How to relieve inflammation of the esophagus of the stomach. Frequent symptoms of reflux esophagitis. Therapy for inflammation of the esophagus

Every person from birth is accustomed to constantly having breakfast, lunch, and dinner, since a person cannot live without food. Apart from sun-eating and spiritual food lovers, the process of food entering the body is the same for all mammals. The esophagus is the only organ through which food naturally enters the stomach. Like the entire body, it is susceptible to diseases, such as. To commit right actions in case of damage, it is necessary to know the causes of diseases, how to properly treat the esophagus, contraindications in treatment, and how to prevent the development of the disease.

To understand the process of food entering the stomach, consider the structure of the esophagus and its location.

The esophagus is a hollow, flattened tube made of muscle tissue to deliver food from the pharynx to the stomach, being part of the . The organ consists of the cervical (4-7 cm), thoracic (16-20 cm) and abdominal (3-5 cm) sections.

In an adult, the esophagus has a length of 23-27 cm. The structure of the organ wall is a layered “pie” of vascular, muscular, submucosal, etc. The muscularis propria combines the circulation layer on the inside and the longitudinal layer on the outside. Food moves from the esophagus into the stomach when the lumen is opened in only one direction. The influence of external and internal reasons leads to organ disease. What changes should you pay attention to?

Symptoms, types of disease, treatment of esophageal diseases

General symptoms

The main symptoms of the changes that have begun are belching, heartburn, bad breath, pain when swallowing, and discomfort in the body. Basic negative reason is a violation of motility - the ability of the esophageal muscles to push food through, which is associated with vascular damage and the growth of tumors. This can pose a great threat to health and life.

Types of diseases

Mechanical damage

Mechanical damage- the most common cause of injury to the esophagus, in which the mucous membrane walls

Depending on the severity of the symptom, the patient gets worse general state, blood clots are released while eating, severe pain occurs when swallowing. All three sections of the esophagus are susceptible to injury.

The reasons are:

Entry of foreign objects from the larynx.
Infliction of gunshot, stab, laceration, and cut wounds.

Depending on the severity, surgery is indicated or conservative treatment.

Important! Mechanical damage is a reason to urgently call emergency medical assistance.

Burns of various origins

Burns of the esophagus can be chemical or thermal. A chemical burn occurs as a result of destruction of the mucous membrane by strong acids and alkalis after they enter the digestive tract. Drinking very hot liquids or food will cause thermal burns.

The reasons are children's curiosity, accidental consumption of aggressive substances in food, and inattention. Depending on the severity of the burn, the esophagus may appear strong pain with poisoning of the body, nausea, fever and organ failure.

Before starting treatment for a chemical burn, it is necessary to rinse the stomach to remove it from the esophagus. chemical substances. After neutralizing the chemical residues, procedures are prescribed to improve the patient’s condition.

Severe 2nd and 3rd degree burns affecting all layers or only the submucosal layer are treated only in a hospital.

Paralysis and spasms of the esophagus

Paralysis and spasms of the esophagus lead to impaired muscle tone, causing dysphagia - difficulty drinking and swallowing food. Occurs frequently aspiration pneumonia– entry of the contents of the stomach or nasopharynx into the lower Airways.

The cause is emotional stress, the occurrence of inflammation as a result of a foreign body entering the esophagus. Diphtheria, alcoholism, and botulism intoxication contribute to the development of the disease.

Treatment consists of psychological support and relief emotional stress, removal of a foreign object.

Cardiospasm (achalasia)

As a result of this disease, food does not enter the stomach due to incomplete opening or blockage of the lower esophageal sphincter. Cardiospasm is determined by the inability to swallow food, regurgitation, muscle pain from a full esophagus, increased salivation. In advanced cases, the disease can cause the growth of cancerous tumors.

The reasons are psycho-emotional stress and developmental abnormalities.

In the initial stage of treatment of achalasia, drugs are used that improve the movement of food through the esophagus. It is more effective to expand a narrow area using a special cylinder. When the wall of the esophagus is thinned and there is a danger of its rupture, surgical intervention is used.

Hiatal hernia

With congenital anomalies or acquired damage, it occurs. The internal abdominal organs move to chest cavity as a result of defects in the diaphragm, which ultimately leads to hidden bleeding and anemia.

To eliminate the reflux of stomach contents into the esophagus, conservative treatment is used. Dilatation of the esophagus, elimination of bleeding, and ineffectiveness of drug treatment are corrected by surgery.

Ulcer

Perforation of the wall of the esophagus as a result of the action of gastric juice on it is defined as an esophageal ulcer. An ulcer can be true (peptic) or of an uncertain nature (symptomatic).

The causes of occurrence are determined by the effect of gastric juice on the esophagus, stress, and the influence of chemicals and medications.

In the initial stage, combining drug treatment with diet is effective. If there are no positive results, surgery is used.

Tumor formation

Neoplasms, or tumors, in the digestive system are divided into benign and malignant (cancerous). More often benign education, leiomyoma, affects the smooth muscle of the esophagus.

Lymphoma, adenocarcinoma, squamous cell carcinoma - cancerous tumors, which grow in any part of the esophagus.

Reasons for appearance:

DNA mutation.
Very hot food.
Smoking, alcohol abuse.
Low content of greens and fruits in the diet.
A large number of pickled products.

Treatment of tumors in 98% of cases is performed surgically. Parallel chemotherapy procedures with compliance special diet increase the effectiveness of recovery by 3-5 times.

Diagnosis of esophageal diseases

Techniques and methods for diagnosing diseases of the digestive tract depend on the quality of the patient’s interview and identification of all symptoms. During the examination, hardware methods are used, using a probe with catheters or balloons.

To determine muscle spasm of the esophagus and its deformation, X-ray examination is used, and if necessary, contrast agent, barium salts. Internal pH-metry helps to identify dysfunction of the lower esophageal sphincter by determining the degree of acidity of the environment.

Choice of treatment method

If you have a disease of the digestive tract, you can do without surgery by treating it at the moment of its onset. In addition, it is necessary to take into account concomitant diseases that make it impossible to use individual species treatment. Self-medication at home is contraindicated; a medical diagnosis is required and professional choice method of treatment.

Treatment options

Conservative treatment with antispasmodics, sedatives, drugs, medications with enveloping properties that reduce the concentration of gastric juice.
Expansion of bottlenecks in the esophagus using pneumatic balloons.
Application surgical intervention when esophageal cancer is detected in the later stages of the disease.
Use of radiation therapy, chemotherapy.

The combination of nutrition and a special diet plays a significant role in the patient’s recovery.

Prevention and diet in the treatment of the esophagus

To prevent and prevent diseases, it is necessary to bring your weight to normal. When sleeping, you need a pillow at a high head of the bed, which helps prevent food from refluxing into the esophagus.

Fractional intake of small portions of food from chewing thoroughly relieves muscle tone and facilitates the passage of food to the stomach.

The consistency of the food should be homogeneous, heated to body temperature. Eating porridge is beneficial. The use of sea buckthorn and olive oil, which is taken in small portions on empty stomach. Eating and digesting food while standing is recommended when gastric juice refluxes into the esophagus. In case of exacerbation, it is necessary to switch to daily fasting using medicinal mineral water.

Important! The choice of diet and diet must be agreed with the attending physician.

The similarity of symptoms of esophageal disease with gastric disorders, heartaches, pulmonary diseases allows them to skillfully disguise themselves as third-party diseases. Ignoring discomfort in digestive tract, reluctance to follow a diet, lack of constant physical activity - a direct path to the operating table. Often, it's a one-way journey. It's up to you to decide which path to take.

Anton palaznikov

Gastroenterologist, therapist

Work experience more than 7 years.

Professional skills: diagnosis and treatment of diseases of the gastrointestinal tract and biliary system.

The disease erosion of the esophagus can cause mass unpleasant symptoms, some of which can cause serious harm to the human body. Patients with erosion experience heartburn and pain in the area of the esophageal tube, which intensifies with the intake of dry or hard foods.

Concept

Esophageal erosion is a disease in which the mucous membrane of the esophageal tube suffers from inflammation caused by gastric juice entering the esophagus. The mucous membrane is irritated under the aggressive influence of hydrochloric acid.

Photo of esophageal erosion during diagnosis

Most often, gastric juice penetrates the esophagus due to complications. In addition to a hernia, it can also provoke an inflammatory process.

Not all patients experience suspicious symptoms caused by erosion. Most people learn about the presence of the disease only during gastroscopy. Erosion, despite the mild symptoms, is very dangerous, as it can lead to bleeding, peritonitis, and other dangerous ailments.

Causes

There are many reasons for erosion, but most often the disease occurs under the influence of factors such as vitamin deficiency and diseases that lead to insufficient oxygen supply to tissues.

The most common causes of erosion of the esophageal tube are the following factors:

viral infections;
gastrointestinal diseases;
intestinal diseases;
dysfunction of the lower esophageal sphincter;
operations on the gastrointestinal tract;
dysbacteriosis;
obesity;
ingestion of chemicals into the esophagus;
faults in nutrition.

Also, esophageal erosion can occur in those patients who take a number of medications for a long time, including:

beta blockers;
dopamine;
and etc.

The appearance of diaphragmatic hernias, which are a common cause of the disease, is accompanied by the following factors:

shortening of the esophagus surgically when removing tumors;
weak esophageal tone;
liver pathologies;
inflammation of the esophagus;
kyphosis;
enlargement of the diaphragmatic opening.

Symptoms of esophageal erosion

The severity of symptoms with esophageal erosion is quite weak. The main signs that may indicate danger are:

pain syndrome, reminiscent of angina pain;
burning, dull or sharp pain in the chest and abdominal area, radiating pain is possible;
discomfort or pain when moving the body to another position or while eating;
pain similar to the feeling of overeating, which tends to decrease in vertical position housings;
vomiting, hiccups and regurgitation;
dysphagia or pain when swallowing food and drinks;
increased salivation;
unpleasant odor from the mouth.

All of the symptoms characteristic of esophageal erosion are not specific. That is why the patient cannot independently come to the conclusion that he has of this disease. Similar symptoms may also indicate.

In this regard, if signs of illness occur, you should undergo instrumental examination from a specialist.

Kinds

Medical practice describes different types of esophageal erosion, according to specific symptoms. One of the main classifications divides erosion into 2 types, based on the causes of occurrence:

Primary type. It implies erosion, as a disease of the esophageal tube itself.
Secondary type. Lesions of the mucous membrane occur under the influence of other concomitant diseases.

Erosion of the esophagus is also divided into the following subtypes:

Erosions not associated with tissue malignancy. This subspecies has several different types: acute types of lesions, erosive gastritis, as well as chronic, polypoid, flat, linear, multiple and single types of various types of lesions.
Erosions associated with malignant lesions. Most often they are diagnosed in the event of dangerous processes occurring in the cavity of the esophageal tube.

Today, world medicine continues to thoroughly study the disease and identify its more distinct subtypes.

Consequences

Even despite the mild severity of the symptoms accompanying esophageal erosion, the disease is still considered quite dangerous. This is explained by the threat from possible complications.

The consequences of the disease can be very varied, but perhaps one of the most dangerous is the rupture of a vessel and the opening of bleeding in the esophagus.

The main sign of a ruptured vessel is the appearance of vomiting with scarlet blood. Most often, this complication appears in a number of men suffering from alcohol addiction, as well as smoking abusers. Often to similar situation lead frequent stress and depression. This condition occurs less frequently in older patients.

Other common consequences of esophageal erosion are the following damage to the tissues and mucous membrane of the organ:

thrombosis of blood vessels in the organ;
ulcers of the mucous membrane;
formation of scars, obstructions;
narrowing of the esophagus, complicating blood flow;
the appearance of tumors.

Any complication can overtake the patient in case of neglect of the disease. That is why there is no time to waste and it is worth taking time to diagnose. After the diagnosis is made, the patient needs to undergo compulsory treatment. Only in this case the prognosis for recovery is positive.

Diagnostics

Most often, the patient learns about erosion during an examination by a gastroenterologist. News about the presence of the disease often puts a person in a stupor.

That's why preventive examinations should not be ignored. IN as a last resort, you need to consult a doctor when suspicious symptoms are identified.

First of all, the doctor is interested in the patient’s complaints, that is, he collects an anamnesis. When collecting complaints, the doctor pays special attention to the type of pain irradiation (in the neck, sternum, spine, epigastric region), as well as the nature of the symptoms (constant or periodic).

During diagnosis, the doctor carefully examines the following factors:

condition of the esophagus;
condition of the abdominal organs;
condition of the skin and chest.

Palpation is also mandatory, which allows you to determine swelling or the presence inflammatory process. Mandatory methods for diagnosing esophageal erosion are:

blood chemistry;
stool test for occult blood;
Analysis of urine;
X-ray examination;
colonoscopy;
esophagotonokymography.

How to treat esophageal erosion?

Self-treatment of esophageal erosion is impossible. The disease is complex, and that is why the complex therapeutic measures can only be prescribed by a competent doctor.

In addition to a number of medications, the doctor also necessarily prescribes diet therapy to the patient. Sometimes a patient may be recommended a number of traditional methods of therapy.

Medicines

Typically, a set of measures for the treatment of esophageal erosion includes:

Antacids. These drugs are prescribed to combat heartburn and increased acidity. Among them are Almagel, Phosphalugel, Maalox.
Biologically active alginates. These drugs envelop the mucous membrane and protect it. Such drugs include Gaviscon.
Inhibitors. These include drugs such as Omez, Nexium, Omeprazole, as well as h²-histamine blockers, including Ranitidine, Zontak. These drugs reduce the secretion of gastric juice.
Prokinetic agents. Such drugs greatly facilitate the work of the stomach. Cisapride, Motilium and Ganaton are usually prescribed.

It is not safe to buy and drink these drugs without prior examination and prescription by a doctor. The range of drugs for each patient is prescribed individually, based on the severity of symptoms and diagnostic results.

Folk remedies

There are a number of means traditional therapy, which can help overcome the symptoms of esophageal erosion and speed up the healing of the affected mucosa.

For 1-2 months, half an hour before meals, you should take two tablespoons of potato juice. Courses of such treatment should be carried out 2-3 times a year.
For 4-10 weeks you should drink potato and carrot juice 4 times a day half an hour before meals. It is worth going through 3-4 such courses of treatment per year.
You should take one tablespoon of honey 3-4 times a day. It is advisable to take honey 30 minutes before meals. The product is able to envelop the affected esophagus and heal erosions that occur on the esophageal mucosa.
One of the most effective means for esophageal erosion, use sea buckthorn oil. Oil can restore the mucous membrane, it destroys microbes and accelerates healing. You need to take one teaspoon of oil three times a day, 10 minutes after meals. Treatment should last until full recovery and another 10-20 days after.

Traditional methods can help only in combination with drug treatment, so you should definitely contact a specialist.

Diet

The diet, in addition to observing the intake and refusal of certain dishes, also includes a number of nutritional rules, the observance of which is mandatory:

Eating too cold or hot food can worsen the patient's health.
Doctors recommend drinking 200 ml. milk every time before going to bed.
While consuming food, you should completely avoid drinking water or other drinks.
During an exacerbation of the disease, it is recommended to exclude from the diet any vegetables or fruits that have not been subject to pre-heat treatment.
Food should be consumed more often than usual - 6 times. You need to eat in small portions. This will get rid of high acidity.
During an exacerbation, it is also recommended to take soft, porridge-like foods. These are cream soups, pureed vegetables and fruits, boiled fish, jelly or jelly.

For esophageal erosion, the doctor may prescribe one of the following diets:

Therapeutic diet 1a - prescribed for exacerbation.
Therapeutic diet table 1b - prescribed after 10-14 days.
Diet No. 1 is prescribed after 20 days.

During the period of decline of the disease and recovery, the doctor usually prescribes diet No. 1, but the specialist can make some adjustments to it.

You can consume:

warm drinks and warm, gentle dishes;
dairy products;
steam cutlets from chicken or low-fat fish;
steamed and boiled dishes in crushed form.

fried meats and fish, fried vegetables and fatty foods;
sauces;
hot spices;
ice cream, cold drinks;
hot dishes;
dry food without pre-processing;
soda;
sour juices and compotes;
strong drinks.

Even the slightest deviation from the nutritional rules prescribed by the doctor can lead to an immediate deterioration in the patient’s condition. As a preventive measure, it is recommended to refuse.

Esophagitis is an acute or chronic inflammatory disease of the mucous membrane of the esophagus. It often occurs in men aged 25 years and older. The occurrence of esophageal erosions due to chronic esophagitis is dangerous in relation to the development of bleeding and strictures (scar narrowing) that reduce the lumen of the esophagus.

Most often it develops due to gastroesophageal reflux, but other causes should also be remembered. Diagnosis is based on endoscopic examination, however, in 30-40% of patients with GERD, endoscopic signs of inflammation are not detected. The Los Angeles classification of esophagitis is most often used.

Causes of esophagitis

The disease is caused by local irritants (burns with caustic acids and alkalis, prolonged vomiting, probing), focal infection (tonsils, teeth, gallbladder, appendix) and general infection (scarlet fever, sepsis). One should distinguish between acute (ulcerative), subacute, and chronic esophagitis.

The causes of esophagitis may be the following:

Infections: fungal (Candida, Aspergillus), bacterial (staphylococcus, streptococcus) and viral.
Systemic diseases: pemphigus, Behcet's syndrome.
TPH reaction.
Inflammatory bowel disease: The esophagus is rarely affected in Crohn's disease.
Drug-induced esophagitis.
Exposure to food and air allergens.
Chemo- and radiation therapy: possible development of inflammatory changes in the mucous membranes. Irradiation at a dose of 30 Gy leads to esophagitis, which is potentiated by chemotherapy.

Esophagitis is called inflammation of the mucous membrane of the esophagus. It can be caused by chemical (acids, alkalis, etc.), thermal (mainly hot food and drink) or mechanical effects (scratching the walls of the esophagus by accidentally swallowing sharp object, for example, fish bone, etc.) on the mucous membrane of the esophagus. Esophagitis can also develop during acute infectious diseases, sepsis. Esophagitis is often accompanied by acute pharyngitis and gastritis.

Subacute and chronic esophagitis occurs, as a rule, due to repeated or long acting and the mucous membrane of less strong irritants, which may be too hot, rough and spicy food, strong alcoholic drinks, chemicals, as well as medications. Chronic esophagitis may accompany chronic inflammatory diseases nasopharynx, stomach, and sometimes observed in chronic infectious diseases such as tuberculosis and syphilis. A common cause of subacute or chronic esophagitis is the reflux of gastric contents into the esophagus. This happens with hernias hiatus diaphragms, which are quite common; their occurrence is predisposed by obesity, overeating, increased intra-abdominal pressure and excessive exercise stress, as well as operations on the stomach and esophagus.

Esophagitis caused by chemicals often leads to irritation of the esophagus and prevents the bolus from moving through it. In such cases, carry out surgery. The choice of each operation depends on the specific case.

Damage to the mucous membrane of the esophagus can occur due to aggressive food exposure. The cause may be abuse of spicy, sour, chemically aggressive foods, strong alcoholic drinks and alcohol substitutes. Another factor is consuming extremely hot or rough food.

Esophagitis may be a component of some systemic diseases connective tissue, such as systemic scleroderma. Then he even enters diagnostic criteria diseases.

Chemical agents, such as strong acids and alkalis, also cause damage to the mucosa and the development of acute esophagitis, which results in necrosis of the esophageal mucosa. The use of such substances occurs through negligence, sometimes with the aim of committing suicide. It is necessary to find out from the patient what substance was taken, since the mechanism of action, course and emergency assistance are different. When exposed to acid, an alkaline drink is indicated, and in case of an alkaline burn, an acidified drink is indicated. Acids often cause coagulative necrosis with the formation of a scab, and alkalis, on the contrary, cause liquefaction necrosis, which has no tendency to limit itself.

Occupational factors can also cause this disease. Many patients who work in contact with vapors of acids, alkalis, and various types of dust, after a certain time begin to present complaints characteristic of chronic esophagitis.

Such complaints are possible against the background of other diseases of the esophagus associated with prolonged stagnation of food in the esophagus and trauma to its wall (for example, with diverticulosis or achalasia of the cardiac esophagus).

Esophagitis observed against the background of traumatization of the mucous membrane of the esophagus by a foreign body, most often a fish bone, a fruit stone, or a splinter solid, become the impetus for the onset of the inflammatory process.

Infection

Esophageal candidiasis occurs in weakened individuals and patients taking antibiotics wide range actions or cytotoxic drugs. This is a particular problem in patients with AIDS, who are also susceptible to other esophageal infections.

Corrosive substances

Suicide attempts using bleach or battery fluid result in painful burns oral cavity and pharynx and widespread erosive esophagitis. Esophagitis is complicated by perforation of the esophagus with the development of mediastinitis and the formation of strictures. In the acute phase, conservative treatment based on pain relief and adequate nutrition is indicated. After the acute phase, it is necessary to conduct a radiopaque study with barium sulfate to visualize the severity of the strictures. Endoscopic dilatation of the esophagus is usually necessary, but this procedure is associated with technical difficulties and dangerous because strictures are usually long, tortuous and easily perforated.

Medicines

Potassium supplements and NSAIDs can cause ulcers if the tablets become lodged above an esophageal stricture. In such patients, liquid forms of these drugs must be used. Bisphosphonates, especially alendronate, have been associated with esophageal ulceration and should be used with caution in patients with established esophageal disease.

Pathogenesis of esophagitis

Depends on the etiological factor that caused the process. In this case, there is always damage to the mucous membrane of the esophagus.

Classification of esophagitis

According to the course, esophagitis can be acute, subacute and chronic.

Morphologically, the following forms of esophagitis are distinguished:

catarrhal;
hydropic;
erosive;
pseudomembranous;
hemorrhagic;
exfoliative;
necrotic;
phlegmonous.

According to the area of the lesion - focal and diffuse esophagitis.

According to the course of the disease they are classified:

acute esophagitis (duration no more than 2-2.5 months);
subacute esophagitis (duration over 3-6 months);
chronic esophagitis (duration over 6 months).

Symptoms and signs of esophagitis

The clinical triad is pain, dysphagia, vomiting, often bloody, although often inflammatory changes occur without subjective symptoms.

Retrosternal pain is of a burning nature and is not relieved, unlike peptic ulcers, by eating or using alkalis. Swallowing, especially hard food, increases pain. Bleeding is frequent, even significant. Possible perforation of the esophagus with the development of signs of acute mediastinitis.

Acute inflammation of the esophagus is manifested by pain when swallowing along the esophagus, profuse drooling, sometimes dysphagia - disorders of the act of swallowing, unpleasant sensations, rawness and pain behind the sternum.

Hemorrhagic esophagitis is characterized by the appearance of vomiting mixed with fresh blood. And with esophagitis, which accompanies diphtheria and scarlet fever, fibrin films are found in the vomit.

An abscess of the esophagus occurs with a picture of septic intoxication: an increase in body temperature to 39-40 ° C, general weakness, chills and heavy sweats; which sometimes causes icteric discoloration of the skin and various rashes. In this case, you should immediately consult a doctor or call " ambulance" Often, as a result of acute esophagitis, patients are completely unable to take food, even liquid food.

Subacute and chronic esophagitis are characterized by heartburn and a burning sensation, in in rare cases- chest pain, which sometimes resembles heart pain. If there is a hernia in the esophageal opening of the diaphragm, then, in addition to heartburn, the patient also complains of belching, which especially intensifies when the torso is tilted forward and when the patient lies down. Only a special examination - esophagoscopy - allows one to assess the severity of the disease, its prevalence, and nature; X-ray examination makes it possible to detect a hiatal hernia.

Pain syndrome occurs in all diseases of the esophagus. First, the pain appears in the esophagus and is interpreted by patients as retrosternal. Patients complain of a “stake” in chest. As a result, it is required differential diagnosis with diseases of cardio-vascular system. The pain is noticeable during or after eating, and its intensity is much stronger when eating spicy, hot or cold, rough food. It can radiate to the back, between the shoulder blades, in lower jaw. Relief of pain, especially with reflux esophagitis and alimentary esophagitis, occurs after the use of antacids.

Dysphagia - characteristic symptom diseases. Usually associated with pain in the esophagus and provoked by the same factors. Dysphagia is a swallowing disorder in which patients feel that the bolus of food is stuck at a certain level and does not pass further, which is accompanied by bursting pain in the chest. Swallowing problems due to inflammation of the esophageal mucosa are often associated with the consumption of liquid or chemically aggressive foods.

Regurgitation is the throwing of the contents of the esophagus into the oral cavity during congestive esophagitis.

Belching in chronic esophagitis is not a frequent and obligatory symptom. There is belching of air and also food. Vomiting is typical for alcoholic esophagitis, sometimes morning vomiting.

Diagnosis of esophagitis

General clinical research methods for independent lesions of the esophagus have no definite value. Esophagoscopy plays an important role, in which swelling, thickening and hyperemia of the mucous membrane of the esophagus, and the presence of mucus on its surface are noted. With more severe course First, single and then multiple erosions and bleeding appear when touched with an endoscope. X-ray examination is carried out using barium sulfate as a contrast and is carried out in the morning. The day before, the patient should not eat later than 18:00 the previous day. X-ray examination reveals characteristic changes organ shapes and organ contours. On an x-ray with esophagitis, you can see an uneven contour of the esophagus, thickening of the folds and swelling of the mucous membrane.

The diagnosis is most accurately established by esophagoscopy with examination of biopsied material to exclude cancer or a specific lesion (tuberculosis, syphilis). Esophagitis should be distinguished from cholecystitis, peptic ulcers, duodenitis, acute peritonitis sometimes giving similar symptoms.

Eosinophilic esophagitis

The disease is more common in men. Food and air allergens can act as etiological factors. The autoimmune nature of the disease cannot be ruled out. It is generally accepted that the allergic reaction in eosinophilic esophagitis is a type IV reaction. Except typical symptoms, characteristic of GERD (heartburn, belching, dysphagia), patients may experience epigastric pain and other signs of allergy: allergic rhinitis, bronchospasm, dermatitis.

Treatment: elimination diet, systemic or topical corticosteroids. The use of the latter is preferable (two sprays in the mouth followed by ingestion for 6 weeks).

Esophagitis officinalis

It is known that many medicines can cause damage to the esophagus. In 90% of cases these are NSAIDs, antibiotics (especially tetracycline), antiviral drugs, potassium chloride, iron supplements, quinidine and bisphosphonates.

Patients with strictures and tumors of the esophagus, achalasia, scleroderma should take medications in a standing position, washing them down big amount water.

Chemotherapy-induced esophagitis is caused by adriamycin, fluorouracil, methotrexate, and vincristine. All of these drugs cause oropharyngeal damage, manifested by dysphagia. In the absence of changes in the mouth area, the esophagus is usually not affected.

Treatment of esophagitis

Treatment of esophagitis depends on the causes of the disease and the severity of the pathological process.

So, in case of chemical substances entering the esophagus, i.e. in case of poisoning with acids and alkalis, it is necessary to lavage the stomach as quickly as possible using a probe, and then give the victim a weak solution to drink boric acid, if poisoning with alkalis has occurred, or burnt magnesia mixed with water, if poisoning with acids has occurred. The patient should be laid down and an ice pack placed on the chest. To remove pain He can be given pieces of ice or ice cream to swallow, as well as cold cream, milk or oil emulsions.

In case of abscess and phlegmon, as well as in some other situations (in case of hiatal hernia, obstruction of the esophagus), the doctor refers the patient to a hospital for treatment and prescribes antibiotics, and if such treatment is ineffective, bougienage of the esophagus or surgery. They also organize feeding the patient with nutritional mixtures either through a tube, or through drip enemas, or through intravenous infusions of solutions for parenteral nutrition.

When treating acute and chronic esophagitis at home, the doctor prescribes a gentle diet No. 1, and sometimes fasting for several days. The diet includes mucous, enveloping jelly-like dishes, vegetable oil, raw eggs, jelly.

Before meals, you need to take astringents, for example, basic bismuth nitrate or silver nitrate, as well as magnesium and aluminum hydroxide, precipitated calcium carbonate, etc.). If esophagospasm occurs, the doctor may prescribe an antispasmodic agent (ganglefen).

For tube feeding they produce dry nutritional mixtures. They provide physiological need the body in proteins, fats, carbohydrates, minerals and vitamins. They also contain food ingredients that are essential for humans (some amino acids, polyunsaturated fatty acid and etc.).

Aluminum and magnesium hydroxides are antacid, absorbent and enveloping substances. Therefore, they are successfully used in the treatment of esophagitis. They are prescribed orally, 1-2 tsp. 4 times a day 30 minutes before meals and before bed.

In case of hiatal hernia, patients should especially strictly follow the doctor’s recommendations. For example, you need to be exclusively in a vertical position for 20-30 minutes after eating, adhere to fractional meals and avoid strong tension abdominals. Therefore, all types of heavy physical labor are contraindicated for patients. Doctors recommend that such patients sleep with the upper half of the body elevated, that is, in a semi-sitting position, which prevents gastric contents from flowing into the esophagus.

Failure to comply with doctor's instructions can lead to very sad consequences. As a complication of this pathology, perforation of the esophageal wall and peritonitis may occur; severe acute and chronic esophagitis can lead to cicatricial shortening of the esophagus, which further contributes to the enlargement of an existing hiatal hernia.

Treatment of chronic esophagitis includes a strict diet with mechanical, thermal, chemical sparing, complete cessation of smoking and alcohol, and a change of place of work if the disease is of an occupational nature.

Drug treatment includes drugs from the group of gel antacids, which form a protective film on the surface of the esophagus. In this case, immediately after taking the drug you must take horizontal position for 10 minutes and turn from side to side. The dosage of the drugs is standard, and the duration of use of the drug is determined by the severity of the disease.

Complications of esophagitis

Cellulitis and abscess of the esophagus and, as a consequence, perforation of its wall with the occurrence of mediastenitis or peritonitis; esophageal bleeding, strictures and cicatricial changes in the esophagus, Barrett's esophagus, oncological pathology esophagus.

Prognosis for esophagitis

In complicated esophagitis, the prognosis is serious; in chronic esophagitis, the prognosis depends on the timeliness and adequacy of treatment and prevention.

Prevention of esophagitis

Preventive treatment of chronic esophagitis includes taking antacids and astringents, as well as avoidance of work and physical activity.

As aid treatment can be used mineral water, which is aimed at reducing the acidity of gastric juice, normalizing the functioning of the esophagus and stomach, reducing the inflammatory process in the mucous membrane of the esophagus. In this case, alkaline is usually prescribed. mineral water, heated to 38-40 °C, 45-60 minutes after meals, a glass 3 times a day.

In sanatorium-resort institutions, physiotherapists prescribe mineral baths at a water temperature of 36-37 °C; per course of treatment - 8-10 procedures in the absence of generally known contraindications. Mud therapy is also carried out in the presence of concomitant diseases (such as peptic ulcer, cholecystitis, colitis, etc.) and in the absence general contraindications(including anemia, gastrointestinal bleeding etc.).

To prevent inflammation of the esophagus, one should not allow persistent vomiting, trauma to the esophagus with a probe during frequent or rough probing, etc. For acute burns with caustic substances, early gastric lavage (removal of the caustic substance). Non-irritating foods; swallow pieces of ice, ice cream, in the acute stage ice on the neck and chest, give orally olive oil, almond milk, as well as bismuth carbonate, soda, enveloping mixtures (Mixtura gummosa) with the addition of morphine inside. Glucose is administered intravenously, atropine and morphine are administered under the skin. In chronic cases, lapis solution taken orally. With secondary narrowing of the esophagus, bougienage.

In gastroenterological practice, a disease such as esophagitis of the esophagus is often encountered. This is a pathology in which the mucous membrane of the organ becomes inflamed. The disease manifests itself burning pain in the chest, heartburn and difficulty swallowing. If esophagitis is not treated promptly, there is a risk of complications (ulcers, bleeding, stenosis).

Inflammation of the esophageal mucosa

Esophagitis is mainly called non-communicable disease, in which the esophagus becomes inflamed. In severe cases, the deeper layers of the organ (muscle) are affected. In 30–40% of patients, esophagitis is asymptomatic. Changes are identified in the process endoscopic examination(FEGDS). Gastroesophageal reflux disease is identified separately.

This pathology develops when poor nutrition due to the reflux of stomach contents (chyme and juice) into the esophagus. The disease occurs in acute, subacute and chronic forms. Depending on the nature of changes in the tissues of the organ, the following forms of esophagitis are distinguished:

catarrhal;
hydropic;
hemorrhagic;
exfoliative;
necrotic;
pseudomembranous;
phlegmonous.

In advanced cases, suppuration occurs. There are 3 degrees of severity of acute esophagitis. This division is based on the depth of the lesion and the presence of defects (ulcers or erosions). At stage 1, only inflammation occurs surface layer. There are no erosions or ulcers. The second degree of esophagitis is characterized by the appearance of foci of necrosis.

The mucous membrane is affected throughout its entire thickness. There may be ulcers. The most dangerous is the 3rd degree of inflammation. It may cause bleeding and perforation of the organ wall. After a course of treatment, such patients often develop scars. Esophagitis develops in people of different ages. If you don't treat a person, then acute inflammation becomes chronic.

Why does the esophagus become inflamed?

Depending on the main etiological factor, the following types of inflammation of the esophagus are distinguished:

allergic;
nutritional;
thermal;
infectious;
stagnant;
professional.

Most often this pathology develops with reflux. The following factors are crucial in the development of esophagitis:

eating hot food;
consumption of strong alcoholic drinks;
esophageal motility disorder;
eating at night;
food allergies;
metabolic disorders;
viral and bacterial infections.

This disease often affects people working in harmful conditions labor. The cause may be inhalation of toxic substances and dust. The development of gastroesophageal reflux disease is caused by a decrease in the tone of the sphincter located between the esophagus and the stomach. This is possible when drinking hot drinks and food. Carbonated water has a bad effect on the esophagus.

Causes of inflammation associated with reflux include taking medications (calcium antagonists, painkillers, antispasmodics). Irritation of the esophagus occurs against the background of alcoholism. Predisposing factors include: carrying a baby, smoking, physical inactivity, ascites, flatulence, increased stomach acidity, ulcers and hyperacid gastritis, the presence of a diaphragmatic hernia, non-compliance with food intake.

People whose menu is dominated by fatty foods often suffer from esophagitis. Adverse Impact Spices and fried foods have an effect on the esophagus. You can't eat in a hurry.

Risk factors for the development of esophagitis include excess body weight. Sometimes this pathology is caused by congenital anomalies (short esophagus).

How does esophagitis manifest?

The clinical picture is determined by the form of inflammation and the cause. In acute esophagitis, the following symptoms are possible:

heartburn;
chest pain;
difficulty swallowing food;
regurgitation;
difficulty breathing;
dyspepsia.

A common sign of inflammation of the esophagus is a burning sensation behind the sternum. This is heartburn. It develops due to gastroesophageal reflux. Pain with esophagitis is felt in the upper abdomen or chest area. It radiates to the back and neck. In case of a burn to the mucous membrane, the oral cavity is also affected.

Possible hoarseness. In severe esophagitis, dysphagia occurs. This is difficulty swallowing food. When eating solid food, such people are forced to wash it down with water. Sometimes difficult to swallow liquid food. Extremely severe forms diseases are manifested by vomiting mixed with blood. This symptom indicates esophageal bleeding.

Sometimes there is a period of imaginary well-being. This is an unfavorable sign. With esophagitis, regurgitation of recently eaten food is possible. This often happens at night. Symptoms of esophagitis include sour or bitter belching. Some patients experience periodic coughing at night.

Such people often develop inflammation of the bronchi. The reason is the reflux of acid into the respiratory tract. If esophagitis develops against the background peptic ulcer or gastritis with increased secretion, then dyspepsia is expressed. It includes bowel movements, nausea and vomiting. Sometimes with massive chemical burns of the esophagus, painful shock develops.

Perforation (perforation) of the organ wall is possible. With a simple catarrhal form of inflammation, the symptoms are scanty. Possible increased sensitivity for hot dishes and drinks. Chronic esophagitis occurs less violently. It is characterized by heartburn, shortness of breath, and pain. Possible complications include the development of asthma, laryngeal spasm and frequent pneumonia.

Development of gastroesophageal reflux disease

Reflux esophagitis, associated with the reflux of food from the stomach upwards, is separately identified. U healthy person The pH of the esophagus is close to neutral. The gastric contents have a medium of 1.5–2.0. When acid is released, irritation of the esophageal mucosa occurs. Over time, this becomes a cause of inflammation. With reflux esophagitis, the following symptoms are observed:

heartburn;
dysphagia;
fast saturation;
sour belching;
feeling of a foreign body in the throat;
cough;
a sore throat;
bad breath;
increased secretion of saliva.

Often deep erosions and ulcers form. Complications may develop (Barrett's esophagus, cancer, stricture). Esophagitis is sometimes detected in infants. The main symptom will be repeated regurgitation of food while the baby is lying down. A dangerous complication inflammation is the development of Barrett's esophagus. Otherwise, this condition is called metaplasia. In such patients, normal squamous epithelium is replaced by columnar epithelium. This is a precancerous disease.

Patient examination plan

Treatment of esophagitis begins after confirmation preliminary diagnosis. This requires the following studies:

FEGDS;
impedancemetry;
pH-metry;
Ultrasound of the abdominal organs;
tomography;
X-ray examination;
general blood and urine tests.

The attending physician must examine the mucous membrane. This is done using an endoscope. The following changes are possible:

redness;
edema;
inflammation;
the presence of ulcers and erosions;
hemorrhages;
bleeding;
narrowing of the lumen of the esophagus.

An important component of diagnosis is interviewing the patient. During it, the main complaints, the time of their occurrence and the connection with various factors (time of day, food intake, person’s posture) are established. A physical examination is required. If there is a strong burning sensation behind the sternum, coronary heart disease (angina) must be excluded. For this purpose, ultrasound and electrocardiography are performed.

Must be studied medical card sick. If there is a history of hyperacid inflammation or an ulcer, then gastroesophageal reflux disease can be suspected. Additionally, drug tolerance is determined.

This is important for subsequent therapy. In case of bleeding, the person is examined after first aid.

How to cure inflammation of the esophagus?

For esophagitis, treatment can be conservative or surgical. If inflammation is caused chemical burn, then rinsing is required. When damaged by acids, weak alkalis are used and vice versa. At mild form medications are prescribed for esophagitis. The drug Almagel is often used. It is also effective for reflux disease. Gaviscon is often prescribed.

These drugs neutralize acid. If esophagitis is caused by hyperacid gastritis or ulcers, then blockers are effective proton pump and prokinetics. The latter improve the motility of the digestive organs. The drug treatment method is combined with non-drug therapy. It assumes:

quitting cigarettes;
diet;
walking after eating;
refusal of alcoholic drinks;
eliminating body bending and abdominal exercises;
wearing only loose clothing.

All patients should adhere to a diet for esophageal esophagitis. Citrus fruits and other sweet and sour fruits, carbonated water, spices, coffee, chocolate, spicy foods, and marinades are excluded from the diet. It is recommended to consume food in semi-liquid form. You can't eat fried foods. Nutritional recipes are selected by a nutritionist.

Dishes should not be too hot. The optimal temperature is +30…+40ºC. It is necessary to chew food thoroughly. To prevent reflux, you should avoid snacking before bed and at night. You should not lie down on the sofa after eating. If you have esophagitis, it is not recommended to overeat.

You need to sleep with the head of the bed raised. The pillow should be high. In acute infectious forms of esophagitis, antibiotics are prescribed. May be required infusion therapy. In the treatment of chronic esophagitis good effect They give physiotherapy. The most commonly performed are electrophoresis and amplipulse therapy. If medicinal recipes do not help, then radical therapy is required.

The following types of operations are possible:

radiofrequency ablation;
fundoplication;
endoscopic dissection of strictures;
dilatation of the esophagus;
bougienage;
resection;
plastic.

Thus, inflammation of the esophagus over a long period of time can lead to narrowing of the organ, difficulty eating and cancer. To avoid this, you need to consult a doctor in a timely manner.

Inflammation of the esophagus, or esophagitis, can cause a person a lot of unpleasant symptoms and pain.

This article will discuss in detail what causes inflammation of the esophageal mucosa, how this disease manifests itself, and how to properly treat it.

The main reasons that can provoke inflammation of the esophageal mucosa are:

Flu.
Diphtheria.
Burn of the esophagus.
Chemical burn of the esophagus (accidental ingestion of gasoline, acetone, acid, etc.),
Infectious diseases.
Poor nutrition (eating too spicy or sour foods, drinking alcohol).
Smoking.
High blood pressure.
Taking medications that can affect the acidity in the stomach.
Eating too hot food.
Unfavorable working conditions associated with inhalation of toxic chemicals.
Long-term intoxication (poisoning) of the body.
Food allergies.
Digestion problems.
Gastroesophageal reflux or, which damages the lining of the esophagus and causes inflammation.
Herpes virus.
AIDS.
Physical damage to the esophagus.

Symptoms of inflammation of the esophagus

Inflammation in the esophagus is expressed by the following symptoms:

Frequent nausea and vomiting.
Strong.
Pain in the throat area.
Feeling of something stuck in the throat.
Pain when swallowing.
Pain when eating hot or too cold foods.
Increased salivation.
Burning sensation in the throat area.

Also, when a person has inflammation of the esophagus, herpes and stomatitis (mouth ulcers) can often occur. This happens due to sharp decline immunity and infection.

Drug treatment

Therapy against inflammation of the esophagus is primarily aimed at eliminating acute pain in the patient. For this purpose he is assigned various antacids, which have a pronounced gentle and enveloping therapeutic effect(Almagel, Vikaira, Vikalin, Enteros gel).

These medications should be taken 4-5 times a day, thirty minutes before meals, until acute heartburn and pain in the esophagus stop. As a rule, the duration of such treatment should be at least ten days.

In addition to the above groups of drugs, in case of severe esophagitis, the attending physician may prescribe H2-histamine blockers, vitamins and drugs that improve the regeneration of the damaged mucous membrane of the esophagus.

If the inflammation was caused by poisoning, then the patient is prescribed sorbents. He is also advised to rinse his stomach.

If esophagitis is caused by infection, the patient is prescribed antibiotics.

In addition, during treatment of inflammation of the esophagus, you must adhere to the following recommendations:

Don't overeat.
Do not eat three hours before bedtime.
Perform physiotherapeutic procedures.
Follow a strict diet (table No. 1).

Completely eliminate the following foods from your diet:

carbonated drinks;
sweets, cakes, pastries and other sweets;
smoked meats;
sausages;
coffee;
garlic;
tomatoes;
margarine and butter;
semi-finished products;
fried food;
fried food;
pepper;
fatty meats and fish;
milk;
salty food;
conservation;
jam;
salo.

The basis of the diet should be the following products:

porridge with water;
jelly;
yogurt and low-fat kefir;
vegetable stew;
steamed meat and fish;
vegetable soups.

Folk remedies or how to relieve inflammation of the esophagus

Treatment of inflammation of the esophagus traditional methods effective using the following recipes:

Treatment with potatoes. To do this, you need to grate several raw potatoes on a fine grater and squeeze out the liquid from the resulting mass. You need to drink the finished juice (2-3 tablespoons) in one gulp and eat it with a teaspoon of sugar. This will help get rid of the burning sensation in your chest.
Treatment with teas. It is best to use chamomile, mint and raspberry tea. They need to be brewed immediately before taking. Drink twenty minutes before meals.
Dill recipe to relieve inflammation in the esophagus. To prepare it, you need to take two teaspoons of dill seeds and crush them in a mortar. Pour a glass of boiling water and leave for two hours. Take a tablespoon three times a day before meals.
Jerusalem artichoke remedy. To prepare it, you need to grate a couple of tubers of this vegetable on a fine grater. Mix with 1 grated apple and take a tablespoon twice a day.
Herbal remedy:

take a teaspoon of crushed oak bark;
a tablespoon of chopped walnut leaves;
1 tbsp. l. St. John's wort color.

Pour this mixture with 3 glasses of cold water and leave for three hours. After this, the product must be strained and brought to a boil. Take two tablespoons twenty minutes before meals.

You should also sleep on a high pillow to prevent stomach acid from rising up the esophagus and causing heartburn.

Prevention of inflammation of the esophagus

In order to prevent this from occurring unpleasant disease, as esophagitis, the following recommendations should be followed:

Stop smoking.
Minimize or completely eliminate alcohol consumption.
Eat right (the menu should not include too spicy or fatty foods).
Watch your weight (obesity can lead to problems with the esophagus).
Do not wear too tight clothes or belts.
Do not lift anything weighing more than 10 kg.
Avoid overeating and late-night meals.
Eat at the same time in small portions, following the regime.
Eat slowly, chewing food thoroughly.
Timely diagnose and treat diseases that can cause inflammation of the esophagus (flu, diphtheria, herpes, etc.).
Do not self-medicate or take medications without a doctor’s prescription, since they can cause problems not only with the esophagus, but also with blood pressure, digestion, etc.

Anton palaznikov

Gastroenterologist, therapist

Work experience more than 7 years.

Professional skills: diagnosis and treatment of diseases of the gastrointestinal tract and biliary system.