One of the most common gastrointestinal diseases is reflux esophagitis,
almost half of the population is registered. Appears
due to inflammation of the mucous membrane of the esophagus, developing
due to ingress of hydrochloric acid and other components of the gastric
juice into the esophagus. According to numerous studies conducted in
Europe, USA, Russia, the prevalence of this disease among
the adult population is 40-60%, and in recent years
There is a significant increase in this indicator.
However, patients often hesitate to consult a doctor when
symptoms of reflux esophagitis, and the treatment is delayed or requires
more radical measures due to the total damage of the esophagus and
the occurrence of complications.
What is reflux esophagitis?
Рефлюкс эзофагит – это заболевание пищевода,
accompanied by the development of the inflammatory process on his
mucous membrane. According to statistics, 2% of adults have
reflux esophagitis, which is more often (2 times) detected in men.
Often, the symptoms of this disease become habitual and enter
in the daily norm. The man does not pay attention to a small
afternoon heartburn that passes after Almagel pills
or water with soda.
In normal operation of the digestive system, this sphincter
opens only upon ingestion of food and water from the esophagus to
stomach. The weakening of the sphincter muscle ring leads to the fact that
- semi-digested food residue
- hydrochloric acid,
- pepsin and other components of gastric juice,
enters the esophagus back, irritates its mucous membrane and causes
a lot of unpleasant feelings in a patient. Provoke
sphincter insufficiency may hernia hiatus
aperture: when the latter expands, a throw occurs
Thanks to the sphincter, which is located at the junction
stomach and esophagus, reflux esophagitis occurs very rarely and lasts
no more than five minutes. This condition is considered quite normal.
Abnormal is food reflux, repetitive
daily and lasting at least one hour.
Types of disease
- Chronic reflux inflammation of the esophagus is accompanied by
periodic painful sensations behind the sternum. Are intensifying
signs when running, lifting weights, taking food.
- Acute reflux esophagitis is characterized by inflammatory
changes directly in the esophageal wall. When a person
takes food, he senses that the movement of the food bolus
stops behind the sternum. This increases the temperature
salivation increases, swallowing problems occur. Belching
observed in the final stage of the disease.
Non-Erosive Reflux Esophagitis
What is non-erosive reflux esophagitis? So complex term
referred to as one of the varieties of GERD, characterized by
specific clinical symptoms, in the absence of damage
tissues of the esophagus. Usually do not need serious therapy. Usually,
patients are on the mend after normalization of nutrition and exclusion
spicy, fatty and salty foods.
Erosive reflux esophagitis
Erosive form is one of the most dangerous, since
her mucous begins to be covered with ulcers. In the absence of treatment
they may bleed or cause more serious
the consequences. The aggravation of the course of the disease provoke
nutritional errors that are in the use of acidic
products of various types, caffeine and alcohol.
Often, the course of the disease is aggravated and drugs,
even so harmless at first glance as paracetamol, analgin,
aspirin, etc. The disease can last for a long time without symptoms.
or have the same symptoms as gastritis.
In the absence of treatment данное заболевание может поразить не
only the upper cells of the esophagus, but also the deeper layers. therefore
treatment is carried out under the strict supervision of a physician.
Any factors may cause reflux esophagitis.
reduce or completely eliminate the effectiveness of the listed
protective mechanisms. They may be:
- Chemical, food factors;
- Nervous strain;
- Increased pressure in the peritoneum.
Often, reflux esophagitis accompanies gastrointestinal diseases such as:
- stomach ulcer or cancer;
- defeat of the vagus nerve;
- violation of duodenal esophageal patency;
- chronic pancreatitis, cholecystitis;
- pyloroduodenal stenosis;
- hiatal hernia.
Symptoms of reflux esophagitis
During exacerbation of reflux esophagitis, inflammation of the walls is observed
esophagus and pain when eating food and fluids. Patients
complain about the general deterioration of health, fever,
chest pains. Additionally, symptoms include
heartburn, profuse salivation, impaired function of swallowing.
Frequent symptoms in adults:
- constant heartburn from almost all foods
- feeling of heaviness in the stomach
- feeling overcrowded
- feeling of coma in the throat,
- constant obsessive belching with air or sour.
In addition, there is pain in the chest, which
often perceived as cordial. Sometimes the listed symptoms
absent altogether, but there is a violation of the process of swallowing
Reflux esophagitis can occur completely hidden, and can
annoy the patient with a variety of clinical manifestations. With this his
Symptoms are divided into:
|Esophageal reflux esophagitis||Esophageal symptoms are often provoked by overeating, late
dinner, dietary errors, alcoholic or carbonated
drinks, psycho-emotional disturbances or physical
overloads. Characteristic features:
In addition to these symptoms of reflux esophagitis, the patient has
there may be signs of damage to the bronchi, lungs, voice
ligaments and trachea. Acid refluxes can enter the respiratory tract.
and cause inflammation of these organs. As a result, a person may
treat long-term and unsuccessfully for chronic bronchitis, asthma,
laryngitis, recurrent pneumonia, etc.
The symptoms of GERD (gastroesophageal reflux disease) – their
severity and influence on the general condition of the patient – directly
depend on the degree of damage to the mucous membrane of the esophagus.
The disease goes through several stages, depending on which
Its manifestations change:
- Stage 1 Formation of separate small erosions, and
also erytherm, localized in the distal esophagus.
- Stage 2 Erosion gradually increases and coalesces between
itself, however, does not cover the entire surface of the esophageal mucosa.
- Stage 3 The spread of erosion to the lower third of the esophagus, which
приводит к полному поражению mucous membrane.
- Stage 4. Characterized by chronic peptic ulcer and
In the presence of the mentioned symptoms, the patient must
to be examined, since the severity of clinical manifestations is not
всегда соответствует тяжести повреждения mucous membrane. therefore даже
banal heartburn can be a formidable symptom.
To make an accurate diagnosis and determine the extent
damage to the mucous membrane of the patient is prescribed:
- X-ray diagnostics with contrast agents – this is necessary
to detect ulcers, constrictions, inflammatory changes in the esophagus and
estimates of its patency;
- Daily pH-metry, which allows for research
esophagus throughout the day to identify the total time
manifestations of symptoms of reflux esophagitis and maximum
the duration of the episode.
- Fibrogastroduodenoskopiya – FGDS – one of the most informative
methods, allows the specialist to see and assess the condition
esophageal mucosa and the presence of erosions, inflammation and other
- Esophagomanometry, a special catheter is inserted, which
measures pressure in the lumen of the esophagus, with reflux pressure
- Acid-perfusion test – Bernstein test for the purpose of early
detecting reflux esophagitis in children with duodenal
Treatment of Reflux Esophagitis
How to treat the disease? Therapeutic scheme of reflux disease
includes complex effects aimed at eliminating it
causes and symptoms. Long-term treatment is necessary for complete recovery.
Compliance with all points of the treatment scheme:
- lifestyle correction;
- drug treatment;
To prevent recurrence of the disease and alleviate the condition
the patient must:
- lose weight
- observe the regime of work and rest,
- stop smoking
- drinking alcohol or any psychoactive substances
- avoid elevated physical and neuropsychiatric
- adjust medications that aggravate
manifestation of the disease.
Independently alleviate the manifestations of reflux esophagitis and reduce
oftenту рецидивов (обострений) можно выполняя следующие
- Sleep on a bed with a raised head end (for 10–15
- Do not wear tight clothes, belts, belts;
- Stop smoking, alcohol consumption;
- Get rid of excess weight;
- After eating, avoid physical exertion.
- Avoid drinking plenty of fluids;
- Do not take medicines that provoke the appearance
- Follow the correct diet.
For the treatment of reflux esophagitis, various
groups of drugs, but one of them is assigned to almost all
больным – это ингибиторы протонной помпы (сокращенно ИПП).
These drugs effectively reduce the acidity of gastric juice.
Influencing the cells that produce hydrochloric acid,
they reduce its concentration. Thanks to this effect, casts
gastric content less damage the mucous membrane.
Drug therapy for reflux esophagitis spend at least
8-12 weeks with subsequent maintenance therapy for 6-12
Tablets used to treat reflux esophagitis:
- Blockers of histamine H2 receptors (antisecretory
drugs), with the help of which the intake of salt is reduced
acid into the lumen of the stomach (“Ranitidine”, “Fatomodin”, “Omez”).
�”Ranitidine” is prescribed to adults and children under 12 years 2 times a day for
150 mg. The treatment is carried out for a duration of 4 to 8
- Antacids that protect the gastric mucosa from
hydrochloric acid: phosphalugel, almagel, maalox.
- Prokinetics increase pressure in the lower esophageal sphincter and
reduce intragastric pressure Increase the tone of the lower
esophageal sphincter following drugs: motilium, genaton,
motilak. Motilak, 10 mg: adults, 20 mg 3-4 times per
throughout the day, children over 5 years old, 2.5 mg / kg body weight, three times
in a day;
When symptoms of reflux esophagitis are detected, drug-induced
It is recommended to carry out the treatment very carefully so that
irritate the lining of the esophagus.
In the absence of the effect of drug therapy, it is shown
surgical treatment, the essence of which is to restore
normal anatomical relationships in the esophagus and
Benefits of endoscopic surgery for complications of reflux
- invisible postoperative scars;
- slight blood loss;
- minimum postoperative pain;
- high accuracy of diagnosis and treatment;
- high organ-sparing principle.
Indications for radical surgery
- preservation of symptoms and endoscopic manifestations of esophagitis
subject to adequate medical treatment for
half a year;
- the development of complications (recurrent bleeding, narrowing and
- Barrett’s esophagus with established severe dysplasia;
- частые пневмонии, развивающиеся из-за аспирации
gastric кислого содержимого;
- combination of reflux esophagitis with not amenable to adequate
treatment of bronchial asthma;
- personal desire of the patient.
Diet при рефлюкс-эзофагите исключает все продукты, способные
increase the acidity of the stomach and cause bloating. Diet
a patient with esophagitis is 4–5 times a day, small
in portions. Evening reception should be no later than 2-4 hours before
If a reflux of the esophagitis is detected the patient is recommended
reduce the consumption of dairy and other foods that cause
- fresh or sauerkraut;
- black bread;
- green peas;
- fresh berries, fruits;
- carbonated drinks.
If discomfort occurs after eating, you need to
pay attention to what foods were eaten and,
accordingly, exclude them from the diet.
Diet при рефлюкс эзофагите должна включать следующие
- Low fat grated cottage cheese
- Milk and sour cream with a small percentage of fat
- Fresh eggs (chicken or quail), boiled soft-boiled
- All kinds of cereals
- Steam patties (preferably veal)
- Baked Sweet Apples
- Baked Vegetables
- Boiled and baked fish.
During the diet, you must adhere to the following
- Meals can be diversified products, after use
which does not occur discomfort.
- You should not eat too cold or hot food, because it
irritates the esophagus.
- eliminate nerve overload at work, get enough sleep,
- In addition, you need to pay attention to the diet.
Eat 4-5 times a day (eat slowly, avoid
- after a meal, it is recommended to walk or work standing (not
There are many
способов лечения рефлюкс-эзофагита даже
but before applying them, it is better to consult a doctor.
- Take a tablespoon of oregano, calendula, calamus rhizomes,
fruits of anise, fireweed, white ashberry, mint. Ingredients chop.
The broth is prepared, as in the previous recipe, but first insist, and
then boil. Drink medicine 50 ml up to 6 times a day;
- It is necessary to pour boiling water 3 tbsp. spoons of flax seeds and wait 3
hours, drain, eat 2 tbsp. spoons for 20 minutes before making
food. This jelly envelops the mucous membrane.
- A good folk remedy for chronic
reflux esophagitis. Therapeutic blend of herbs and juice from the roots
celery In the treatment of the disease will help the juice of dandelion flowers with
сахаром months. Drink 1 tbsp. spoon of celery root juice for 30
minutes to eat
- Papaya contains a special enzyme that helps naturally and
effectively treat reflux esophagitis. Just use this
wonderful fruit every day. Additionally you can
use other folk remedies to combat this
- It is possible to treat the disease by collecting on the basis of Althea root.
and limes. The collection also includes yarrow, licorice root, grass
Common Shandra, the grass of the thousand-thrived rhizome
wheatgrass and St. John’s wort A tablespoon of the mixture pour a glass of boiling water and
to cover with a lid. Take the medicine twice a day half
Reflux esophagitis has, as a rule, a favorable prognosis for
working capacity and life. If there are no complications, then it does not reduce
its duration. But with inadequate treatment and non-compliance
data recommendations of the doctors are possible new relapses of esophagitis and
- the formation of Barrett’s disease;
- high risk of malignant tumors;
- pinching and development of ulcers of the esophagus.
Внимательное отношение к своему здоровью поможет избежать
опасных последствий и осложнений рефлюкс-эзофагита.
Не рекомендуется пытаться самостоятельно лечить это
the disease, its complications can be very serious.