Reflux-esophagitis: causes, symptoms, diagnosis, diet and treatment

Reflux-esophagitis is such a pathology, withwhich damages the lower part of the esophagus as a result of throwing into it the contents of the stomach. In the chronic form of this disease and the absence of therapy, stenosis or strictures are formed. This further complicates the movement of food through the esophagus and requires an operative correction.

Causes

The most common etiologic factor of the emergence of reflux-esophagitis is a decrease in the tone of the muscles of the lower sphincter in the esophagus, which leads to its full or partial opening.

The following reasons may contribute to this violation:

• increased pressure in the abdominal cavity;
• psycho-emotional overload;
• exposure to chemicals;
• the use of acute or poor-quality food;
• hernia diaphragm.

Many people ask, what is this - reflux esophagitis 1 degree?

With violations of motor (dyskinesia) bile ducts, biliary reflux develops, which is associated with an irritating effect of bile secreted outside the proper digestion process.

In addition, the factors leading tothe appearance of reflux, is considered a long stay with a torso bending forward, excess weight, smoking, drinking coffee, spices, alcoholic beverages. Often this pathology develops during pregnancy, in some cases is the result of taking certain medicines, for example, "Nitroglycerin" or "Metoprolol."

Also, reflux esophagitis is often diagnosed whenthe presence of gastric 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

Самой распространенной жалобой при reflux-esophagitis is heartburn (burning in the upper part of the esophagus), which is worse after eating, drinking alcohol, coffee, soda. There may also be an acidic eructation of the contents of the stomach.

Dysphagia is characteristic of esophageal reflux,which is manifested by difficulty in swallowing and impaired passage of food through the esophagus. In inflammatory processes in the mucous membrane, the intake of any food causes a rather pronounced pain syndrome. It should be noted that reflux esophagitis (ICD-10 - K21.0) sometimes manifests symptoms that mimic the damage to other organs:

1. Кардиальный синдром, когда наблюдается появление pain in the sternum, which resemble the symptoms of angina. Such pain appears, as a rule, after overeating, taking acute or acidic foods. All this is accompanied by heartburn with reflux esophagitis.
2. Catarrhal syndrome characterized by developmentinflammation 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. Signs of reflux esophagitis may be other.
3. Dental disorders that are caused by the ingress of acid into the oral cavity, which leads to tooth decay and provokes caries.
4. Pulmonary cider, in which there is a cough inas a result of bronchial obstruction, which is often observed at night. The cause of accumulation in the bronchi of sputum is microaspiration into 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 foci on its mucosa.
• 2 degree at which erosion begins to merge among themselves, but without total damage to the mucous surface.
• Grade 3 is characterized by a solid, extensive ulcerative focus in the lower part of the esophagus.
• 4 degree, when there is the presence of chronic ulcers and esophageal stenosis.

In addition, if you consider the depth of the defeatmucous membrane, superficial esophagitis is secreted 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 lesions and ulcers appear on the mucosa.

Reflux esophagitis in children

It should be noted that reflux in childhoodExperts consider it 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 the overcrowding of the stomach with food, however, abundant and sustained regurgitation may 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 copious regurgitation observed;
• vomiting after feeding;
• low body weight;
• nasal congestion in a child for a long time;
• restless 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 provokethe development of otitis media, sinusitis, pneumonia, loss of 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 of reflux esophagitis, the doctor first conducts a comprehensive examination.

Diagnosis of pathology

If you suspect the development of the disease is recommended to conduct a number of specific surveys, which include:

• endoscopy with biopsy sampling;
• bilimetry, which is performed with biliary reflux;
• x-ray examination;
• daily pH-metry;
• omeprazolovy test;
• Bernstein test;
• scintigraphy

Signs of this pathology may resemblethe clinical picture, which is characteristic of damage to the lungs or the heart, therefore, the disease in the absence of the correct therapeutic approach over time becomes protracted. In chronic form, reflux esophagitis contributes to the development of esophageal stenosis and becomes the main cause of the so-called “Barrett syndrome”, in which epithelium cells are reborn, which greatly increases the risk of developing esophageal cancer.

Symptoms, causes and treatment of reflux esophagitis are interrelated.

Treatment

In case of short-term reflux attacks due tonutritional errors specific therapy is not required. To do this, it is enough to eliminate the factors that irritate the stomach, for example, to exclude spicy dishes or alcohol from the diet.

With more frequent occurrence of reflux sickmust adhere to a special diet. To relieve 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 medical devices can be taken in cases where it is not possible to receive medical assistance immediately, but when normalizing the condition, one should not forget that it is only a doctor who can correctly determine which drugs can be used to treat this pathology.

Схема терапии определяется, как правило, в 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 tight clothes, lift weights and take medications that reduce the tone of the esophageal sphincter (Eufillin, sedatives and sleeping pills).

Any activity and exercises that provide for bending forward or staying in a similar position for a long period of time are also prohibited.

Drug groups

Reflux esophagitis therapy includes the use of the following groups of drugs:

1. Prokinetics that increase the tone of the esophageal sphincter. The most frequently prescribed drugs are Motilak or Motilium, in which the active substance is represented by dompyridone.
2. Antacids are drugs that can reduce acidity in the stomach due to the fact that they neutralize hydrochloric acid. Almagel is considered to be the main drug from this group.
3. Antisecretory agents that reduce acidity as a result of inhibition of hydrochloric acid production. The most common representatives of these drugs are Omez or Omeprazole.

Is it possible to cure reflux esophagitis forever? This is a frequent question.

It should be noted that medication therapyshould be carried out strictly on doctor's prescription and in compliance with the recommendations specified in the instructions. This therapy is very long and takes about 12 weeks. After the condition is normalized, maintenance treatment is carried out, which takes several more months.

Cure Reflux Esophagitis Conservativemethods possible, but it depends on the severity of the lesion of the esophagus, the clinical manifestations and the course of this pathology. The operative solution of the problem, as a rule, is carried out among young patients, in whom no favorable dynamics is observed after drug treatment. In addition, surgery is recommended in the presence of bronchial asthma, as well as some complications, the most dangerous among which are the development of esophageal strictures, bleeding and the formation of Berrette syndrome. Nutrition with reflux esophagitis is of particular importance.

Nutrition Basics and Diet

Meals should be organized as follows:

1. Fractional 6 meals a day, at which uncontrolled snacks and overeating are excluded, because when the stomach is full of food, its contents are more intensively thrown into the esophagus.
2. The size of a single portion is reduced to 300grams, and the nutritional value of the diet at the same time should not decrease. A similar balance is achieved through a specially selected diet. Caloric intake per day for this disease should be 2000 - 2500 kcal.
3. Some time after a meal can not take a horizontal position.
4. It is strictly forbidden to eat at night.

What else does power mean whenreflux esophagitis? Under the ban enters fatty, spicy, rough food, as well as alcohol, citrus, soda, garlic, tomatoes, tea and coffee. Also, when reflux esophagitis should limit salt intake.

Food should only be processed withboiling, stewing or baking. Hard products need to pre-fray and chop to puree. In addition, you need to sufficiently chew food, in the process of which is better processed by enzymes contained in saliva.

From food with exacerbations of reflux esophagitisexcluded sweet. During the period of remission, the patient is recommended to focus more on his own feelings - if a certain sweetness in a small amount does not worsen the condition, then you can use it periodically.

It is important to observe the drinking regime, and drink at least 1.5 liters of pure water daily, which will significantly improve digestion.

Sample menu

An exemplary menu for this pathology is compiledtaking into account individual clinical manifestations and stage of the disease. However, there are some variants of the general menu, which should be followed by people suffering from the throwing of contents from the stomach into the esophagus.

Breakfast options:

1. Pumpkin-semolina puddings, steam omelets, tea, cookies.
2. Baked potatoes and boiled broccoli with low fat sour cream sauce, steam patty.
3. Milk porridge with grated berries, tea.
4. Soft-boiled eggs, bread, a piece of boiled chicken.
5. Porridge cooked in water, with the addition of crushed dried fruit, jelly.

Snack options:

1. Potato casseroles, baked apples with honey, herbal tea.
2. Curd casseroles, compotes.
3. Cottage cheese with sour cream and dried fruits.
4. Liver pate with boiled carrots.
5. Fruit jelly, bananas.

Lunch options:

1. Vinaigrette, soup with meat and noodles, compote.
2. Baked potatoes, boiled fish, herbal tea and biscuits.
3. Boiled vermicelli and omelette with vegetables and greens.
4. Mashed potatoes, meatballs, low-fat yogurt.
5. Rice porridge, steamed patties, vegetable stew.

Dinner options:

1. Cauliflower puree, boiled chicken breast, bread and tea.
2. Pumpkin and apple puree, compote with cookies.
3. Rice porridge, vegetable stew.
4. Boiled or baked fish in sour cream, vegetable salad, compote.
5. Kefir and crackers.

Such a diet helps to eliminate the unpleasant symptoms of the disease and prolong the period of remission.

"Omeprazole" with 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.

Когда активное вещество данного лекарства penetrates the acidic environment of the stomach, it begins to affect the cells that are responsible for the production of gastric juice and enzymes, and proceeds to normalize these processes. The drug reduces the secretion of gastric juice, as well as its level of activity, has an adverse effect on adverse bacteria, the presence of which is observed in this pathology.

We reviewed the symptoms, causes and treatment of reflux esophagitis.