1 Physiology of the stomach and esophagus

To understand that you develop this disease and how to treat reflux esophagitis, you first need to familiarize yourself with the structure of the gastrointestinal tract.

Behind the trachea is the esophagus, which is a hollow organ, in men it is about 25-30 cm, and in women 23-24 cm. It has several layers, including the mucous membrane, muscles and the outer shell. Due to the contraction of the muscles, there is a movement along the esophagus of food towards the stomach.

Muscles form two valves, one of them is located in front of the stomach. When a person does not eat, he is in a closed state. After eating, the valve opens and food enters the stomach. If there is a disruption of the operation of this valve, the symptoms of reflux esophagitis begin to appear in a person and the indicated disease develops.

In addition to the work of the stomach muscles, the food is digested with the help of gastric juice, it contains various enzymes and hydrochloric acid. In adults, 20-30 natural casts of the contents of the stomach into the esophagus are normal, and there is no discomfort, and the symptoms of this disease do not appear, since this is not a disease. The development of this disease begins in the case when the work of the esophagus is broken and its protective functions do not work.

Nature has thought out how to protect the esophagus from reflux: for this, there is a mucous membrane that protects the esophagus from mechanical damage, it can occur during the passage of food on it and from the action of gastric juice that enters the esophagus during physiological refluxes.

The presence of the lower valve does not allow hydrochloric acid to enter the esophagus freely, but the fact that this organ has a good blood supply allows it to recover quickly in those cases when the damage is obtained. All of the above protects the esophagus, and if everything is normal, then this disease will not develop and its signs are absent.

2 Etiology of the disease

The development of the disease becomes possible in the event of failures in the lower valve of the esophagus, if its muscles lose their tone, after which the contents of the stomach unobstructedly enter the esophagus.

The main causes of the development of this disease are:

• the presence of chemical or physical negative factors;
• frequent nerve strains;
• high pressure in the abdominal cavity, with part of the stomach can penetrate into the chest cavity, and its contents will be squeezed into the esophagus;
• hernia of the esophageal opening of the diaphragm.

There are the following factors that predispose to the emergence of this pathology:

• man tilted forward;
• presence of excess weight;
• smoking and alcohol;
• coffee;
• spices;
• pregnancy;
• medications, such as nitroglycerin;
• ulcer.

Any of these factors can cause discomfort due to throwing the contents of the stomach into the esophagus.

3 Clinical picture of

The main symptom is the appearance of a burning sensation at the top of the esophagus, this phenomenon is called heartburn.

It appears usually after taking coffee, chocolate, fatty foods or if there are a lot of spices in it, after taking alcohol. It usually occurs when a person leans forward or takes a horizontal position.

The next symptom is the eruption - it can be both air and acidic gastrointestinal contents. If during a meal you feel that it is hard for you to swallow and the food does not go well, this may indicate inflammation of the mucosa of the esophagus.

If a person has reflux esophagitis, then this can cause bronchial blockage in secret, which leads to chronic coughing. In this case, small particles from the esophagus enter the bronchi, and cough occurs mainly at night. Many experts believe that this can serve as an impetus for the development of bronchial asthma.

After overeating or eating very spicy food, chest pains, which are similar in character to angina pectoris, may appear. This disease often leads to the development of rhinitis, pharyngitis, this is due to the frequent ingestion of part of the contents of the stomach into the larynx.

Another symptom may be the destruction of tooth enamel, because increased acidity in the mouth leads to the development of caries.

Most people who have found these symptoms do not even suspect that all this is associated with reflux disease and begin to treat the consequences, whereas it is necessary to treat reflux esophagitis, so the desired results are not obtained.

Before starting to take medications, when these symptoms appear, you should consult a gastroenterologist or a therapist who can examine the body and determine the causes that led to such symptoms.

In most cases, this disease develops over several years, people do not pay attention to its symptoms and do not start on time to treat reflux esophagitis. If the disease is correctly diagnosed and the treatment is started on time, then drugs are prescribed that allow good results to be obtained. It should be noted that in cases where the treatment of reflux esophagitis stops and a person returns to the usual way of life, in many cases a relapse occurs.

4 Diagnostics

First the doctor talks to the patient and listens to all his complaints, pays attention to the food, and then conducts the examination. When the disease develops, the patient's tongue is covered with a touch of white. To exclude the development of diseases such as gastritis, pancreatitis, palpation of the abdomen is performed.

The main method of investigation in this case is fibroesophagogastroduodenoscopy - the introduction of a probe with a camera, this is done through the mouth. About the development of this disease will testify to the red mucosa, the contents of the stomach in the esophagus can be detected, all this is seen by the doctor on the monitor. This is a painless procedure, and during it a person feels only a small discomfort, during the FGDS, a biopsy can be done.

X-rays with contrast can be prescribed, barium is used for this. Before conducting such an examination a person should drink a glass of barium fluid and lie on his back.

To determine the daily level of acidity in the esophagus, daily pH measurement is performed. The norm in this organ is 4 pH.Having done an analysis of this indicator, the doctor will be able to determine the frequency of reflux and the severity of the disease.

To assess the performance of the lower esophagus valve, esophagomanometry is performed. Catheters can be administered through the mouth or nose and with their help measure the pressure inside the lumen of the esophagus: if everything is normal, then it is within 6-25 mm Hg. If the pressure is lower, this indicates the development of this pathology.

For the exclusion of angina pectoris, an ECG can be administered. To exclude diseases of the respiratory system, can appoint a chest x-ray. If there are problems with the teeth, refer to the dentist.

5 Conducting treatment for

On the question of whether it is possible to cure reflux esophagitis, the answer is yes. But treatment should always begin with the elimination of possible causes: quit smoking, get rid of excessive body weight, avoid stress. An adjusting diet is prescribed. If you use only medications and do not stick to a diet, then you will not get the expected effect. The diet should be observed constantly, but especially strictly in the event that the symptoms of the disease appeared.

The correct regime of the day is of great importance: one must try to expose the body to a minimum of nervous overloads, sleep should be taken 7-8 hours a day. That at night refluxes did not arise, to sleep it is necessary on a small pillow, the head should be above a body on 25-30 °.

Food should be taken at least 4-5 times a day in small portions, for 2-4 hours before sleep, there is nothing. You can not overeat, the food should be thoroughly chewed. After eating, you can not go to bed immediately, you have to be like or at least just sit.

In order not to increase intra-abdominal pressure, you should wear loose clothing. From wearing tight clothes will have to give up. We should try to minimize the pressure of the press and not take medications that reduce the tone of the lower esophagus valve - these are hypnotics, sedatives.

In the treatment of this disease, diet is very important. The list of products that can not be consumed will be prompted by your doctor, and he will point out the products that are recommended for use in the presence of this disease.

6 Medical therapy

If the patient has a mild form of reflux esophagitis, treatment can only be through diet. But in other cases the doctor will prescribe medication for the disease.

To increase the tone of the valve prescribe prokinetics, for example motilium, motilac. To reduce the increased acidity by neutralizing it, the doctor ascribes antacids - it can be an almagel or similar drugs.

To suppress the production of excess amounts of acid used antisecretory drugs, such as omeprazole, famotidine.

The duration of drug treatment will depend on the severity of the illness: usually it takes a month, and in severe cases, treatment can last 6 or more weeks.

If you do not give meaning to the symptoms of reflux esophagitis and do not start on time for treatment, then this can lead to the development of a disease such as an ulcer of the esophagus. In this case, bleeding can develop, for the elimination of which endoscopic surgery is performed.

If the inflammation is chronic, then stenosis develops - the walls of the esophagus become thicker, which reduces its passage. In such cases, surgical treatment is necessary. There may be a replacement of the epithelium of the esophagus by the epithelium of the stomach, which increases the probability of esophageal cancer by a factor of 10.

It is necessary to respond to the symptoms of reflux esophagitis in time and to consult a doctor - only in such cases the treatment will be quick and effective.