Gastroesophageal reflux - symptoms and treatment. Traditional and folk therapy for reflux esophagitis

Reflux is the reverse flow of the contents of hollow organs in comparison with its normal movement.

This may be a natural phenomenon for a given physiological process or a consequence of the development of various pathologies. Often the cause is dysfunction of the sphincters that separate the hollow organs. The substance that moves in the opposite direction from the natural direction is called refluxate or refluxate.

Usually two organs (departments) are involved in reflux. The first will be the one from where the cast comes from, the second - where the refluxate comes from. For example, it can be gastroesophageal, duodenogastric, vesicoureteral.

In some cases, reflux denotes not only the moment when the contents of one organ are thrown into another, but also a pathology, the cause of which is this physiological process. This is typical for vesicoureteral and pharyngolaryngeal reflux. It is important to understand the difference between gastroesophageal reflux (GER), which is considered a physiological act that is not always a pathology, and gastroesophageal reflux disease (GERD).

Common Types of Reflux

Gastroesophageal or gastroesophageal - in this case, the contents of the stomach enter the esophagus.
Duodenogastric - when the contents of the duodenum enter the stomach.
Duodenogastroesophageal or duodenogastric, in which the contents of the intestine reach the esophagus. It is a pathological disease.
Duodenogastroesophageal or duodenogastric, in which the contents of the duodenum reach the mouth.
Pharyngolaryngeal - the contents of the stomach enter the pharynx. It is always a pathological form. Occurs due to a disorder of the upper esophageal sphincter.

That's what reflux is. Let's take a closer look at some of its forms.

Reflux esophagitis

This disease is one of the most common pathologies that are characteristic of the esophagus. Due to the fact that the mucous membrane of this organ does not have protection from various aggressive substances, contact with them can significantly damage the epithelium. The resulting inflammatory process in the esophagus provokes pain.

Alas, it is simply impossible to trace the actual frequency of this pathology, since the disease passes with mild symptoms, and patients do not even seek help from doctors. There is also a category of patients with permanent pronounced signs of the disease that require outpatient treatment. The most dangerous are refluxes with complications such as ulcers and various bleeding. This requires mandatory hospitalization and thorough treatment.

Consider what reflux esophagitis is in more detail.

Reflux esophagitis often occurs against the background of pathologies in the gastrointestinal tract (with gastritis, ulcers, erosion). It can also be a sign of a hernia in the region of the esophageal opening of the diaphragm septum. How does this disease manifest itself? The symptoms of reflux are listed below.

Signs of pathology

Each age group has its own signs of this disease. So, reflux esophagitis in infants manifests itself in the form of belching and frequent regurgitation, sometimes accompanied by vomiting of milk. During the lifting of the baby in a vertical position, a decrease in the mentioned symptoms can be observed, and immediately after the next feeding they may appear again. If you continue to stay in a horizontal state, reflux may increase. For this reason, after feeding, mothers carry their babies in a "column", that is, vertically, for some time until the baby burps.

Reflux symptoms can vary among different age groups. For older children, an important feature is the presence of complaints of disturbing frequent heartburn and belching of acidic fluid. In addition, there is often a burning sensation in the area behind the sternum. These types of symptoms are most noticeable after eating, as well as when bending the body and at night. Reflux in a child should not be ignored.

It is noteworthy that delayed gastric emptying occurs in 50% of the total number of all patients who are diagnosed with esophageal reflux. Due to the stretching of the volume of the stomach, the amount of contents in it also increases. This, in turn, is a prerequisite for the formation and development of the disease.

With reflux in a child, the reflux of substances that were the contents of the stomach into the esophagus occurs for a number of reasons. It is noteworthy that it is considered to be the norm, which can be present even in completely healthy infants and older children. In infants, it is noted in the form of brief episodes. They frequently regurgitate milk or formula. If the disease is uncomplicated, then therapy is not required. The frequency of reflux in babies will decrease over time, because the angle between the stomach and esophagus will increase.

In a child, you can most often detect the presence of:

refusal to eat;
severe vomiting;
hiccups;
arching of the back and neck;
frequent cough;
changes in the timbre of the voice;
aspiration during regurgitation;
ear inflammation;
swallowing disorders;
poor weight gain.

In relation to adults, it should be said that here most often one can notice pain in the area behind the sternum, a lump in the throat, and heartburn. Some patients also experience extraesophageal signs of the disease. These include manifestations such as sinusitis, caries, damage to tooth enamel, pharyngitis and inflammation of the larynx. The disease can also be similar to bronchial asthma - a person suffers from a strong cough and shortness of breath. By looking at the symptoms, you can better understand what reflux is.

stages

The disease, as already noted, is present in many. But it may proceed differently. It depends on the stage of the disease. There are the following degrees of reflux:

The initial stage of the development of the disease is considered gastroesophageal reflux disease, that is, reflux without esophagitis. It is often referred to as non-erosive reflux disease. The main characteristic of the initial stage is that during the study of the esophagus, ulcerative changes in the mucosa are not detected.
1 degree. The presence of separate areas with point-sized erosions is noted. There is mucosal edema and hyperemia. There may be no obvious signs, which makes it difficult to make a diagnosis.
2 degree. It has an erosive form. The size of erosions is 5 mm, they are merging and multiple.
3 degree. On examination, extensive areas with ulcers on the mucosa are noted. Symptoms of the disease cause anxiety regardless of food intake.
4 degree. It is characterized by the presence of gastroesophageal reflux. That is, an extensive ulcerative lesion of the esophagus, an area of more than 75% of the entire surface. Poorly treated, often turns into cancer.

If you experience discomfort during or immediately after eating, frequent heartburn, you should immediately consult a doctor. He will conduct an examination and prescribe a comprehensive treatment that will prevent complications and serious consequences.

Forms

This disease can be acute and chronic:

The acute type of gastroesophageal reflux is expressed in inflammation of the esophageal walls and painful sensations that are relevant when eating. Typical for him are symptoms such as fever against the background of general malaise, as well as pain behind the sternum. In addition, there is a burning sensation and pain in the neck area, along with profuse salivation and belching, and there is also a violation in the correct function of swallowing.
Reflux of the chronic type is expressed by the corresponding inflammation of the walls of the esophagus, which is accompanied in parallel by the appearance of pain behind the sternum. Often this can be accompanied by gastritis. Unpleasant symptoms can make themselves felt when running, in addition, hiccups, difficulty in swallowing and heartburn, accompanied by vomiting, may also occur.

Symptoms of biliary reflux gastritis

Reflux gastritis may be biliary. The reason for this pathology is the reflux of bile moving along the bile ducts back into the stomach.

With the biliary type of gastric reflux, the symptoms are manifested in a feeling of heaviness. As well as overflow in the stomach, which is relevant during a meal or immediately after it. Additionally, there is the presence of bitterness and belching, an unpleasant aftertaste felt in the mouth, nausea, all kinds of stool disorders, such as constipation, which alternate with diarrhea and bloating. Mostly biliary reflux is not expressed as a pain symptom. If it occurs, it is dull and aching in nature, which is aggravated after eating. It should be noted that the described disease leads to the pathology of assimilation of the necessary nutrients by the body. In this regard, there is a significant weight loss, general weakness, the formation of jam on the lips, dry skin.

Causes of biliary reflux

This type of disease is associated with disorders of the biliary system, with problems in its motility, that is, with dyskinesia and uncoordinated functioning of the sphincters.

Due to the formation of such disorders that occur due to bile enzymes, as well as the pancreas, the contents that are in the duodenum enter the stomach and significantly burn it, forming the well-known gastritis. Very often, biliary reflux can be combined with a diagnosis of duodenitis, in other words, inflammation of the duodenum. Doctors attribute this combination to irritation that is produced by bile secreted outside of healthy digestion.

Symptoms of erosive reflux

With this form of the disease, the esophageal mucosa can be deeply affected. Symptoms include heartburn, nausea, occasional vomiting, and belching. There is pain behind the sternum, it becomes difficult to swallow and a lump is felt in the larynx. Despite the fact that these symptoms are generally characteristic of esophagitis, in this situation they are more likely to be more pronounced, which means they bring more anxiety and discomfort to the patient.

The development of the disease can provoke errors in nutrition, consisting in the use of all kinds of acidic foods, caffeine and alcohol. Often the course of the disease can be aggravated by medications, even such harmless ones as the usual paracetamol, aspirin, analgin.

How to get rid of the disease

In order to treat reflux, regardless of its form, it is necessary to eliminate, first of all, the root cause. These include gastritis, neurosis, peptic ulcer or gastroduodenitis. With proper treatment, the symptoms of reflux will subsequently become less pronounced. In parallel, it will be possible to reduce the harmful effects of gastric contents entering the esophagus.

The first stage of treatment is nothing more than a proper reflux diet, during which tomatoes, caffeine, spicy, fatty foods, chocolate, citrus fruits should be excluded. It is also important to give up bad habits - stop smoking and not drinking alcohol.

The last meal should be no later than three hours before bedtime. Overeating has a very negative effect on the digestive tract. You need to eat in small portions, but quite often - up to six times a day.

When diagnosed with reflux esophagitis, the patient should reduce the diet of dairy and other products that cause bloating:

fresh or sauerkraut;
black bread;
green peas and beans;
mushrooms;
fresh berries, fruits;
carbonated drinks.

In this case, it is allowed to include in food:

eggs, but soft-boiled;
cottage cheese;
cereal products;
crackers and stale bread;
meat or fish soufflé;
steamed lean meat meatballs;
baked apples;
compote.

In addition, the doctor in such cases prescribes drugs, the effect of which significantly reduces the amount of acidity in the stomach (antacids). Due to this, intestinal motility is normalized. You also need to put extra pillows during sleep. This measure helps to reduce heartburn, as well as pain that may appear in the sternum. The reflux diet must be followed.

Thus, in order to diagnose the disease, it is recommended to contact a gastroenterologist. Based on the patient's complaints, the severity of the pathology and duration, as well as the endoscopic and morphological assessment of the changes, appropriate treatment is prescribed.

Treatment of reflux with folk remedies

Effectively helps in the fight against reflux dandelion. Rinse the yellow inflorescences of the plant thoroughly and put in a 3 liter jar. Fill the container to the top. Sprinkle the flowers with sugar and leave until the juice appears. Dandelion syrup is diluted with water and drunk daily before meals.

To prevent and cure this disease, you should drink celery juice. It is better to do this on an empty stomach for 1 tbsp. l. half an hour before meals.

To alleviate symptoms and eliminate inflammation, you can use dill infusion. To prepare it, grind 2 tsp. seeds and pour boiling water over them. The container is covered and kept for three hours. Take four times a day for 1 tbsp. l.

Herbal decoctions can relieve inflammation and relieve pain by normalizing the acidity of gastric juice. The most useful are:

motherwort herb;
licorice;
Melissa;
flax-seed.

You can combine these components with each other. All ingredients are ground to powder. Each plant must be taken 1 tablespoon, pour boiling water. Heat in a water bath for 10 minutes. With esophagitis, you need to take 60 ml 4 times a day.

For heartburn and belching, a different prescription should be used. To do this, calamus, rosehip, valerian and dandelion flowers are mixed in equal proportions and poured with boiling water. The mixture is infused for fifteen minutes. A teaspoon of infusion is taken on the first day. 30 ml of pure water is added to it. Take 3 times a day before meals. On the second day, a large spoonful of water is added. In the rest, the dosage is increased to 2 tbsp. l. The course of therapy in this way is sixty days.

You can use plantain juice. It has a powerful healing effect. It should not be drunk by people with high stomach acidity. Juice is easy to make. To do this, you need to take well-washed leaves and grind in a blender. Then squeeze through gauze. Juice drink 1 tablespoon during meals. Do not use more than four times a day.

Flaxseed-based products have enveloping properties.

With reflux esophagitis take honey. It is best to do this an hour or two before meals. Doctors advise diluting it with water, as it is more gentle on the stomach. The course of therapy is about 2 months.

We looked at what reflux is and how to properly treat it.

With reflux esophagitis, there is a pathological ejection of stomach contents into the esophagus. Erosive reflux esophagitis occurs due to chronic irritation of the esophagus with acid: ulcers and erosion appear on the mucous membranes. Reflux esophagitis is characterized by severe pain. Consider the features of the course of reflux esophagitis, the symptoms and treatment of this disease.

The main reason for this disease is that acidic contents enter from the stomach into the esophagus. This happens because the esophageal sphincter is in a relaxed state (which should not be normal).

In a healthy organ, the sphincter relaxes for only a few minutes to allow food to pass into the stomach. Further, it contracts, which prevents acid from getting back from the stomach.

Reflux esophagitis occurs in humans with such pathologies of the gastrointestinal tract:

an ulcer in the stomach (it may appear due to excessive activity of the Helicobacter bacterium);
cancerous tumors of the stomach;
pathological conditions of the vagus nerve;
pathology of the lumen of the duodenum;
chronic inflammatory disease of the pancreas;
prolonged inflammatory process in the gallbladder;
pylorospasm;
hernia of the esophagus.

Sometimes the reflux of the contents of the stomach into the esophagus occurs after surgical interventions on the stomach. Erosive esophagitis sometimes occurs in those patients who abuse strong alcoholic beverages, smoke a lot, drink excessive amounts of coffee.

In some people, part of the stomach may enter the chest (normally, the organ is entirely in the abdominal cavity). This anomaly occurs in obese individuals.

Pathogenesis

The human esophagus consists of mucous, muscular and external tissues. On the mucous membrane there are several folds that facilitate the process of getting food into the stomach. The muscular layer in the esophagus is necessary to facilitate this process. They form two sphincters, with the lower one located on the border between the two organs. They serve to prevent food from entering the esophagus from the stomach. It can only open when swallowed.

Normally, a person may have several dozen physiological reflux of food into the esophagus. But signs of pathology are not observed. And only when the sphincter system is disrupted, a person may experience symptoms of reflux esophagitis.

The appearance of esophagitis, reflux esophagitis is also associated with impaired functioning of the protective functions of the esophagus. Such conditions are most often created with poor nutrition, mechanical irritations, etc. I must say that a significant part of patients do not know what it is - reflux esophagitis, and do not pay enough attention to the normal process of chewing food. Frequent injuries of the mucosa and lead to disruption of the esophageal sphincter and the development of gastric diseases.

The erosive form is a complicated type of reflux esophagitis. In this case, small sores appear on the mucous membrane of the organ - erosion. Symptoms of reflux become pronounced, bring the patient some discomfort. Due to erosion, the pain increases significantly after eating, consuming Acetylsalicylic acid.

Stages and symptoms

This disease is characterized by several stages.

At the first stage, separate erosions form on the mucosa, which do not merge and do not capture a significant part of the esophagus.
The second stage is called confluent, because small ulcers and erosion areas become larger and larger. At the same time, they capture a small part of the esophagus.
In the third stage, the lower third of the organ is affected.
At the fourth stage of the disease, stenosis of the esophagus, a chronic ulcer is observed.

Note! Often in the third or fourth stage of the disease, the patient is recommended surgery. It is associated with certain risks and complications.

To prevent this from happening, you need to contact a specialist immediately after the appearance of unpleasant symptoms of diseases of the abdominal organs. It is especially difficult to treat advanced ulcerative esophagitis.

When esophagitis occurs in adults, there may be discomfort that occurs in the chest cavity. They give to the region of the heart and shoulder. Often, patients may not associate the appearance of such pain with the esophagus and take (most often uncontrolled) heart medications. Naturally, they do not give any result.

Reflux esophagitis has many manifestations. The most characteristic of them are:

belching (it can be either air or stomach contents);
painful heartburn;
nausea turning into vomiting;

frequent regurgitation (it often happens in children);
acid taste in the mouth;
dysphagia (in this case, the patient feels difficulty in the normal swallowing of food);
a cough that lasts for a long time at night (it occurs due to the so-called microaspiration of small particles of food from the esophagus into the upper respiratory tract);
damage to the teeth by caries due to the ingress of acid into the oral cavity;
hiccups.

Important! Without treatment, esophagitis can last for years. His symptoms may get worse. This inevitably leads to the formation of scars on the mucosa of the esophagus.

All manifestations of reflux esophagitis increase significantly after a person lies down. In a standing or sitting position, pain, heartburn or hiccups almost do not bother.

Sometimes the patient may feel signs of pharyngitis, nasal congestion. These signs appear because the acidic contents of the stomach irritate the throat, which makes the patient tickle in the throat.

Features of diagnostics

If a patient is suspected of reflux esophagitis, his treatment is possible only after a correct diagnosis. Diagnosis occupies an important place, because it depends on how to further treat reflux esophagitis, what medications to prescribe to the patient.

Diagnostics consists of the following measures:

Interview with the patient. When collecting an anamnesis, the doctor identifies the characteristic complaints of the patient, the duration of the symptoms and the degree of their severity.
Examination of the oral cavity. The presence of affected teeth, inflammation of the mucous membranes suggests that the patient may develop reflux.
Palpation.
FEGDS is the main diagnostic method, on which further treatment will depend. In this case, a thin fiber optic probe is inserted through the patient's mouth. The state of the gastric and esophageal mucous membranes is being studied. Using the latest computer technology, the image is displayed on the screen. With reflux esophagitis, the mucosa is hyperemic and colored in red shades.
Radiography is performed using a special contrast agent (barium sulfate). Suspension does not have a pronounced taste, non-toxic to humans. With the pathology under consideration, the movement of barium suspension into the esophagus will be visible.
Examination of the acid index of the esophagus. In pathology, it will be reduced, since the penetration of gastric juice into the esophagus "acidifies" its membranes.
Esophagomanometry evaluates the normal contractile activity of the lower sphincter. This method clarifies the diagnosis.
The cardiogram is carried out for the purpose of differential diagnosis.
X-ray of the chest organs is performed to exclude pathologies of the lungs.

Remember that esophagitis can be cured when this disease is most accurately determined.

What is dangerous esophagitis

Do not assume that reflux esophagitis refers to "harmless" and "safe" pathologies. If left untreated, a person may develop the following dangerous diseases:

The appearance of ulcers on the esophageal mucosa may be in a patient if he suffers from the disease for a long time. For the treatment of hemorrhages, an endoscopic operation is used, which consists in the fact that with the help of a mini-electrocoagulator, cauterization of the vessel is done.
Esophageal stenosis develops in humans due to a chronic inflammatory process on its mucosa. The patient complains of pain during swallowing and the sensation of a lump in the throat. For treatment, a rather complicated surgical operation is performed.
Barrett's syndrome is a dangerous risk of developing a malignant neoplasm.

The sooner the patient sees a doctor for the treatment of reflux esophagitis, the easier his treatment will be.

Nutrition and lifestyle

For the treatment of such a disease, diet is very important. Practice shows that drugs to reduce the acidity of gastric juice and other pills will not be effective if the patient eats junk food. It will not bring a healing effect.

Can reflux esophagitis be cured with the right diet? In some cases, it is possible to cure esophagitis forever if you adhere to proper nutrition and take medications prescribed by your doctor.

The way of life of a patient with chronic reflux esophagitis should be like this.

It is necessary to completely eliminate all nervous overload.
Get enough sleep (at least 8 hours). Moreover, it is necessary to ensure that the head is slightly higher than the body. At the same time, the number of refluxes at night can be significantly reduced.
Five meals a day are necessary: it will eliminate long breaks in eating and overeating.
In the treatment of erosive reflux esophagitis, it is very important not to lie down after eating. Again, avoiding overeating will not make the patient want to take a nap after dinner. But walking in such cases is useful.
To prevent the causes of reflux esophagitis, you do not need to wear tight clothing and belts.
It is forbidden to lift weights, because this increases the symptoms of reflux esophagitis.
It is necessary to exclude the use of drugs that cause relaxation of the esophageal sphincter.

The following foods and drinks are prohibited:

alcohol;
soda;
coffee, black tea;
chocolate products;
seasonings;
legumes;
marinades, pickles, smoked products, canned foods;
fatty food;
sour juices;
Rye bread;
shop sauces, including mayonnaise;
all snacks and fast food;
chewing gum;
all fried foods.

For a patient with reflux esophagitis, the following therapeutic diet is useful:

sour cream and low-fat milk;
soft-boiled eggs;
cottage cheese (preferably low-fat);
dried bread;
cereals;
steamed dishes;
salads and vegetable stews;
lean fish, meat.

Note! A diet with this pathology should be followed throughout life. This is the only way to prevent relapses and complications.

Of course, with chronic reflux esophagitis, nutrition is not limited to the above meals alone. There is a large amount of nutritious and tasty food that does not cause an exacerbation of the disease.

Treatment

How can reflux esophagitis be treated with medication?

First of all, we note that people, not knowing why there are exacerbations of reflux esophagitis and what it is, try to choose the “most suitable” medicine for themselves in the pharmacy. This is absolutely impossible to do, because this can only worsen the state of health. Only a doctor can choose a drug. Treatment of reflux esophagitis should not occur on its own.

The causes and treatment of this disease are interrelated: the doctor selects the right medicine only after finding out all the factors that led to it. As a rule, such drugs are prescribed:

Prokinetic drugs are needed to improve the tone of the lower esophageal sphincter. This is Motilium, Ganaton.
Antacids are needed to effectively reduce the acidity of gastric juice. Among them, many doctors pay attention to Almagel - he effectively fights the manifestations of hyperacidity of gastric juice.
Antisecretory agents are represented by hydrogen pump inhibitors (omeprazole or famotidine).

If the patient has symptoms of reflux esophagitis, treatment may continue for up to 6 weeks. It all depends on the severity and stage at which the disease is diagnosed.

Folk methods

How to cure reflux with unofficial remedies? Informal medicine knows many effective ways to treat the disease in question. Before treating reflux esophagitis, you need to contact a therapist: he will help you choose the most effective method for getting rid of the disease.

Consider some ways to treat the manifestations of reflux esophagitis in non-drug ways.

Reduces the intensity of inflammatory phenomena medicinal mixture of chamomile, flax, dog nettle, lemon balm leaf, licorice. To prepare a decoction, you need to take 2 tbsp. l. plants and brew in boiling water, evaporate in a water bath for 10 minutes. Drink a third of a glass, 4 times a day.

A mixture of calamus, anise, yasnitka, oregano, mint leaves, marigolds and fireweed (2 tablespoons) should be poured with water and heated in water. Drink half a cup 6 times a day.

Highlander root, plantain leaf, shepherd's purse, dandelion flowers, chamomile, yarrow grass, oregano are mixed, steamed in water. The decoction must also be consumed the same number of times in the same quantity.

This treatment should be combined with drug therapy.

Prevention

It is much easier to prevent this disease than to treat it. It is necessary to adhere to such recommendations:

avoid emotional stress;
do not abuse alcoholic beverages, and even better - completely abandon them;
no smoking;
avoid foods that irritate the esophageal mucosa;
eat more often and in small portions;
avoid hypodynamia, do exercises every day, play sports;
after eating, you do not need to lie down, but walk a little.

So, reflux esophagitis should not be taken lightly. You need to start getting rid of it as soon as possible. Self-medication is extremely dangerous, because it can lead to relapses and complications. Only early and comprehensive diagnosis, a healthy diet will help keep the esophagus in good condition.

Gastroesophageal reflux is the pathological backflow of part of the contents of the stomach into the overlying part of the digestive system - the esophagus. This condition, which is also called gastroesophageal reflux, is normally almost not observed in healthy people, often serves as a background for inflammatory-dystrophic processes of the esophagus and respiratory tract.

Gastric contents (chyme with gastric juice) at all stages of digestion are highly acidic (pH 1-4) due to the presence of hydrochloric acid. When it enters the esophagus (gastroesophageal reflux), in the lumen of which there is often a neutral reaction, damage to the mucous membrane is observed in the form of redness (hyperemia), erosion. With the involvement of the deep parts of the esophagus, as well as with prolonged exposure to an aggressive factor, in some cases, esophageal ulcers can form and even tumor transformation (development of esophageal cancer) can be observed.

Causes of gastroesophageal reflux

The cause of duodenogastric reflux can be an imbalance in the work of the gastroesophageal sphincter (smooth muscle that normally prevents the contents of the stomach from entering the esophagus), a violation of the nervous regulation of this muscle formation due to diseases of the stomach, other adjacent organs, a failure in autonomic innervation. Chronic gastritis, inflammation of the duodenum, tumor processes in the cardial part of the esophagus, stomach, and peptic ulcer of various localizations often lead to gastroesophageal reflux.

Work associated with prolonged and regular lifting of weights can increase intra-abdominal pressure and form an esophageal hernia of the diaphragm (stretching of the diaphragmatic opening), and this, in turn, can lead to duodenogastric reflux.

With age, there is a weakening of the entire muscular system, sphincters, including the gastroesophageal. Therefore, duodenogastric reflux in the elderly is a common occurrence, especially against the background of regular overeating, diabetes mellitus, hypothyroidism and obesity.

The pathology of other parts of the digestive system can affect the course of the disease and cause gastroesophageal reflux. For example, chronic pancreatitis with symptoms of flatulence (bloating), colitis with chronic constipation, increase intra-abdominal pressure and contribute to the progression of the reflux of stomach contents into the esophagus.

Chronic constipation, chronic hypomotor colitis, dolichosigma, slow transit of colonic contents may contribute to reflux if other factors are present. constipation cause an increase in pressure in the abdominal cavity, which, with a long history of the disease, especially in combination with overweight, contributes to the reflux of acidic contents from the stomach into the esophagus.

The constant wearing of weights, pronounced power loads involving the abdominal press can potentiate the pathological processes leading to reflux.

Symptoms of gastroesophageal reflux

Gastroesophageal (duodenogastric) reflux is manifested by a feeling of heartburn, or a painful burning sensation along the entire esophagus, in the sternum, nausea, loss of appetite, periodically acidic vomiting. Sometimes bitter belching is observed (with concomitant duodeno-gastric reflux). Concerns about heaviness in the epigastric (epigastric) zone, pain after eating, often on an empty stomach. Over time, pain symptoms can become permanent. To relieve discomfort, patients are often forced to take antacids (almagel, phosphalugel), soda.

With a long course of reflux and acute (or chronic) irritation of the epithelial tissue of the esophagus, esophagitis develops (an inflammatory process in the esophagus), sometimes ulcers form. The esophageal ulcer is characterized by a constant pain syndrome, longer than with erosions.

Throwing acid into the lumen of the esophagus, as well as the oral cavity at night during sleep, can lead to irritation of the larynx and even the trachea. Constant exposure to acid contributes to chronic processes in the lungs (bronchitis, asthma, laryngitis). Aspiration, especially in debilitated patients, can lead to pneumonia.

For the diagnosis of duodenogastric reflux, the endoscopy method (EFGDS) is more often used, which allows you to examine in detail all the defects of the mucosa, take a biopsy of the suspicious area.

Principles of treatment of gastroduodenal reflux

Patients suffering from esophageal reflux are prescribed strict adherence to diet, with the exception of coffee, cocoa, fried, rich in extractives and spices, fatty foods, carbonated drinks, alcohol, concentrated juices, acidic foods.

It is desirable to modify the lifestyle features that adversely affect the course of reflux. Rational advice to reduce the severity of duodenogastric reflux can be weight loss, fight against hypodynamia, constipation.

Used to relieve inflammation antisecretory agents and antacids, according to the doctor's prescription, antiulcer treatment is carried out. In some cases, prokinetic drugs are used to reduce the degree of reflux from the stomach.

When symptoms of reflux appear and heartburn self-medication is often ineffective, since the success of therapy depends on the timeliness of an accurate diagnosis and treatment of the disease itself, and not just its symptoms. Also, the symptoms of heartburn and chest pain can hide many diseases that are not directly related to the esophagus (for example, heart disease, lung disease).

Reflux esophagitis is one of the most common esophageal diseases. It occurs as a result of direct contact between the mucosa of the esophagus and the contents of the intestine. Due to the characteristic increased acidity, damage to the lower esophagus occurs, due to which symptoms are characteristic of reflux esophagitis in the form of heartburn, pain, and similar disorders of the digestive system.

Features of the disease

Tracking the incidence rate according to real indicators is not possible, because reflux esophagitis occurs with mild symptoms, in which, as a rule, there is no appeal to specialists. Meanwhile, going to the doctor is almost mandatory, even as a symptom or. The occurrence of reflux esophagitis, in addition, can act as a symptom of the occurrence of a diaphragmatic septum. In this case, we are talking about getting into the hole of the part of the stomach, in the normal state of which there should not be there in principle. There are also a number of specific types of foods that cause stomach contents to enter the esophagus. This includes, in particular, chocolate and citrus fruits, tomatoes and fatty foods. Additionally, for adults, coffee, alcohol, and smoking act as concomitant products of getting into the esophagus.

Reflux esophagitis: symptoms

Each age category has its own characteristic signs of this disease. So, reflux esophagitis, the symptoms of which occur in children, manifests itself in the form of belching and frequent regurgitation, vomiting of milk and belching of air. When the child is raised in a vertical position, a decrease in the isolated phenomena is observed, meanwhile, after the next feeding, they appear again. If you continue to be in a horizontal position, reflux esophagitis increases in manifestations, and therefore the head end of the child's bed should be slightly raised or a pillow should be placed higher - this will remove the characteristic symptoms.

For older children, a characteristic feature is the presence of complaints of frequent heartburn, sour belching, often there is a burning sensation in the area behind the sternum. The listed symptoms are most often relevant after eating, with body tilts, at night.

As for adults, pain is most often noted in the area behind the sternum, and the most common of the symptoms occurs, which has the character of a “coma” sensation in the throat. In addition, the symptoms characteristic of reflux esophagitis may also correspond to symptoms of a completely non-esophageal nature, expressed in a constant cough, hoarse voice, dental diseases, etc.

Increased reflux of stomach contents into the esophagus can be increased for a number of different reasons. So, this, first of all, may be associated with a violation that occurs in the motility of the gastroduodenal zone, which is most often relevant in the presence of various types of pathology in the digestive organs. It is also associated with a slowdown in gastric emptying. It is noteworthy that delayed gastric emptying is observed in about 50% of the total number of patients diagnosed with reflux esophagitis. By stretching the stomach, the volume of contents in the stomach increases, which, in turn, contributes to the occurrence and development of reflux. Due to the disturbance in pyloroduodenal motility, duodenogastric reflux is formed. In this case, we are talking not only about an increase in the volume of the contents of the stomach, but also the formation of an additional factor that contributes to damage to the mucosa as a whole.

Degrees of reflux esophagitis

This disease has its own degrees characterizing it.

I degree - manifestations are in a separate type of erosion that does not merge with each other, as well as in erythema that occurs in the distal esophagus;
II degree - erosive lesions are confluent, but without capturing the entire surface of the mucosa;
III degree - the manifestation of ulcerative lesions in the esophagus in the lower third of its part. In this case, they merge when capturing the surface of the mucosa in the complex;
IV degree - is expressed in a chronic ulcer of the esophagus and in stenosis.

It is noteworthy that the moderate severity of reflux esophagitis is characterized by the manifestation of heartburn not only after eating. So, the pains become more intense and frequent, disturbing the patient even if he takes dietary food. The manifestations in the form of belching with air, the lining of the tongue and an unpleasant aftertaste in the oral cavity are also frequent.

Forms of reflux esophagitis

This disease is characterized by acute and chronic manifestations.

Acute reflux esophagitis manifests itself in inflammation of the walls of the esophagus with the simultaneous presence of painful sensations that are relevant when eating, as well as liquids. Characteristic for him is an increase in temperature with general malaise, behind the sternum, the patient experiences discomfort along the esophagus. There is also a burning sensation and pain in the neck, profuse salivation, belching, a violation in the function of swallowing.
Reflux esophagitis, chronic manifests itself in chronic inflammation of the walls of the esophagus, which is accompanied by the occurrence of pain in the area behind the sternum. Often, the chronic form of reflux is also accompanied by gastritis. Rawness behind the sternum can also occur when running, in addition, there may be difficulty in breathing, hiccups, heartburn, and even vomiting.

Esophagitis also occurs catarrhal, characterized by swelling that occurs in the mucosa of the esophagus and hyperemia, as well as erosive, the nature of the development of which is determined by acute infections.

Biliary reflux esophagitis: symptoms

A violation of the process of digestion of food, in which the contents of the stomach are in the intestines when causing inflammation and irritation in it, as well as the flow of intestinal contents into the stomach determines reflux. Accordingly, the gastritis formed against the background of this process is defined as reflux gastritis. The reasons that provoked reflux determine its type, which can be duodenal or biliary.

Let us dwell on such a form as biliary reflux esophagitis, the symptoms of which are expressed in a feeling of heaviness and fullness in the stomach, which is important in the process of eating, as well as immediately after it. Additionally, we note bitterness and belching, an unpleasant aftertaste felt in the mouth, nausea, various kinds of stool disorders (alternating with diarrhea, as well as bloating). Mostly biliary reflux gastritis is not expressed as a pain symptom. When pain occurs, it is aching and dull in nature, aggravated after eating. It is noteworthy that this disease leads to violations of the body's absorption of nutrients obtained through food. For this reason, there is an impressive weight loss, the formation of "jam" on the lips, general weakness, as well as dry skin.

Causes of biliary reflux esophagitis

This type of disease is associated with the presence of disorders of the biliary system, as well as disorders in motor skills (that is, with dyskinesia), and the lack of coherence in the work of sphincters. Thus, violations provoke a failure in the sequence and in the force of pressure that occurs in the intestines and in the bile ducts. Further, at the reflex level, failures occur in the compression of the ducts of the stomach and pancreas. Due to the occurrence of the biliary type of disorders, impregnated with bile and pancreatic enzymes, the contents from the duodenum end up in the stomach, burning it and thereby forming gastritis. Often, biliary reflux esophagitis is combined with a diagnosis such as biliary duodenitis (or inflammation of the duodenum). This combination is explained by the irritation produced by bile, which is secreted outside the process of normal digestion.

Erosive reflux esophagitis: symptoms

Esophagitis in its form, in which the esophageal mucosa is deeply affected, is defined as erosive reflux esophagitis, the symptoms of which are manifested in the form of heartburn and belching, nausea (occasionally vomiting), pain in the area behind the sternum, sensations of swallowing pain and the presence of "coma " in the throat. Despite the fact that these manifestations are generally characteristic of esophagitis, in this case they are more pronounced, respectively, bringing more anxiety and discomfort to the patient.

The aggravation of the course of the disease is provoked by errors in nutrition, which consist in the use of acidic foods of various types, caffeine and alcohol. Often, the course of the disease is aggravated by drugs, even such harmless, at first glance, as paracetamol, analgin, aspirin, etc.

Treatment of reflux esophagitis

For the treatment of reflux esophagitis in any form, it is natural that the root cause, that is, the disease that provoked its occurrence, should be eliminated. These include gastritis and neurosis, or peptic ulcer. When the correct therapy is determined, the symptoms of reflux esophagitis may subsequently be less pronounced, while with its help it will be possible to reduce the harmful effects of gastric contents that enter the esophagus. Also, therapy in its correct form will increase the overall resistance of the esophageal mucosa, contributing to the rapid cleansing of the stomach after eating.

The first step in the treatment of esophagitis is nothing more than a diet in which spicy and fatty foods, chocolate, tomatoes, citrus fruits, caffeine and, if possible, smoking should be excluded.

Additionally, the specialist prescribes drugs that reduce the acidity of the stomach, in particular, these include antacids. Peptic ulcer disease, as well as erosion, involve taking antisecretory drugs (proton pump inhibitors or H2-blockers). Due to this, intragastric pressure decreases, which ensures the overall resistance of the stomach to food intake. Additionally, due to this, intestinal motility is normalized, and all symptoms characteristic of reflux esophagitis are eliminated. To avoid exacerbating the symptoms that occur when lying down, additional pillows are placed to elevate the upper body - this measure will help reduce heartburn, as well as pain that occurs in the sternum.

To diagnose reflux esophagitis, as well as its accompanying diseases, you should contact a gastroenterologist. Based on the patient's complaints, the duration and severity of the disease, as well as the morphological and endoscopic assessment of changes, the appropriate treatment will be determined.

The digestive tract of the human body is arranged in such a way that food passes from top to bottom - from the mouth to the esophagus, to the stomach and to the intestines. Sphincters exist to prevent the backflow of food and the contents of the stomach or gallbladder.

But with some pathologies, acid is thrown from the stomach into the esophagus. This article will discuss the causes of this negative phenomenon, symptoms and diagnostic methods.

The reflux of the contents of the stomach into the esophagus, or gastroesophageal reflux, is a pathology characterized by the return movement of food masses, along with hydrochloric acid and bile, into the esophagus from the stomach.

Causes of reflux

The reasons for the reflux of food from the stomach into the esophagus may be of an external nature and associated with the characteristics of the human body. External causes include:

Factors related to the state of the human body:

features of the anatomical structure of the digestive organs, their topography in the abdominal cavity;
hereditary features of the connective tissue structure sphincters, which even leads to the reflux of bile into the esophagus from the duodenum 12;
elevated pH gastric juice and the presence of diseases such as gastritis or peptic ulcer.

Bile reflux

Particular attention should be paid to the release of bile into the esophagus, or bile reflux. It differs from the ejection of gastric contents by a bitter, unpleasant taste.

Bile is a specific, bitter-tasting liquid produced by the liver. Its main function is to emulsify fats and activate intestinal motility during the digestion process. Consists of bile acids and enzymes. Normally, bile does not enter the stomach, but only into the duodenum.

The reasons for the reflux of bile into the stomach and esophagus are associated with some pathological conditions of the gastrointestinal tract:

reflux gastritis characterized by a constant release of bile into the stomach;
neoplasms and injuries of the abdominal organs, which provoke pressure on the duodenum 12, which leads to the penetration of bile into the stomach;
chronic duodenitis;
dyskinesia bile ducts;
gallbladder surgery or lack thereof;
pregnancy.

If there is a release of bile into the esophagus, the reasons for it most often are provocative factors:

Symptoms of gastroesophageal reflux

How is the reflux of bile into the esophagus manifested? The symptoms are as follows — heartburn, belching and difficulty swallowing. Groups of symptoms in this condition can be divided into:

Dental. This is when acid from the stomach destroys the structure of tooth enamel, which leads to the development of caries.
Cardinal when there are painful sensations behind the sternum, with irradiation to the region of the heart. Therefore, this condition can be confused with angina attacks.
Pulmonary. This is when, as a result of constant reflux from the stomach into the esophagus, mucus, entering the bronchi, clogs them, which leads to the development of a wet painful cough.
Otolaryngological. They develop in the form of inflammatory processes in the throat as a result of contact with the acidic contents of the emissions from the stomach.

Among the characteristic signs indicating the presence of gastroesophageal reflux, the following can be distinguished:

Useful video

If there is a reflux of gastric juice into the esophagus, it is advisable to start treatment as soon as possible. To provoke the reflux of food from the stomach into the esophagus, the causes of which have already been considered in detail, are caused by various factors. This is discussed in the video.

Throwing acid from the stomach into the esophagus: treatment and diagnosis

Diagnosis of gastroesophageal reflux begins with the identification of symptoms. Its main characteristic features are associated with discomfort in the epigastric region and behind the sternum, with belching of acidic stomach contents and moderate pain. In more severe cases, patients complain of drooling, hoarseness, difficulty swallowing food, and decreased appetite. Some patients indicate the presence of cough and shortness of breath.

To conduct a reliable diagnosis, only the data of anamnesis and physical examination are not enough. For diagnostic purposes, instrumental methods are used:

x-ray examination, with the help of which pathologies such as diaphragmatic hernia, neoplasms of the esophagus, ulcerative defects and strictures are detected;
pH meter;
scintigraphy;
esophagomanometry- measurement of pressure in the esophageal tube.

The main method of diagnostics, which gives a reliable, comprehensive result, is endoscopy. It confirms the presence of GERD, provides information about the degree of the disease, its severity.

Subsequently, using endoscopy monitoring of the results of therapy is carried out. In a condition such as discharge from the stomach into the esophagus, treatment should be immediate. In the process of endoscopy, biomaterials of the esophageal mucosa are taken with subsequent histological examination. This is done in order to differentiate the diagnosis into " Barrett's esophagus". This is a serious disease that develops as a complication GERD which is considered a precancerous condition.

If there is a reflux of bile into the esophagus, adequate treatment should be prescribed, therefore additional studies may be prescribed:

esophagogastroduodenoscopy– examination of the lower parts of the esophagus;
ultrasound abdominal organs;
examination of the tone of the gallbladder - choledochoscintigraphy, which gives information about the contractile function of the esophageal sphincter.

General clinical tests of blood, urine and feces are also prescribed. A biochemical blood test helps to investigate the functionality of the liver and pancreas.

Based on the collected results of clinical signs and instrumental examination, the gastroenterologist makes an accurate diagnosis and prescribes the appropriate treatment and diet for the patient.