Ulcer of the esophagus is an acute or chronic ulceration of the esophagus. The disease leads to severe pain, can threaten health and life. With timely treatment, prolonged treatment and exacerbation of symptoms can be avoided.
The concept of the disease
The disease is associated with peptic ulcer of the stomach and duodenum. Approximately ΒΌ of the population, this problem is not only in the esophagus, but also in other organs of the digestive tract. Especially when it comes to peptic ulcers.
Isolated form occurs 50 times less often. Almost always a prerequisite for the development of the disease is the inadequacy of the sphincter, GERD.
The disease is more likely to affect middle-aged and older people. In men, the disease occurs up to 5 times more often. Predisposition is transmitted to 60% of the paternal line, and 40% of the cases are maternal. In children, the ulcer of the esophagus is very rare.
In pregnancy, however, the development of gastroesophaginal reflux increases. If you do not start treatment, ulcers become a complication.
Types of
Ulcers are divided into:
- Peptic( true). They arise under the influence of gastric juice, which falls on the walls of the esophagus.
- Symptomatic. Complications of diseases of other organs. For example, because of malignant tumors.
Peptic
They constitute 0, 21-1.5% of all lesions.
Acute form may occur in diseases that are accompanied by frequent vomiting of acidic juice or as a result of traumatic damage to mucous membranes.
Chronic forms develop with long-acting factors.
The main prerequisite for development is to throw into the esophagus from the stomach due to a lack of cardia.
Peptic ulcer can be observed due to surgical interventions, with the atrophy of smooth muscle fibers. The peptic ulcer often appears due to the increased acidity of the gastric juice.
Symptomatic
This species is triggered by various phenomena:
- Congestive. The compression of the esophagus is due to the growth of the neoplasm.
- Medicinal. Ulcers appear when taking medication.
- Decubital. Occurs in patients receiving food through a probe.
- Stressful. Against the background of excessive production of adrenaline.
Thermal conditions can also lead to an ulcer of the esophagus, when a person is in a state between life and death, caused by burns, massive injuries, neglected diseases of the kidneys, heart.
Reasons for the emergence of
There are three main factors in the formation of the disease:
- disruptions in the neuroendocrine regulation of digestion with an increase in the number of gastrointestinal hormones;
- increased formation of hydrochloric acid in the stomach;
- heterotopy of sites of the gastric mucosa in the esophagus.
Stress ulcers are usually formed in people against the background of serious pathologies. Viral species are found more often in drug addicts, HIV patients and homosexuals.
Doctors point out the factors leading to the formation of pathology:
- emotional stress,
- frequent consumption of hot and spicy food,
- smoking,
- alcohol consumption,
- hereditary factors.
Symptoms of esophagus ulcers
One of the main symptoms is the regular appearance of a burning sensation behind the sternum.
The intensity of the manifestation increases in the prone position, with leans forward or after a plentiful meal.
After hot, cold or sour food, painful swallowing syndrome may occur. This sensation gives to the left side of the chest.
May extend under the scapula, lower jaw. A person might think that he had a heart attack.
Additional notes:
- impaired swallowing,
- pain when swallowing,
- syrup eructation,
- vomiting.
The latter sometimes happens with an admixture of blood. If the process is left without attention for a long time, the affected areas begin to be tightened with the formation of scars. Because of this, the esophageal tube deforms and the diameter decreases. The result is a regular vomiting of undigested food.
Stages of development
The disease occurs in four stages:
- The first. A small ulcer develops with swelling and redness. Damage is superficial.
- Second. Separate ulcers appear in the lower part of the esophagus atop the edematous folds. Pathology affects the thickness of the mucosa.
- Third. A large number of ulcers are found that merge with each other. There is a great puffiness, redness.
- Fourth. All mucous membranes are covered with ulcers that bleed strongly.
In the third and fourth stage, the disease spreads to layers of tissue under the mucous membrane. This leads to a risk of development of bleeding and disruption of the integrity of the walls of the esophagus. The body itself is shortened, narrowed and deformed.
Diagnosis
If you have symptoms, you should see a gastroenterologist. You can diagnose after the
- esophagoscopy,
- radiography.
In the first case, a biopsy of the material taken from the ulcer is assigned. It is examined by histological and morphological features. This allows you to differentiate the disease with cancer and specific ulcers.
On endoscopic signs three types of ulcers are distinguished:
- Focal. The defect is not more than 10 mm in diameter. It has no effect on the motor system of the organ.
- In-depth. It can reach a diameter of up to 30 mm has a deep bottom. Its edges rise above the mucous membrane.
- Pliophonization. It does not rise above the wall, it has hyperemic boundaries. The bottom of such an ulcer is covered with fibrin.
The material is also taken to establish Helicobacter pylori. This bacterium in the course of its vital activity affects the walls of the digestive tract.
Radiographic examination is performed with ingestion of a barium suspension. This makes it possible to detect a ulcerative defect. These research methods are supplemented with:
- ultrasound,
- MRI,
- CT,
- coprogram,
- biochemical blood test.
How to treat an ulcer of the esophagus?
Treatment begins with medication. If they do not give a stable or pronounced effect, surgical treatment is prescribed.
Medication Therapy
Drugs are prescribed that are able to neutralize the effects of aggressive gastric juice and stimulate the protective properties of the body. These include anthracite agents( Almagel, Maalox, Reni).
These drugs neutralize the effect of acid. Protect mucous membranes. These include Gaviscon, Venter. Inhibitors of proton pump suppress the production of hydrochloric acid. Such medicines include Omeprazole, Creon.
In addition, medicines are used that:
- normalize the motility of the digestive system,
- lead to the healing of affected areas,
- shorten the contact time of acid and mucous,
- reduce the frequency of food spills into the esophagus.
Covering agents are drunk in a warm form in small sips for 10-12 minutes. With ulcers formed as a result of stress, sedatives or antidepressants are prescribed.
Surgical treatment of
Operative intervention is used when therapy with other means has not brought results or complications, for example, a violation of the integrity of the walls of the esophagus, severe stenosis, bleeding. An operation is also prescribed for a cancerous degeneration of an ulcer.
An intensive care course is performed prior to manipulation. It is aimed at reducing the size of the ulcer, removing the edema from other tissues.
Folk remedies
One of the popular methods is the use of sea buckthorn oil. Within a month, you need to take 5 ml of the remedy 40 minutes before eating. Additionally can be used:
- Aloe leaves. They need to be held in the refrigerator for a day, then passed through a meat grinder. The resulting composition is filled with honey. Three days later, you need to add a glass of red dry wine. The received medicine is taken before meals. The course is no more than 2 months.
- Young cherry twigs. 2 tsp.300 ml of hot water are poured into the shredded branches. The mixture should be allowed to stand overnight. It takes 60 ml per day.
- Propolis. Grind 40 gr.propolis and tune in a water bath in 500 ml of vegetable oil. After 30 minutes you can remove from the fire. It is taken on a tablespoon on an empty stomach.
Nutrition
In the case of an ulcer of the esophagus, diet No. 1 is prescribed. The food should contain a sufficient number of proteins, fats and carbohydrates.
Foods that are difficult to digest or lead to irritation of the mucosa are excluded. You need 5-6 times a day. It is better to cook boiled dishes or steamed.
Do not abuse salt in case of illness. You can not eat hot and cold. The first dishes are prepared on potato or carrot broths. You can refill ready meals with cream, butter or egg-milk mixture.
Complications of
In the absence of proper treatment, holes may be formed in the walls of the esophagus or changes in the size of the lower part of the esophagus. In extreme cases, ulcers can spread to neighboring organs.
The prognosis for the disease is favorable only with the timely application of medical care.
When identifying chronic forms, it is necessary to be on dispensary records and undergo annual treatment and diagnostics.
Prevention
Methods of protection against the formation of ulcers are simple enough:
- avoid stress,
- eat the last time a day 3 hours before bedtime,
- timely treat diseases of the digestive tract.
Often the cause of the development of pathology is hernia of the esophagus, GERD, a disease associated with the transfer of stomach contents into the esophagus. Started timely treatment will not allow the emergence of complications.