If a person does not have disorders in the work of the gastrointestinal tract, then the digestive process passes without attracting much attention. A burn of the esophagus can cause great difficulties in eating and is fraught with serious health consequences. You should know why this situation may happen to avoid it.
Species and causes of
Esophagus has a functional purpose - transporting the food mass from the oral cavity to the stomach. Its structure is a tube with lumens of different sizes and folds to provide movement mechanics.
Esophagus has three layers of tissues:
- mucosal surface,
- muscle fibers,
- connective tissue.
Specialists distinguish several types of lesions of the esophagus with a burn, depending on the cause of the problem:
- Chemical damage is due to ingestion of aggressive liquids:
- alkalis:
- ammonia,
- caustic potassium,
- caustic sodium,
- caustic soda;
- of heavy metal salts:
- of mercury,
- of copper sulphate;
- acids:
- hydrochloric,
- acetic,
- sulfuric;
- alcohol,
- if the patient suffers from a reflux disease( part of the food comes back from the stomach to the esophagus), a situation is created for the negative effect of gastric juice on the lower parts of the esophagus;
- other chemical substances, for example:
- phenol,
- solution of potassium permanganate.
- of mercury,
- Thermal damage to is possible with too hot food, as well as from vapor entering the esophagus area from boiling liquid.
- Radiation lesion - appears when exposed to the body of radioactive rays, it can happen during the passage of radiation therapy on neighboring organs.
Usually the causes of burns are:
- Inattention to the storage of dangerous liquids, which can lead to children from curiosity or ignorance can take them in.
- Insane state, for example, intoxication - as a result of taking a liquid that causes a burn( by mistake).
- Intentional use of such liquids for the purpose of suicide.
Symptoms of
A burn of the esophagus shows itself vividly. The degree of damage to the organ and the nature of the substance that acted as an aggressor in relation to the tissues of the esophagus affect the nature of the symptoms.
Local
Esophageal burn has local signs that are expressed by discomfort, other sensations, and also the effects of organ damage.
This:
- Burn marks are observed in the oral cavity - tissue necrosis.
- Lips become edematous, have dead spots in places.
- Severe pain in such places:
- behind the sternum,
- in the zone of the esophagus,
- in the oral cavity,
- in the upper abdomen,
- in the neck.
- Salivation is observed.
- Spasm of the esophagus makes swallowing difficult.
- The edema spreads along the course of the aggressive fluid:
- tongue,
- pharynx,
- esophagus.
- The voice becomes hoarse due to damage to the vocal cords.
- Swelling of the larynx provokes shortness of breath, creates a life threat( in case of severe swelling).
- In case of third degree damage, the formation of apertures on the esophagus is possible.
General
With a burn of the esophagus, signs appear that express general well-being. The affected tissue of the esophagus may be in a state of a certain degree of destruction. Decay products are involved in the body's intoxication.
Signs of a general nature:
- renal-hepatic failure,
- cardiac dysfunction,
- very weak state of health,
- fever,
- nausea.
Degrees
The degrees of esophageal damage indicate to what extent are affected by the negative process of the organ tissue.
- First degree burn - it is understood that the problem touched only the first layer of the body( mucous membrane).
- The second degree is ascertained by if pathological changes have spread to the second layer of the esophagus( muscle tissue).
- The last degree of lesion of - the pathological process covered all layers of the organ. At this stage, there may be holes in the esophagus. Damage can spread beyond the body and create a high background of intoxication.
Diagnosis
The disease is determined by the characteristics that characterize it. It is established, in what way the burn was obtained, what factor became the determining factor in the defeat of the esophagus.
Studies using the equipment in the first three days do not, so as not to add a risk of trauma to the tissues of the organ.
When the condition is slightly stabilized, if necessary, X-rays are made. This method shows the condition of the internal surface of the esophagus, the degree of mucosal damage.
Endoscopic examination is also used. It is carried out at different periods in order to understand what processes occur in the esophagus and the stage of their development.
Treatment and first aid
If esophageal damage is second or third degree, then an ambulance must be called in order for specialists in the hospital to provide the necessary assistance.
The first thing you need to do to the patient is gastric lavage. The injured person is offered to drink a large amount of liquid( one liter), then exert efforts to induce vomiting.
The second step that relates to first aid measures is the neutralization of the residues of the substance that caused the burn. For this procedure, solutions are used, prepared depending on the nature of the aggressive fluid that triggered the burn.
In a hospital, rinsing is done through a probe. In this case, the patient is given pain medication, and the probe is carefully lubricated with oil.
Chemical burn of the esophagus and stomach
Most often, the esophagus burns from the ingress of aggressive liquids onto its walls. Signs that with the man this trouble happened:
- no voice, the patient suffers suffocation;
- the person is frightened, the rhythm of breath is brought down;
- around the mouth may be leaking,
- mouth slightly ajar, look frozen, drooling;
- in the vomit can be the inclusion of blood,
- person in a cold sweat, looks pale,
- the affected person may be unconscious.
Stages of
Classification of lesions of the esophagus with a chemical burn provides information on the stage at which the process is caused by the lesion.
- At the initial stage, the situation is designated as acute, the mucous membrane acquired a red, inflamed color and became swollen. The acute stage lasts up to 10 days. During this period the patient experiences discomfort and severe pain. Observed:
- rapid breathing,
- elevated temperature,
- decreased blood pressure,
- increased number of heartbeats.
- possible shock state.
- The second stage is determined if the process of necrosis of tissues has begun, that they have been burned. As a result of necrosis, the surface of the esophagus can be covered with sores. The second stage has a duration of up to three weeks. The patient already swallows food somewhat more freely than in the first stage.
- The third stage is characterized by the fact that the lesions begin to heal.
- The fourth stage indicates the period of appearance of scars in places where tissue healing occurs after deep necrosis. This process can last several years after the healing began. Scars can provoke narrowing of the esophagus.
Lesions in children
Children account for the majority of the number of people in trouble( 65%).This situation occurs when parents are not concerned about their safety and do not hide in a safe place the fluids that can attract the attention of children and harm them.
Treatment
After first aid, the patient is treated to prevent the consequences of a burn. Events are appointed by the doctor. Self-medication is not recommended.
In cases where the degree of defeat is second or third, treatment procedures are carried out only in a hospital.
Apply medications of this direction( if necessary):
- pain relievers,
- antispasmodics,
- anti-shock,
- antibiotics,
- to prevent the creation of scars.
Alcohol damage
As a result of a burn, the mucosa is covered with a white coating. This film is the result of the necrosis of the cells of the mucous layer. In a sense, the film plays a positive role, because it does not penetrate to a deeper level.
Such a trauma to the esophagus refers to dangerous cases, because necrosis of tissues in such a volume causes poisoning of the body. In-patient examination is necessary. Assistance often takes place in the intensive care unit.
People who have already had such a history in their medical history must permanently refuse to take alcohol.
Alkali
The action of alkalis on the walls of the esophagus is very aggressive.
There is such a reaction that the tissues do not interfere with the penetration of the solution to other organs. Therefore, it is especially important to start providing assistance sooner.
Often as an aggressive liquid of alkaline nature, ammonia is used as ammonia.
In such cases( alkali burn), rinsing is done with acid solution of a weak consistency( lemon or acetic).You can use for this purpose, vegetable oil.
Hot food
Esophageal injury can occur if a person takes food that has a temperature of over 40 degrees. This can cause a burn of the esophagus with all the relevant symptoms.
Thermal burn in comparison with other cases is less dangerous.
The esophageal mucosa is affected, but the process does not extend to deeper levels. It is necessary to put the patient in bed.
If the victim can take food, then it is allowed to use it in a cool and liquid form. You should consult a doctor in case of prolonged discomfort in the throat and chest area.
Acetic essence
The effect of acid on the walls of the esophagus is very detrimental. Coagulant necrosis occurs. The necrosis of tissue is a dangerous process for the body. However, the fact that a film is formed, as with alcohol burns, creates a protective barrier from the penetration of the lesion to deeper levels.
In such cases, washing is performed using alkali. To do this, a liter of warm water dissolve baking soda( half a teaspoon).
Gastric juice
Cases are possible if a person suffers from a gastrointestinal disease, in which the food gets retrograde motion and is returned by some part of the stomach into the esophagus. Gastric juice is an aggressive environment for the esophagus mucosa and its damage occurs.
The process of mucosal disease is formed over a period of time. The patient has time to notice this phenomenon, to be examined, to identify the cause and to receive the appointment of a specialist.
Therapeutic prophylaxis of cicatricial narrowing of the esophagus after a burn
To ensure that the esophagus does not get an undesirable narrowing of the lumen, a procedure for boiling is provided. This is called expansion of the esophagus with the use of elastic tubes( probes).
Types of bougie
Depending on the characteristics of the patient, such types of bougie can be used:
- through the blind hole "blind", if the patient does not have serious esophageal injuries;
- , too, but under the supervision of an esophagoscope - is used if there is cicatricial stenosis;
- bougie "by thread" is prescribed if the patient has stenosis of cicatricial and rigid character;the probe is inserted into the gastrostomy( artificial entrance to the stomach), but is withdrawn through the nostril.
Indications for the use of bougie
If the patient received a second or third degree burn of the esophagus, bougies are provided to prevent constriction of the organ. This procedure is not possible if the patient has such esophageal lesions:
- complete scarring,
- acute esophagitis,
- diverticula,
- fistula,
- perforation.
Video about what to do when burning the esophagus:
- alkalis: