obtain a visualization of the hernial cavity. In some cases, deep breathing and additional inflating the hernial cavity, which will cause diaphragm movements, may be useful.
Based on this, it can be concluded that a combination of several functional and anatomical features is required to diagnose a hiatal hernia. This is the presence of a hernia, the reduction in the distance from the cardia to the anterior incisors, transcardial prolapse of the gastric mucosa (which all gastroenterologists have to know). In such cases, dramatic changes occur that indicate the presence of a serious problem.
At the medical board
This pathological condition often causes serious health problems, human well-being. In these cases, young people of military age have a reasonable question - will they take the gastric mucosa into the esophagus with prolapse.
As practice shows, this disease is not a sufficient basis for exemption from service in the armed forces. Moreover, in some cases this ends in trouble. For example, a young man with this diagnosis is called up for service, and after a few weeks he has an ulcer. In this case, he has to urgently commiss.
Complications
It is important to start treatment of prolapse of the gastric mucosa in time. Only in this case you will be able to avoid the dangerous and unpleasant consequences of this ailment.
One of the most dangerous and unpleasant complications in this situation is the reflux esophagitis, that is, the throwing of acidic gastric contents into the esophagus. It poses an increased danger.
Most of the remaining complications are associated with exposure to acid, as well as other aggressive components on the walls of the esophagus. If you do not treat this pathology, inflammation in the stomach and esophagus, bleeding, ulcers, erosion, changes in the structure of the mucous membrane of the esophagus, anemia begin to develop.
Proper nutrition
To successfully deal with this disease, an important component will be proper and balanced nutrition. Its main goal is to prevent the excessive formation of gastric juice and reduce acidity. Also, a diet will help prevent constipation and flatulence, which significantly increase intra-abdominal pressure.
With this pathology, nutrition should be necessarily fractional. Food should be taken in small portions, chewed thoroughly. This will eliminate excess pressure on the lower esophageal sphincter and diaphragm.
From the diet, it is necessary to exclude products that provoke gas formation. This is cabbage, legumes, mushrooms, milk, carbonated drinks, fresh bread, pastry. Also, do not eat fried, fatty, sour, salty and smoked dishes. Please note that hot and spicy spices can irritate the esophagus and gastric mucosa.
As a prevention of these complications, it is recommended that you strictly follow the list of simple rules that will protect you from this pathology. Here's what you should start to do:
- fight constipation and overweight;
- give up alcohol and cigarettes;
- Avoid hard physical work, especially those associated with tilting the body forward and lifting weights;
- Do not eat in a horizontal position and at bedtime;
- do not sleep on your left side;
- not to be in an inclined position for a long time;
- Do not wear tight clothes and tight belts.
Physical activity
Of great benefit with prolapse of the gastric mucosa into the esophagus is moderate physical activity, especially if the patient is at risk and there is a likelihood of developing such a disease.
Physical therapy helps many people prevent the formation of prolapse. It contributes to the normalization of the stomach, establishing metabolism, strengthening the lower esophageal sphincter and diaphragm. The main thing is that the load is distributed moderately. Exercises should be performed when at least two hours pass after a meal.
The easiest, but at the same time effective way to strengthen the abdominal muscles and reduce intra-abdominal pressure is breathing exercises. Exercises should be performed while sitting or standing. During inhalation, stick out your stomach, fix in this position for two to three seconds, then slowly exhale and relax the whole body. To get the effect of the exercise, you should perform several months three to four times a day.