Reflux esophagitis: symptoms, treatment, diet

At the onset of the disease, the person feels a constant burning sensation, pain in the abdomen and chest. If you do not go to the doctor in time, foci and small ulcers formed by erosion, which grow over time and aggravate the physical condition, are formed.

  • ulcer,
  • pyloroduodenal stenosis,
  • chronic cholecystitis,
  • hernia diaphragm food holes,
  • chronic pancreatitis,
  • oncological diseases - tumors in the stomach (cancer),
  • poor esophageal permeability.

The development of reflux esophagitis occurs due to the weakening of muscle tone and poor functioning of the esophageal (cardiac) sphincter. It remains open, and the mass contained in the stomach freely enters the esophagus.

  • great pressure on the diaphragm,
  • reduced muscle tone of the lower esophageal sphincter (LES),
  • poor bowel cleansing and fluid problems,
  • stresses
  • irritation of the mucous membranes when eating hot and drinking, alcohol, drinking large amounts of coffee,
  • binge eating,
  • chemical factors (excess of iodine, strong acids, alkalis), toxic substances entering the esophagus through the air or food,
  • smoking,
  • violation of the formation of acids
  • increase in aperture,
  • stenosis,
  • violation of gastric emptying.

Another esophagus reflux esophagitis sometimes occurs after a surgical operation performed on the stomach. The development of the disease often provokes a hernia of the diaphragm. Excess weight or weight lifting increases the pressure on the abdominal cavity and part of the stomach penetrates the chest.

The development of reflux esophagitis provoke: poor diet, poor lifestyle, pathological condition and physiology of the body:

  • process of gestation,
  • overvoltage
  • food allergies
  • obesity,
  • poisoning by food, drink or chemicals
  • taking medications that help relax the sphincter muscles.

Symptoms of the disease

Symptoms of reflux esophagitis come with painful sensations that are hard to miss. The top list includes:

  1. Heartburn is a burning sensation with pain in the chest and abdomen.
  2. Belching sour.
  3. Difficulty swallowing and painful passage of food (dysphagia).
  4. The pain of the sternum is transmitted to the neck and the area between the shoulder blades. Occurs when bending and sharp movements.
  5. Bleeding during exacerbation of reflux esophagitis.
  6. Foam in the mouth, a rare symptom, occurs due to increased saliva production.

Symptoms wear a mask of other diseases:

  1. "Pulmonary mask" - bronchial obstruction, when small food particles fall into the bronchi. There is a chronic (especially at night) cough with reflux esophagitis.
  2. "Cardiac" - tingling, like pain in the heart. Occurs from overeating and after taking spices, spicy and sour dishes and drinks.
  3. "Otolaryngological" - symptoms of rhinitis and pharyngitis appear.
  4. “Dental” - begins to develop caries, as the acid in the mouth eats away and injures the tooth enamel.

Some patients try to cure other diseases against this background, since the pain during reflux esophagitis is misunderstood, not suspecting that reflux disease is cleverly disguised. Moreover, the patient does not get better, and gastroesophageal reflux with esophagitis progresses.

Reflux esophagitis in children is also not uncommon. In infancy, reflux is considered common, it takes about 10 months. After a year, the disease may appear due to poor cardia of the esophagus. The reasons are a violation of anatomy, abnormal structure of the body, obesity, diseases of the digestive organs.

Remedies for reflux esophagitis are prescribed at the 1-2th stage of development, when the symptoms are not very pronounced and can be cured. Stage 3-4 is treated by surgery.

Extent of the disease

Chronic reflux esophagitis has several stages, which go on increasing symptoms:

  • Stage 1 - characterized by external redness of the esophagus, small erosive zones begin to appear.
  • Stage 2 - an increase in the area of ​​damage, swelling, thickening and bruising appear.
  • Grade 3 - ulcerative lesions occupy 75% of the esophagus, gradually merging with each other.
  • 4th degree - the affected area exceeds 75%, a chronic ulcer appears.

Erosive reflux esophagitis is a complication of the disease when small ulcers appear. Symptomatology is more pronounced, accompanied by great discomfort and pain.

Biliary reflux esophagitis - when inflammation of the esophagus occurs, caused by ingestion of bile and gastric juice from the stomach and intestines. This mixture has a terrible effect on the surface of the esophagus.

Diagnostics

In order to know the exact diagnosis, to determine the degree of severity, you must be examined by a doctor. The doctor will examine the oral cavity, feel (palpate) the abdomen, direct it to appropriate tests (blood, urine, endoscopy, biopsy).

An x-ray of the esophagus will confirm the presence of a hernia and reflux esophagitis. The probe will help to know the percentage of acidity in the stomach and to establish the state and degree of reflux. The very first thing they do is endoscopy, which shows the stage of the disease.

After collecting all the tests and examinations, the doctor selects an effective treatment for reflux esophagitis, based on the patient's age and the stage of the disease severity.

How to treat reflux esophagitis?

Treatment of reflux esophagitis is determined by a gastroenterologist, it is necessary to strictly follow the instructions set by him and take only prescribed medications.

Treatment should begin with the elimination of bad habits, then - adjust your life and diet:

  • stop smoking
  • get rid of excess weight, while not heavily loading your body,
  • do not be nervous,
  • give up alcoholic beverages and junk food,
  • the menu for reflux esophagitis should be restrained and useful,
  • do not heavily load the stomach, eat 6-8 times a day in small portions and do not take food two hours before bedtime,
  • pay attention to a good and full sleep, while the head should be above the body,
  • walk in the fresh air after eating, so that food digests faster and goes into the intestines,
  • forget about tight clothing that presses on the stomach so that the pressure on the diaphragm does not increase,
  • strain less and not drag heavy.

Dietary intake

Diet for reflux esophagitis includes:

  • dairy products and milk with low fat content, low-fat cottage cheese,
  • cereal cooked in pure water without the addition of milk,
  • scrambled eggs,
  • steam meatballs or veal patties,
  • baked or cooked vegetables,
  • boiled and baked lean fish,
  • dry white bread softened in water (only not fresh pastries).

When an exacerbation of reflux esophagitis occurs, it is not recommended to eat fresh fruits and vegetables. Nutrition with reflux esophagitis is strict; food should not make you feel worse and provoke illness.

  • coffee and tea spirits,
  • sparkling water
  • spicy and sour foods,
  • peas, beans,
  • chocolate, cocoa,
  • alcohol,
  • mushrooms,
  • sauerkraut and raw cabbage
  • smoked meat
  • sour juices,
  • black bread,
  • pickled and canned foods
  • sauces (ketchup, mustard, mayonnaise),
  • crackers, nuts, chips, etc. from this series,
  • fatty foods
  • chewing gum,
  • fried foods (fish, meat, vegetables).

So is it possible to cure reflux esophagitis?

In the early stages, if you go to the doctor in time, then, of course, yes! If the disease is started, and it has reached the third or fourth stage, with proper treatment, the symptoms become less pronounced and are put to sleep for a while. The disease does not affect life expectancy, unless, of course, reflux esophagitis progresses.

Treatment of reflux esophagitis involves the general diligence of the doctor and the patient himself, since the fulfillment of all prescriptions depends on him. Prescribed medications to cure GERD (reflux esophagitis) should help improve the esophageal self-purification, protect the mucous membranes, and reduce the effects of gastric masses.

Preparations for the treatment of reflux esophagitis prescribed by a doctor:

  1. Prokinetics - increase the tone of the muscles of the esophagus, normalize the motility of the gastrointestinal tract ("Motilium", "Metoclopramide", "Domperidone").
  2. Antacids - when using drugs, the acidity of the gastric juice is reduced and neutralized ("Antarite", "Maalox", "Rennie", "Phosphalugel").
  3. Antisecretory drugs - suppress and reduce the acidity ("omeprazole", "famotidine", "rabeprazole").

Doctors sometimes prescribe complex multivitamins ("Duovit", "Aevit", "Multi-Tabs"). They increase the restorative and protective functions of the body, prevent hypovitaminosis.

How long the treatment lasts depends on the severity of the disease. Medical prescriptions for reflux esophagitis are prescribed by the attending physician, where he indicates when, how and in what quantity to take the medication.

If long-term treatment with drugs did not produce results, as well as the development of third and fourth degrees of reflux esophagitis, surgical intervention is required, after which the normal state of the stomach is restored.

Folk remedies for the treatment of reflux esophagitis

Treatment of folk remedies with reflux esophagitis is carried out as a minor procedure. Basically it consists of herbal decoctions and tinctures.

  1. Heartburn with reflux esophagitis is well helped by an infusion of dill seeds, it eliminates burning sensation and stops inflammation. Apply squeezed juice of fresh potatoes, which they drink 20 minutes before the start of a meal at 50 grams.
  2. Ground calamus root struggles with the symptoms of the disease. Drink half a teaspoon with water. Use powder of ground roasted peas and ground buckwheat.
  3. Tincture of leaves of wormwood and chamomile helps to get rid of inflammatory processes in reflux esophagitis with a calming effect.
  • In the mug put one tsp. crushed wormwood and tsp. pharmaceutical chamomile,
  • Brew about 1 hour.
  • Drink before meals 3 times a day for 1/4.
  • Not the worst effect gives the broth prepared in the same way from the dried leaves of plantain and St. John's wort.
  1. Rosehip tincture is excellent for helping to treat reflux esophagitis. To 1 liter of boiling water add 2 tbsp. l dried berries, insist at least 5 hours. Good filter and drink.

To recover quickly after reflux esophagitis, regularly take infusions and decoctions. Constantly alternate them for two months. They make decoctions of mint leaves, calendula flowers, raspberry leaves, dandelion flowers. Practically for all diseases of the digestive system it is recommended to use Jerusalem artichoke (earth pear).

Prevention

The best prevention of reflux esophagitis is a regular and timely visit to a gastroenterologist and an annual medical examination.

In order to avoid diseases, first of all lead a healthy lifestyle, including:

  • leisure,
  • doing sports
  • maintaining optimal weight, avoiding overeating,
  • street walks, especially after eating,
  • no bad habits
  • avoidance of stress
  • proper nutrition
  • healthy sleep.

If you adhere to the correct lifestyle, the disease will not arise and will not let itself be known. Prevention is always more effective than the treatment of reflux esophagitis.

What is irritable bowel syndrome and how to treat it, see here.

Disease description

What is reflux? Reflux in medicine refers to the process of moving the contents of one hollow organ in another in the direction opposite to the normal one. Reflux can occur not only in the digestive organs, but also, for example, in the urinary organs. However, most often the person is faced with gastroesophageal reflux. Reflux of this type is characterized by the fact that with it the contents of the stomach are thrown into the esophagus, which, naturally, should not be normal - because the esophagus is designed just to deliver food to the stomach, and not vice versa.

In order to prevent gastroesophageal reflux, the lower esophageal sphincter is intended, which shrinks after food passes into the stomach and does not allow it in the opposite direction. However, in some cases, the contents of the stomach can still enter the esophagus.

Gastroesophageal reflux itself is not a pathological process. A healthy person per day can experience reflux, for example, after a hearty meal. In general, two or three reflux per day do not go beyond the normal range. It is quite another thing when reflux is repeated regularly and is accompanied by abundant outpouring of the contents of the stomach out. This leads to inflammation of the esophagus and a number of other unpleasant symptoms. After all, the esophagus does not have a mucous membrane that can withstand the aggressive components of gastric juice for a long time. The situation is further aggravated when the contents of the duodenum are added to the gastric contents along with the bile.

Such a syndrome, in which there is a lesion of the esophagus, caused by a regular reflux of the stomach contents, is called gastroesophageal reflux disease (GERD), or reflux esophagitis. Some experts, however, share the concepts of reflux esophagitis and GERD, referring to the first state only those cases where there is marked inflammation of the esophagus. Sometimes this disease is called simply “reflux”, but this is completely wrong, as reflux is just a physiological process and, as mentioned above, it is not always equivalent to a disease. Thus, reflux esophagitis is a disease, and gastroesophageal reflux is just one of its mandatory symptoms.

The disease is more common in adults than in children. In addition, men suffer from it 2 times more often than women.

Why do some people get GERD and others don't? There may be different factors, for example:

  • stomach ulcer or gastritis,
  • hernia of the esophageal diaphragm,
  • taking drugs that promote low tone of the lower esophageal sphincter.

Some side effects can also play a role:

  • smoking
  • pregnancy,
  • chronic constipation
  • infectious diseases,
  • stomach tumors
  • pathology of the vagus nerve,
  • chronic pancreatitis or cholecystitis,
  • alcohol consumption,
  • wrong diet
  • weight lifting
  • genetic predisposition
  • stresses.

Little serious illness is symptom free, and reflux esophagitis is no exception. By itself, gastroesophageal reflux can not always be identified, so the main symptom by which reflux esophagitis is determined is heartburn. It occurs in 80% of patients. Also, often reflux esophagitis is accompanied by belching, sometimes with a sour taste (when throwing bile from the duodenum - bitter), and sometimes chest pain, especially after eating, abundant salivation at night. GERD pains usually resemble angina, but they are easily distinguished from the symptoms of heart disease, since they usually disappear after taking antacids.

There are also a number of signs that most people do not associate with GERD, and yet they are directly related to it. The fact is that gastroesophageal reflux can cause the ingress of particles of gastric contents — food debris and aggressive gastric juice — into the respiratory tract and oral cavity.
Therefore, if a patient has symptoms such as chronic bronchial asthma and other diseases of the lower respiratory tract, chronic pharyngitis and laryngitis, persistent diseases of the teeth, for example, caries, then this is a reason to go to a gastroenterologist.

Treatment of reflux esophagitis

In most cases, the treatment of reflux esophagitis is conservative. Methods of conservative treatment can be divided into drug and non-drug.

During the treatment, the following objectives are pursued:

  • protection of the mucous membrane of the esophagus,
  • neutralization of aggressive components of gastric juice,
  • increase the speed of passage of the food bolus through the esophagus,
  • an increase in the tone of the pylorus of the stomach and an increase in the activity of the cardial part of the stomach.

Drug treatment

The main classes of drugs that are prescribed for GERD:

  • prokinetics
  • antacids,
  • proton pump inhibitors,
  • histamine receptor blockers and anticholinergics.

The most commonly used group of drugs are antacids that lower the acidity of the gastric juice due to the neutralization reaction. Therefore, if reflux occurs and gastric juice is thrown into the esophagus, then it has a less irritating effect on its mucosa. The most popular drugs of this group are Maalox, Almagel.

However, the disadvantage of many antacids is that in response to a sudden alkalization of the stomach, a strong release of hydrochloric acid can occur and the level of acidity of the stomach will return to previous indicators.

This deficiency is deprived of drugs that are called proton pump inhibitors. They act on specific cells that release hydrogen ions (protons) and block this process, resulting in a steady decrease in the level of acidity in the stomach. One of the most well-known drugs of this class is Omeprazole.

Histamine receptor blockers are used in cases where, for whatever reason, proton pump inhibitors cannot be used. They act on special histamine receptors of type H2, located in the gastric mucosa, which work at the moment when food enters it. A typical representative of this type of drug is Ranitidine.

Prokinetic preparations improve peristalsis of the stomach and upper sections of the intestine, increase the tone of the pylorus of the stomach, contribute to the speedy advancement of the food bolus along the gastrointestinal tract, prevent vomiting, hiccups and reflux. Most of these drugs use metoclopramide.

Drug-free methods

Reflux esophagitis cannot be cured with drugs alone. Non-drug treatments include diet and lifestyle changes and eating habits. To reduce the unpleasant symptoms associated with GERD, a number of foods should be excluded from the diet:

  • carbonated drinks,
  • spicy food
  • coffee,
  • cocoa,
  • alcohol,
  • fatty and fried dishes,
  • spices,
  • too cold or hot dishes
  • mushrooms,
  • legumes.

It is also recommended to reduce the consumption of fresh berries and fruits.

What products are useful to use:

  • scrambled eggs,
  • low-fat cottage cheese,
  • porridge,
  • crackers,
  • meat steam meatballs,
  • compotes.

The use of boiled and easily digestible food, dairy products is recommended.

It is also necessary to remember about the diet. When GERD can not overeat, therefore, should eat small portions, but as often as possible. Also, do not eat right before bedtime. Between the last meal and going to bed should take at least two hours. After each meal it is not recommended to sit or lie down, it is better to walk for a while.

In addition, the following recommendations will work for patients with GERD:

  • to give up smoking,
  • should arrange a place of sleep so that the head of the bed would rise a few centimeters,
  • it is necessary to establish a full sleep with a duration of at least 8 hours,
  • avoiding wearing tight clothing with straps, corsets, etc.
  • refusal to lift weights, moderation in physical exercises,
  • weight loss
  • reducing the number of stressful situations.

Surgical methods

In severe cases, reflux esophagitis is treated by surgical methods. They are resorted to in case of unsuccessful treatment of the disease by conservative methods, to correct serious complications (for example, hernia of the esophagus) or in cases where the disease has gone into extreme stages (the formation of Barrett's esophagus).

Complications

Without treatment, the disease will only progress. In the early stages of the disease, only certain parts of the esophagus are affected, and pathological processes affect only the surface layer of the mucous membrane. However, subsequently, the disease will grow in breadth and depth, affecting more and more large surface area of ​​the esophagus and penetrating into the deeper layers of tissue. As a result, reflux esophagitis can lead to complications such as esophageal perforation, erosive esophagitis, as well as a condition called Barrett's esophagus, in which this organ hyperplasia occurs. This condition is already precancerous, that is, with a high probability it leads to malignant tumors.

A complete cure for GERD is unlikely, but modern medical methods can significantly improve the patient's quality of life, prevent the progress of the disease, and save the patient from the most unpleasant symptoms.

Features of the disease

The mucous membrane of the esophagus is affected due to chronic, periodically repeated reflux of the acidic contents of the stomach into the esophagus. But this is not the only cause of esophagitis, the occurrence of which contribute to:

  • infections,
  • chemical burns
  • esophageal sphincter atony,
  • violation of the stomach,
  • strong experiences
  • pregnancy,
  • posture for a long time
  • excess weight,
  • smoking,
  • taking medication drugs that increase blood levels of dopamine.

According to the site of the lesion of the esophageal tube, experts distinguish total esophagitis, developing throughout the mucous membrane of the organ, proximal, appearing at the beginning, and distal, appearing in the lower part of the esophagus. The latter is observed most often. It occurs in adults, but it also happens in children.

Signs of disease

Symptoms of reflux esophagitis depend on its type, on the degree of development and on the form of the disease, which is reflected in the table.

The formSymptoms
SharpPain when passing food.
Belching.
Swallowing disorder.
Burning.
Increased body temperature.
Malaise.
ChronicSternum pain is optional during meals.
The urge to nausea.
Vomiting.
Hiccups
Enhanced salivation.

Treatment of reflux esophagitis is prescribed after examination and confirmation of the diagnosis. The doctor chooses treatment methods after determining the type of the disease.

Most often there are catarrhal (with edema and redness of the esophageal tube) and erosive (with acute infections) esophagitis. Official medicine uses different methods of treatment for each type: with the help of drugs and surgery.

The patient must take into account: to recover, you need to completely change your lifestyle, especially the power system.

Cure at home

To get rid of all the symptoms of reflux esophagitis, many use the treatment of folk remedies. This is an effective alternative to taking pills and undergoing procedures. The most effective recipes use natural raw materials: herbal infusions, decoctions, teas.

The therapeutic effect of homemade infusion is valid only during the day - every day you need to cook fresh.

  • Dill infusion. This soothing medicine will help relieve the inflammation characteristic of the acute form of the disease. It is only necessary to prepare the seeds of this plant in the fall or purchase them at a pharmacy. To prepare the infusion, pour 200 ml boiling water of 6 g (2 tablespoons) of dill seeds, crush and leave to infuse for three hours. Daily pattern of use - 4 times a tablespoon.

How easy is it to recover?

Treatment of the disease with folk remedies is most often prescribed in conjunction with drug therapy. But any specialist will also focus on proper nutrition of the patient. None of the most effective drugs will benefit if you do not follow a diet. It is necessary to exclude from the menu fried and smoked, salted and marinated.

The use of prescriptions created by our ancestors should be monitored by the attending physician. After all, some of them can cause complications. These are recipes with the addition of burning alcohol, alcohol or vodka, which will cause even more irritation of the esophageal mucosa. If you follow all the recommendations homemade recipes will help restore health.

Stages and symptoms

For such a disease is characterized by several stages.

  1. At the first stage, separate erosions are formed on the mucosa, which do not merge and do not capture a significant part of the esophagus.
  2. The second stage is called merging, because small ulcers and areas of erosion become larger. However, they capture a small part of the esophagus.
  3. In the third stage, the lower third of the organ is affected.
  4. At the fourth stage of the disease is observed stenosis of the esophagus, chronic ulcer.

Note! Often in the third or fourth stage of the disease, the patient is recommended surgery. Its implementation is associated with certain risks and complications.

To avoid this, you should contact a specialist immediately after the unpleasant symptoms of diseases of the abdominal organs. Launched ulcerative esophagitis is especially difficult to treat.

When esophagitis occurs in adults, discomfort may occur in the chest cavity. They give to the region of the heart and shoulder. Often, patients may not associate the appearance of such pain with the esophagus and take (most often uncontrollably) cardiac drugs. Naturally, they do not give any result.

Reflux esophagitis has many manifestations. The most characteristic of them are:

  • belching (it can be either air or stomach contents),
  • painful heartburn
  • nausea, vomiting,

  • frequent regurgitation (it is often in children),
  • taste of acid in the mouth,
  • dysphagia (while the patient feels difficulty in swallowing food normally),
  • a cough that lasts long at night (it is due to the so-called micro-aspiration of minor particles of food from the esophagus to the upper respiratory tract),
  • teeth caries damage due to acid ingress into the oral cavity,
  • hiccups

Important! Without treatment, esophagitis occurs in humans for years. Its symptoms may get worse. This inevitably leads to the formation of scars on the esophageal mucosa.

All manifestations of reflux esophagitis are greatly enhanced after a person falls. In a standing or sitting position, pain, heartburn or hiccups almost do not bother.

Sometimes the patient may experience signs of pharyngitis, nasal congestion. These signs appear because the acidic contents of the stomach irritate the throat, causing the patient to have a sore throat.

Diagnostic features

If the patient is supposed to have reflux esophagitis, his treatment is possible only after a correct diagnosis. Diagnosis occupies an important place, because it depends on how to continue to treat reflux esophagitis, what medicines to prescribe to the patient.

Diagnosis consists of such measures:

  1. Conversation with the patient. When collecting the history, the doctor identifies the characteristic complaints of the patient, the duration of the symptoms and their degree of severity.
  2. Examination of the oral cavity. The presence of affected teeth, inflammation of the mucous membranes suggests that the patient may develop reflux.
  3. Palpation.
  4. FEGDS - the main diagnostic method on which further treatment will depend. At the same time, a thin fiber optic probe is inserted through the mouth into the patient. A study of the state of the gastric and esophageal mucous membranes. With the help of the latest computer technology image is displayed on the screen. With reflux esophagitis, the mucosa is hyperemic and colored in red shades.
  5. Radiography is performed using a special contrast agent (barium sulfate). Suspension does not have a pronounced taste, non-toxic to humans. With the pathology under consideration, the movement of barium suspension into the esophagus will be seen.
  6. Examination of the acid indicator of the esophagus. In pathology, it will be reduced, since the penetration of gastric juice into the esophagus “acidifies” its membranes.
  7. Esophagemanometry assesses the normal contractile activity of the lower sphincter. This method clarifies the diagnosis.
  8. The cardiogram is performed for the purpose of differential diagnosis.
  9. Radiography of the chest cavity is performed to exclude pulmonary pathologies.

Remember that it is possible to cure esophagitis when this disease is most accurately identified.

What is dangerous esophagitis

You should not assume that reflux esophagitis refers to "innocuous" and "safe" pathologies. If left untreated, then the person may experience the following dangerous diseases:

  1. The appearance of ulcers on the mucous membrane of the esophagus can be a patient if he suffers from a disease for a long time. Endoscopic surgery is used for the treatment of hemorrhages, which consists in using a mini-electrocoagulator to cauterize the vessel.
  2. Stenosis of the esophagus develops in humans due to a chronic inflammatory process in its mucosa. The patient complains of pain during swallowing and the presence of a lump in the throat. A rather complicated surgical operation is performed for the treatment.
  3. Barrett's syndrome is a dangerous risk of developing a malignant neoplasm.

The sooner the patient goes to the doctor to treat reflux esophagitis, the easier his treatment will be.

Nutrition and Lifestyle

For the treatment of such a disease is very important diet. Practice shows that drugs to reduce the acidity of gastric juice and other pills will not be effective if the patient consumes junk food. The therapeutic effect will not bring it.

Is it possible to cure reflux esophagitis with the help of properly selected nutrition? In some cases, it is possible to cure esophagitis forever, if you adhere to proper nutrition and take medication prescribed by a doctor.

The way of life of a patient with chronic reflux esophagitis should be like this.

  1. It is necessary to completely eliminate all nervous overload.
  2. It is necessary to sleep enough (at least 8 hours). Moreover, it is necessary to ensure that the head is slightly higher than the body. At the same time, the number of reflux at night can be significantly reduced.
  3. It needs five meals: it will eliminate long breaks in eating and overeating.
  4. In the treatment of erosive reflux esophagitis is very important not to lie down after a meal. Again, eliminating overeating will not make the patient want to take a nap after lunch. But walking in such cases is useful.
  5. To prevent the causes of esophagitis reflux, it is not necessary to wear tight clothes and belts.
  6. It is forbidden to lift weights, because it contributes to increased symptoms of reflux esophagitis.
  7. It is necessary to exclude the use of drugs that cause relaxation of the esophageal sphincter.

Prohibited such meals and drinks:

  • alcohol,
  • soda,
  • coffee, black tea,
  • chocolate products
  • seasoning
  • legumes,
  • pickles, pickles, smoked products, canned meals,
  • fatty food
  • sour juices
  • Rye bread,
  • shop sauces, including mayonnaise,
  • all snacks and fast food,
  • chewing gum,
  • all fried foods.

Such a therapeutic diet is useful for a patient with reflux esophagitis:

  • low fat sour cream and milk,
  • boiled eggs,
  • cottage cheese (preferably low-fat),
  • dried bread
  • porridge,
  • steamed dishes
  • salads and vegetable stews,
  • lean fish, meat.

Note! Diet for this pathology should be followed throughout life. This is the only way to prevent recurrences and complications.

Of course, in chronic reflux esophagitis nutrition is not limited to the above dishes alone. There is a large amount of nutritious and delicious food that does not cause exacerbation of the disease.

How can you cure reflux esophagitis with medication?

First of all, we note that people, not knowing why aggravations of reflux esophagitis occur and what it is, are trying to independently choose the “most appropriate” medicine for themselves at the pharmacy. This is absolutely impossible to do, because it can only worsen the state of health. Only a doctor can choose a drug. Treatment of reflux esophagitis should not occur independently.

The causes and treatment of this disease are interrelated: the doctor selects the right medicine only after finding out all the factors that led to it. As a rule, such drugs are prescribed:

  1. Prokinetic medications are needed to improve the tone of the lower esophageal sphincter. This is Motilium, Ganaton.
  2. Antacid medicines are needed to effectively reduce the acidity of the gastric juice. Among them, many doctors pay attention to Almagel - he effectively fights manifestations of hyperacidity of gastric juice.
  3. Antisecretory agents are represented by inhibitors of the hydrogen pump (omeprazole or famotidine).

If the patient has symptoms of reflux esophagitis, his treatment can last up to 6 weeks. It all depends on the severity and stage at which the disease was diagnosed.

Folk methods

How to cure reflux by unofficial means? Informal medicine knows many effective ways to treat the disease in question. Before you treat reflux esophagitis, you need to turn to a therapist: he will help you choose the most effective method of getting rid of the disease.

Consider some ways to treat the manifestations of reflux esophagitis with non-drug methods.

The mixture of chamomile, flax, dog nettle, lemon balm leaf, licorice reduces the intensity of inflammation. To prepare the broth, you must take 2 tbsp. l plants and brew in boiling water, evaporated in a water bath for 10 minutes. Drink a third of a glass, 4 times a day.

A mixture of calamus, anise, ashberry, oregano, mint leaves, marigold and fireweed (2 tbsp. Spoons) should be poured with water and heated in water. Drink half a cup 6 times a day.

Highlander root, plantain leaf, shepherd's bag, dandelion flowers, chamomile, yarrow grass, oregano mixed, steamed in water. The broth should also be consumed as many times in the same quantity.

This treatment should be combined with drug therapy.

What is reflux esophagitis in adults?

Reflux esophagitis is an inflammatory disease of tunicae mucosae (mucosa) of the distal esophagus, caused by exposure to gastric or duodenal peptic refluxate. Distal - this is the part of the esophagus, which is adjacent to the stomach. See the structure of the esophagus.

Manifestations in adults are esophageal (heartburn, belching, dysphagia, retrosternal pain and burning, a lump in the throat), and extraesophageal (dry cough, hoarseness, pain in the tongue, bitter mouth) symptoms.

In the pathogenesis, there are 3 main causes of reflux esophagitis:

  1. Insufficiency of the lower esophageal sphincter (LES), which is divided into relative (the result of excessive motility of the stomach with a normally functioning NPS) and absolute - the result of impaired work of the NRS. This can contribute to:
    • axial hernia,
    • gastroduodenitis, duodenitis, bulbit,
    • hypertrophic, hyperacid gastritis,
    • gastric and duodenal ulcerogenic lesions, especially when Helicobacter pylori is infected,
    • conditions after gastrectomy,
    • JVP - biliary dyskinesia with biliary reflux, conditions with low acidity of gastric juice,
    • overuse of muscle relaxants (nitrates, beta-blockers, tranquilizers).
    • alcohol and smoking abuse
    • stressful situations
    • starvation.
  2. Violation of the rate of emptying and cleansing the esophagus (esophageal clearance).
  3. Violation of mechanisms that protect the mucosa from damage.

Based on the causes of the disease, it is clear that for effective medical treatment it is necessary not only to influence the symptoms caused by the disease of the esophagus, but also to cure the diseases that caused this condition.

Classification

RE has two main forms - acute and chronic.

Causes of acute reflux esophagitis can be:

  • allergic diseases
  • exacerbation of chronic diseases of the stomach (condition after gastrectomy, HH, subatrophic gastritis, peptic ulcer),
  • infection (candidal, septic esophagitis).

Acute reflux esophagitis is manifested by the following symptoms:

  • general malaise,
  • temperature increase
  • dysphagia
  • heartburn
  • burp,
  • pains along the esophagus during meals.

Chronic reflux esophagitis, can develop as an outcome of a poorly treated acute form, or as a primary chronic disease. This form of the disease is often accompanied by diseases of the gastrointestinal tract, it is characterized by both esophageal and extraesophageal symptoms of ER.

  • Depending on the prevalence of the pathological process, there are:
    • focal reflux esophagitis - the pathological process takes one or several foci on the back or side wall of the organ in the distal (adjacent to the stomach) section,
    • diffuse re - pathological process occupies all or most of the body.

Depending on the depth of the lesion, the walls are distinguished: non-erosive reflux esophagitis (superficial) and erosive.

Non-erosive forms of pathology

Non-erosive forms are divided into catarrhal and edematous. Distal non-erosive reflux esophagitis is a mild superficial form of the disease. Symptoms are usually mild, patients complain of slight discomfort in the retrosternal area, sometimes heartburn occurs, belching (more often after overeating or sharp torso). Sometimes the pathological condition proceeds without heartburn.

Treatment mainly includes:

  • diet
  • phytotherapy (various herbal teas and tinctures of herbs),
  • physiotherapy.

Assign enveloping, astringents, anesthetics. Non-erosive reflux esophagitis ends in complete recovery.

Erosive forms

In this form, the inflammatory reaction is manifested by epithelial destruction, the deeper layers of the esophageal wall are not involved in the process.

Signs of erosive reflux esophagitis are:

The uncomplicated form is treated conservatively: diet therapy, drug therapy, methods of traditional medicine. If complications arise, surgical treatment is possible.

Symptoms of Reflux Esophagitis in Adults

Rarely, the disease occurs with moderate symptoms or asymptomatic. More often, the symptoms of reflux esophagitis in adults are pronounced. There are symptoms of the esophagus and the symptoms of neighboring organs.

Symptoms of the esophagus:

  • heartburn,
  • burp
  • pains in the retrosternal area (“stiffening behind the sternum”), often radiating to the neck and back, removed by antacids,
  • dysphagia, of varying severity, of a transient nature,
  • with severe current disease, vomiting is possible with blood.

Symptoms from other systems and organs:

  • on the part of the cardiac system: extrasystoles, conduction disturbances, cardialgia,
  • on the part of the pulmonary system: dry cough (sputum appears when a secondary infection joins), shortness of breath, difficulty breathing, sleep apnea,
  • on the part of the otorhinolaryngological organs: symptoms of pharyngitis (pain and mucus in the throat, redness of the throat is possible), the onset of symptoms of acute laryngitis due to reflux disease (hoarseness, pronounced soreness when swallowing, sore throat),
  • on the part of dental organs: phenomena of glossitis (feeling that the tongue is burning, pain in the tongue), damage to the tooth enamel, stomatitis,
  • from the blood: the phenomenon of anemia.

Cough with reflux esophagitis is dry, often painful. Drip infections arising on this background are difficult, and may be complicated by the development of bronchial asthma.

There are two mechanisms for the development of cough syndrome:

  1. Refluctant particles, with a pronounced lesion of the esophagus, get into the pharynx, and from there into the nasopharynx and trachea, where the mucous cough receptors irritate.
  2. If refluctate reflux is low and the process is localized only in the distal esophagus, irritation of the vagal centers located in the lower part of the esophagus, which activate the cough center of the brain, is possible.

In order to properly treat cough with reflux esophagitis, it is necessary, first of all, to increase the pH of the gastric juice in order to remove the cause of it causing (antacids, IGR, IPP). With frequent aspiration pneumonia, surgical treatment is required. To make it easier to carry attacks, you can take cough remedies recommended by alternative medicine (honey, aloe, propolis). Often used breathing exercises.

Extrasystoles

Extrasystole (extraordinary contractions of the heart muscle) is a frequent complaint for diseases of the stomach and gastrointestinal tract as a whole. Extrasystoles occur due to viscerocardiac reflexes, are functional in nature. Special antiarrhythmic treatment is not required, especially for moderately pronounced extrasystoles.

Another cause of arrhythmia is the prolonged effect of reflux on the vagal centers located in the lower part of the esophagus. The consequence of which is the development of vegetative-vascular dystonia with psychosomatic manifestations.

Treatment should be aimed at eliminating the pathology that caused the beats.

When patients do not tolerate extrasystole, especially if it is accompanied by increased excitability (fear, insomnia), of course, correction of the condition is required. But before treating an extrasystole, it is necessary to consult a neuropsychiatrist, since substances usually prescribed for neurosis (antidepressants, tranquilizers, antipsychotics) can worsen the condition of the lower esophageal sphincter.

Table 1. Symptoms of chronic reflux esophagitis

Types of reflux esophagitisSymptoms
Catarrhal and edematousThe mildest forms of the disease, accompanied by inflammation of the mucous membrane.

The clinical picture is expressed moderately or weakly.

Patients complain of slight discomfort in the retrosternal area and epigastria, occasional heartburn, belching.

All symptoms are aggravated by overeating and physical activity.

The course is usually benign, with proper treatment ends in complete recovery. Erosive The general condition is not broken.

In patients over 60 years of age, whitish patches are often found in the thoracic esophagus during endoscopic examination - this is intracellular glycogen deposition (esophageal acanthosis).

Complaints to retrosternal burning pains that occur both during eating and outside meals, heartburn, provoking a constant intake of soda, belching, hypersalivation.

The disease is often accompanied by extraesophageal symptoms.

Severe complications are possible. FibrinousComplaints of difficulty swallowing, heartburn, belching, sharp chest pain, radiating to the back and pericardial region, the appearance in the mouth of gray films. ErythematousDisrupted general condition.

Patients complain of dysphagia, vomiting, regurgitation of mucus, heartburn, burning sensation in the chest, retrosternal pain.

The clinic is dominated by regurgitation with bloody mucus, vomiting with blood, severe dysphagia, and solitude - feeling pain during the passage of food through the esophagus, chest pain, melena - stool with blood. NecroticDevelops on the background of serious diseases (uremia, agranulocytosis, sepsis),

the disease is manifested by dysphagia, odinophagia, repeated vomiting, sharp retrosternal pains, aggravated by swallowing.

Table 2. Reflux esophagitis and severity

Reflux esophagitisSymptomsTreatment
1 degreeHeartburn that occurs when the diet is disturbed and when overeating, discomfort in the retrosternal area, belching.Drug treatment is usually not required.

It is recommended to follow a diet, not to violate the daily routine, it is possible to use traditional medicine. 2 degreeHeartburn dominates the clinic.

The feeling of burning increases with physical activity, especially when the body is bending.

Patients complain of: belching, retrosternal pain, bad breath, white bloom on the tongue, a feeling of coma in the throat.Strict adherence to diet.

Receiving drugs that reduce the concentration of H + ions in reflux

(antacids, IGR, IPP), prokinetics. 3 degreeHeartburn, belching, retrosternal pains are almost always disturbing.

Extra-esophageal signs of the disease appear: dry, coughing, coughing, palpitations, arrhythmias, mouth pain, hoarseness.This degree requires massive therapy with a duration of at least 8 weeks.

Apply IPP, antacids, prokinetics, reparants. 4 degreeThis is the stage of complications:

  • esophageal strictures,
  • ulcers
  • diseases that often lead to cancer (Barrett's esophagus).
Drug treatment, as in grade 3 + treatment of complications.

Operation is possible.

Diagnostic methods

Re is diagnosed with endoscopy (with biopsy), x-rays of the esophagus and stomach, inside the esophageal pH-metry and manometry.

  1. Esophagoscopy allows you to carefully examine the mucosa of the esophagus, determine the extent of organ damage according to the Los Angeles classification (a, b, c, d), take a biopsy for histological examination.
  2. X-ray with esophagus contrast allows you to identify the lesion, the degree of narrowing of the lumen of the organ.
  3. Long-term measurement of the acidity of the esophagus allows us to state the presence of gastroesophageal reflux.
  4. Manometry of the esophagus - allows you to assess the motility of the body, determine the clearance of the esophagus.

After the examination, a diagnosis is made and drug treatment is prescribed.

Reflux esophagitis and drug therapy

For rational treatment of the disease it is necessary:

  • change the way of life to eliminate the negative effects that led to the disease,
  • take all medications prescribed by a doctor
  • If necessary, supplement drug therapy with traditional medicine.

Drug therapy is prescribed in accordance with the severity of the inflammatory process and the severity of the pathological process. How long and in what dosage to take the pills is determined by the doctor.

Pathogenetic drugs are:

  • antacids and alginates - drugs increase the pH of gastric juice, thereby reducing the acid aggression on the esophageal mucosa, in addition, they envelop the mucous membrane, providing cytoprotection (cell protection).
  • antisecretory agents (IGR, IPP) - reduce the concentration of H + ions in the gastric juice,
  • prokinetics - drugs that accelerate the movement of food from the stomach into the intestine, thereby eliminating congestion in the stomach, increases the tone of the lower sphincter.

Table 3. The most effective drugs for the treatment of reflux esophagitis in adults

Proton pump inhibitors

A drugHow to use
PhosphalugelThe dose of the drug is prescribed individually.

The drug is prescribed immediately after meals and at night.

AlmagelOn 5-10 ml (1-2 measured spoons) 3-4 times a day after food
Maalox1-2 packets an hour after a meal or if you have heartburn
TrimedatThe daily dose for oral administration is 300 mg, rectally, 100-200 mg, parenterally, 50 mg.

Duration of application depends on the clinical situation.

Domperidone

(Motilium)

1 tablet (10 mg) three times a day.

Max dose 30 mg

GanatonTake 50 mg 3 times a day
Ittomed1 tablet (50 mg) three times a day
Iberogast20 drops 3 times a day before meals with a small amount of water
Zeercal5-10 mg three times a day
Ranitidine150 mg twice daily
Lansoprazole1 capsule per day
20 mg twice daily
20 mg per day (1 tab.)
1 tab. (40 mg) per day
Antiulcer drugs with bactericidal activity against Helicobacter pylori
De nol 1tab 2-3 times a day for half an hour before meals
Ursosan1 capsule 1 time per night
Venter1 gr. in the morning and before bedtime
UrsofalkThe dose is prescribed individually
Hofitol2 tab. three times a day before meals
Allohol2 tab. three times a day
Odeston1-2 tab. (200-400 mg) three times a day
Duspatalin135 mg 3 times a day
Creon1-2 capsules with meals
Eglonil50-150 mg per day

Attention! Patients should be aware of what medications should be consumed at night with severe nighttime heartburn - the so-called “nocturnal acid breakthrough.” These are Phosphalugel (antacid), Omez Insta (a special form of IPP), chamomile tea (1 cup).

But even the most effective drugs will not help if the patient does not change the lifestyle, does not eliminate the causes of the disease, and does not follow the diet.

What if the disease does not go away? First of all, you should know that the treatment of reflux esophagitis is a long process. How much time will require treatment depends on the severity of the disease, in any case, not less than 6-8 months. You need to be emotional. If the disease is really difficult to treat, repeat examination is recommended, especially if there are complaints (yellow on the tongue, constant bitterness in the mouth) to rule out biliary reflux of esophagitis, biliary gastritis, pancreatic pathology. If the survey does not reveal anything, the question arises about the operation.

Lifestyles for reflux esophagitis

Before proceeding to the treatment of reflux esophagitis, it is necessary to get rid of those addictions and habits that led to the failure of the cardia. This means that you need to listen to simple recommendations and strictly follow all medical advice:

  1. Diet therapy is one of the main components in the treatment of patients with gastrointestinal tract. Patients should strictly adhere to the recommended diet, excluding from the menu all prohibited foods. Food should be warm, boiled (or steamed), soft. It is necessary to eat regularly, often in small portions.
  2. Patient RE is necessary to avoid physical and mental overvoltage, stressful situations. However, it is impossible to completely abandon physical activity (you can visit the pool, go for walks).
  3. It is necessary to provide a full 8-hour night sleep. Sleep better on a special wedge-shaped pillow from GERD, one end of which is raised twenty centimeters above the bed, which prevents the backward movement of gastric contents and allows you to sleep properly.
  4. Give up alcohol and smoking.

All these tips must be followed after the clinical manifestations subside, as they are the prevention of recurrent exacerbations.

Surgical treatment

Surgery for reflux esophagitis is an extreme measure. They resort to it only if the consequences of abandoning the operation are much heavier than the operation itself and the risks of its complication.

Indications for surgical treatment:

  • complex, prescribed in maximum doses, drug therapy, conducted for more than six months, did not produce results,
  • the patient has frequent, threatening severe pulmonary pathology, aspiration pneumonia,
  • severe complications of chronic reflux esophagitis have developed (cicatricial esophageal stenosis, severe ulcerative pathology, Barrett's esophagus, bleeding),
  • the patient has a hiatus hernia.

Is Reflux Esophagitis Dangerous?

The symptoms of an uncomplicated course of the disease are very unpleasant. But what is dangerous with reflux esophagitis is complications. The most dangerous consequences include:

  1. Stenosis of the esophagus that occurs with prolonged chronic inflammation. Normal mucosa is replaced by scar tissue, narrowing the lumen of the body.
  2. Gullet ulcer. If inflammation exists for a long time, then not only the superficial, but also the deep layers of the esophageal wall are affected. Ulcers are often complicated by bleeding, requiring emergency surgical treatment.
  3. Barrett's esophagus. This is a cellular metaplasia of the esophageal mucosa. With this pathology, the probability of developing esophageal cancer is very high.

Table 3. Traditional medicine

MeansActRecipe (and how to take)
Sea buckthorn oilIt has an anti-inflammatory effect.

Normalizes the production of digestive juices.

Enhances regenerative processesBuy at the pharmacy

Dessert spoon after meals 3 times a day (2 weeks)

Potato JuiceIt has an enveloping effect, reduces the symptoms - heartburn and retrosternal painSqueeze the juice from 1 potato tuber.

Fresh juice is drunk before meals 3 times a day (for 2 weeks) HoneyAnti-inflammatory effectOn 25 grams 2 times a day in 1 hour after food Linseed oilAccelerates the regeneration of damaged mucous membranes, which is important for the treatment of reflux esophagitisDrink a teaspoon 2 times a day for an hour before meals (10 days) Flax seedsPossesses the enveloping property, reduce the concentration of H + ionsOn the night of flax seed pour boiling water in the ratio of 1: 5, taken in the morning before meals.

Drink weekly courses with a 10-day break HerbsReducing the concentration of H + ions in the reflux.

Acceleration of mucosal regeneration.

Increased motility of the stomach and tone NSP.

Reduction of fermentation processes in the intestines, reduction of flatulenceCollection: chamomile flowers, flax seeds, licorice rhizome, lemon balm leaves, taken in a ratio of 2: 2: 1: 1.

Ingredients are crushed and poured 1000 ml of boiling water.

A mixture of herbs boiled in a water bath.

Leave for 2 hours, the broth is filtered.

Drink the drink should be four times a day in an amount of 50 ml. ChamomileAnti inflammatory1 bag of pharmaceutical chamomile brewed with boiling water.

Drink as tea 2 times a day after meals AloeJuice has regenerative and anti-inflammatory properties, helps to reduce the concentration of H + ionsFreshly squeezed aloe vera juice diluted with water (0.060–0.030), drink aloe before meals Oatmeal jellyIt is used as a component of the diet with reflux esophagitis and gastritis.Flakes Hercules pour cold water in a ratio of 1: 3.

Leave overnight.

In the morning, filter and boil over low heat until the liquid thickens.

Used as a breakfast MintMenthol oil has a spasmolytic, prokinetic effect.

Reduces the activity of Helicobacter pylori.

Mint solution prepared incorrectly can cause aggravation.3 fresh leaves of mint pour 0.25 liters of boiling water.

Drink 1 time per day for 0.5 hours before meals RosehipIt has an anti-inflammatory effect.

Normalizes the gastrointestinal tract, reduces the concentration of H + ions in the gastric juice60 grams of dry berries pour 1000 ml of boiling water, insist 6 hours.

Drink instead of tea 3 times a day ChicoryBlocks nausea, heartburn and discomfort after eatingBrew like coffee, take after meals Goat milkSymptomatic remedy to quickly relieve inflammation and such unpleasant symptoms as heartburn and belching1 cup daily in the morning before meals Plantain GrassSuppresses pain, reduces the severity of symptoms, inflammatory response, reduces the concentration of H + ionsSqueeze the juice from the leaves of the plantain, diluted in 250 ml of water, drink during the day CalendulaIt has analgesic, anti-inflammatory, antiseptic and antispasmodic properties.5 grams of dried flowers brew 1 cup boiling water.

Drink like tea after meals DandelionThe remedy reduces the severity of the inflammatory response and the severity of the main symptoms.Dandelion flowers tightly fill the container, sprinkling with sugar.

A teaspoon of the resulting syrup is dissolved in a glass of water.

Drink before each meal

Mineral water with reflux esophagitis

Mineral alkaline waters are used for reflux esophagitis and gastritis during remission. Apply low-mineralized medical table water. They normalize the motor and secretory functions of the stomach. Beneficial effect on the function of the sphincter of the esophagus.

Course treatment of RE with Borjomi mineral water during diet therapy significantly reduces the number of complaints, reliably reduces the acidity of gastric juice, improves its enzymatic properties, and cleanses the walls of the esophagus. The course of treatment is 21 days (drink 150 ml without gas three times a day 40 minutes before meals).

Borjomi resort

Is it possible to cure reflux esophagitis forever

It all depends on the severity of the disease. When reflux esophagitis 1 degree for complete remission it is quite enough to eliminate the causes of the disease, diet, use of alternative medicine, which have anti-inflammatory, enveloping effect.

If the course is severe, then complex medical treatment is necessary to prevent complications.

If complications did occur, it is likely that surgical treatment will be required.

Of course, the prognosis for life is quite favorable, but to get rid of reflux esophagitis forever, when the first symptoms appear, it is better to immediately consult a doctor for treatment.

Watch the video: Gastro Esophageal Reflux Disease Causes, Symptoms & Treatment, Fortis Healthcare, Bangalore, India (December 2019).

Loading...

Popular Categories