Symptoms and treatment of erosive ulcerative reflux esophagitis. Reflux esophagitis: symptoms and treatment, diet, prognosis Signs of reflux esophagitis in adults

The disease reflux esophagitis is mainly chronic and is the backfilling of gastric juice from the stomach into the esophagus. The diagnosis of reflux esophagitis occurs in 50% of the adult population, 20% of whom develop Barrett's esophagus. Our article will talk about what reflux esophagitis has symptoms, and what its treatment is based on.

Types of disease

This disease has different classifications, based on the course of the disease, it is divided into:

• Acute, which has the following types of lesions: superficial, proceeds without ulcers and erosions, edematous, characterized by ulcerative lesions of the mucosa, pathological leads to perforation of the submucosal.
• Chronic is characterized by hyperemia, erosive defects.

Based on the cause, the disease is divided into:

• alimentary,
• stagnant,
• allergic,
• infectious,
• professional trend.

Based on pathological changes, the disease is divided into erosive and non-erosive reflux esophagitis. The latter is divided into:

• hydropic,
• hemorrhagic,
• pseudomembranous,
• necrotic,
• exfoliative,
• necrotic.

Reasons for the development of the disease

Reflux esophagitis has different causes of development, they are divided into internal and external factors. Most often, this phenomenon occurs due to internal factors, which include:

• excessive consumption of food;
• hernia that developed on the diaphragm;
• cholelithiasis;
• inflammation of the stomach;
• stomach ulcer;
• not proper nutrition, based on the frequent use of spicy, salty, pickled, fried;
• tumor neoplasms;
• scleroderma;
• increased body weight;
• the presence of frequent vomiting;
• Often there is esophagitis during pregnancy.

External factors in the development of pathology include:

• infections such as: herpes, candidiasis;
• often it occurs in people with reduced immunity, in patients with AIDS;
• drugs taken for a long time cause this ailment;
• food burn with chemicals such as alkali, solvents;
• regular use of alcoholic beverages;
• allergic manifestations;
• receiving radiation therapy.

Symptoms of the disease

With reflux esophagitis, the symptoms can be divided into 2 groups: food and non-food. Food signs include signs that have arisen as a result of the negative influence of food:

• heartburn;
• pain in the chest after eating;
• nausea;
• failure to move food through the digestive tract;
• reflux of gastric juice into the mouth.

This disease is sometimes difficult to recognize because it also exhibits symptoms that are not related to the digestive system, these include:

• sore throat, scratching, which are often mistaken for inflammation of the pharynx. This occurs due to the fact that the thrown gastric juice enters the esophagus;
• cough, shortness of breath, shortness of breath, asthma attacks, most often manifested at night, mimic inflammation of the upper respiratory tract;
• tooth enamel is destroyed. Since hydrochloric acid destroys the protective enamel;
• pain in the region of the heart are frequent companions of diseases of the digestive system.

All of the above signs are conditionally combined into groups of signs by which this pathology can be determined.

• Pain syndrome, which manifests itself an hour after eating and from a change in body position.
• Burning sensation in the chest.
• Spasms that occur during the promotion of food.

Diagnosis of the disease

Reflux esophagitis needs treatment. However, before you start taking the drug, you need to consult a doctor who will identify the causes and treatment will be more effective. Before the examination, the attending physician collects an anamnesis, finds out the drugs used medical preparations and food. Then he will examine the oral cavity, because white coating on the tongue - a sign of this disease and palpates the abdomen to exclude gastritis, cholecystitis, pancreatitis. After that, the specialist prescribes the following examination:

• FEGDS. This method is able to detect problems in the esophagus and stomach, allows you to take a biopsy for research and the exclusion of oncology.
• An x-ray with the introduction of a coloring substance allows you to see a pathological reflux into the esophagus.
• Daily study of the pH level. In a healthy person, the level should be within 4, if it is lower, then this indicates that gastric juice can be thrown from the stomach into the esophagus.
• Esophagomanometry allows you to explore the contractility of the sphincter.
• An ECG is needed to rule out angina pectoris.
• A chest x-ray can help rule out any lung problems.

Treatment of the disease

Drug treatment of reflux esophagitis performs the following tasks:

• Neutralization of the aggressive environment of gastric juice.
• Strengthening the contractile function of the sphincter.
• Increasing the speed of movement of products through the digestive tract.

How to treat reflux esophagitis, the doctor will tell you. To date, 2 therapeutic schemes are known in medicine. The first treatment regimen for esophagitis reflux involves taking antacids with simultaneous lifestyle changes and dietary adjustments. If the method is not effective, then the doctor may prescribe more potent drugs.

The second scheme, on the contrary, implies first taking stronger means. If a person begins to recover, then they either gradually reduce their dosage, or replace them with less strong ones. For the treatment of medications are usually prescribed:

• antacids, Phosphalgel, Almagel, Maalox;
• peptin blockers, for example, fomotidine, ranitidine;
• drugs that block the proton pump - Esomeprazole, Omeprazole;
• eliminating nausea, for example, Metaclopromide, Motilium.

Traditional medicine methods

Treatment, drugs in which will not harm the body, is unrealistic. Since all medicines have a lot of side effects. This is where help comes in. ethnoscience, which affirmatively answers the question of whether reflux esophagitis can be cured. However, one should not forget that folk recipes can only be used in combination with traditional medicine methods. The most effective means include:

• freshly squeezed potato juice;
• juice from celery roots;
• infusion of chamomile, wormwood, mint. Take 2 tsp. herbs, pour 1 liter of boiling water over them, insist for 2 hours, consume before meals;
• dill infusion. 2 tbsp. l. dill seeds, pour 1 cup boiling water, insist for 3 hours, drink before meals.

There are reviews of patients who claim that plants such as mountain ash, dandelion, plantain, mountain ash increase the production of gastric secretions. In addition, honey and seeds have an irritating effect.

Often answering the question of how to cure reflux esophagitis, doctors argue that an effective remedy is the right attitude to nutrition. It is recommended to use stewed, boiled, steamed dishes, mainly vegetables. When the exacerbation of reflux esophagitis passes, then you can begin to slowly introduce the usual food. Doctors recommend adhering to the following rules regarding the field of nutrition:

• The usual portion should be divided by half, it is recommended to eat at least 5 times a day.
• It is necessary to completely exclude foods that cause high acidity, such as tomatoes, coffee, smoked meats, chocolate, alcohol, onions, citrus fruits, garlic.
• An effective method in the treatment of the disease is the hardening of the body, feasible sports loads.
• Regular intake of vitamins, the correct daily routine help to improve the protective functions of the body.
• After eating, you should not take a supine position, you can not eat at night. During nighttime sleep, it is recommended to raise your head higher, thus, fewer refluxes occur.
• It is necessary to wear loose clothing, a tight belt or tight underwear leads to a worsening of the course of the disease.
• You shouldn't overeat. The body needs to rest from the digestion of food and excess food.
• It should be eaten in small pieces, chewing food thoroughly, while avoiding the capture of air.

Disease prevention

Prevention of esophagitis reflux with simultaneous treatment will allow you to forget about this unpleasant phenomenon forever. First of all, those factors that contribute to the reflux of gastric juice should be avoided.

It is also important to follow the right clothes, which is important not only for women, but also for men, since they often wear a tight belt. Visit your doctor regularly and follow all his recommendations.

Reflux esophagitis is a rather unpleasant condition that often occurs in the adult population. With timely treatment for its symptoms, you can forget about this condition.

Reflux esophagitis is inflammation of the lining of the esophagus. It is formed due to the release of pH from the stomach. It instantly begins to corrode the mucous membrane that protects the esophagus from an aggressive environment. In the absence of such protection, a person begins to feel pain. There are erosions, ulcers, complications.

The most common causes of reflux - esophagitis - are unhealthy diet, long-term alcohol consumption and very spicy food. With improper treatment or its absence, scars form on the walls of the esophagus. And also reflux can occur against the background of weakening of the muscles, when the valve begins to pass gastric juice.

The most common causes of esophagitis are:

• high pressure and bursting in the peritoneum;
• wrong diet;
• spicy, smoked and fatty foods;
• stress;
• chemical factors;
• obesity;
• ulcers;
• the period of bearing a child;
• excessive drinking;
• smoking.

Any of these factors can lead to an exacerbation and return of the disease. For this, even a simple tilt forward is enough.

Types of esophagitis

Classification of esophagitis is divided into 2 main forms - acute and chronic. They, in turn, are divided into:

• pseudomembranous;
• (otherwise superficial);
• necrotic;
• exfoliative;
• hydropic;
• phlegmonous (may be limited or diffuse).

Spicy esophagitis occurs in the lower esophagus, often combined with gastric diseases. Pathology occurs against the background of vitamin deficiency, gastrointestinal disorders, infections. Acute reflux causes soreness when eating or drinking liquids.

It appears as a separate disease or is formed as a complication after an acute form. Accompanied by a stable inflammation of the esophagus. Pain appears in the chest. Often the chronic form is supplemented by gastritis

Stages of development

Esophagitis develops in stages. In the first stage (A) of the disease, the affected area is 4-5 millimeters in diameter. There may be several such places on the mucosa. In this case, the affected zones do not touch.

In the second stage (B) of the disease, several defective areas expand and become more than 5 mm in diameter. At the same time, the affected areas begin to merge. Large defective areas are formed. However, they do not apply to the entire mucosa.

Her third is affected in the 3rd stage (C). The last stage - the fourth is accompanied by extensive ulcers on the mucosa. The sites of lesions occupy from 75 percent of the surface. Stenosis may be diagnosed.

Symptoms

The first signs are general malaise and fever. A person is tormented by pain behind the sternum, along the entire tube of the esophagus. An additional symptom of reflux esophagitis may be heartburn, vomiting, or.


Pathology can proceed secretly. Sometimes signs uncharacteristic for this disease join esophagitis. Each form has the same symptoms:

• lump in the throat;
• heartburn;
• burning or pain in the chest;
• nausea.

An hour and a half after eating, pain in the esophagus begins. This is already a pronounced inflammation. The symptoms are aggravated when the person lies down. Symptoms of reflux esophagitis may vary depending on the stage and type of disease:

1. Pulmonary caused by heartburn and unpleasant belching. Bronchial obstruction appears - a prolonged cough, nocturnal suffocating attacks, lack of air. This can trigger the formation of asthma.
2. Cardinal accompanied by symptoms inherent in angina pectoris, due to the proximity of nerve endings. Pain always occurs after sour or spicy food, fried or fatty foods, overeating.
3. Otolaryngological, in addition to belching and heartburn, accompanied by sore throat, perspiration. Nasal congestion and discharge from it in the form of clear mucus may appear.
4. dental form is accompanied by the appearance of caries. This is facilitated by gastric juice, which corrodes tooth enamel.

Symptoms of subtypes of chronic reflux esophagitis

The hemorrhagic form is a type of acute esophagitis. It appears very rarely, against the background of severe erosive inflammation. Accompanied by bloody vomiting and chalky (tarry stool).

Note! Without timely treatment, the disease can last for years. Over time, the symptoms will intensify, and eventually irreversible changes in the mucosa occur, scars appear on it.

Diagnosis of the disease

When diagnosing esophagitis, the degree of mucosal damage and the form of the disease are determined. For this, an x-ray is used, the pictures of which clearly show whether the valve passes gastric juice. During endoscopy, the entire length of the esophagus is examined.

Before treating reflux, a scintigraphy is performed. It shows the presence or absence of abnormalities in the work of the gastrointestinal tract. A biopsy is taken for histological analysis. The pH-metry procedure determines the degree of acidity in the stomach.

Treatment

Treatment of esophagitis is always complex. The scheme includes medicines, diet, physiotherapy, exercise therapy and other methods. Initially, therapy is aimed at eliminating the causes of the disease.

General events

Treatment of gastric reflux begins with general measures aimed at correcting the quality of life. This greatly reduces muscle damage, which helps with a quick recovery:

1. Stop smoking, as nicotine increases acidity and relaxes the digestive muscles.
2. After eating food, you can’t immediately lie down, it’s better to sit quietly or go outside. walking tour. Fast walking and running are excluded.
3. Restriction of physical activity helps to reduce the symptoms of the disease. You can not lift anything more than 3 kilograms.
4. A couple of hours before bedtime, food and alcohol are excluded.
5. It is necessary to sleep on a raised (15-20 cm) pillow.
6. Avoid wearing tight clothing.

If there are additional diseases (obesity, ulcers, etc.), you need to treat them. Otherwise, reflux esophagitis therapy will have no effect.

Medical

When making a diagnosis of reflux esophagitis, the treatment regimen is prescribed depending on the type of development of the disease:

1. To reduce the activity of AP-enzymes, "Pantoprazole", "Rabeprazole" is used.
2. After the 13th week of bearing a child, Lansoprazole is prescribed.
3. With bronchial asthma, "Omeprazole", "Esomeprazole" are indicated.
4. If liver function is impaired, any PPI (proton pump inhibitor) is used, but Rabeprazole is preferred.
5. For a quick and stable decrease in acidity, Pantoprazole or Lansoprazole is used.

If PPI therapy was ineffective, then histamine blockers are prescribed. However, they are used in large dosages, so they are used only when absolutely necessary - Nizatidine, Famotidine, Roxatidine and their analogues.

To reduce the aggressive effects of refluxes and their number, prokinetics are prescribed. They improve digestion and facilitate the passage of food. The most effective include:

• "Domperidone";
• "Cisapride";
• "Metoclopramide".

To quickly eliminate pain in the esophagus or heartburn, antacids are prescribed. They do not cure the disease, but partially alleviate the symptoms of reflux. Can be assigned:

• "Maalox";
• "Renny";
• "Gaviscon";
• "Megalac".

These drugs act quickly, retain their effect for a long time, and significantly reduce acidity. For the treatment of cardia insufficiency (incomplete closure of valves), Ranitidine, Omeprazole, Solpadein, Regidron are used. For complications, antibiotics are prescribed.

Diet Features

- one of the main directions in the treatment of esophagitis. Food can be cooked in only a few ways:

Attention! The likelihood of esophagitis increases due to malnutrition, smoking, drinking large doses of coffee, undiluted fruit juices and alcoholic beverages.

With intestinal esophagitis, the use of mayonnaise or oil in dishes is excluded, or they are added in minimal quantities. Do not use ketchups, hot sauces, horseradish and mustard for dressings. They will irritate the mucous membrane even more and increase the acidity of gastric juice. Too hot or cold food is prohibited.

When diagnosing reflux esophagitis, therapy includes strict dietary restrictions.

The menu includes vegetables and fruits, but it is not recommended to eat them raw, it is advisable to bake or stew. You need to eat every three hours, in small portions. The last dinner should be 4 hours before bedtime.

Physiotherapy

GERD can be treated with physical therapy. It is prescribed for severe symptoms, pain syndrome. Types of physiotherapy procedures for esophagitis:

• TCEA (transcranial electroanalgesia);
• aerotherapy;
• electrosleep therapy;
• electrophoresis with antispasmodics;
• baths with sodium chloride;
• galvanization;
• interference therapy;
• UHF (ultra high frequency inductothermy);
• cryotherapy in the epigastric region;
• magneto and laser therapy;
• coniferous and iodine baths;
• galvanization of the brain of the head.

Physiotherapy depends on the form of the disease, its severity, the presence or absence of complications. It helps to restore the functionality of the autonomic nervous system, partially relieves inflammation, and accelerates the healing process. Simultaneously improves the functioning of the digestive system and relieves spasms.

exercise therapy

With esophagitis, physical exercises help speed up the healing process, help strengthen the body.

Workouts and exercises are selected depending on. In this case, the maximum load tolerance should be taken into account. Exercise helps to get rid of heartburn, develops the muscular system, strengthens the sphincter, and promotes rapid healing of ulcers.

The main direction is breathing exercises. The main methods include diaphragmatic, according to Strelnikova. Separately, exercises for holding the breath are worked out, aerobic training is carried out.

Surgery

Surgical treatment of esophagitis is an extreme measure, used for serious complications. Surgical intervention may be prescribed for severe bleeding in the esophagus, persistent stricture, irreversible damage to the sphincter.

Also, the operation is prescribed in case of a precancerous condition of the mucosa, with active reproduction and degeneration of cells. Surgery is indicated for oncology of the 1st and 2nd degree. During surgical intervention complete or partial removal of the esophageal tube is performed, the integrity of the organ is restored, the tumor is excised.

Folk methods

The treatment regimen for reflux esophagitis includes as adjuvant therapy. In this case, decoctions of herbs, healing baths and teas are used.

One of the popular treatments for reflux with heartburn is baking soda. However, this brings additional harm. During the first passage through the esophagus, the mucosa is irritated even more. In response to alkalization, a strong release of acid occurs, refluxes become even more aggressive. Therefore, instead of soda, it is desirable to use antacids.

Reflux esophagitis caused by spicy, fatty or smoked foods, in initial stage treated with simple herbs. Herbal decoctions of motherwort, licorice, lemon balm and flax seeds help relieve inflammation.

Esophagitis in adults often causes. Rose hips, valerian, dandelion flowers and calamus powder save them from them. Plantain juice has a strong healing effect. However, it is contraindicated in people with acid reflux.

For the treatment of chronic esophagitis of the esophagus, decoctions of chamomile are made. They can be combined with flax seeds. The remedy is drunk three times a day. Flax seeds have at the same time an enveloping effect, reduce high acidity. This is a good prevention of cancer and reduce the symptoms of the disease.

Honey should be consumed a couple of hours before meals. It is desirable not in whole form, but diluted with a small amount of liquid. You can not use honey during an exacerbation of esophagitis. This will irritate the lining of the esophagus.

Sea buckthorn oil has a healing effect, improves secretory function and digestion. potato juice envelops the mucous membrane, creating an additional protective film. It helps reduce heartburn and chest pain.

Can reflux esophagitis be completely cured?

It is possible in the early stages. However, despite the successful conservative therapy of reflux esophagitis, it is not completely cured. Any deviation from the diet and symptoms may return. This often leads to an exacerbation of the disease.

The exclusion of provoking factors from the life and diet helps to prevent serious complications in the form of perforation of the ulcer, oncology.

It is known that a disease such as erosive reflux esophagitis is characterized by the presence of small areas on the esophageal membrane that have undergone pathological changes. This is a complicated form of esophagitis, in which the signs of the disease become aggravated, and bring the patient severe discomfort. Symptoms are aggravated after eating and taking pharmaceutical drugs, such as salicylates.

The eroded areas become very thin, due to which the esophagus loses its ability to fully function. In the absence of treatment and adherence to dietary recommendations, there is a risk of developing an ulcerative form of the disease.

Course of the disease

This is a rather rare type of disease that occurs if the pathology exists for a long time and is not subjected to any therapeutic effect. At the same time, the superficial form of the disease, which is characterized by slight hyperemia and swelling, due to the ongoing impact of an aggressive environment, gradually transforms into an erosive one, while the mucosa of the esophagus changes its structure.

Prolonged exposure to gastric juice when it is ejected from the stomach leads to thinning of the walls of the esophagus and damage to the deeper (muscular and submucosal) layers. The walls are covered with fibrinous plaque. An erosive-ulcerative defect of the esophageal membrane is formed.

The course of the disease is characterized by several successive stages of development, as the erosive lesion progresses:

• Erosive reflux esophagitis of the 1st degree is manifested by focal erosions that do not merge together and erythema of the lower esophagus.
• The second degree is characterized by erosive areas, which do not occupy the entire area of ​​the mucosa.
• Esophagitis of the 3rd degree has the form of ulcerative defects of the distal organ, which are confluent in nature and capture the entire surface of the esophageal membrane.
• Erosive esophagitis grade 4 is an ulcer of the esophagus with stenosis.

Classification of reflux esophagitis according to the severity of the disease, taking into account the condition of the organ and symptoms, makes it possible to establish an accurate diagnosis and determine the tactics of treatment.

Symptoms of the disease

Characteristic signs of the disease are pain behind the sternum, which can radiate to the region of the heart and shoulder. This symptom is sometimes quite difficult to differentiate from heart pain in angina pectoris.

In addition, signs erosive reflux esophagitis are:

• belching;
• constant heartburn;
• unpleasant taste in the mouth;
• nausea;
• night cough;
• cutting pain when swallowing;
• obsessive hiccups.

The sensations tend to be worse in the horizontal position, especially immediately after eating. When the patient sits down, his state of health improves a little.

Diagnostics

To determine the condition of the mucosa and the level of acidity of the esophagus, as well as violations in the valve and the presence of a diaphragmatic hernia, modern research methods are used. The erosive form of the disease requires the following diagnosis:

• esophagoscopy (the method makes it possible to determine areas of hyperemia and hemorrhage, tissue edema, erosive defects).
• X-ray of the esophagus helps to diagnose hiatal hernia and to fix gastric reflux with the help of a radiopaque substance.
• daily pH-metry of the esophagus, which is a measurement of the acidity of the esophagus using a probe, is recognized as a highly informative method. The method allows you to fix the duration, frequency and intensity of reflux.
• esophagography is an additional diagnostic method and is carried out in conjunction with esophagoscopy. Allows you to determine the unevenness of the contours and hypertrophy of the mucosal folds. The method is completely safe and can be used repeatedly.
• analysis of feces for hidden hemorrhage.
• general blood analysis.

Therapy depends on the severity of the pathology and general diseases. With the first degree of reflux esophagitis, it is enough to follow a diet, the second is effectively treated with drugs, and in the last stages, pharmacotherapy may not work, and the disease requires surgical intervention.

Acute treatment

If the cause of esophagitis is a chemical burn of the mucous membrane, then the treatment of such a disease should begin with urgent gastric lavage in order to immediately free the organ from the aggressive substance. During the treatment of an acute form of reflux esophagitis, the patient should refrain from eating on the first day of the disease. Further treatment involves the use of PPIs or histamine H2 receptor blockers to reduce the secretory activity of the stomach.

The severe course of the disease includes the most sparing diet or parenteral administration of saline solutions in order to detoxify and maintain the patient's life. To suppress the bacterial flora, antibiotic therapy and gel antacids are needed.

With ulcerative reflux esophagitis, which is accompanied by severe pain syndrome, it is necessary to introduce myotropic antispasmodics (No-shpa, Papaverine, Drotaverine) and painkillers. In this case, gastric lavage is contraindicated. If the erosive necrotic focus is not treatable, then surgical debridement of the mucosal area should be performed. Also an indication for surgical treatment erosive reflux esophagitis are esophageal strictures if bougienage or balloon dilatation fails.

Treatment of the chronic form

Treatment of the chronic form of esophagitis is to eliminate the factors of its occurrence. The main components of the treatment of the disease are such measures as changing the diet, menu composition, exclusion bad habits. The diet involves the use of crushed food of a mushy consistency, the temperature of which should be in the range of 35-37 degrees.

The patient should exclude the use of pharmacological agents that affect the tone of the esophageal sphincter (prostaglandins, theophylline, tranquilizers and sedatives).

Drug therapy consists of the following drugs:

• proton pump inhibitors;
• myotropic antispasmodics;
• gel antacids with anesthetic components;
• prokinetics;
• antibacterial drugs (if necessary);
• blockers of H2 histamine receptors.

Physiotherapeutic measures that complement drug treatment:

• electrophoresis;
• amplipulse therapy;
• balneotherapy;
• mud treatment.

Physiotherapy procedures are not recommended for 3-4 degrees of reflux esophagitis. In this case, surgical treatment is indicated, which consists in dilatation or bougienage, as well as endoscopic dissection of strictures. If necessary, surgical plastic surgery and resection of the esophagus are used.

Diet food

It is possible to treat such a disease only with the unconditional observance of dietary nutrition, which includes easily digestible food of a semi-liquid consistency. Foods that irritate the inner lining of the esophagus and stomach should be completely eliminated in order to help eliminate the inflammatory process and eliminate the release of gastric juice.

The nutrition of the patient must meet the following conditions:

• Porridges, meat soufflés and vegetable purees, mashed soups are recommended. At the time of treatment, fresh fruits and vegetables are excluded so that the coarse fiber contained in them does not irritate the surface of the diseased esophagus.
• The food must be home cooking, canned food, semi-finished products, products fast food, spicy and spicy dishes, marinades and pickles.
• Confectionery and flour products, coffee and carbonated drinks are contraindicated.
• Cooking food should be steamed or boiled, stewed without adding fat. Fried and baked foods are prohibited.
• The consistency of the food should be semi-liquid so as not to injure the inflamed mucosa of the esophagus.
• Dinner should be done long before going to bed, after eating food, you should not take a horizontal position, lift weights and bend over. It is desirable to sleep with a raised headboard. In addition, you should not wear tight clothing that squeezes the stomach and chest.

Non-traditional methods

Phytotherapy involves the use of herbal decoctions and infusions that promote the regeneration of damaged tissues of the esophagus, improve the tone of the sphincter muscles, and have an anti-inflammatory effect.

The most suitable herbs for making decoctions (0.030–0.500) are:

• motherwort;
• chamomile;
• plantain;
• Melissa;
• flax seed;
• liquorice root.

Before using herbal medicine, you need to discuss it with your doctor, who will confirm the absence of contraindications and prescribe safe doses of herbal decoctions. Erosive reflux esophagitis is a serious form of the disease, in which the doctor can very rarely advise treatment with herbal decoctions, in order to avoid bleeding and worsening the patient's condition.

- the disease is not easy, so patients need to be attentive to the appearance of symptoms of this disease and be sure to undergo an examination by a specialist.

Only complex therapy will help get rid of reflux esophagitis, so it will be useful for every person who suffers from this disease to know how this disease should be properly treated with the help of a competent doctor.

So let's get started.

Can reflux esophagitis be cured permanently? You can, if you turn to a competent doctor and get modern treatment.

Doctors identify several effective and efficient treatment regimens for reflux esophagitis. All of them are selected strictly on an individual basis for each patient after receiving the results of the examination.

1. Therapy with one drug. This does not take into account the degree of soft tissue damage, as well as complications. It's the least efficient scheme treatment of patients, which can cause deterioration of health.
2. Reinforcing therapy. Doctors prescribe different drugs to patients, which differ in the degree of aggressiveness. Patients need to strictly follow a diet and take antacids.
3. Taking strong proton pump blockers. When the symptoms begin to disappear, patients are prescribed prokinetics. This treatment regimen is suitable for patients diagnosed with severe reflux esophagitis.

Reflux esophagitis: treatment regimen

The classical scheme of treatment of the disease is divided into 4 stages:

1. First degree reflux esophagitis. Patients should take antacids and prokinetics for a long time ().
2. 2 degree of the inflammatory process. Patients need to adhere to proper nutrition and take blockers. The latter contribute to the normalization of the level of acidity.
3. 3 degree of the inflammatory process of a severe form. Patients are prescribed the use of receptor blockers, inhibitors and prokinetics.
4. The last degree of reflux esophagitis is accompanied by pronounced clinical manifestations. Treatment with medicines will not bring a positive result, so patients undergo surgery in combination with a course of maintenance therapy.

How to cure reflux esophagitis permanently? The duration of therapy depends on the degree of damage to the gastrointestinal tract. The initial stage of reflux esophagitis can be cured with a proper and balanced diet. The course of therapy is calculated for each patient individually.

How to treat reflux esophagitis

If the process of digestion of food is disturbed, then the contents of the stomach during a long stay in it causes an inflammatory process and irritation of the walls.

Patients feel heaviness in the intestines, a feeling of fullness in the stomach, nausea and bitterness in the mouth. After eating, the pain becomes severe and becomes acute.

There are several effective methods of treating reflux esophagitis, which are prescribed only by the attending physician after diagnosis and study of the patient's history.

Note! Vitamins for reflux esophagitis are not always prescribed: the need for this is determined by the doctor when choosing therapy, when he decides what to take for reflux esophagitis for you.

Medical treatment

How to get rid of reflux esophagitis? Depending on the form of the course of the disease, doctors prescribe patients to take proton pump blockers or H2-histamine receptor inhibitors. The first group of drugs helps to normalize the work of the glands of the stomach and the mucous membrane of the digestive system. These medications are prescribed to patients for additional protection of the walls of the esophagus, duodenum and stomach.

With the correct use of blockers, damaged areas of the mucous membrane begin to recover faster. Medicines taken for a long time, and if the patient is diagnosed with a severe form of reflux esophagitis, then they are prescribed a double dosage at the initial stage of treatment.

The most effective drugs include:

Features of antacids

These substances help to quickly and effectively cope with the manifestations of heartburn. After using antacids, their main components begin to act on the body after 15 minutes. the main task such therapy is to reduce the amount of hydrochloric acid, which causes burning and soreness in the chest.

The most effective drugs are:

• Rennie;
• Maalox;
• Gastal;
• Phosphalugel;
• other.

Alginates

Gaviscon is an effective and safe new generation alginate. After taking this remedy, hydrochloric acid is neutralized, an additional layer is formed to protect the stomach and the functioning of the gastrointestinal tract is normalized.

Prokinetics

The main task of prokinetics is to improve the motor function of the stomach, muscles and upper small intestine. Physicians advise their patients to use metoclopramide and Domeridon. These medicines will reduce the amount of time the esophagus comes into contact with hydrochloric acid.

Physiotherapy procedures

Amplipulse therapy has been used for a long time to treat reflux esophagitis.

The procedure is carried out in a physiotherapy room and is aimed at relieving pain, eliminating foci of inflammation, improving gastric motility and blood circulation.

If the patient has severe acute pain, then electrophoresis is performed with ganglioblocking agents. Microwave therapy is indicated for patients who, along with reflux esophagitis, have been diagnosed with pathological disorders in the liver, gastric and duodenal ulcers.

Also, the most effective methods of physiotherapy treatment include applications with sulfide silt mud and electrosleep.

Medical nutrition and diet

It is important for patients to review the diet and diet. Food should be boiled, steamed or stewed with a minimum amount of oil. An important condition is fractional nutrition in small portions. Patients are not allowed to lie down immediately after eating. Compliance with this rule helps to reduce the intensity and number of attacks at night.

Important! It is unacceptable to eat smoked, fried and salty foods. Under the ban are alcoholic beverages, soda, chocolates, citrus fruits, tea, coffee, garlic, tomatoes and onions.

Patients should not overeat, because when the stomach is full, there is an increase in the reflux of contents into the esophagus.

You can learn more about what medical nutrition should be for this disease.

Surgery for reflux esophagitis

Surgical treatment of reflux esophagitis is carried out in the event that when drug therapy fails. The main goal of surgery is the complete cessation of the reflux of stomach contents into the esophagus. Before the operation, patients undergo a complete comprehensive examination, and only after that a fundoplication is performed.

Access to the stomach can be open or laparoscopic. During surgery, the bottom of the stomach is wrapped around the esophagus to create a cuff. The least traumatic method of the operation is laparoscopic, which has a minimum number of complications.

Treatment with folk remedies

Maybe only after consultation with your doctor. It is possible to use collections of plant components only at the initial stage of the development of the disease.

Aloe juice is effective tool, which envelops the mucosa of the esophagus, reduces the inflammatory process and contact with food.

A decoction of flax seeds acts on the body in a similar way to antacids. After taking such a drug, the level of acidity in the stomach decreases, the esophagus is enveloped and protected.

Breathing exercises for reflux esophagitis

The main feature of this treatment is proper breathing. This technique It can be used on its own or in combination with exercise.

Breathing exercises for reflux esophagitis are performed according to the following scheme:

1. Patients take a comfortable position for themselves - sitting or standing. Take a deep breath and slowly exhale. A person needs to engage the muscles of the abdominal cavity. The optimal number of such approaches is 4 times.
2. A calm breath is taken and a quick exhalation by the abdominal muscles (up to 10 approaches).
3. Patients take a deep breath, hold their breath and squeeze the abdominal muscles strongly. It is necessary to make every effort and pause for up to five seconds. After that, a calm breath is taken.

During breathing exercises pauses are necessary because some patients become dizzy. It is important not to rush and do the exercises consistently. How long reflux esophagitis is treated, so much time and it is recommended to perform these exercises, and in most cases even longer, to ensure the stability of the results.

Gymnastics

The following features of gymnastic exercises for reflux esophagitis can be distinguished:

1. Gymnastics does not help patients get rid of excruciating heartburn. During exercise, the recovery process is accelerated, periods of exacerbation and the number of spasms are reduced.
2. Each patient will be able to choose for himself the optimal set of gymnastic exercises that will provide real help.
3. Classes do not belong to the main method of treatment, so they must be combined with drug therapy.

Yoga for reflux esophagitis

Patients diagnosed with reflux esophagitis can practice yoga. Such exercises bring great benefits to the body and internal organs. Static postures or asanas will fully activate the circulatory system, as well as strengthen the muscle mass of the body.

You can combine static postures with slow movements of the limbs, which will help improve blood circulation in the muscles and internal organs. This unique technique provides patients with the most effective therapeutic effect.

During yoga, all respiratory centers are activated, the saturation of the body with useful oxygen increases, metabolism accelerates, the functioning of internal organs improves, and absolutely all muscle groups are worked out.

Should you sleep on your left side with GERD or not?

Scientists who have studied the physiological characteristics of the body argue that with reflux esophagitis it is best to sleep on the right side.

This will minimize pressure on the stomach, intestines and liver.

To prevent the reflux of food from the stomach into the esophagus at night in patients it is recommended to sleep on a high pillow.

The scheme of treatment of different types of reflux esophagitis

There are several important rules treatment different forms diseases that may differ from each other. How long is reflux esophagitis treated depending on this?

Treatment of reflux esophagitis with low acidity

The main treatment for patients is to take stomach acid tablets with meals. Such drug therapy helps food move faster into the intestines.

It is important to remember that you should not overdo it with taking pills and take them without a prescription from your doctor, because such an attitude towards your own health can lead to a deterioration in overall well-being. This is due to the fact that the acidic contents of the stomach will not be neutralized with the available amount of bicarbonates.

With this form of the disease, it is important for patients to adhere to a strict diet in order to prevent further progression of the disease and serious complications.

Treatment of reflux esophagitis during pregnancy

Pregnant girls need to take care to prevent constipation, follow a strict diet, eat small portions and not overeat. Fried foods, chocolate, red peppers and spicy foods are excluded from the diet. As drug therapy antacids are prescribed, which are not absorbed into the blood and envelop the stomach. Surgical treatment during pregnancy is not carried out.

Distal reflux esophagitis: treatment

It occurs as a result of inflammation of the esophagus after the penetration of viral and bacterial infections. In bacterial pathology, patients are prescribed antibiotics.

Only a doctor can select treatment after diagnosing patients, which takes into account the body's sensitivity to antibiotics. medicines. In the complex, patients are prescribed immunostimulating substances and antiviral drugs.

Reflux esophagitis is a serious disease that requires urgent treatment and therapy. Patients are forbidden to self-medicate and buy medicines without a doctor's prescription.

Erosive reflux esophagitis is a complicated course of the disease, characterized by the reflux of stomach contents back into the esophagus. Often localized in the distal part, i.e., in the lower esophagus, and is characterized by the occurrence of ulcers (erosions) on the mucous membrane. With this form of the disease, all the symptoms of the usual manifest themselves more clearly and cause significant discomfort to the person.

The main reasons for the formation of ulcers of various sizes are - sliding hernia of the esophagus, ulcerative stenosis of the stomach, short esophagus, severe vomiting, as well as complications after surgery on the gastrointestinal tract. Symptoms of such a disorder are considered to be a violation of the process of swallowing food, and, depending on the stage of the disease, it can be expressed from a constant feeling of a lump in the throat to complete obstruction of solid or liquid food. Also signs are - constant soreness, heartburn and belching with an unpleasant smell of recently eaten food.

Diagnosis of the erosive type of the disease is based on the study of the medical history and examination of the patient. The final diagnosis is established on the basis of laboratory tests and instrumental examinations, consisting of radiography, ultrasound, and biopsy. The treatment is complex and consists in prescribing drugs, following a strict diet, using folk remedies. Surgical intervention is addressed in case of a severe course of the disease.

Etiology

The main factor in the development of such a pathology is the constant reflux of the contents of the stomach into the esophagus, which eventually contributes to the formation of single or multiple erosions on the mucous membrane. Predisposing causes for the occurrence of such a disorder are:

• ulcerative neoplasms of the stomach and duodenum;
• the presence of a hernia of the esophageal opening in the diaphragm;
• damage to the esophagus of a mechanical nature, for example, when a probe is inserted during diagnostics, or in order to carry out the process of feeding seriously ill patients;
• malnutrition - addiction to excessively fatty and spicy dishes;
• maintaining an unhealthy lifestyle - abuse of nicotine, alcoholic beverages or drugs;
• accidental or intentional ingestion into the esophagus chemical substances;
• acute course of infectious processes of the gastrointestinal tract;
• complication after medical intervention directly on the esophagus or other organs of the gastrointestinal tract.

Varieties

Medicine knows several classifications of erosive reflux esophagitis, depending on the stage and nature of the course. Thus, there are several forms of the course of the disease:

• acute form- the most common expression of an erosive disease. It consists in superficial or deep lesions of the mucosa. Symptoms of the disease appear suddenly and are pronounced. With effective treatment tactics, it is eliminated quite quickly, without complications;
• chronic form- occurs quite often and is characterized by periods of exacerbation and remission. Due to the fact that the disorder has developed over time, it can become a predisposing factor in the formation of irreversible complications. Chronic erosive esophagitis involves the course of the disease for six months;
• ulcerative form- a pathological form in which erosion affects the deeper layers of the mucous membrane of the esophagus. Ulcerative esophagitis requires a long and complex therapy;
• peptic form- the development of the disease occurs due to the penetration of gastric juice into the esophagus;
• catarrhal form- there is damage to the upper layers of the mucosa.

Depending on which department the disease affects, there are several types of erosive reflux esophagitis:

• total- there is damage to the entire esophagus;
• proximal- localization of the pathological process is observed in the upper section;
• distal- the disease affects only the lower esophagus, near its connection with the stomach. This is the most common type of ailment that is diagnosed in patients.

In addition, such a disorder is divided as the ulcer spreads. There are several stages of erosive reflux esophagitis:

• first stage- single erosions begin to appear on the membrane of the esophagus, no more than five millimeters in size;
• second stage- erosion can merge with each other, but the pathology does not penetrate into the deep layers of the mucosa;
• third stage- at this stage, the inflammatory process extends to the entire mucous membrane. Erosions larger than five millimeters can merge with each other, forming ulcers;
• fourth stage- characterized by the presence of chronic ulcers of the distal esophagus and developing narrowing of its lumen.

Regardless of the type and stage of the course of the disease, it is necessary to start complex treatment as early as possible.

Symptoms

Specialists identify several characteristic signs of the disease, the presence of which has diagnostic value. Erosive reflux esophagitis is expressed by the following symptoms:

• difficult process of passing food - in the early stages of the disease it can be expressed by a feeling of a coma or a foreign object in the throat, at later stages there is obstruction of solid food and difficulty in passing liquids;
• eructations with a sour smell and taste of recently eaten dishes;
• persistent heartburn - the intensity of which may increase during or after eating, exercising, or even when bending forward;
• soreness in the retrosternal region - increases at night or during physical exertion, as well as in a horizontal position of the body.

Other symptoms include slight increases in body temperature, weakness of the body and bouts of dizziness.

Complications

In cases of ignoring symptoms or untimely treatment, a number of serious complications may develop, including:

• penetration of ulcers into the deeper layers of the mucosa and tissue of the esophagus;
• severe narrowing of the lumen of the distal section;
• the occurrence of hemorrhages;
• ingress of gastric juice into the pharynx or larynx;
• changes in the structure of mucosal cells;
• oncology, .

Diagnostics

The diagnosis of "erosive reflux esophagitis" is established on the basis of a study of the patient's medical history, finding out the possible causes of the formation of such a disorder, as well as the presence and intensity of signs of the disease. These factors will help the specialist determine the stage of the course of the disease.

Laboratory diagnostic methods include general and biochemical analysis blood - to detect concomitant pathologies. The study of fecal masses is necessary to confirm or deny the presence of internal bleeding.

Instrumental diagnostic procedures include:

• manometry - aimed at assessing contractile activity and synchrony of esophageal peristalsis;
• measurements of the acidity level of the distal section;
• endoscopic examination of the inner surface of the esophagus and other organs of the gastrointestinal tract. The examination involves a biopsy - the collection of a small piece of the mucosa for subsequent histological studies;
• radiography using a contrast agent;
• breath tests - to determine the presence of the bacterium Helicobacter pylori;
• Ultrasound, MRI and CT - performed to detect changes in the esophagus and associated diseases of the gastrointestinal tract.

After receiving all the results of the tests and examinations of the patient, the specialist prescribes an individual treatment regimen.

Treatment

After confirming the diagnosis of erosive reflux esophagitis, absolutely all patients are prescribed complex therapy, which includes:

• the use of drugs;
• adherence to a special diet;
• the use of folk remedies;
• surgical intervention.

Drug treatment consists of the use of certain groups of drugs aimed at healing erosions, protecting the mucous membrane, normalizing the tone of the muscles of the lower sphincter and reducing acidity. These substances include - antacids, alginates, PPIs, in some cases, the use of antibiotics is indicated. In addition, medications are prescribed that eliminate the general symptoms of erosive mucosal lesions and increase the level of the immune system. The choice of the drug and the duration of the course of its use is determined by the attending physician individually for each patient.

Diet therapy includes the use of a large number of foods containing fiber. It can be - potatoes, pasta, cereals, bread with bran. It is also worth completely abandoning the intake of fatty and fried foods, smoked meats, salts and marinades, hot spices and mayonnaise. You need to eat in small portions six times a day, the last meal should be three hours before bedtime.

Surgical operations are treated extremely rarely, often when other methods of treatment are ineffective or in the presence of complications.

Prevention

In order to avoid problems with the formation of erosive reflux esophagitis, it is necessary to follow simple rules:

• live a healthy life;
• observe proper nutrition;
• timely treat diseases that can cause the onset of the disease;
• regularly undergo preventive examinations by a gastroenterologist.

Similar content

Reflux esophagitis is a disorder of a chronic nature, which is characterized by the reflux of stomach contents into the esophagus, which is accompanied by irritation of its walls. A feature of the disease is that it is expressed by mild symptoms, so often the diagnosis of the disease occurs when completely different disorders are detected, for example, peptic ulcer or gastritis. Often this pathological condition is one of the signs of a hernia of the esophageal opening.

Treatment of reflux esophagitis, like any other ailment of the digestive system, necessarily includes a special diet. Its main task is to reduce the intensity of the manifestation of symptoms during an exacerbation of the pathology, to prevent the development of relapses in the future. In addition, proper and sparing nutrition helps protect the mucosa of the esophagus and stomach from the aggressive effects of irritants. sample menu for each day (or week) should be compiled by a qualified nutritionist together with a gastroenterologist. It is important to use exactly those foods that the doctor will allow. In addition to prescribing a diet, with reflux esophagitis or gastritis, a nutritionist can also advise some recipes for preparing delicious and healthy dishes.