Treatment of reflux esophagitis with drugs: we talk about the most effective pills. Treatment of gerb and the most effective drugs Exacerbation of gerb treatment

In the treatment of gastroesophageal reflux disease, antacids, histamine receptor blockers, proton pump inhibitors, and prokinetic drugs are used.

The use of a particular group of drugs depends on the age of the patient, the stage of the pathological process, and the severity of symptoms. Next, it will be described how to treat reflux esophagitis, which pills the doctor prescribes.

Antacids

- a group of drugs whose purpose is to neutralize the excess acidity of gastric juice using chemical reactions. Most modern drugs contain magnesium, calcium, aluminum in the form of chemical compounds. It is on these substances that the mechanism of action is based.

In addition to the main components, the composition may contain auxiliary substances that have the following effects:

• laxative;
• antispasmodic;
• painkillers (anesthetic) and others.

Antacids are classified on the:

• absorbed (systemic);
• non-absorbable (non-systemic).

The difference between them is that systemic ones have the ability to be absorbed into the blood, while non-systemic ones do not.

Systemic antacids

These drugs are also used for reflux esophagitis. Their positive side is the speed of the onset of the therapeutic effect, patients note the elimination of heartburn within a few minutes.

On the other hand, the effect of the use of these drugs is quite short-lived. In addition, gastroenterologists describe the phenomenon of rebound after the withdrawal of absorbable drugs. It consists in the fact that when the intake of the active substance in the body is stopped, the synthesis of hydrochloric acid (HCl) by the parietal cells of the stomach increases.

Another disadvantage is the formation of carbon dioxide during the chemical neutralization of hydrochloric acid. This leads to stretching of the stomach, which provokes new gastroesophageal refluxes.

Excessive absorption of the active substance into the blood can cause a shift in the acid-base balance towards alkalization (alkalosis).

Among the drugs of the group of non-systemic antacids, there are:

• Rennie;
• Bourget mix;
• sodium bicarbonate;
• calcium carbonate;
• magnesium oxide and others.

With prolonged use of calcium-containing products, constipation, the formation of kidney stones may occur, and when combined with dairy products, nausea, vomiting, and bloating occur.

Non-systemic antacids

They differ from systemic ones in a slower onset of the therapeutic effect. However, the non-absorbable group acts much longer than the absorbed drugs.

Non-systemic drugs do not have the phenomenon of rebound, do not form carbon dioxide when neutralizing hydrochloric acid, in general, have fewer side effects.

According to their composition, they are divided into:

• aluminum phosphate containing (Phosphalugel);
• magnesium-aluminum products (Alumag, Almagel, Maalox);
• calcium-sodium (Gaviscon);
• containing aluminum, magnesium, calcium (Talcid, Rutacid).

In addition, there are combination drugs, the most popular of which are magnesium-aluminum combinations. Almagel A includes anestezin, which adds an analgesic effect to the drug.

Simethicone is also added to the main substance, which is used in the treatment of bloating (flatulence). These funds include Gestid, Almagel Neo. Other drugs are also used to treat reflux esophagitis in adults.

Histamine receptor blockers

Histamine (H2) receptor inhibitors have the ability to suppress the secretion of hydrochloric acid by the parietal cells of the stomach. This is a fairly old group of drugs, which is now used only in some categories of patients.

This is due to the fact that they cannot provide 100% control over the production of hydrochloric acid, since its production, in addition to histamine, is also regulated by gastrin and acetylcholine. Also, H2 blockers have a rebound phenomenon, which was described above.

In addition, the effect of their use decreases with each repeated dose (tachyphylaxis). Tachyphylaxis appears on the third day of daily use of the drug. As a result, histamine receptor blockers cannot be used for very long-term therapy for reflux esophagitis.

It is worth noting that the above phenomena manifest themselves in each person individually.

There are several generations of this group:

The most effective drug according to the degree of inhibition of the secretion of hydrochloric acid, Famotidine (trade name Kvamatel) is considered. The relatively low incidence of side effects and the economic factor also point in its favor.

3rd generation drugs may be indicated for the treatment of gastroesophageal reflux disease in patients who do not experience tachyphylaxis.

proton pump inhibitors

What other medicines for reflux esophagitis help? Proton pump blockers (PPIs, Na/KATPase inhibitors) are a group of drugs aimed at inhibiting the secretion of HCl (hydrochloric acid) by acting on the parietal cells of the stomach. Unlike H2 blockers, PPIs allow full control of secretion through dosage adjustments.

PPIs are considered effective, and are used in gastroduodenitis with high acidity, duodenal ulcer and stomach ulcers.

When ingested, the active substance of the drug, dissolving, enters the bloodstream, then to the liver, after which it enters the membranes of the main cells of the gastric mucosa. Further, as a result of complex physico-chemical interactions, the cells stop secreting hydrochloric acid, thereby reducing the level of acidity (PH) of gastric juice.

There are up to 7 generations of PPIs, but they are all the same in terms of the mechanism of action, they differ only in the speed of the onset of the effect (slightly) and the speed of excretion of the active substance from the body.

most famous and most used PPI drug is omeprazole(Omez). It belongs to the first generation of proton pump inhibitors and is considered the best in terms of price to quality ratio.

There are also widely used drugs for reflux esophagitis, such as:

In the case of prolonged use of large dosages, the risk of fractures of the bones of the extremities, the spine increases, there is a risk of developing hypomagnesemia (decrease in the level of magnesium in the blood).

Prokinetics

Prokinetics are a group of drugs that normalize the motility of the gastrointestinal tract. They are divided into several subgroups according to the mechanism of action, but the most popular are representatives of dopamine receptor blockers (D2).

In the treatment of gastroesophageal reflux disease, they are used due to the ability to eliminate the pathological reflux of gastric contents into the esophagus, and prokinetics in general have a positive effect on the motility of the stomach and intestines.

The first generation is Metoclopramide (Cerucal), it is also referred to as antiemetics. This is a fairly old drug, which gradually fades into the background after the appearance of the 2nd generation of prokinetic drugs ( Domperidone, Domrid, Motilium).

The difference between the first and second generations is that the latter have fewer side effects. It is achieved due to the fact that 2nd generation dopamine receptor blockers have the ability not to penetrate the blood-brain barrier. Therefore, they do not cause spasms of the muscles of the face and eyes, protrusion of the tongue and others. Also, the 2nd generation practically does not provoke fatigue, headaches, weakness, noises in the head.

How to treat reflux esophagitis? Preparations Itopride (Itomed, Primer) are also included in the subgroup of D2 receptor blockers, but in addition it is able to inhibit acetylcholinesterase. This increases the amount of the mediator acetylcholine, which is necessary to improve the motility of the gastrointestinal tract.

Antibiotics and vitamins in the treatment of GERD

Antibacterial drugs, that is, antibiotics for reflux esophagitis are not prescribed. Their target is bacteria that cause an inflammatory response. In the case of GERD, inflammation is caused only by the reflux of the acidic contents of the stomach into the alkaline environment of the esophagus.

macrolide antibiotics(Azithromycin, Clarithromycin), which are used to eradicate Helicobacter pylori (type B gastritis, peptic ulcer) have a positive effect on gastric motility, reducing the number of gastroesophageal refluxes. But their purpose is not indicated in the treatment of reflux esophagitis.

Vitamins for reflux esophagitis

Multivitamin complexes may be prescribed ( Duovit, Aevit, Vitrum, Multi-Tabs). Their use helps prevent hypovitaminosis, increase the protective and restorative functions of the body.

Useful video: pills for reflux esophagitis

Treatment regimen

When treatment is carried out for reflux esophagitis, what drugs to take are sorted out, now it is important to know how to do it. The frequency of admission, dosage and choice of medicines is carried out by the attending physician after an internal consultation. Self-medication can lead to a worsening of the course of the disease, a decrease in the quality of life, and irreversible consequences.

To eliminate the neutralization of hydrochloric acid in the first few days, systemic ( Rennie) or non-systemic antacids ( Phosphalugel, Almagel). In case of intense pain, it is more rational to use Almagel A.

From the first day, the use of proton pump inhibitors ( Omeprazole, Omez) course for 4-6 weeks. During this period, the doctor adjusts the dose, choosing the optimal minimum dosage for a particular person. It is worth noting that PPIs are considered the main component of the treatment of GERD in adults.

The last link is prokinetic drugs ( Domperidone) course for several weeks to reduce the number of gastroesophageal refluxes.

In some cases, allow the use of H2 blockers ( famotidine) instead of proton pump inhibitors. This is basic information on the treatment of reflux esophagitis with the most effective medications.

The pathogenesis of a disease such as GERD is multifaceted, multifactorial, and the manifestations of the disease spread to different areas of the body. Therefore, the treatment of gastroesophageal reflux disease requires special attention, and measures should be aimed not so much at eliminating the pathology itself, but at ridding patients of the negative manifestations of the disease. With the elimination of the patient's disturbing symptoms, healing of the affected areas of the gastrointestinal mucosa simultaneously occurs (concerns erosive manifestations).

GERD treatment regimen: main aspects

To figure out whether GERD is treatable, you need to approach this process in many ways. Therefore, therapy, as a rule, includes several directions, which provides:

• reduction of the aggressive influence of the contents of the stomach on the gastrointestinal tract and other organs;
• strengthening the basic functions of the lower esophageal sphincter - unimpeded transportation of the contents to the stomach, and, conversely, preventing its return (already with aggressive properties) to the esophagus or other organs;
• decrease in contact time during the return of the contents of the gastrointestinal tract with the mucous membrane of the esophagus (regurgitation);
• protection of the esophageal mucosa from damage by aggressive contents.

How to treat GERD? There are the following most effective methods:

• Non-drug measures aimed at normalizing (optimizing) lifestyle, changing the daily routine (including behavioral changes) and correcting the type of diet (dietary measures);
• Medical treatment;
• Conservative maintenance therapy;
• Surgical measures (surgery for GERD is prescribed rarely and for special indications).

Non-drug treatments or lifestyle changes

Despite the fact that statistics on the course of this disease show that lifestyle factors have little effect on its development, recommendations for lifestyle changes in GERD are very important. All of them are aimed at eliminating / reducing the influence of factors that cause reflux, or reduce the clearance of the esophagus (the time period during which the pH of the contents of the esophagus changes from acidic to neutral).

• reduced consumption of fat-containing foods, since fats lower the pressure of the LES;
• increased consumption of foods high in protein - proteins increase LES pressure;
• a decrease in the volume of food consumed, since in this way it is possible to reduce the volume of the contents of the stomach, and, therefore, reduce the frequency and strength of refluxes;
• exclusion from the diet of foods with an irritating mucous effect (for example, citrus fruits, tomatoes, chocolate, coffee, tea, onions, garlic, alcohol, etc.). Some of these products have a direct irritating effect, and some lower the pressure of the LES.

1. Permanent weight control. Excess weight is considered one of the causes of reflux. Although weight loss does not always reduce the manifestations of the disease.
2. Follow two rules - do not eat immediately before bedtime (three hours before bedtime), do not take a horizontal position immediately after eating. These measures can reduce the volume of stomach contents in this position and reduce the frequency of reflux.
3. Exclude tight (tight-fitting) clothes, tight belts from your wardrobe. Wearing such things increases intra-abdominal pressure, which leads to increased reflux.
4. Avoid certain conditions and processes: bending over, especially after eating, being in a bent position for a long time, lifting weights exceeding 8-10 kg (in both hands), physical exertion with tension in the abdominal muscles. Increase reflux.
5. Eliminate certain drugs: sedatives, sleeping pills, tranquilizers and calcium antagonists, etc. They lower LES pressure and / or impair esophageal motility.
6. Eliminate smoking - it lowers the pressure of the LES.

Is it possible to cure GERD: medication methods

As a rule, the treatment of gastroesophageal reflux disease requires the use of drugs and is divided into 2 stages - initial (or initial therapy) and secondary (remission period).

The initial stage is characterized by the appointment of a fleeting pump inhibitor (for example, pantoprazole or lamprazole), which heals mucosal damage in erosive esophagitis and contributes to the disappearance of clinical symptoms. Reception of drugs is calculated for 4 weeks. After that, the patient is prescribed the same drug, but at a dose that should support the onset of remission for another 4 weeks.

In case of erosive GERD, the duration of initial therapy is from 4 to 12 weeks, followed by the prescription of drugs according to one of the regimens adopted for long-term drug treatment.

At the stage of deciding how to treat GERD, the traditional option is considered - taking antisecretory drugs, which includes the first appointment of proton pump inhibitors in double doses, for admission for 4-8 weeks, with further transfer of patients to long-term therapy.

At the second stage - the remission period, a new treatment regimen for GERD appears: long-term treatment is prescribed to achieve a stable remission. It is prescribed according to the testimony of analyzes in the following options:

• daily intake of a proton pump inhibitor in doses that prevent the occurrence of relapses - for a long time;
• "necessity" therapy: taking a proton pump inhibitor at the maximum dose, but in a short course for 3-5 days - prescribed in case of worsening symptoms;
• the use of the "weekend therapy" technique - taking drugs in maintenance doses from Friday to Sunday inclusive, and in the period Monday-Thursday, the intake is stopped.

Additional drugs

In situations where initial therapy does not bring the desired results after two weeks of it, and the patient's condition does not improve (symptoms do not disappear / intensify), he is prescribed pH monitoring and esophagoscopy.

If, according to the monitoring results, it turns out that the patient's symptoms recur at night, that is, the acidity increases sharply during this period, he is added to the proton pump inhibitor in a double dose of renitidine, or famotidine. When reflux is bilious in nature, a cytoprotector or ursodeoxycholic acid preparations are prescribed.

To increase the resistance of the esophageal mucosa to the effects of an aggressive substance, decoctions of flax seeds are used, and antacids are taken: maalox, sucralfate (Venter), phosphalugel, gastralugel, gastal, gelusil, pe-hoo, etc. Doctors believe that in the treatment of GERD the most effective effects are exerted by the drug Maalox.

Such patients are well affected by prokinetics - cisapride and metoclopramide, which increase the tone of the lower esophageal sphincter, and reduce the strength of attacks and the frequency of reflux, and reduce the oxidation process in the esophagus.

Sea buckthorn oil, rosehip oil are also added to the GERD treatment regimen, their intake has a positive effect. The dose for each patient is selected individually - from one tsp. at night up to one tsp. 3-4 times a day.

How to treat such a pathology as gastroesophageal reflux disease, and how to determine the effect of the therapy? This is where statistics help.

IMPORTANT! Doctors determine the effectiveness of the treatment according to several criteria:

• The rate of healing of erosive lesions of the esophageal mucosa;
• Absence of heartburn attacks;
• Improving the quality of life.

With GERD accompanied by erosions, when the doctor's recommendations are followed, relapses during the year (after the end of therapy) are statistically 40-65%.

How to cure GERD: surgery

Endoscopic correction or surgical treatment (surgery) of patients with GERD is recommended only in certain situations:

• if it is necessary to carry out drug therapy for a long time, but it is impossible for any reason to meet the required deadlines;
• lack of a positive effect of drug treatment (or weak effect); ongoing, pronounced symptoms and manifestations of GERD, significantly worsening the quality of life of the patient, despite repeated courses of drug antireflux therapy.
• the results of endoscopic examination confirm for a long time reflux esophagitis III-IV degree, which persists against the background of repeated courses of drug therapy.
• GERD aggravated by a hernia of the esophageal diaphragm.
• the presence of a constant reflux in a large volume;
• the appearance of complications of GERD - stricture, bleeding, Barrett's esophagus, esophageal cancer;
• the appearance of new symptoms of a different nature;
• personal desire of the patient (in the absence of contraindications).

Most often, patients with indications for surgical treatment of GERD undergo antireflux operations - Nissen fundoplication, or laparoscopic fundoplication. Less commonly used surgical operations on Dora, Tal, Tupe.

In any particular case, the decision on how to treat GERD is made by the doctor.

Supportive care

The conclusion of doctors on how to treat gastroesophageal reflux disease, and on the need for maintenance drug therapy for any form of GERD, is unequivocal. It is extremely necessary and obligatory - this is due to the fact that this disease is chronic, and is accompanied by frequent relapses, changes in symptoms, the occurrence of erosions on the mucous membrane of the esophageal walls.

Supportive therapy for a long time is included in the mandatory list of recommendations for the treatment of GERD, as it prevents or reduces the frequency of relapses, prevents the occurrence of complications, and improves the quality of life of patients by mitigating attacks.

The question of the duration of maintenance therapy, which is often asked by patients, is decided on an individual basis, as well as whether GERD can be cured forever. This is explained by the results of follow-up of similar patients for 2 and 10 years, from which it follows that in some cases, patients with GERD require lifelong maintenance therapy or long-term treatment.

The nature of the disease, a large number of manifestations and symptoms of different origins, require an individual approach to each case, and the treatment regimen for GERD, as well as maintenance therapy regimens, is prescribed for each patient differently. In addition, it depends on the form of the disease, the type of symptoms, the severity, the time of the course of the disease.

Experts assess the standard severity of GERD using the Los Angeles classification, which provides a starting point for determining the composition of drugs for a course of maintenance therapy. However, doctors approach each case of the disease differently, and treatment of reflux disease involves various schemes.

It is precisely known that with a decrease in the dose of the drug, replacing it with a less effective one, relapses become more frequent, and their strength increases. And the effect of "weekend therapy" has not yet been confirmed, and is the subject of discussion.

In conclusion, drug treatment is a solid foundation for improving the lives of patients with GERD.

What is heartburn - an innocent discomfort, or a symptom of a serious illness? Gastroenterologists note that it occurs when the digestive system malfunctions. Reflux gastroesophageal disease is currently diagnosed in 40% of the population. Doctors insist on the seriousness of the disease and the dangers of ignoring symptoms. Having become acquainted with valuable first-hand information from doctors, you can detect and cure the disease in time.

What is gastroesophageal reflux disease

The contents of the stomach can be thrown into the lumen of the esophagus: hydrochloric acid, pepsin (gastric juice enzyme), bile, pancreatic juice components. In this case, unpleasant sensations appear, these elements have aggressive properties, therefore, they damage the mucous membrane of the esophagus. Often occurring heartburn makes the patient go to the clinic, where reflux esophagitis of the esophagus is diagnosed. Over the past decade, this disease has become the most common among diseases of the digestive tract.

Causes of reflux

The risk group for reflux gastroesophageal disease is headed by men. Women are seven times less likely to suffer from esophageal disease. This is followed by older people who have crossed the fifty-year milestone. There are many unexplored factors that affect how the valve works between the stomach and the food transporter. It is known that esophagitis of the esophagus occurs when:

• obesity
• recurrent gastritis;
• alcohol abuse, smoking;
• sedentary lifestyle;
• the predominance of fatty, protein foods in the diet;
• pregnancy;
• intensive sports, when there is a strong load on the press;
• increased acidity of the stomach;
• valve prolapse between the stomach and the alimentary canal;
• hereditary predisposition.

Symptoms of GERD

Reflux disease is a very serious disease. According to the code in the ICD (International Classification of Diseases) 10 revision, a disease such as bronchial asthma can be the result of the reflux of aggressive acidic stomach contents into the esophagus and even into the respiratory tract. Signs of GERD:

• belching;
• pain in the larynx;
• bursting sensations in the chest and esophagus;
• morning cough;
• frequent diseases of ENT organs: sore throat;
• erosion on the surface of the teeth;
• heartburn in the throat;
• painful swallowing (dysphagia).

Diagnostic methods

If for more than five years a person does not know the cause of heartburn, then he needs to visit a gastroenterologist. The main and most reliable ways to detect the disease:

1. Gastroscopy. During the study of the esophagus, the doctor may see erosive lesions or changed epithelium. The problem is that 80% of patients do not experience heartburn so often, so they do not seek help from a doctor.
2. Daily PH meter. With this diagnostic method, a thin probe is inserted into the lumen of the esophagus, which during the day fixes the reflux of acid into the lower esophageal region.

How to Treat GERD

Heartburn sufferers take baking soda, milk, or other antacids the old-fashioned way. If you have repeated discomfort after eating for several years, you should not self-medicate. It is not recommended to take medications on your own to relieve the symptoms of the disease, this can only harm your health and lead to irreversible processes in the esophagus. It is recommended not to ignore the doctor's prescriptions, but to fulfill all his prescriptions.

medicines

Modern medicine treats gastroesophagitis of the esophagus by influencing the secretion of hydrochloric acid. Patients with reflux disease are prescribed prokinetic drugs that block its release in the stomach, reducing the aggressiveness of gastric juice. It continues to be thrown into the esophagus, but does not have such a negative effect. Such treatment has a downside: with a decrease in acidity, pathogenic microflora begins to develop in the stomach, but side effects develop slowly and cannot harm a person in the same way as regular reflux of acid into the esophagus.

Surgical treatment

Surgical intervention for esophageal disease is inevitable in such cases:

• when medical treatment fails to overcome the disease. With prolonged exposure to drugs, there are cases of addiction to them, then the result of the treatment is zero;
• progression of reflux esophagitis;
• with complications of the disease, such as heart failure, bronchial asthma;
• in the presence of ulcers of the stomach or esophagus;
• the formation of malignant tumors of the stomach.

Treatment of GERD with folk remedies

Natural methods of struggle can successfully cope with reflux disease, not only at the initial stage, but in a chronic, neglected degree. For the treatment of the esophagus, it is necessary to regularly take decoctions of herbs that lower the acidity of the stomach. Here are some recipes:

1. Crushed plantain leaves (2 tbsp.), St. John's wort (1 tbsp.) Place in an enameled container, pour boiling water (500 ml). After half an hour, the tea is ready to drink. You can take a drink for a long time, half a glass in the morning.
2. Fill a teapot with centaury herb (50 gr.), pharmacy chamomile flowers with boiling water (500 ml). Wait ten minutes, take instead of tea three times a day.

Diet for GERD

One of the important components of the treatment and exclusion of recurrence of GERD disease is dietary nutrition. The diet for reflux esophagitis of the esophagus should be based on the following principles:

1. Eliminate fatty foods from the diet.
2. To maintain a healthy esophagus, avoid fried and spicy foods.
3. With a disease of the esophagus, it is not recommended to drink coffee, strong tea on an empty stomach.
4. People prone to diseases of the esophagus are not recommended to eat chocolate, tomatoes, onions, garlic, mint: these products reduce the tone of the lower sphincter.

Possible Complications

Reflux disease is dangerous for its complications. The body reacts negatively to the constant damage to the walls of the esophagus by the mucous acid. With a long course of reflux disease, the following consequences are possible:

1. One of the most severe consequences is the replacement of the esophageal epithelium from flat to cylindrical. Experts call this state of affairs a precancerous condition. The name for this phenomenon is Barrett's esophagus. The patient does not feel any symptoms of such a complication. The worst thing is that when the epithelium changes, the severity of symptoms decreases: the surface of the esophagus becomes insensitive to acid and bile.
2. The child may develop narrowing of the esophagus.
3. Oncology of the esophagus leads to high mortality: patients seek help too late, when it is impossible to cope with the tumor. This is due to the fact that signs of cancer appear only in the last stages.
4. The risk of developing bronchial asthma, pulmonary disease is high.

Prevention

To avoid reflux gastroesophageal disease of the esophagus, you need to monitor your health, treat it with care and great responsibility. Many methods of prevention will help prevent the development of the disease. This:

• giving up bad habits: smoking, alcohol;
• exclusion of fatty, fried, spicy foods;
• in case of esophageal disease, it is necessary to limit the intake of hot food and drinks;
• exclude work in an inclined position, load on the press;
• men need to replace the belt that pinches the stomach with suspenders.

Find out what duodenogastric reflux is - symptoms, treatment and prevention of the disease.

Video about gastroesophageal reflux

The article will consider the modern treatment of GERD. What is this pathology? How to get rid of it?

Gastroesophageal reflux disease (GERD) is a pathological condition in which there is a reflux of what is contained in the stomach into the lumen of the esophagus. This disease can often develop against the background of insufficiency of the cardia. This kind of disease can manifest itself at any age, regardless of the gender of the person. In order to cure this pathology, not only traditional medicine methods are used, but also folk remedies.

Treatment of GERD with the help of folk remedies is considered today no less effective than therapy involving the use of synthetic medications. But, of course, the only condition immediately before using this or that folk medicine or pharmaceutical is a mandatory consultation with your doctor. Next, let's talk about how GERD is treated, and also consider the methods of alternative and drug therapy.

Symptoms of pathology

The main symptoms of this disease are heartburn with belching, which appear at least twice a week for four to eight weeks or longer. Patients may also complain of a feeling of some kind of constriction in the epigastric region, which occurs fifteen to forty minutes after eating. This feeling, as a rule, can be provoked by the use of foods that stimulate the synthesis of hydrochloric acid in the stomach. These include the following foods: fried and spicy foods along with juices, alcohol, dry red wine, carbonated drinks such as Coca-Cola, Fanta, and so on. In addition to them, provocateurs are: coffee with chocolate, cocoa, radish and butter in excessive quantities.

Often, patients with reflux disease may complain of pain behind the sternum, which in this case is given to the neck, jaw, shoulder or arm, and in addition, under the left shoulder blade. In the event that there is pain in the region of the left shoulder blade, then a differential diagnosis with angina pectoris should be carried out.

The symptoms and treatment of GERD often go hand in hand. Directly with gastroesophageal reflux disease, chest pain is associated with the following factors:

• Excessive consumption of food, mainly overeating.
• Low position of the head during rest and sleep.

These or other complaints, as a rule, are provoked by physical exertion associated with frequent torso bending, and in addition, with the fact that the stomach is full of liquid, sweet or fatty foods and alcohol. Unpleasant symptoms may worsen at night. The entry of contents from the esophagus into the region of the bronchial lumen can lead to bronchial spasms and Mendelssohn's syndrome. In this case, it should be noted that for the onset of a fatal case, it will be enough if about four milliliters of gastric juice enters the bronchial tree.

How is reflux disease treated?

Drug treatment of GERD is divided into two stages: initial (initial) and secondary.

In the first phase, fleeting pump inhibitors are prescribed, for example, substances such as lamprazole or pantoprazole. Preparations based on these components are prescribed for the healing of erosive esophagitis. They also help to completely overcome clinical manifestations. Initial therapy should be continued for four weeks. Next, patients are transferred to a dose that maintains remission over the next month. In the erosive form of the disease, the duration of initial therapy should be four to twelve weeks, followed by the use of one of the long-term treatment regimens. As part of the generally accepted antisecretory drug therapy strategy, double doses of inhibitors are initially given for two months, followed by a transition to long-term treatment.

Treatment of GERD (second phase) is supposed to be long-term, the goal of which is to achieve remission. There are three types of treatment. First, long-term daily use of inhibitors is prescribed. Second, full-dose inhibitor therapy for a short three-day course is given if symptoms worsen. Thirdly, they carry out “day off” therapy, within the framework of which the use of inhibitors in an anti-relapse dosage is prescribed.

If initial therapy fails within two weeks, esophagoscopy with pH monitoring should be performed. In the event that monitoring indicates nocturnal breakthroughs in acidity, then the patient will be prescribed Famotidine or Ranitidine in addition to a double dose of inhibitors. In situations where the reflux is bilious, patients are shown the appointment of ursodeoxycholic acid. To achieve resistance of the esophageal mucosa, a decoction of flax seeds is recommended, as well as such drugs for the treatment of GERD as Maalox, Phosphalugel and Gestal.

At the same time, Maalox is considered the most effective. Such patients are also prescribed prokinetics in the form of Cisapride or Cerucal, which increase the tone of the esophageal closure and reduce the severity of gastroesophageal reflux. These medicines, among other things, reduce the acidification of the esophagus. A positive result is achieved through the use of sea buckthorn and rosehip oils. The dose is selected individually: from one teaspoon to three times a day. Consider the main methods of treatment for GERD.

Endoscopic and surgical treatment

Endoscopic, and in addition, surgical treatment of GERD is recommended for patients in the following cases:

• The body's need for long-term medical treatment.
• Insufficient effect of drug treatment.
• Diaphragmatic hernia of a large volume of reflux.
• Complications in the form of bleeding, stricture and development of Barrett's esophagus, and in addition, the presence of cancer of the esophagus.
• The personal desire of the patient.

But before that, drug treatment of GERD is most often carried out. We will consider the most effective folk remedies below.

The criteria for the effectiveness of therapy in this case are the following goals:

• Achieving healing of erosive lesions of the esophagus.
• Getting rid of heartburn.
• Improving the overall quality of life.

The recurrence rate during the first twelve months after successful completion of therapy is, as a rule, from forty to sixty-five percent for the erosive type of pathology.

The treatment regimen for GERD is selected by the doctor individually.

What diseases can be associated with this pathology?

The nature of gastroesophageal reflux disease is explained by the fact that the motility of the stomach and esophagus is disturbed. This disease develops with a reduced antireflux barrier, reduced tone of the esophageal closure and clearance. An increased risk of symptoms of this disease are patients who suffer from a violation of the production of digestive hormones, and in addition, pancreatic enzymes, which occurs due to a decrease in the resistance of the esophageal epithelium. It is also important to reduce the production of saliva along with a violation of the cholinergic innervations of the esophagus. GERD often develops in patients who are carriers of Helicobacter pylori. For such patients, there is a higher risk of stomach ulcers.

What else is included in the effective treatment of GERD?

Therapy without leaving home

The most important condition for the treatment of this pathology is a change in habitual lifestyle, which involves the adoption of the following measures:

• Complete rejection of bad habits such as smoking and drinking alcohol.
• It is extremely important to reduce excess body weight and lose weight.
• It is recommended to avoid lying down immediately after eating. Thus, in no case should you go to bed after eating.
• You should stop wearing corsets, and in addition, various bandages and, in general, everything that can increase intra-abdominal pressure in the body.

Treatment of GERD with esophagitis should be comprehensive. It is equally important that a person be able to change the regime, as well as the nature of his diet:

• It is required to completely eliminate overeating.
• You can not eat food at night.
• It is important to try to minimize foods that are rich in fats in your diet, such as milk, goose, duck, pork, lamb, coffee and coca-cola. You should also not lean on citrus fruits, tomatoes, garlic, and in addition, dry red wines.

Dispensary observation is subject to patients who suffer from prolonged heartburn for ten years or more. Patients with an erosive form of pathology and Barrett's esophagus must also be observed. In cases of development of Barrett's esophagus, inhibitors should be prescribed to patients in a double dose for at least three months, followed by a decrease in the amount of the drug to the standard norm. With regard to endoscopic control with biopsy, it must be carried out annually. In the presence of high-grade dysplasia, an endoscopic examination with multiple biopsies from the affected mucosal areas is required. Patients suffering from Barrett's syndrome and dysplasia are recommended endoscopic mucosal resection or surgical esophagotomy.

Reviews of GERD treatment abound.

What drugs are used to treat gastroesophageal reflux disease today?

To date, the following drugs are prescribed for the treatment of this pathology by specialists:

• The medicine "Pantoprazole" is prescribed 20 milligrams twice a day or 40 times a day at night. The therapeutic course in this case is a month. The maintenance dose is 20 milligrams at night for the next month.
• The drug "Famotidine" is also prescribed 20 milligrams twice a day: first before breakfast and then before dinner.
• The drug "Ranitidine" is taken at 150 milligrams twice a day. The most effective drugs for the treatment of GERD are sold at any pharmacy.
• The pharmaceutical agent "Sukralfat" is taken 500 milligrams one and a half hours after meals up to four times a day.
• The drug "Maalox" is used two packets up to three times a day.
• Metoclopramide is taken 20 milligrams three times a day.

GERD and traditional medicine

It is important to understand that traditional medicine will not help eliminate the main cause of the disease, which lies in the weakness of the cardiac sphincter. Folk methods only help to reduce the intensity of symptoms. In the people today, there are many tools that help normalize the condition of patients with GERD. We are talking about the use of special decoctions prepared from herbs with the addition of, for example, honey. In addition, you can turn to drinking mineral water or tinctures. It is important to emphasize that before using any folk remedy, it is recommended to consult with your doctor.

What else does the treatment of GERD with folk remedies involve?

Application of potato juice

In this case, starch, which is contained in potatoes, in which there is a lot of it, has a special healing property. Starch can completely envelop the esophagus, thereby becoming a defense against the negative effects of hydrochloric acid. Of course, the disease will not go away from the use of this remedy, but it will be possible to get rid of the feeling of heartburn for a long time.

Using Chaga Mushroom Tincture

This mushroom grows on birches. It is widely used for the treatment of diseases of the digestive system. The mushroom must first be crushed and brewed with boiling water. The mixture is then infused for one hour. The medicine is taken several times a day. It perfectly helps to eliminate the symptoms of this unpleasant disease. The mushroom has the following beneficial properties:

• The composition of the product contains many useful trace elements that have a stimulating effect on the immune system. In addition, they contribute to the binding of hydrochloric acid, which is secreted by the stomach.
• The composition of the fungus includes anti-inflammatory substances, they perfectly cope with inflammation in the esophagus, which are provoked by the aggressive influence of hydrochloric acid.

The disadvantages of using this tool are as follows:

• The appearance of allergic reactions in the presence of individual intolerance.
• This mushroom is toxic, so it should be used strictly according to the recipe.

Plants and herbs

For the effective treatment of GERD with folk remedies, herbs with various plants are widely used. The most effective are the well-known chamomile with nettle, St. John's wort, sea buckthorn and lemon balm. But it is very important to be able to brew them so that they have a healing effect. The most effective remedy is considered to be a decoction made from chamomile with St. John's wort and lemon balm. All these herbs must be taken in equal parts and brewed with boiling water, and then let it brew a little. It is necessary to use the decoction in the form of tea. In order to enhance the beneficial properties, it is recommended to add a little honey. The resulting drink has an anti-inflammatory, soothing and wound-healing effect.

Nettle also has an anti-inflammatory effect, in this regard, it can be brewed or added to various dishes, such as soups. Sea buckthorn oil is famous for its wound-healing effect, but it is allowed to use it in small quantities. It is important to note that only water-based products are allowed to be used for the treatment of this pathology. It is strictly forbidden to use alcohol tinctures in view of the fact that ethyl alcohol can have an irritating effect on the mucosa of an already affected esophagus.

In the folk treatment of GERD, aloe juice is often used.

The use of aloe juice

Aloe juice is considered a unique remedy that is rich in a mass of healing properties. This tool is actively used to treat many diseases that occur in the digestive system. To reduce the symptoms of GERD, you need to mix the juice of this plant with honey, and then dilute with some water. The resulting medicine is taken throughout the day. It is important to note that it is not advisable to use pure honey for GERD. Thanks to aloe juice, the following beneficial effects can be achieved:

• The immune system is activated.
• Removes inflammation.
• It appears to have a healing effect.
• There is an enveloping effect.

Treatment of GERD during pregnancy

Treatment of such an ailment as gastroesophageal reflux disease in pregnant women is carried out under the supervision of specialized specialists. In the event that this disease manifested against the background of pregnancy, then it is quite likely that it will be temporary, and the symptoms will be reduced to zero immediately after childbirth. At the initial stage of this pathology during pregnancy, doctors, as a rule, recommend lifestyle changes along with herbal medicine, and only if there are extremely uncomfortable symptoms, drug treatment is considered appropriate. Basically, GERD therapy in pregnant women is symptomatic and improves the quality of life along with the well-being of the expectant mother.

Treatment of GERD in children

For the treatment of this pathology in children, the following methods are used:

• non-drug therapy;
• drug therapy;
• surgical correction.

The younger age group is treated with a non-drug method using postural therapy (change in body position) and nutritional correction.

To reduce gastroesophageal reflux and reduce the risk of esophagitis, you should breastfeed while sitting at a 50-60 degree angle. Overfeeding is not allowed. After feeding, be sure to hold the baby in an upright position. During sleep - a special elevated position of the body.

In order to correct nutrition, mixtures with anti-reflux properties are selected, which contribute to the thickening of food and reduce reflux.

Older children should:

• often eat fractional portions;
• increase proteins in the diet, reduce fats;
• exclude fatty foods, fried foods, spicy foods;
• do not drink carbonated drinks;
• limit sweets;
• stay upright after eating for at least half an hour;
• do not exercise after eating;
• eat no later than three hours before bedtime.

As medicines you can use:

• proton pump blockers - Rabeprazole;
• prokinetics - "Domperidone", "Motilium", "Motilak";
• means that normalize gastric motility - "Trimebutin";
• antacids to neutralize hydrochloric acid (Maalox, Phosphalugel, Almagel).

In more severe cases, surgery is indicated.

What specialists will help with the development of GERD or diagnostic methods

First of all, you need to contact a gastroenterologist. When examining patients suffering from gastroesophageal reflux disease, the following signs are usually detected:

• The appearance of dry mouth, which is also called xerostomia.
• The appearance of hypertrophied fungiform papillae of the tongue, which is the result of a process of gastric hypersecretion.
• The presence of a positive left or right frenicus symptom.
• The appearance of signs of laryngitis, which manifests itself in the form of hoarseness.

The diagnosis of reflux disease is confirmed by x-ray, when backflow of the contrast agent from the stomach into the esophagus area becomes apparent. In addition, the results of round-the-clock pH monitoring are being studied. But the main standard for diagnosing GERD is the endoscopic research technique.

To date, there is the following classification of lesions of the esophagus according to esophagoscopy data:

• Grade zero, in which the esophageal mucosa is intact.
• At the first degree of severity, doctors observe individual signs of erosion, which do not merge with each other.
• At the second degree of severity, erosions are observed that merge with each other, but they do not spread to a large area of ​​the esophageal mucosa.
• At the third degree of severity, erosive lesions occur, which occupy a third of the esophagus. In this case, erosion can merge and spread to the entire area of ​​the mucosa of the esophagus.
• At the fourth degree of severity, doctors observe erosive and ulcerative changes with complications. In this case, there may be a stricture of the esophagus with bleeding and metaplasia of the mucosa with the formation of Barrett's esophagus.

Specialists are guided by the following diagnostic criteria in case of suspected GERD:

• The presence of typical clinical symptoms in the form of heartburn and sour belching.
• Testing with proton pump inhibitors. As part of the study, the effectiveness of a weekly course of using modern inhibitors is being evaluated.
• Perform endoscopic confirmation of esophagitis.
• Presence of positive results of 24-hour esophageal pH monitoring.

For the diagnosis of symptoms of GERD and treatment in the future, the following techniques are used:

• Delivery of a general blood test with its biochemical study.
• Testing for Helicobacter pylori.
• Taking a biopsy. Such an analysis is indicated if endoscopy suspects the presence of intestinal metaplasia. Also, this analysis is necessary for patients suffering from ulcerative lesions of the esophagus, stenosis, and in addition, with suspected non-reflux origin of esophagitis.

In conclusion, it should be said that today a disease such as GERD is a very common phenomenon. Its treatment can be effective if targeted therapy is carried out using modern drugs. As for folk methods, they also have the right to use in this case and are applicable as an additional stimulating treatment.

Gastroesophageal reflux disease (GERD) occurs when the contents of the stomach are expelled into the esophagus under the influence of hydrochloric acid.

Due to this, pepsin is broken down and the digestive system is disturbed, unpleasant symptoms appear.

GERD with esophagitis can be treated with various methods, but first you need to know the causes and symptoms of the disease.

Establishing diagnosis

Doctors can establish a diagnosis only after collecting an anamnesis, as well as instrumental diagnostic methods.

Often, with a mild course of the disease, patients simply take complaints, on the basis of which a diagnosis is established.

There are also mandatory diagnostic methods that are carried out once, these include:

1. X-ray examination. A picture of the esophagus, gastrointestinal tract is taken so as not to confuse GERD with esophagitis with other similar pathologies.
2. Esophagoscopy. In addition to taking a picture, it is necessary to do esophagoscopy, which determines the esophagitis itself, its stage of development, as well as possible complications. At this stage, doctors rule out possible tumors.
3. Carry out a daily examination of pH-metry. The method allows to determine the acidity when using inhibitors. This research method is very informative for the diagnosis of GERD.
4. An intraesophageal manometry is done. On it, doctors can determine the degree of performance of the esophagus. With insufficient tone of the sphincter, the diagnosis of GERD is established.
5. An ultrasound of all organs of the abdomen is performed.

As a rule, the collected data is enough to establish a diagnosis. If GERD cannot be cured for several weeks, then additional diagnostics are performed, which include provocative tests:

1. Bernstein test. A similar method allows you to determine the sensitivity of the esophagus and its walls to acids. When using the equipment, the patient is injected with an acid solution into the esophagus. If after 10-20 minutes the main symptoms begin in the patient, then the test is positive and indicates the disease. After using antacids, symptoms should disappear. The diagnostic method is very informative and can indicate pathology, even if esophagoscopy has not yielded results.
2. A common test for GERD that uses acid. 300 ml of a special solution is launched into the stomach, after which an examination is carried out, changing the position of the body and conducting various breathing and other exercises. Based on the data obtained, a diagnosis and its assumptions are established.
3. Test using an inflatable balloon. Such a device is installed 10 cm higher than the sphincter, and they begin to fill it with air, at a dosage of 1 ml. If symptoms appear with an increase in the balloon, then the diagnosis is positive.

In addition to the described diagnosis, laboratory tests are collected, which include:

1. Blood analysis.
2. Definitions of blood group and Rh factor.

Doctors say that Helicobacter pylori bacteria cannot provoke GERD, but due to acidity disorders, their development in the body is possible.

In addition, the patient can develop quite quickly gastritis in an atrophic form, and even cancer.

Due to this, patients with GERD who have a rather long treatment should be screened for Helicobacter pylori. Approximately people can recognize the disease if they know the main causes.

Causes of esophagitis

Esophagitis can appear as a result of several main reasons:

1. Great pressure in the abdomen and stomach, which appears during pregnancy, obesity, overeating and flatulence.
2. Slow bowel movement.
3. Anatomical features in which part of the work of the esophagus is disrupted. In some cases, the cause is a hernia or scleroderma.
4. The result of malnutrition can be the cause, as an excess of certain foods relaxes the sphincter and reflux occurs.

GERD often occurs in people who are ill or have been ill with diseases of the gastrointestinal tract, for example, gastritis or ulcers.

Symptoms

There are several main symptoms by which GERD with esophagitis can be identified. These include:

1. Heartburn. This symptom can most often be identified in sick people. The cause of a burning sensation in the chest is prolonged contact of gastric juice with the walls of the esophagus. Symptoms often appear after ingestion of junk food, as well as alcohol, coffee and chocolate. Another provocateurs are strong physical exertion, frequent bending of the body, tight clothes, especially in the abdomen. Heartburn is treated with antacids.
2. Belching. When reflux occurs, patients begin to belch, which is accompanied by a bitter and sour taste. The problem appears immediately after a meal, lying down and after heavy exertion on the body.

The disease may not appear for a long period, and all the symptoms may be so insignificant that patients simply do not notice them.

All this refers to the chronic course of the disease. The main symptom in chronic pathology is prolonged heartburn, which gradually begins to torment the patient.

At the initial stage, reflux simply causes a slight itching in the throat area, which is very similar to the onset of the flu.

As a result, patients use cold remedies that do not work. After this, heartburn begins, especially after a hearty meal.

In the advanced stage, patients may have different symptoms, it all depends on the walls of the esophagus and their condition. The first sign of the disease is a hoarse voice.

In general, the disease can be divided into 5 stages of the course:

1. At the very beginning, there is a sore throat that does not go away after swallowing the products. The mucosa is covered with spots of a pink hue, but if there is an exacerbation. As a rule, it is difficult to establish an accurate diagnosis at the first stage, and doctors use a description of the symptoms from the words of the patient, his complaints and make a presumptive diagnosis.
2. In the second stage, the patient develops erosions that can affect about 20% of the esophageal mucosa. All symptoms get worse.
3. At the next stage, erosion affects half of the mucosa, after which reflux with esophagitis causes discomfort while eating, because small ulcers appear.
4. In the fourth stage, ulcers appear on the mucosa of the entire esophagus. Even without food, in a calm state, the patient begins to experience pain, and other symptoms are possible in the form of constant nausea, weakness in the body, loss of appetite. Patients begin to lose up to 10% of body weight.
5. At the last stage, the patient must be hospitalized, because further treatment is carried out only by surgery.

It is impossible to start the disease, because this leads to a solution to the problem only by surgery. Knowing the symptoms, it is necessary to consult a doctor in the early stages of the onset of the disease.

Treatment rules

1. The patient needs to control his weight and avoid obesity.
2. At the time of treatment, it is necessary to limit yourself to cigarettes.
3. All things should be free; with GERD with esophagitis, it is forbidden to wear squeezing clothing.
4. It is necessary to equip the bed and make the right headboard.
5. On the stomach and stomach, it is necessary to reduce the load.
6. It is necessary to exclude or limit as much as possible the intake of drugs that can provoke symptoms characteristic of reflux esophagitis.

The essence of drug treatment is the rapid removal of the main symptoms of the disease, as well as the healing of wounds caused by esophagitis.

Also, medicines will prevent repeated acid emissions and prevent complications.

The use of medicines

The treatment, which is carried out with a medical method, consists in the use of drugs that can reduce the effect of gastric juice on the esophagus.

As a rule, all drugs of the antisecretory type must be taken once a day.

Treatment of GERD is carried out for about one and a half months if there are no ulcerative wounds in the esophagus.

If the esophagus is affected by ulcers, then the treatment is extended for a couple of weeks, but only if the ulcers have not affected the entire esophagus and they are single. If the esophagus is covered in ulcers, then therapy continues for another 2 months.

Medicines do not always give positive results, therefore, if the doctor is ineffective, the dosage of the drugs and the course of treatment itself are increased.

Once GERD with esophagitis is detected, doctors prescribe antacids. They are used in the early days of therapy along with prokinetics.

When using this treatment, the removal of symptoms is carried out quickly, heartburn no longer appears. In addition, antacids are always used to stop heartburn, which is quite rare.

Antacids should be taken three times a day an hour after a meal. At night, you can use the medicine only when the symptoms are persistent and severe.

Often, after taking antacids, patients experience improvement and GERD with esophagitis does not develop into a severe form.

When prescribing prokinetics, patients notice an improvement in the functioning of the stomach, and the main work of the esophagus is also stimulated. Prokinetics are used for a combined type of treatment.

The most commonly used "Domperion" at a dosage of 10 ml. It must be taken three times a day. In addition to the drug, the use of "Metoclopramide" in the same dose is prescribed.

The third medicine for therapy includes Bethanechol, it is taken 15 ml 4 times a day. In rare cases, doctors prescribe the medicine "Caesapride", which must be taken three times a day.

Reflux esophagitis can be treated with medication if the disease is not in advanced form. The result of such therapy is positive and quite fast.

Surgical intervention

Not always the treatment of GERD is carried out with medications, in some situations only surgery may be required. Patients with the following parameters are allowed for the operation:

1. The patient's age is up to 35 years.
2. There are no chronic diseases.
3. The patient does not use certain medications throughout life.
4. There is no bleeding in the esophagus.
5. The operation is not performed if the esophagus is in a precancerous condition.
6. Surgery is prohibited if the patient has GERD with non-esophageal symptoms.

Removal of reflux esophagitis is performed using an endoscope. In general, the procedure is not complicated, in some cases there may be a choice of therapy depending on the following:

1. The severity of the pathology.
2. The patient's decision on how to treat.
3. The cost of therapy.
4. Possible complications.
5. Experience of doctors in carrying out operative intervention.
6. The equipment that is in the hospital.

Even before surgery or drug treatment, doctors advise you to review your lifestyle and adjust your diet.

Folk remedies

Reflux esophagitis, as a rule, is not treated with folk remedies, and their use is not included in the mandatory therapy.

Of course, you can use herbal decoctions and infusions, but they will not get rid of the pathology, but they will relieve certain symptoms.

Doctors advise using the following recipes:

1. To reduce the pain syndrome, as well as remove inflammation of the mucosa and lower the pH level, it is necessary to use chamomile flowers (2 tbsp), flax seeds (2 tbsp), motherwort (1 tbsp), lemon balm leaf (1 tbsp .l.) and licorice root (1 tablespoon). All ingredients are crushed and poured into 1.5 liters of water. Then it is necessary to steam the medicine in a water bath for 10 minutes and drink 100 ml 4 times a day two hours later.
2. Symptoms of reflux esophagitis can be overcome with dill infusion. For this, 2 tbsp. crushed into powder and poured into a glass of boiling water. After a couple of hours, the remedy is filtered, and taken before meals, 1 tbsp. 4 times a day.
3. Jerusalem artichoke can be used for any pathologies of the gastrointestinal tract, including GERD. Two tubers with one apple should be grated and eaten twice a day. The burning sensation in the chest will immediately pass.

GERD is not a disease that is easy to overcome with folk methods, the use of medicines is mandatory. Another treatment for pathology is nutrition, which will be discussed below.

Proper nutrition

People who have GERD and esophagitis should follow the basic rules in the diet for the normal functioning of the gastrointestinal tract, as well as a quick recovery:

1. You need to cook food for a couple, you can cook and stew food. Eat baked foods at least a couple of times a week.
2. For cooking, the temperature is not higher than 40 degrees. This will not irritate the walls of the mucosa.
3. Feed fractional 5-6 times a day. The last meal should be no later than 20:00.
4. The main load on the stomach falls before lunch, after which lighter dishes are used.

To prevent reflux, it is necessary to exclude from the diet:

1. Any type of snack, including breakfast cereals, sandwiches and fast food. Especially if the esophagitis is in an exacerbated form.
2. Harmful food is necessarily excluded from the diet, namely fried and spicy, pickled and salty foods, smoked ingredients, sweets, soda.
3. You can not eat hard-boiled eggs, as well as fried.
4. Legumes, corn, pearl barley are not used in dishes. Mushrooms are also better to exclude, they are very difficult for the digestive tract.
5. A variety of sauces and ketchups, mustard should be excluded. Fatty sour cream, fermented baked milk is not used.
6. All vegetables that can provoke heartburn are removed from the diet, these include radishes, cabbage, cucumbers and tomatoes with peel, exotic foods, including bananas. Vegetables and fruits are best used not fresh, but baked, boiled or stewed.
7. The first dishes that are cooked in meat broth should not be consumed.
8. With sweets, you also need to be careful. It is allowed to use honey in liquid form, but only when added to tea. It is not recommended to eat jam, as it irritates the walls of the esophagus.

To prevent reflux esophagitis, you can use the following tips:

1. Avoid cigarettes and alcohol.
2. Adjust your diet and lifestyle.
3. Sleep on several pillows so that the head is higher than the body.
4. The last meal should be 2 hours before bedtime.
5. All medications should be taken with plenty of water.
6. When sick, only loose clothing is worn.
7. Weight should be controlled and obesity avoided.
8. Constantly checked by a gastroenterologist. For prevention, an examination every six months is necessary.

Knowing the basic rules for the appearance of the disease, as well as methods of treatment and prevention, you can quickly recover and prevent GERD from appearing.

Useful video

Since reflux esophagitis can be due to various reasons, the therapeutic approach is complex. It includes dietary and postural therapy, treatment with medications and aids, and surgical correction. The choice of drug, dosage and duration of its use also depend on many factors. Therefore, it is necessary to take medications after consulting a specialist.

The main principles of treatment of reflux esophagitis are:

• the introduction of restrictions in the diet and the maintenance of a certain lifestyle;
• reducing the acidity of the contents of the stomach by prescribing appropriate drugs;
• stimulation of the motility of the digestive tract, increased evacuation activity;
• the appointment of drugs that provide restoration and protection of the gastric mucosa.

It should be noted that all principles of treatment are closely interconnected. Failure to comply with one of them significantly reduces the effectiveness of therapy.

The main course of medical therapy

The duration of the main course of therapy for reflux esophagitis is 4 weeks. If an erosive form of the disease is observed, then the duration of treatment is increased to 8 weeks, while it is possible to increase the dosage of drugs. If there are changes outside the esophagus (especially in elderly patients), then therapeutic treatment can last up to 12 weeks. When the effect is achieved, the patient is prescribed maintenance therapy.

It should be noted that in many patients with reflux, the disease is chronic and is accompanied by relapses. In this case, if the symptoms of esophagitis are not observed, then drugs are prescribed as needed.

At the erosive stage

In the presence of minor and single erosions, the treatment of reflux esophagitis can also last 4 weeks. Otherwise, the duration of treatment is 2 months. Prescribe proton pump inhibitors (morning and evening). Additionally, the reception of omeprazole, lansoprazole, pantoprazole, esomeprazole is indicated. These drugs are also taken twice a day. The most effective in this case is rabeprozole, which is enough to take once a day.

Even after successful treatment of erosive reflux esophagitis, the vast majority of patients remain at risk of recurrence throughout the year. Such people need long-term therapy with PPIs taken in half doses. The treatment regimen is selected by the doctor, taking into account many individual parameters (age, complications, and others).

At non-erosive stage

If there are no erosions, then the PPI is taken once a day for 4 weeks. The amount of the drug taken depends on the intensity of inflammation and is in the range of 10-40 mg. Without fail, after the main course, maintenance therapy is indicated, the duration of which is determined by the attending physician and can last up to six months.

Possible treatment regimens

In the treatment of reflux esophagitis, the following schemes can be used.

1. The same drug is used. Accompanying symptoms, complications and changes in the mucous membrane are not taken into account. This is an inefficient approach.
2. It implies diet therapy, taking antacids. Medications are prescribed with varying degrees of exposure, depending on the severity of the inflammatory process.
3. Effective in the treatment of severe forms of the disease. First, the reception of strong PPIs is shown. After the removal of the inflammatory process, weak prokinetics are prescribed.

The choice of the scheme is carried out by the attending physician based on the clinical picture and examination data.

Classic scheme in 4 stages

The classic treatment regimen for reflux esophagitis, presented in 4 stages, depends on the degree of the disease.

As can be seen from the table, the higher the degree of development of the disease, the stronger the drugs.

Important milestones

Drug treatment is carried out in 2 stages. The first is aimed at eliminating provoking factors and ensuring the healing process of the mucous membrane of the organ. At the second stage, the goal of therapy is to achieve remission. In this case, 3 treatment options are possible:

• taking PPI for a long time in a high dosage;
• as needed, short-term (5 days) intake of PPIs;
• the drug is taken only if symptoms appear.

The doctor chooses the necessary option, after agreeing it with the patient.

Preparations

For drug treatment of reflux esophagitis, different groups of drugs are used, which differ from each other in many factors. They may have a different mechanism of action, the duration of the onset of the effect, vary in time of administration, price, and so on.

Antacids and alginates

The purpose of antacids is to neutralize hydrochloric acid. In addition, they promote the release of bicarbonates, bind bile acids, and inactivate pepsin. Preference is given to non-systemic preparations that contain aluminum and magnesium, for example: Gastal, Phosphalugel, Maalox. Experts recommend using drugs in liquid form for the treatment of reflux esophagitis.

Alginates are also designed to reduce the acidity of the stomach contents. They contain alginic acid. These include: sodium alginate, Gaviscon, Topolkan. They are preferred over antacids containing aluminum.

PPI - proton pump inhibitors

Proton pump inhibitors - PPIs - drugs designed to reduce the acidity of gastric juice by blocking the release of hydrochloric acid by the cells of the body. They have a number of advantages:

• fast action;
• are not absorbed into the bloodstream;
• have a minimum of side effects.

The most common inhibitors are: Rabeprazole, Omeprazole, Pantoprazole, Lansoprazole.

H2-histamine receptor blockers

H2-histamine receptor blockers are drugs whose purpose is also to reduce the acidity of gastric juice. They act on H2-histamine receptors, block them, as a result of which the release of hydrochloric acid stops. To date, there are 5 generations of drugs in this group, the most preferred of which are: Ranitidine and Famotidine.

NOTE! A characteristic feature of H2-histamine receptor blockers is to cause a backlash in the event of a sharp cessation of their intake (rebound syndrome).

Prokinetics

Prokinetics include drugs that increase the motility of the stomach and its evacuation activity. In addition, they operate in the following areas:

• reduce the time of contact of the contents of the body with the inner wall of the esophagus;
• contribute to the cleansing of the esophageal mucosa;
• increase the tone of the lower esophageal sphincter.

Often, prokinetics are prescribed concomitantly with PPIs. Among them are: Domperidone, Itoprid, Tegaserod.

Cytoprotectors

This group of drugs includes drugs whose action is aimed at increasing the protective properties of the inner wall of the esophagus and stomach. Their use allows:

• increase the secretion of mucus and enhance its protective properties;
• improve blood circulation in the mucous membrane of the esophagus;
• reduce stomach acid (misoprostol);
• accelerate the healing of erosions and ulcers on the mucosa of the esophagus and stomach.

Among the drugs can be noted: Dalargin, Misoprostol.

Symptomatic treatment

Reflux esophagitis can be caused by another disease or occur with concomitant pathology against its background. In this case, the treatment will be symptomatic:

• If the cause is nervous, neurological or psychological problems, then consultation of the appropriate specialist is required. Sedatives, antidepressants, and others may be prescribed.
• In the presence of a stomach ulcer, antibiotics are additionally indicated.
• If the mucous membrane of the esophagus is exposed to third-party effects on the background of reduced immunity, then it is recommended to take immunostimulating agents in parallel.

According to the same principle, treatment is carried out if any other disorder is a prerequisite for reflux esophagitis.

Homeopathy for reflux esophagitis

When prescribing homeopathic remedies, the symptoms present at the moment and the prescribed medications are taken into account without fail. The task of homeopathy in this case is to preserve and maintain the ongoing therapy, accelerate the regeneration of the tissues of the esophagus and stomach, as well as normalize the motor function of the digestive tract. In the course of treatment, the following means can be used:

• magnesium phosphate (pain relief);
• iris versicolor, veratrumalbum (for heartburn and chest pain);
• potassium bichromicum (heartburn, increased secretion of hydrochloric acid);
• belladonna, argentumnitricum (severe inflammation, erosion in the esophagus).

Homeopathic remedies are selected in strict accordance with the characteristics of the patient's constitution. Pay special attention to the physical and mental state, the intensity of the disease. At the first stage, symptomatic drugs are selected, and then, as the condition improves, the main drugs are prescribed, usually in high dosages (no more than three drugs).

Multivitamins

To accelerate tissue regeneration, restore general and local immunity and ensure a speedy recovery, vitamins and macro- and microelements are needed. The usual diet does not provide sufficient intake of these compounds in the body, especially in diseases of the digestive tract. Therefore, you also need to take multivitamin complexes.

Approaches

To date, there are various approaches to the medical treatment of reflux esophagitis. The choice of either method is determined by the severity of the disease, morphological changes in the esophageal tissue, secretion features and other factors:

• According to Sheptulin. The essence of the approach: the appointment of drugs of varying degrees of aggressiveness in several stages.

1. Combination of antacids with diet therapy and lifestyle changes.
2. Use of prokinetics or blockers of H2-histamine receptors.
3. The use of proton pump inhibitors or H2-histamine receptor blockers in conjunction with prokinetics.

• According to Grigoriev Therapy is based on the stage of the disease and its form.

• According to Titgat:

1. At the initial stage of development of reflux esophagitis, diet therapy is indicated in combination with antacids. The latter can be replaced with a short course of H2-histamine receptor blockers.
2. In the second degree, a long course of prokinetics and H2 blockers is prescribed. A short course of treatment with proton pump inhibitors is possible.
3. In the third stage of the disease, H2 blockers are combined with PPIs. Another option: prokinetics and blockers in high dosages.

If the effect of drug therapy is absent, then surgical intervention is indicated. In the event of a deterioration in the psychological state of the patient, Eglonin or Grandaxin with Teralen are prescribed.

Supportive care

The tasks of maintenance therapy include reducing the aggressive effects of drugs. In the first two stages of the disease, this function is performed by prokinetics in the usual dosage. With a more severe course of reflux esophagitis, strong H2-blockers are added to the prokinetics. Admission is permanent, under diagnostic control of the state of the mucous membrane.

Pregnancy and GERD

During pregnancy, the appointment of high doses of antacids with aluminum, as well as sodium bicarbonate, is contraindicated. Taking antacids with magnesium will result in a mild laxative effect. For treatment, you can use such medicinal and herbal remedies as:

• chamomile flowers;
• alginates;
• starch;
• alder seedlings.

The greatest effect is achieved with a combination of alginates and astringents.

Children

Drug therapy of reflux esophagitis in children should be carried out only under the supervision of a physician. The diagnosis is made after a thorough examination. With a mild degree of the disease, antacids or H2-histamine receptor blockers (Ranitidine, Famotidine) are most often prescribed. When used independently, it must be remembered that these remedies eliminate only the symptoms of the disease, and not the cause.

Early age

In infants, reflux is a normal physiological phenomenon, but its course also requires special attention. In the event of its transition to a pathological form, urgent measures will need to be taken to prevent the further development of the disease. Treatment of reflux esophagitis in infants is not schematized, as it is performed only according to strict indications and in accordance with a specific case. Basically, postural therapy, antireflux mixtures, correction of diet are used.

older age

For older children, as well as for infants, the treatment of reflux esophagitis begins with a change in diet, diet therapy, and the use of herbal decoctions. If non-drug therapy does not lead to relief of the condition, then drugs are used. At an older age, according to the testimony of a doctor, it is possible to use drugs such as:

• antacids and alginates;
• blockers of H2-histamine receptors.

The main drugs for treatment in this case are antacids. If the symptoms of reflux esophagitis in a child appear regularly, then the use of PPIs and blockers is additionally indicated.

ATTENTION! The choice of the drug, its dosage and the duration of the course of treatment is carried out only by a doctor!

Conclusion

Treatment of reflux esophagitis is a long process that requires a medical stage. If the drugs and the treatment regimen are chosen correctly, then this contributes to a faster recovery and prevention of relapses. Otherwise, the disease may take a chronic form and / or go to the next stage. Therefore, it is very important to contact a specialist in time and follow his instructions in a timely manner. To date, there is a sufficient number of medications and methods that allow you to get rid of pathology at any age.