Under esophagitis is meant inflammation of the mucous membrane of the lower esophagus. Often it occurs with frequent or prolonged casts from the stomach of aggressive juice.
The erosive form is one of the most dangerous, since with it the mucosa begins to become covered with sores. If untreated, they may bleed or lead to more serious consequences.
Erosive reflux esophagitis - what is it?
This is an ailment that affects the entire lining of the esophagus mucosa or part of it. According to ICD-10, the disease belongs to the group K20-K31. These are diseases of the stomach and duodenum.
The disease can last for a long time without symptoms or have the same symptoms as gastritis. In the absence of treatment, this disease can affect not only the upper cells of the esophagus, but also deeper layers. Therefore, treatment is carried out under the strict supervision of a doctor.
Erosive form often occurs not only in the progression of the catarrhal disease, but also in patients who have suffered gastrectomy or gastroectomy.
Causes of
Erosive esophagitis may appear for various reasons:
- overweight,
- smoking,
- excessive physical exertion,
- inaccuracies in the diet,
- emotional overstrain,
- wearing tight clothing,
- hernia in the esophageal opening of the diaphragm.
Erosions may appear due to taking medication. Especially when it comes to anti-inflammatory and sedative drugs.
The erosive form may result from acute or chronic inflammation of the esophagus. Erosions are also formed after chemical burns with acids, alkalis and various technical fluids.
A prerequisite for the disease can be severe viral, bacterial or fungal infections, regular use of glucocorticosteroids and non-steroidal agents.
Classification of
Several main forms of esophagitis are distinguished:
- acute,
- chronic,
- superficial,
- ulcerative,
- distal.
Acute
This form is the most common. It is accompanied by superficial or deeper inflammation of the mucous membrane. The ailment develops gradually, therefore, with timely begun treatment can take place without complications.
Chronic
Occurs if a negative effect on the walls of the esophagus was permanent. Develops over a long period of time. Therefore, sometimes it is the cause of irreversible effects that can affect all layers of the mucosa and other parts of the digestive tract.
Superficial
Sometimes it is called catarrhal. This form is characterized by the appearance of inflammation and swelling of the esophageal mucosa. Under the influence of negative factors, only the surface layers are in this form. Therefore, the disease does not cause significant destruction of tissues.
Ulcerous
This is a condition in which inflammation not only penetrates the esophageal mucosa, but also when it causes ulceration. This disease requires a serious approach to treatment.
The formation of foci of lesions can begin both with prolonged contact with the irritating factor, and with short-term ones.
Distal
An erosive form can be detected if only the lowest esophagus has been affected by ulcers. It also connects with the stomach.
Degrees
The erosive form has several forms:
- 1 degree. For her, a particular type of erosion is characteristic. They do not touch each other. Sometimes erythema is found at this stage. It is more often found in the distal esophagus.
- 2 degree. Erosive lesion in which erosion has a fusing character. Despite this fact, the focus of the lesion does not affect all mucous membranes.
- 3 degree. Its feature is that ulcers form in and in the lower part of the esophagus. It turns out that all the mucosa is one large ulcer with some healthy tissue.
- 4 degree. It includes not only the appearance of erosions, but also is accompanied by stenosis. This form, as a rule, has a chronic course.
Symptoms of
Characteristic for the disease are the pain that occurs in different areas of the esophagus. They can appear during eating. Patients report frequent heartburn, a burning sensation behind the sternum, a regurgitation of food or mucus. There may be a burp with an admixture of blood.
The signs of the disease include:
- Pain of different intensity. Mostly appears behind the sternum. May worsen during eating, at night or during physical exertion.
- Heartburn. Occurs when exposed to an acidic environment from the stomach to the esophagus. The condition can occur when the body is in a horizontal position and under physical stress.
- Belching. It indicates insufficient cardiac function. In some cases, it is so strong that it resembles vomiting.
- Dysphagia. Appears in severe forms of esophagitis. For a serious condition, the sensations of food delay in the area of the xiphoid process are characteristic.
Diagnosis
It is necessary to identify the disease in time. According to the results of the study, it is possible to determine not only the severity of the pathology and its degree, but also the appropriateness of the treatment.
One of the most effective methods is fibrogastroduodenoscopy. In the procedure, the mucosa is examined using an endoscope. The method allows to detect the presence of redness, the degree of motor disorder and the inflammatory process. If there are ulcers, constrictions or scars, the method will help to identify them.
Morphological evaluation is given after studying the material under a microscope. Cells are taken the same way as during a biopsy. It allows you to exclude malignant degeneration and identify signs of pathology.
X-ray with contrast agent. Before using the X-ray, a suspension of barium is introduced. In the process of research, erosion is identified. The patient is looked at both horizontally and vertically. This also makes it possible to establish the presence of refluxes or hernia of the diaphragm.
How to treat erosive reflux esophagitis?
To cope with the disease, a person is encouraged to revise their lifestyle, make some adjustments.
It's worth to quit smoking, to avoid serious physical activities related to slopes. This will provoke the transfer of the contents of the stomach into the esophagus.
Drugs
Two tactics are used for treatment. The first includes powerful medications.over time, intensive medication is reduced. The second principle is that first drugs are prescribed that have minimal effectiveness. As the treatment proceeds, the pharmacological effect is increased.
One of the effective methods is the reception of secretolytics. These drugs are necessary to reduce gastric secretion. Reducing acidity reduces the harmful effect on the delicate esophageal mucosa.
These drugs include:
- proton pump inhibitors,
- H-blockers,
- M-cholinolytics.
The duration of medication depends on the degree of disease and the amount of erosion.
The minimum rate is about a month. Among soft medicines, various antacids are noted that neutralize the action of hydrochloric acid. To increase the resistance of the esophageal mucosa, doctors can additionally prescribe medications for treatment.
Folk remedies
Patients with erosive form are given decoctions of herbs that have wound healing, anti-inflammatory and bactericidal action. These include nettle, calendula, chamomile, mint and sage.
To fight heartburn, freshly squeezed potato juice, dry raspberry leaves or blackberries can be used. The latter can be simply chewed.
Diet
With erosive form of pain can occur even with an insignificant, at first glance, imbalance in food. The diet should be gentle.
It is necessary to exclude products that enhance gas generation processes. Cold and hot meals are excluded. From the menu, products that reduce the tone of the lower sphincter should be excluded. That is, you should not abuse chocolate, onions, garlic, pepper and coffee.
Before drinking food, drink a glass of water without gas. This will help protect your esophagus mucosa. During the day, you can eat a couple of slices of potatoes in their raw form. This will reduce the occurrence of gastric juice. Potatoes can be replaced with several nuts.
Prognosis and prevention
The erosive form requires more treatment. If there are no complications, then the prognosis is favorable, and the life expectancy does not decrease. If the disease is not treated, then the likelihood of developing precancerous and cancerous conditions is high.
Prevention of erosive reflux esophagitis is a constant compliance with the diet. It is important to sleep on an extra pillow so that the head is always above your legs. This will not allow for a violation of the cardia to have a negative effect on the digestive tract.
It is not recommended to wear tight clothes. Remove the belts and sashes that would tighten the abdominal cavity. The best drinks for prophylaxis are rose hips, dried fruit compote, low-fat milk.