What does the diagnosis of reflux esophagitis of the 1st degree mean. Reflux esophagitis: causes, symptoms, treatment. How dangerous is esophagitis?

Reflux esophagitis is a disease of a chronic nature, which consists in the pathological reflux of gastric contents into the esophagus.

Since there is no protection against such aggressive substances in the mucous membrane, epithelial damage occurs due to contact with them, with further inflammation and, accordingly, painful sensations.

When reflux esophagitis occurs, the acidity level of the esophagus drops markedly due to the mixing of the contents of the esophagus with acidic gastric reflux and digestive enzymes. The result of prolonged contact of the mucous membrane of the esophagus with such an irritant is its inflammation and trauma.

In this article, we will look at reflux esophagitis, its first symptoms and the basic principles of treatment, including at home.

Causes

Why does reflux esophagitis occur, and what is it? The cause of reflux esophagitis lies, as a rule, in the excessive relaxation of the esophageal sphincter at the entrance to the stomach. This muscle should be in a compressed state most of the time. A healthy esophagus only relaxes for 6-10 seconds to allow food or liquid to pass through. If the sphincter remains relaxed for longer (up to a minute for patients after each swallow), this causes a regression of the acidic contents of the stomach into the esophagus.

Often reflux esophagitis accompanies diseases of the gastrointestinal tract, such as:

• or stomach cancer;
• vagus nerve damage;
• violation of duodenal patency of the esophagus;
• pyloroduodenal stenosis;

It is not uncommon for reflux esophagitis to occur after stomach surgery. Also, the disease can be the result of smoking, drinking alcohol and drinking a lot of coffee. In some cases, sphincter relaxation occurs in people suffering from a hernia of the esophagus or from penetration of part of the stomach into the chest. This is seen in obese people, as a large belly increases pressure on the diaphragm.

Erosive reflux esophagitis

A complicated form of the disease, in which small ulcers (erosion) form on the esophageal mucosa. With erosive reflux esophagitis, all of the above symptoms become more pronounced, bringing tangible discomfort to the patient. Manifestations of the disease are aggravated after eating, as well as certain drugs, such as aspirin.

Degrees

The course of the disease is characterized by several stages, and the symptoms gradually increase, and the erosive lesion of the esophagus becomes more pronounced.

1. degree - manifested by separate non-merging erosions and erythema of the distal esophagus;
2. degree - merging, but not capturing the entire surface of the mucosal erosive lesions;
3. degree - manifested by ulcerative lesions of the lower third of the esophagus, which merge and cover the entire surface of the mucosa;
4. degree - chronic ulcer of the esophagus, as well as stenosis.

Symptoms of reflux esophagitis

If reflux esophagitis occurs, the symptoms of this disease may be pain behind the sternum, extending closer to the heart and even to the left shoulder, and can also suck in the pit of the stomach. Very often, the patient does not even associate these symptoms with problems with the esophagus at all, they are mistaken for an angina attack.

So, the main signs of reflux-esophagitis in adults are:

• belching air or food;
• heartburn;
• nausea;
• regurgitation;
• sour taste in the mouth;
• incessant hiccups.

Symptoms of reflux esophagitis often worsen when lying down (especially after eating) and disappear when sitting.

Chronic reflux esophagitis

Esophagitis in a chronic form, with a characteristic change in periods of exacerbation with periods of remission, can either be the result of acute undertreated reflux esophagitis, or develop against the background of alcoholism and the intake of coarse poor-quality food.

According to the types of changes, reflux esophagitis can be:

• superficial (distal);
• erosive;
• hemorrhagic;
• pseudomembranous, etc.

Signs of reflux esophagitis in the chronic stage, with a medical examination using X-rays, may be a violation of the mucous membranes of the esophagus, the appearance of ulcers and erosions.

Diagnostics

Today, quite different methods are used to detect gastroesophageal reflux. Thanks to the x-ray of the esophagus, it is possible to fix the ingress of contrast from the stomach into the esophagus or to find a hernia of the esophageal opening of the diaphragm.

A more reliable method is long-term pH-metry of the esophagus (measurement of acidity in the lumen of the esophagus using a probe). This allows you to set the frequency, duration and severity of reflux. And yet the main method for diagnosing reflux esophagitis is endoscopic. With it, you can get confirmation of the presence of the disease, and determine the degree of its severity.

In general, the symptoms and treatment of reflux esophagitis depend on the severity of the disease, the age of the patient, and comorbidities. Some forms require no therapy, while others require surgery.

How to treat reflux esophagitis

When symptoms of reflux esophagitis appear, treatment consists in eliminating the disease that caused it (gastritis, neurosis, peptic ulcer or gastroduodenitis). Proper therapy will reduce the symptoms of reflux in adults, help reduce the harmful effects of gastric contents thrown into the esophagus, increase the resistance of the esophageal mucosa, and quickly clear the stomach after eating.

Conservative treatment shown to patients with uncomplicated disease. It includes general recommendations:

• after eating, avoid bending forward and do not lie down for 1.5 hours
• sleep with the head end of the bed raised by at least 15 cm,
• do not wear tight clothing and tight belts,
• limit the consumption of foods that are aggressive to the esophageal mucosa (fats, alcohol, coffee, chocolate, citrus fruits, etc.),
• give up smoking.

drug therapy with reflux esophagitis, at least 8-12 weeks are carried out, followed by maintenance therapy for 6-12 months. Appoint:

• proton pump inhibitors (omeprazole, lansoprazole, rabeprazole) in regular or double dosage,
• antacids (almagel, phosphalugel, maalox, gelusil-lacquer, etc.) are usually prescribed 1.5-2 hours after meals and at night,
• prokinetics - domperidone, metoclopramide.

To reduce the manifestation of symptoms such as heartburn and chest pain in the supine position, you should adopt the correct posture - the upper body should be slightly elevated, for which several pillows can be used.

Operation

This treatment is rarely used. Main indications for surgery:

• Ineffectiveness of long-term drug treatment.
• Development of Barrett's esophagus with the risk of malignancy (development of cancer of the esophagus).
• Esophageal strictures.
• Frequent esophageal bleeding.
• Frequent aspiration pneumonia.

The main method of surgical treatment is the Nissen fundoplication, which restores the normal functioning of the cardiac sphincter.

Diet

With reflux esophagitis, the diet is quite strict and prohibits eating a certain amount of food. Among them:

• alcoholic drinks, natural fruit juices, carbonated drinks;
• pickled and smoked foods, pickles;
• strong broths and soups cooked on them;
• fatty and fried foods;
• fruits (especially citrus fruits);
• spices, sauces;
• chewing gum;
• products that increase gas formation (cabbage, black bread, milk, legumes, etc.);
• products that relax the lower gastric sphincter and provoke stagnation of food masses in the stomach (sweets, strong tea, chocolate, etc.).

The diet of a person suffering from reflux should include the following foods:

• soft-boiled eggs,
• low-fat milk and mashed low-fat cottage cheese,
• dairy products,
• porridge,
• meat and fish soufflé,
• steamed cutlets and meatballs,
• crackers soaked in water or stale bread,
• baked apples.

• nutrition of patients suffering from reflux disease should be fractional and include five to six meals a day, the last - four hours before bedtime.
• portions should be small so that the stomach is filled with only a third of its volume.
• Afternoon sleep is better to replace with a quiet walk. This contributes to the fact that food quickly gets from the stomach to the intestines, and the reflux of acidic contents into the esophagus will not occur.

To reduce gastroesophageal reflux, you must:

• lose weight
• sleep on a bed with a high headboard,
• observe time intervals between meals and sleep,
• stop smoking,
• stop drinking alcohol, fatty foods, coffee, chocolate, citrus fruits,
• break the habit of drinking water.

Folk remedies

Treatment of reflux esophagitis with folk remedies can only be carried out as an auxiliary procedure. Alternative treatment of reflux esophagitis is based on taking decoctions that soothe the mucous membrane of the esophagus, products that stimulate the tone of the sphincter, reduce acidity and fight heartburn.

Forecast

Reflux esophagitis has, as a rule, a favorable prognosis for working capacity and life. If there are no complications, then it does not reduce its duration. But with inadequate treatment and non-compliance with the recommendations given by doctors, new relapses of esophagitis and its progression are possible.

Reflux esophagitis grade 1 - what is it? This question is of interest to patients. Reflux esophagitis of the first degree is a serious disease associated with violations of the closing functions of the digestive tract in the region of the lower esophageal sphincter, accompanied by inflammation of the esophageal mucosa. The disease occurs due to obesity, wearing clothes that compress the esophagus and provoke the release of its contents.

Causes of the disease

The main cause of the disease is the poor development of the neuromuscular esophagus. Most often this disease affects young children.

1. Due to the strong pressure inside the stomach, the activity of the gastrointestinal tract decreases. The result is a stomach ulcer and gastritis.
2. Weak intestinal motility occurs in moments of stressful situations. A frequent companion of the disease is poor nutrition. Abuse of sweet, spicy, alcohol leads to symptoms of esophageal disease.
3. Excessive use of drugs containing nitrites and prostaglandins. Smoking also contributes to the occurrence of reflux esophagitis of the first degree.

Signs of the disease

The main symptoms of inflammation of the mucous membrane of the esophagus are:

• pain in the stomach associated with damage and inflammation of the surface epithelium;
• hernia of the esophageal opening in the diaphragm and displacement of the stomach into the chest cavity.

Symptoms of the disease:

1. First of all, one manifestation that is always present is heartburn. Heartburn manifests itself during meals and is accompanied by belching, sometimes hiccups.
2. Pain behind the chest, similar to pain in the heart.
3. Violations of the swallowing reflex without signs of hiccups and heartburn, which indicate the onset of complications associated with cicatricial formations of the esophagus and its narrowing.

Classification of the disease. Medical classification of reflux esophagitis:

• Stage A. Erosive lesion of the mucosa, consisting of several erosions that are interconnected. Usually the affected area is 5 mm. This is peptic reflux esophagitis.
• Stage B. Lesions greater than 5 mm in size, connecting with each other, but not extending to the entire surface of the mucosa.
• Stage C. The spread of ulcerative foci occurs on a large area of ​​​​the esophageal mucosa, so reflux esophagitis of the 2nd degree develops.

• lifestyle adjustments: smoking, drinking, being overweight - these must be eliminated. All this is the main reason for the manifestation of reflux esophagitis of the first and second degree.
• Exclusion of heavy physical exertion associated with frequent bending, tension in the abdominal muscles. Avoid wearing tight clothing.

Treatment of narrowing of the esophagus must begin at an early stage of development. After an endoscopic examination, antisecretory drugs are prescribed that reduce acidity in the esophagus.

Why heartburn occurs

According to the results of the diagnosis, drugs are prescribed that improve intestinal motility. To diagnose the disease, daily PH is measured, which allows you to find out the acidity of the esophagus. The higher the acidity, the more pronounced reflux esophagitis.

An additional diagnostic study is esophagomanometry. According to the results of the study, it becomes possible to evaluate the contractile work of the lower esophageal sphincter. During disease of the esophagus, the sphincter is relaxed, and in this condition, manifestations of reflux increase.

Therapeutic diet for reflux esophagitis:

The basis of the diet for diseases of the esophagus is the rejection of the following products:

• chocolate, sweets, coffee;
• alcohol, smoking;
• fat-containing products;
• hot spices;
• fast food products.

Priority in nutrition is given to the following products:

• low-fat dairy and sour-milk products;
• boiled eggs, cereals;
• baked apples;
• dried fruit drinks.

Vegetable stews should be consumed with lean boiled meat, vegetable soups, acid-reducing drinks should be in the daily diet. It is important to observe a temporary diet. It is recommended to eat at least four times a day.

Regardless of the etiology, inflammation of the esophagus is defined by the general term "esophagitis". What is this pathological condition? What symptoms may indicate the presence of an ailment? How to deal with it? We will discuss all this in the article.

Types of esophagitis

All cases of inflammation of the esophagus in medicine are systematized, which helps, focusing on the duration of the disease, its severity and the place of the pathological process, to make an accurate diagnosis. So, depending on the nature of the disease, esophagitis is divided into acute and chronic. According to the severity of the disease, catarrhal (that is, superficial) and erosive (in this case, the deep layers of the mucous membrane are affected) esophagitis are distinguished. Depending on the location of the inflamed area in the esophageal mucosa, the disease can be total (if the entire esophagus is affected), proximal (the upper section is inflamed) and distal reflux esophagitis (pathology in the lower esophagus).

Acute, subacute and chronic disease

The most common is the acute form of esophagitis. Inflammation in this case can be both superficial and deep, but it is always distinguished by the suddenness and speed of development of manifestations. Such inflammation develops as a result of a mucosal burn caused by ingestion of hot food, drink or chemicals, past infectious diseases (for example, diphtheria), foreign body injuries, or radiation damage. Acute esophagitis usually resolves without serious consequences or complications for the patient.

Prolonged inflammation of the walls of the esophagus has a subacute or chronic form. The first can develop with the systematic use of too spicy food, strong alcohol or its surrogate, and the like. A chronic disease is most often caused by reflux (that is, the reverse movement of food from the stomach into the esophagus). Usually this disease accompanies a person for many years, gradually leading to serious changes in the work and structure of the esophagus.

Chronic reflux esophagitis

This is a burn that occurs due to the constantly repeated release or leakage of gastric juice or intestinal contents into the esophagus. Peptic esophagitis is caused by a relative and sometimes absolute failure of the obturator capabilities of the cardiac sphincter that separates the esophagus from the stomach. A rather serious role in the development of this chronic disease is played by the ever-increasing intragastric pressure and impaired motility of the gastrointestinal tract. Often this pathology is combined with a hernia of the food opening in the diaphragm, peptic ulcer or gallstone disease and pancreatitis.

Esophagitis: insufficiency of the cardia

Separately, I would like to dwell on the concept of "insufficiency of the cardia." The upper portion of the stomach is called the cardia. Here is the sphincter that closes the gap between the esophagus and stomach. During normal operation, it passes the food bolus only in one direction, reliably blocking its passage back. In this case, there is no special valve blocking the movement in the esophagus. Anatomically, the mechanism of the obturator function of the cardia is supported by the following structures:

• esophageal sphincter;
• diaphragmatic-esophageal ligament;
• "mucous rosette" (folds of the mucous membrane of the esophagus, which descend into the lumen of the stomach, playing the role of an additional valve);
• normal location of the esophagus in relation to the diaphragm;
• ring muscles of the upper part of the stomach.

If any of these structures does not work well, then cardia insufficiency occurs. And this is one of the serious aspects for the development of esophagitis. Due to the fact that the pressure in the stomach is normally always higher than in the chest cavity, a weakened or deformed sphincter for some reason allows the contents to return back and burn the unprotected esophageal mucosa. And repeated repetition of such a process causes serious pathological changes in this part of the gastrointestinal tract.

Causes of ulcerative esophagitis

If the emissions of acidic contents have become chronic, then the disease can penetrate deep into the mucous membrane of the esophagus, and erosion or ulcers form on it over time. True, the causes that cause ulcerative esophagitis are not only emissions, but also surgical interventions, holes, ulcers of the duodenum and stomach, infectious diseases, chemical burns, excessive intake of spicy food and damage resulting from the introduction of a probe or during radiation therapy.

This disease has several degrees characterizing it:

• The first degree is manifested by the appearance of separate, non-merging erosions in the lower part of the esophagus.
• Erosive and ulcerative esophagitis of the 2nd degree is expressed by the appearance of confluent erosions, which do not capture the entire mucosa.
• The third degree is accompanied by ulcerative lesions in the lower third of the esophagus;
• The fourth degree is a condition of chronic ulcer and stenosis (narrowing of the lumen of the esophagus).

Causes and consequences of candidal esophagitis

The disease occurs not only due to functional disorders in the gastrointestinal tract. It can be caused by infections that have penetrated from the outside, or even by “native” bacteria that, for some reason, have begun to grow rapidly. If the causative agent of the inflammatory process in the esophagus is candida, candidal esophagitis is diagnosed. This is the same thrush, but located on the walls of the esophagus. Candida fungi take root on human tissues very easily and, if the microflora of the digestive tract is disturbed, they begin to develop rapidly. Alcohol, hormonal (including contraceptives) or antibacterial drugs can cause changes in the microflora and, accordingly, the development of a fungal infection.

Candidiasis esophagitis is usually not life threatening, but it can cause a lot of trouble. Due to fungal inflammation, scarring can develop and, as a result, shortening of the esophagus. And this situation greatly increases the risk of axial hernia in the esophageal opening of the diaphragm. Candidal inflammation can cause ulceration, internal bleeding, and perforation of the described part of the gastrointestinal tract.

How dangerous is esophagitis?

I would like to emphasize: in no case should you underestimate esophagitis (that this is a serious disease, we hope you have already understood). It cannot be “tolerated” or drowned out by taking some kind of potion. The described condition is considered in medicine to be the most massive pathology of the esophagus, which leads to serious complications, such as, for example, it later causes the patient difficulty in swallowing and, accordingly, requires a reconstructive operation. Another life-threatening complication also needs surgical intervention - perforation (perforation) of the esophageal wall. Statistics claim that ten percent of patients with esophagitis develop the so-called which is characterized by the degeneration of the cells of its mucous membrane into cells characteristic of the intestinal mucosa. Such a condition in medicine is considered precancerous.

How to determine if you have esophagitis

All the types of disease described above have common signs that should make the patient suspect esophagitis. The symptoms and treatment of this pathology will be discussed below. Therapy should be carried out only under the supervision of a gastroenterologist.

All of these symptoms may be aggravated, for example, after a cup of coffee, smoking a cigarette, hot, hard or spicy food. There are frequent complaints of increased manifestations of the disease in stressful situations. It is clear that the set of symptoms in different patients may differ. It depends on the severity of disorders in the esophagus, and on the localization of the inflammatory process, and on concomitant diseases.

How to distinguish esophagitis from other diseases

Taking into account that the symptoms characteristic of the described disease can also be observed in some other pathologies of the internal organs that are not related to esophagitis and require a completely different treatment, it is necessary to clarify some of the nuances.

• Pain with esophagitis is not felt in the abdomen, but immediately behind the sternum, in the chest.
• Heartburn is usually the main symptom of the described disease. If, along with a burning sensation in the chest, you develop severe weakness, dizziness and shortness of breath, then it is more accurate to assume that there is no esophagitis.
• If a burning sensation in the chest appears from physical exertion, then this may be a sign of angina pectoris.

When is it necessary to visit a gastroenterologist?

We hope that esophagitis, the symptoms and treatment of which are discussed in this article, will not lead to serious consequences for you. To do this, you need to see a doctor in time! Do not delay visiting a specialist if heartburn has become permanent and is difficult to eliminate with drugs; her seizures are not always explicable; you have difficulty swallowing; your voice has changed, and the weight is noticeably reduced; blood appeared in the vomit; the temperature rose to 38 ° C and above; you have long persistent hiccups; the feces became liquid and turned black.

What diseases can be accompanied by inflammation of the esophagus

By the way, it should be mentioned, speaking about esophagitis, that this disease often appears in patients who already have some problems with the gastrointestinal tract. As a rule, we are talking about ailments that stimulate the increased aggressiveness of gastric juice or are accompanied by its excessive formation. The same applies to impaired motility of the gastroduodenal region (stomach and duodenum), slowing down its emptying. All this contributes to the distension of the stomach and, as a result, causes reflux.

Diseases that contribute to the development of esophagitis include gastroduodenitis, peptic ulcer of the stomach or duodenum, hernia of the diaphragmatic esophagus, cholecystitis and other pathologies. By the way, in pregnant women in the later stages of fetal development, the risk of developing reflux esophagitis is also high. This is due to an increase in intra-abdominal pressure in women.

What to do if you have combined esophagitis

It has already been mentioned above that esophagitis is often a complex disease that manifests itself against the background of other problems of the gastrointestinal tract. Therefore, if you have a combined diagnosis of gastritis-esophagitis, then the treatment should be comprehensive. Preparations are selected in accordance with the cause of gastritis and the level of acidity associated with this disease. Therapy also includes drugs that relieve heartburn, stabilize the motility of the esophagus and stomach, as well as substances that accelerate the healing of the mucosa. The same advice applies to treatment for a diagnosis of gastroduodenitis-esophagitis. It is important in the treatment of these diseases to follow diet No. 1, which involves sparing fractional nutrition. At the same time, overeating is strictly prohibited, and the last meal should be taken no later than two hours before bedtime.

How is esophagitis diagnosed?

Esophagitis, the symptoms and treatment of which we cover in the article, usually does not present difficulties in diagnosis. After the doctor listens to your complaints and examines your medical history, he should conduct some research. These include endoscopy of the esophagus, which will show changes in the mucosa, and x-rays using a contrast agent (barium). During the last procedure, a picture is taken, in which disturbances in the esophagus are clearly visible: its swelling and the presence of a large amount of mucus. And with the development of an ulcer, flowing of a contrast agent into its crater is visible.

How to treat acute esophagitis

The main task is to eliminate the causes of the disease, and in the future the patient must follow a strict diet. We are talking about the use of soft pureed food, which should have room temperature. All foods that irritate the mucous membrane of the esophagus are excluded from the diet, including those containing a large amount of fiber, as well as fried foods, soda and alcohol. Smoking for those suffering from this disease is dangerous! Patients diagnosed with "esophagitis" drugs that affect the tone of the esophageal sphincter are prescribed by prior agreement with the attending physician. These can be sedatives or tranquilizers, prostaglandins, and so on. It is advisable for patients to sleep on a bed with a high headboard, do not wear tight clothes, try not to lie down after eating and bend over less often.

Treatment of chronic esophagitis

In the absence of stenosis, perforation, bleeding, and the like, the prognosis for the treatment of the chronic form of the disease is favorable. As a rule, drugs that block the production of acid, antifungal or antiviral drugs, antibiotics are taken. Painkillers are also prescribed. Corticosteroids are recommended to reduce inflammation. If swallowing is difficult, the patient is given intravenous nutrition. In cases where the disease is due to the presence of a hole in the diaphragm, an operation is performed. Surgical intervention is also justified in case of unsuccessful conservative treatment, the presence of complications in the form of bleeding or stricture, and the development of such a dangerous pathology as Barrett's esophagus. It is good to combine conservative therapy with folk recipes that help alleviate the patient's condition.

Treatment with folk remedies

Alternative treatment of esophagitis is, as a rule, recipes aimed at relieving inflammation, alleviating painful manifestations and eliminating heartburn. So, to restore the mucosa of the esophagus, healers recommend taking a decoction of oregano, walnut leaves and oak bark. They are mixed in equal proportions and carefully crushed. One dessert spoon of the mixture should be poured with boiling water and held for fifteen minutes in a water bath. Take this decoction warm, two tablespoons before or immediately after meals.

In order to relieve swelling caused by the inflammatory process, take a mixture of oregano, alder and Ivan da Marya. They are mixed in equal quantities and crushed. Just like in the previous recipe, a spoonful of the mixture, filled with hot water, is kept in a water bath and taken up to seven times a day.

Perfectly removes inflammation and aloe. It is consumed by mixing with or without honey, simply by sucking on a piece of the peeled leaf. And although it will not be very tasty, but this tool will help very effectively.

The root will save from pain in the stomach. One teaspoon of crushed root is poured into a glass of boiling water and allowed to cool. After straining, take half a glass still warm half an hour before meals. And remember that during the day you need to drink at least two glasses of this infusion.

In addition to the treatment options described above, to alleviate the condition, some more prescriptions can be recommended:

• food should be soft, not spicy and not sour;
• eliminate juices from the diet, replacing them with fruit drinks containing vitamin C;
• bite off food in small pieces and carefully chew;
• with difficulty swallowing, tilt your head back, then the food will pass along the back of the throat, facilitating swallowing;
• drink liquid through a straw.

From the article, you learned about such a disease as esophagitis, what it is, what are the causes, symptoms and ways to eliminate the disease. Remember: healing requires discipline. In addition to taking the drugs and traditional medicine prescribed by the specialist, the patient must follow the prescribed diet and give up smoking and alcohol. Only in this way will the disease that prevents you from living a full life will recede. Good luck and good health!

This is a lesion of the esophagus caused by the reflux of the contents of the stomach in the opposite direction. Reflux esophagitis is not a separate disease, but one of the components of the development of peptic ulcer of the stomach and duodenum.

Causes of reflux esophagitis

As a result of disturbed nerve connections between the sections of the gastrointestinal tract, gastric juice with hydrochloric acid, as well as bile, appear in the lower sections of the esophagus. There is a so-called. The mucous membrane of the esophagus is not adapted to the effects of acidic contents and enzymes, therefore it reacts with inflammation.

The cause of reflux can be called mechanical pressure from the peritoneum through the diaphragm. This phenomenon occurs with overeating, a large abdomen (obesity, ascites), hernia of the esophageal part of the diaphragm, flatulence (bloating).

Taking drugs containing sedatives and antispasmodics (papaverine, platifillin, spasmalgon and others), which women are fond of with menstrual pain, migraine, can also cause reflux with subsequent inflammation.

Antispasmodics are included in many over-the-counter pain relievers.

Symptoms of reflux esophagitis in the initial stages

The classic manifestations are pain in the epigastric region, heartburn, belching with sour or bitterness, a feeling of "coma" in the esophagus when swallowing. Often, patients themselves associate symptoms with the intake of plentiful food, hard physical work in the forward bending position.

Sometimes there is hiccups, salivation, nausea.

If symptoms occur once a month, then functional disorders quickly recover on their own. With more frequent complaints, it is necessary to undergo an examination by a gastroenterologist.

Diagnosis of reflux esophagitis 1 degree

Inflammation of the esophagus is visually detected by a doctor conducting esophagogastroscopy.

The method is based on the introduction of a thin tube with an optical device at the end into the stomach and upper part of the duodenum. It allows you to examine all parts of the esophagus.

In the first stage of esophagitis, the esophageal mucosa is intensely red in color with erosion (crack or scratch).

Treatment of reflux esophagitis of the first degree

To eliminate the initial stages of esophagitis does not require special medicines.

It is enough to comply with some conditions:

• do not overeat, provide six meals with small amounts of food;
• stop drinking alcohol, carbonated drinks;
• do not eat at night;
• get rid of excess weight;
• do not lean forward after eating;
• do not wear tight belts and clothes;
• stop taking antispasmodics and sedatives;
• no smoking.

A good effect is provided by folk remedies in the form of decoctions of herbs, medicinal teas.

Children love dandelion flower syrup: pour dandelion flowers and granulated sugar in layers in a glass jar, crush on top. Steep until juice is formed. One teaspoon of juice is diluted in half a glass of water, taken before meals three times a day.

Brew marigold flowers, lemon balm leaves, oregano, plantain as tea in a tablespoon per glass, take 1/3 before meals.

Having learned about such a diagnosis as reflux esophagitis of the 1st degree, most patients do not understand what it is.

Such a pathological process is not a separate disease, but only one of the main elements in the formation of gastric and duodenal ulcers.

It is damage to the esophagus caused by the reflux of gastric contents back. Eliminating the pathology at the preliminary stage is quite simple.

Causes

A variety of factors are capable of provoking distal reflux esophagitis of the 1st degree, which can be eliminated independently by observing a balanced diet or with the mandatory use of medications.

The main causes of this disease include:

• 2nd and 3rd trimester of pregnancy, when the fetus begins to compress the digestive organs and provoke involuntary opening of the sphincter;
• 1 trimester of pregnancy, during which the contents are thrown due to toxicosis;
• accumulation of a significant amount of fluid in the abdominal cavity;
• increased body weight and obesity;
• wearing tight clothing, in particular, tight belts and corsets are dangerous;
• the use of medications - calcium channel blockers and nitrates often provoke pathology;
• a hernia that develops in the opening of the diaphragm;
• regular smoking and alcohol abuse;
• stressful situations and physical stress after eating;
• constant overeating;
• congenital weakness of the food sphincter or its complete failure;
• dry and recurrent cough.

Often, erosive reflux esophagitis of the 1st degree is provoked by diseases of the digestive organs of a chronic nature, which include ulcers, gastritis, pancreatitis, and gallstone disease.

In almost all cases, they are accompanied by the development of insolvency of the sphincter of the esophagus and stomach.

Symptoms

The clinical symptoms of this pathology are diverse. It is worth saying that the severity of all manifestations does not depend on changes inside the esophagus, which complicates proper diagnosis.

Symptoms of the disease are divided into 2 large subgroups:

• Those associated with damage to the esophagus (heartburn, dysphagia, belching, pain in the retrosternal region and regurgitation).
• Those that are not associated with the esophagus: cough, dryness in the larynx, hoarseness, shortness of breath, increased salivation, carious lesions, and others.

According to a patient survey, the most common symptoms are heartburn and sour belching, often occurring during sleep or when leaning forward.

No less common manifestation of pathology are pain in the retrosternal part, which mimic angina pectoris. Other symptoms do not appear very often.

• Heartburn and belching. They are the most popular complaints in patients who have 1 degree reflux esophagitis. Heartburn is a burning sensation of varying intensity in the retrosternal area or near the shoulder blades. It is noted in 9 patients out of 10. The provoking factor of occurrence is the action of gastric contents with an extremely low pH on the mucosa of the lower esophagus. The specialist and the patient need to take into account that the intensity of heartburn does not reflect the severity of damage to the esophagus. At the same time, seizures are observed more often in violation of dietary nutrition, taking a variety of highly carbonated drinks and alcohol, during physical exertion and during sleep. Belching and regurgitation of food is noted in half of the patients. Most often, symptoms appear after eating.
• Pain in the retrosternal region. Discomfort is concentrated behind the sternum, between the shoulder blades and is able to move to the cervical region, lower jaw, left side of the chest. Very often, the symptoms are similar to angina attacks, but they cannot be stopped by the use of nitroglycerin. In view of this, in order to exclude angina pectoris, myocardial infarction and other pathological processes, it is necessary to focus on the causes that provoked painful sensations. Retrosternal discomfort is often associated with a negative prognosis for the patient, in particular when combined with rapid weight loss and impaired swallowing.
• Dysphagia. Impaired swallowing, which is observed less often than other signs, is interconnected with impaired movement of a lump of food through the esophagus. One of the rare manifestations of the pathological process, along with extraesophageal symptoms.

Diagnostics

To make a proper diagnosis, it is possible to use the following examination methods:

• Radiography using CV. It makes it possible to assess the motor ability of the esophagus, to establish a wall diverticulum, a variety of strictures and narrowing of the esophageal gap, indirect manifestations of inflammation in the wall (thickening, blurring of outlines).
• Endoscopy with or without 24-hour intraesophageal pH monitoring. It is the best method of examination. In addition, directly endoscopic diagnosis makes it possible to properly establish the severity of the pathological process in question. Such a diagnosis helps to detect changes in the esophagus and to identify the intensity and frequency of reflux of stomach contents.
• Assessment of esophageal motility. It makes it possible to assess the evacuation capacity of the organ and the functioning of antireflux mechanisms.
• Morphological diagnosis of the esophageal wall. It is of key importance in the detection of Barrett's esophagus (a precancerous condition characterized by pathological changes in the esophageal wall) and adenocarcinoma.

It should be borne in mind that all the above methods of examination are supplemented by the history of the disease and the life of the patient, his complaints. None of the diagnostic methods will give accurate information.

Treatment of the disease

In the treatment of the pathological process under consideration, non-drug and medicinal methods of treatment are of key importance.

It must be remembered that the appointment of therapy is carried out by a specialist after a comprehensive examination of the patient, taking into account indications and contraindications.

Non-drug methods

Any patient with grade 1 reflux esophagitis is required to adhere to the following prescriptions:

• Do not eat large meals and prevent overeating, in particular before bedtime. It is necessary to observe fractional nutrition with the consumption of small portions. Reduce the amount of fatty, spicy, sweet, the use of which serves as a provoking factor in the pathology. Use with caution drugs that contribute to the reflux of gastric contents into the esophagus (sedatives, theophylline, nitrates, verapamil and other calcium channel inhibitors).
• Reduce the amount of physical activity that is associated with lifting weights and tension of the abdominal muscles.
• Sleep with your head up.
• Eliminate bad habits (smoking and alcohol abuse).
• Reduce excess weight.

Medicinal methods

For the treatment of the disease in question, for a long time they use drugs that promote and reduce the acidity of pancreatic juice, and also accelerate the movement of food masses through the esophagus:

• Medicines that reduce the acidity of pancreatic juice. Such treatment is aimed at increasing the pH of the gastric juice and lowering its ability to damage the esophageal mucosa. The most effective in this case will be proton pump inhibitors (omeprazole, rabeprazole, etc.), which inhibit the production of hydrochloric acid and increase the pH level. Less often used are H2-histamine receptor blockers (Ranitidine, Famotidine), which reduce acidity, but are less effective.
• Means that accelerate the passage of food masses through the esophagus and prevent the reflux of gastric contents into the esophagus. These medications include Domperidone, Cerucal and others. They are also used as the only drug in combination with lifestyle changes in the pathology under consideration.

This disease is characterized by mild symptoms (heartburn, belching). Often it does not provoke anxiety in patients.

But, the progression of pathology without proper therapy can cause the formation of dangerous consequences, including cancer.

If the initial manifestations of the disease appear, it is required to immediately seek advice from a doctor in order to carry out timely diagnosis and prescribe appropriate therapy.

Medicines must be used under the supervision of a specialist, since it is necessary to draw up an optimal set of medicines for each patient, taking into account the provocative factor of the pathology in question.

When the patient simultaneously adheres to dietary nutrition and does not have diseases of the digestive organs of a chronic nature, it will be possible to completely get rid of the disease and prevent its progression.

Prevention

For the preventive purposes of the pathological process and its recurrence, it is required to remove all the factors that provoke the onset of the disease:

• normalize the quality, quantity, calorie content of food;
• control weight;
• train the abdominal muscles;
• eliminate bad habits;
• adhere to the frequency of nutrition;
• adjust sleep patterns.

Reflux esophagitis at the initial stage is a reversible condition. Therefore, it is necessary to consult a doctor in a timely manner for diagnosis and initiation of appropriate treatment.

Reflux esophagitis of the 1st degree is infrequently an independent disease. It is often provoked by pathologies of the digestive system.

In such a state, it is imperative to follow a diet and use prescribed medications.

With timely treatment, it will be possible to fully restore the esophageal mucosa and eliminate pain, heartburn and intestinal disorders.

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