What you need to know about the erosive reflux esophagitis
Catarrhal reflux esophagitis is an inflammatory disease of the esophagus, in which the damaged surface layer of the mucous membrane. This pathology develops due to frequent reflux of acidic stomach contents into the esophagus, which causes irritation and injury of the mucous membrane, and symptoms: heartburn and pain. Erosive reflux esophagitis is considered a complicated form of this disease, which is accompanied by the formation of erosions or ulcers of small diameter on the mucosa of the esophagus.
The main reason for the development of erosive reflux esophagitis is the weakness in the lower esophageal sphincter, which can not withstand the intra-abdominal pressure. That is why there is reflux of stomach contents into the esophagus.
- the abuse of alcoholic beverages,
- the presence of a hernia hiatal,
Sometimes treatment some drugs can cause erosive reflux-esophagitis. It can be an application:
- beta-blockers in the treatment of hypertension and cardiovascular pathology;
- bronchodilators in the treatment of bronchial asthma;
- calcium channel blockers;
- sedative and other medications.
If when you receive drugs, the appearance of heartburn, then this should be reported to your doctor. It is necessary to adjust the treatment. Then the heartburn won't bother you again because its cause will be eliminated.
Clinical manifestations of erosive reflux esophagitis resemble catarrhal reflux esophagitis, but they are more pronounced, which causes constant discomfort. Increased symptoms of erosive reflux esophagitis is marked after eating and taking some medications inside.
The most common symptoms of erosive reflux esophagitis:
- Frequent heartburn, seizures and develop long, even after eating low-fat products. In this case, the patient noted the appearance of a burning sensation in the chest, sore throat and increase salivation. Heartburn appears fasting and after eating, increased in the supine position and bending.
- The appearance of acidic burp after drinking alcohol and carbonated drinks; after her mouth retained a bad taste for a long time.
- The feeling of a lump in the throat after exercise, which leads to labored breathing.
- With a strong erodirovannoj mucosa revealed the pain behind the breastbone or in the stomach.
- Displacement of the stomach above inthe chest cavity develops a cough that won't go away; may develop pneumonia due to aspiration of stomach contents.
- The development of caries due to changes in the composition of saliva with erosive reflux esophagitis.
Forms of the disease
Type of erosive reflux esophagitis is divided into the following types:
- Acute erosive reflux esophagitis. Is characterized by painful sensations that occur only when eating. The pain is felt behind the breastbone in the course of the esophagus; often present malaise, impaired swallowing.
- Catarrhal reflux esophagitis is characterized by swelling spilled the entire mucosa. Swallowing of food bolus leads to sharp pain as it progresses towards the stomach.
- With erosive form of reflux esophagitis observed eroded surface layer. Existing ulcers tend to merge and deepen. Clinical manifestations are pronounced, and the treatment should start as early as possible. If treatment is not available, there is a high risk of perforation, or perforation of the esophagus.
- Chronic reflux esophagitis is characterized by the alternation of clinical manifestations and resting phase. The inflammation is chronic. Often identified co-morbid conditions: inflammation of the stomach lining (gastritis), severe shortness of breath, frequent hiccups and vomiting.
The disease and diagnosis
With the development of distal reflux esophagitis (not affecting the deeper layers of the mucosa) goes through several stages. First develops catarrhal reflux esophagitis, but under the influence of precipitating factors for worsening, ulcers of small size. Over time they not only merge, leading to increased ulcers in size, but grow deeper. This is what leads to the violation of the integrity of the esophageal wall and the ingress of the contents into the abdominal cavity, resulting in peritonitis.
Stage of erosive reflux esophagitis:
- the emergence of point erosions in the lining of the esophagus;
- the erosion begin to merge, and heartburn and a burning sensation behind the breastbone occur after eating;
- defeat becomes the upward direction, the symptoms become permanent and do not depend on consumption of food;
- the ulcer becomes chronic, resulting in persistent bad taste in the mouth.
On stage 4 erosive reflux esophagitis observed the development of the following complications: scar narrowing of the esophagus at different levels, malignant neoplasms.
When conducting a comprehensive examination of patients with erosive reflux esophagitis it is necessary to donate blood foradvanced analysis, esophagoduodenoscopy, x-ray examination with contrast, the definition of acidity in the esophagus and stomach, manometry. Only a comprehensive approach helps to determine the cause of erosive reflux esophagitis on the basis of the obtained data to carry out effective treatment.
Treatment of erosive reflux esophagitis begins with a review of the lifestyle of the patient that requires getting rid of existing bad habits. In the presence of excess weight must start the process of getting rid of him. Necessary elimination of precipitating factors. A comprehensive treatment of erosive reflux esophagitis patient compliance with the strict diet – it enables the body to receive the full amount of nutrients and at the same time not to injure the affected esophageal mucosa.
Patients erosive type of the disease are advised to limit physical activity associated with tension of the abdominal muscles. This will help prevent throwing gastric contents into the esophagus. Do not wear tight clothing, belts and corsets.
Drug treatment involves the appointment of the following groups of drugs with erosive reflux esophagitis:
- Antacids reduce the aggressive influence of gastric juice on the mucosa of the esophagus and stomach. Exchange treatment gives a more stable therapeutic effect but drugs are effective in case of emergency withdrawal symptoms. Antacids not only reduce acidity, but also envelop the stomach, protecting it from aggressive influence of hydrochloric acid.
- Antisecretory drugs inhibit the high activity of the secretory cells of the stomach. Such action reduces the volume of secreted gastric juice.
- Prokinetics necessary to improve the tone of the lower sphincter of the stomach. They are prescribed to normalize the evacuation of stomach contents into the intestine that prevents the throwing up into the esophagus.
Surgical treatment is carried out in the absence of effect of standard medicamentous therapy of erosive reflux esophagitis, progressive course, presence of scarring in the esophagus or the development of bleeding from the ulcer.