Regardless of the causes of inflammation of the esophagus, doctors define the disease with the common term "esophagitis".Esophagus is the first department that belongs to the digestive tract. It is closely connected with the oral cavity, pharynx. Therefore, when diseases occur in the esophagus region, the functions of the respiratory system are often affected.
The concept of
Esophagitis is a pathological disease affecting the mucosa of the esophagus. The process can be acute, subacute or chronic.
In the absence of treatment, the disease affects not only the mucosa, but also the deeper layers.
The disease is common, but in 40% of cases, clinical manifestations are not detected. As progression occurs, life-threatening complications, including the formation of tumors.
Classification of
Separate several species that differentiate for different reasons. The most common is catarrhal and edematous. In this case there is hyperemia of the mucosa, its swelling.
If there was an acute infectious process, chemical or thermal burns, then the result could be erosive esophagitis, for which the appearance of erosion is characteristic. If their formation does not occur, the doctors say about the non-erosive form.
Photo of erosive reflux esophagitis
The following forms of esophagitis are distinguished:
- Candidiasis. The defeat of the mucous membranes occurs with fungi of the genus Candida. The disease is rare, and the current is often similar to other ailments of the primary esophagus. If the inflammation is caused by other types of fungus, then talk about fungal esophagitis or mycosis( mycotic).
- Peptic. Occurs in the background of a constantly repeated effect on the mucosa from the side of gastric or duodenal contents. In some cases, the influence of the duodenum affects the mucosa.
- Eosinophilic. It occurs against the background of autoimmune diseases. For this form, an increase in the number of eosinophils in the mucosa is characteristic. Frequent prerequisites are food or respiratory allergies.
- Fibrous. It is usually a complication when proliferation of connective tissue fibers occurs. This leads to fibrotic degeneration of the esophagus. It is limited and diffuse leads to narrowing of the esophagus lumen and shortening of the organ.
- Terminal. In children it is associated with the work of immature muscles of the digestive system. In adults, we form on the background of relaxation of the sphincter, which separates the esophagus from the stomach. The result is swelling of the organ membrane and hyperemia of some areas, which is manifested in the appearance of pinpoint hemorrhages.
- Biliary. Inflammation of the mucosa occurs against the background of bile in the composition of the food lump. Continuous exposure to bile mucosa and pancreatic enzymes leads to the development of inflammation. Because of this, there is an increase in histamine.
- Post and radial. They develop after the passage of radiation therapy for the treatment of cancer of the esophagus, lungs and other organs. The frequency and severity of these forms depends on the increase in the radiation dose, as well as the passage of drug therapy and radiation.
- Atrophic. This form refers to precancerous diseases. It develops with neglected diseases of the esophagus. Under the influence of negative factors, mucosal cells atrophy and cease to perform their functions.
- Erythematous. This form can be acute or chronic. It is characterized by a large accumulation of erosions that merge into a single erythema. There is a pronounced tendency to hemorrhage and bleeding.
Causes of
Acute form often appears due to some short-term effect. This can be:
- infectious diseases,
- physical effect( with probe insertion, burn),
- damage by corrosive chemicals,
- allergic reactions to food.
The most severe consequences are due to chemical damage. With infectious lesions, the cause is a decrease in the body's immune forces.
Chronic forms can be called:
- by unknown causes,
- Vitamins deficiency,
- by prolonged intoxication,
- by evacuation functions of the esophagus.
If gastric contents are thrown into the esophagus, peptic esophagitis develops.
Symptoms of reflux esophagitis in adults and children
The main symptom in adults is the appearance of heartburn. It can develop against the background of eating, when changing positions or when lifting weights. At the advanced stages this sign is of a permanent nature.
Additional symptoms are:
- sour belch,
- nausea,
- vomiting,
- pain during swallowing,
- heaviness in the abdomen.
Sometimes, pain appears in the chest area. Then they can be confused with the symptoms of angina pectoris.
In young children, anxiety is caused by frequent eructations. Vomiting can often occur during adulthood. Sometimes there are pain in the stomach. This disease is bad for the teeth. Since the casting of acidic gastric juice occurs, the correct formation of enamel is broken.
In children, esophagitis leads to hyperreactivity of the bronchi. Because the esophagus is short, the constant casting of food from the stomach and hydrochloric acid when changing positions leads not only to irritation of the mucosa. A small amount of juice can get into the respiratory tract, which leads to frequent bronchitis.
Symptoms of acute form
In acute form, the symptomatology depends on the nature and extent of the esophagus. If the disease is superficial, then it may simply be discomfort when consuming sour or hot food.
In severe form of the disease there are severe pains that are given to the area of the sternum, back, neck.
In rare cases, there is difficulty swallowing and severe heartburn. If the esophagus lesions are particularly severe, then there is bloody vomiting and a shock condition.
Symptoms of the chronic form
The chronic form develops against a background of constant irritation of the esophagus or with an untreated acute form.
Symptoms are as follows:
- Frequent belching of the air and bad breath.
- The language produces a white coating, which almost never disappears.
- An obsessive cough appears. Its result is the hoarseness of the voice, bronchitis.
- Chest pain may disappear and reappear.
There is a rapid development of caries. Because of the gastric juice, the composition of saliva changes. Acidic components corrode tooth enamel.
Video on how to cope with the symptoms of reflux-esophagitis:
Features of the disease in pregnancy
In pregnancy, the cause of the disease is a violation of the esophagus and stomach motility, as well as the aggressiveness of the gastric contents. It develops more often in the 2-3 trimester.
Almost 75% of pregnant women suffer from heartburn, which occurs mainly when the position changes, after eating fatty or spicy foods. Continue heartburn may be from a couple of minutes to several hours.
During pregnancy, the intra-abdominal pressure increases. At the same time, the muscles that close the passage from the stomach to the esophagus are in a relaxed state. This leads to the development of reflux, inflammation of the esophagus. During pregnancy, the only treatment is the elimination of signs of heartburn with medications.
Degrees of development of
In acute form, 4 degrees of lesions are distinguished:
- First. Usually is superficial. The formation of ulcers and erosive defects does not occur. Hyperemia and puffiness are noted. Symptomatic at this stage is absent or weakly expressed.
- Second. On the thickness of the mucosa formed extensive erosion, which may be accompanied by necrosis. The erosion size is more than 5 mm. Heartburn occurs when eating, there is a burning sensation in the chest after eating.
- Third. The walls of the esophagus change as the lesion affects all layers. Ulcers begin to bleed, the formation of scars begins. Ulcers cover less than 75% of the esophagus. Characteristic stage is expressed symptomatology.
- Fourth. Ulcers cover almost the entire esophagus. A sour taste appears in the mouth. Swallowing becomes painful, and discomfort will spread to the area of the chest and stomach. At this stage, the risk of developing stenosis and esophageal cancer increases.
Complications of the esophagus
Complications include the occurrence of ulcers. They can bleed. To eliminate this pathology an endoscopic operation is prescribed.
There may be a stenosis. It is characteristic of the chronic course. There is pain when swallowing, feeling a lump in the throat.
If the epithelium of the esophagus changes, then the diagnosis "Barrett's Esophagus" can be diagnosed. Its danger lies in the fact that the risk of developing cancer increases 10 times.
Diagnosis
The first suspicion of esophagitis occurs when symptoms appear. For diagnostic purposes, instrumental methods of research are assigned.
One of the first to establish a diagnosis using an endoscope. With its help it is possible not only to identify foci of inflammation and erosive changes, but also to replace the epithelium of the esophagus with stomach cells.
The acidity is also studied. Its decrease or increase indicates the presence of reflux. With a decrease in the hydrogen index, one speaks of a request for gastric contents. With increase - about intestinal. T
This pH-meter allows you to determine the number and duration of episodes in the lower esophageal department. Daily data allow you to determine the most appropriate treatment regimen.
Sometimes the above method is combined with impedanceometry. With its help, there is an assessment of the features of the esophagus and the presence of gastroesophageal refluxes.
How to get rid of reflux esophagitis?
Treatment, regardless of form, is always combined. Dietotherapy, medications and various corrective measures are prescribed. Sometimes, surgical intervention is advisable.
Treatment of acute pathology
If acute esophagitis is caused by the use of irritants, first of all, the esophagus and stomach are washed. The procedure is carried out only in a hospital.
In the opposite case, it is possible to form a perforation at the site of damage to the organ. If necessary, anesthetics are prescribed and treatment is conducted to control the shock state.
Regardless of the reason, the patient is assigned bed rest and diet. This allows for faster healing of the affected area. In some situations, the patient receives food in the first days through the gastro.
All treatment is directed to:
- elimination of the disease that caused esophagitis,
- providing reduction of load on the diseased organ,
- administration of anti-inflammatory drugs,
- elimination of complications.
Oral administration of medications is maximally reduced or eliminated altogether. Therefore, patients receive the necessary chemical compounds with the help of droppers or injections. In particularly difficult conditions, the intake of food and water for 2-3 days is excluded. Satisfaction of the needs of the body is due to the use of parenteral nutrition.
Treatment of chronic pathology
As with the treatment of acute form, a diet is prescribed and the problem factor is eliminated. During exacerbations, a moderate consumption of food at room temperature is recommended.
It is necessary to exclude products that have an irritant effect on the mucosa. It is also recommended to stop smoking and taking medications that affect the tone of the sphincter.
Drug therapy includes the reception of:
- Medications that reduce the acidity of gastrointestinal juice.
- Drugs that stimulate cardiac tone.
Physiotherapeutic methods, for example, amplipulse, electrophoresis, may also be prescribed. In extreme cases, an operation is prescribed, including resection and plasty of the esophagus.
Prognosis and prevention of
If the course of the disease without complications, then the prognosis is favorable. It is necessary to follow a diet for a long time, to adhere to the right way of life.