Cure for esophagitis without aluminum. Reflux esophagitis: symptoms and treatment, diet, prognosis. Prescription of medications

Treatment of reflux esophagitis is a rather complex and lengthy process that requires the patient not only to strictly comply with all basic medical prescriptions, but also to undergo serious correctional work regarding their own lifestyle. To cure reflux esophagitis, the patient must give up any existing bad habits and follow a special gentle diet throughout the entire treatment course.

Typically, treatment of reflux disease is carried out conservatively with the help of drug therapy, diet therapy and various traditional methods, however, in some cases, when diagnosing a severe stage of esophagitis, surgical intervention in the form of Nissen fundoplication or other types of operations may be prescribed.

If reflux esophagitis is diagnosed, medical specialists usually prescribe drug therapy, including:

Antacids. They significantly reduce the aggressive effect of gastric juice on the mucous membranes of the esophagus and stomach. The most common and effective antacids include Almagel, Phosphalugel, Taltsid, Gastal, etc.
Antisecretory drugs. The action of this group of drugs is aimed at reducing the acidity of gastric juice. Doctors usually prefer to treat reflux pathology of the esophagus with Omeprazole (Omez), Pantoprazole, Gastrozol, Omitox, etc.
Prokinetics. These drugs are included in the treatment of reflux esophagitis in order to improve gastrointestinal motility. The most commonly used are Cerucal, Motilium, Zelmak, and Mozax.

In addition to all of the above groups of medications, doctors can also prescribe various vitamin and mineral complexes that help strengthen the body's immune system.

To cure reflux esophagitis, you need not only to take appropriate medications, but also to strictly follow a special therapeutic diet. In most cases, with reflux esophagitis, patients are assigned to medical table No. 1 (according to Pevzner). This nutritional system excludes from the daily diet:

sour, pickled, smoked, fried foods;
salty, spicy dishes;
any alcoholic, carbonated drinks;
mushrooms, fresh and sauerkraut;
legumes;
black bread;
chocolate products;
seasoning

boiled porridge;
low-fat fermented milk products;
boiled meat, fish;
boiled vegetables, pureed (non-acidic) fruits;
yesterday's soaked bread (crackers);
baked apples, applesauce;
soft-boiled eggs.

In addition to food rules, diet therapy for reflux esophagitis also includes adherence to a certain diet:

you need to eat food often (at least 5 times a day) and in small portions;
you can’t eat before going to bed;
it is important to eat a variety of foods during the day (you need to fully saturate the body with proteins, carbohydrates and vegetable fats);
It is necessary to consume enough water (about 1.5 liters per day), and try to drink water before meals, and not during or after a meal.

When following a diet, medical experts recommend not overloading the body with various physical activities and paying due attention to rest and sleep.

Supporters of alternative medicine tend to believe that reflux esophagitis can be cured much faster if you combine drug therapy with certain folk remedies. For this pathology, herbalists advise regularly taking:

herbal infusion (you need to take chamomile, lemon balm, licorice root, plantain and motherwort herbs in equal parts, mix them and brew with boiling water, and then leave for a little, strain and take 100 ml four times a day);
medicinal decoction (you need to take calamus root, oregano, anise fruit, fireweed herb, dried calendula flower, dry mint (all 1 tablespoon), mix them, pour two glasses of boiling water and boil a little in a water bath, and then strain and drink 100 ml at least 6 times a day);
dandelion syrup (you need to sprinkle fresh dandelion flowers with sugar, crush them thoroughly, drain the resulting juice, and then boil it a little and take it cooled after eating, 1 teaspoon).

Before treating reflux esophagitis with folk remedies, experts recommend that you always coordinate their use with your doctor, since the use of such drugs can in some cases provoke the appearance of allergic reactions.

Surgery

Currently, surgical treatment of reflux esophagitis is extremely rare, in cases where:

conservative treatment over a long period does not give a positive result;
repeated bleeding occurs, a high incidence of aspiration pneumonia is observed;
reflux disease of the esophagus has caused various serious complications;
stage 4 reflux esophagitis is diagnosed, in which there is a proliferation of intestinal epithelium in the affected esophagus;
the course of reflux disease is accompanied by the presence of an esophageal hernia.

The choice of a specific type of operation for each patient is carried out individually, taking into account the clinical picture of the disease and the general health of the patient.

Gastroesophageal reflux disease (GERD) has become a massive epidemic in the 21st century. Every third resident of developed countries has had the misfortune of experiencing symptoms of inflammation of the esophagus. Doctors believe that the development of new effective drugs for treatment is the primary task of modern pharmacology.

Goals and methods of conservative treatment

Drug treatment of reflux inflammation of the esophagus is aimed at eliminating the cause of the disease, reducing the severity of external manifestations, and recovery of the patient.

To successfully treat GERD with medications, you must:

increase the obturator ability of the cardiac sphincter;
eliminate motor disorders of the esophagus and stomach;
normalize the acidity of gastric juice;
restore the balance between protective mechanisms and aggressive factors of the esophageal mucosa.

Treatment of reflux with medications takes place against the background of changing eating habits, quitting smoking and alcoholic beverages, and observing a work-rest regime.

Medicines for GERD are divided into several main groups:

enveloping agents;
antacid drugs;
proton pump inhibitors (pumps) or PPIs for short;
histamine receptor blockers;
prokinetics;
antibiotics;
enzymes;
healing agents.

Combinations of drugs are selected in accordance with the underlying disease that caused gastroesophageal reflux.

Enveloping agents

The esophageal mucosa experiences constant irritation and inflammation. The depth of damage to the walls of the esophageal canal depends on the degree of aggressiveness of gastric and intestinal enzymes. Alginates and antacids can protect the esophageal mucosa. Alginates contain a gel-like substance that creates a barrier to the penetration of hydrochloric acid into the esophagus.

Biogel Laminal is made from processed seaweed and contains alginic acid, iodine, selenium, zinc. Removes toxins, accelerates the healing of mucous membranes, relieves pain, and enriches the diet with minerals. Used for GERD for children from 6 years of age, a tablespoon 2 times a day 30 minutes before meals. Adults are recommended two tablespoons. The course of treatment is 2 weeks.

Antacids

Antiacid drugs neutralize hydrochloric acid in the stomach by reacting with it. Gels, suspensions, and chewable tablets contain aluminum, magnesium, and calcium salts. New generation products precipitate HCI to insoluble salts, which are excreted unchanged from the body. The most effective preparations combine aluminum and magnesium.

These include:

Maalox;
Gaviscon;
Almagel;
Rutacid;
Gastal;
Rennie.

In addition to the antacid effect, aluminum salts create a protective film, absorb bile enzymes, and increase the tone of the cardiac sphincter. Magnesium salts increase the secretion of protective mucus.

Take symptomatically for heartburn attacks, without exceeding the indicated dosage. The effect of the drugs occurs within 5-10 minutes and lasts up to 3 hours.

Proton pump inhibitors

Treatment of esophagitis is impossible to imagine without proton pump inhibitors. Antacids from this group of drugs disrupt the synthesis of hydrochloric acid at the ionic level, thereby reducing the acidity of the stomach. All proton acidity blockers are benzimedazole derivatives.

The main active ingredients are:

Omeprazole - drugs Omez, Promez, Losek.
Pantoprozol – trade names Pantap, Nolpaza, Ulsepan.
Lansoprazole is commercially available under the name Lantarol.
Rabeprazole - found in the drugs Beret, Razo, Pariet, Rabeprazole.
Esomeprazole - considered the most effective PPI, is available in the pharmacy chain as Emanera, Nexium, Ezokar, Neo-Zext.

In-demand inhibitor drugs for the treatment of reflux esophagitis in adults act for 24 hours. Take once a day before breakfast or after meals. Therapy is continued for up to 2 months. Together with antibiotics, they can cure gastritis and stomach ulcers - the original causes of reflux.

Long-term uncontrolled PPI therapy is fraught with complications - nausea, headache, stomach polyps, insomnia, kidney failure.

Histamine receptor blockers

H-2 histamine blockers inhibit the action of histamine. Secretion of HCI occurs in the parietal cells of the gastric mucosa. Secretory cells are located mainly in the fundus. Histamine is a mediator in the reaction of synthesis and release of hydrochloric acid. The substances in histamine blockers are similar in structure to histamine. They bind to histamine-sensitive receptors, turning them off temporarily.

Medicines from the group of histamine blockers:

Lafutidine;
Cimetidine - analogues Belomet, Simesan, Gistodil, Primamet;
Roxatidine – marketed as Roxane;
Ranitidine - found in the drugs Acyloc, Gistak, Zantac, Ranisan;
Famotidine - can be found under the names Gasterogen, Kvamatel, Ulfamid, Famotel.

The production of drugs for esophagitis has been launched in injection solutions and tablets. Ranitidine is included in the list of vital drugs that relieve allergic manifestations on the lining of the esophagus and promote the healing of shallow damage to the mucosa.

Prokinetics

Prokinetic drugs and acid blockers play an important role in the treatment of esophagitis. The action of prokinetics is aimed at stimulating peristalsis of the antrum. The process of evacuation of stomach contents into the intestines is accelerated, congestion is eliminated, and the tone of the esophageal sphincters increases. The cardiac sphincter is located at the junction of the esophagus and the stomach. The intensity and frequency of heartburn depends on the tone of its muscles.

Indications for taking prokinetic medications include nausea after eating, heaviness in the stomach, flatulence, belching, and heartburn. All known trade names of prokinetics are based on the substance domperidone.

Pharmacy chains offer medications:

Domet;
Domstal;
Domridon;
Motinorm;
Passengers.

Use in children over 5 years of age, pregnant and lactating women with caution. Possible side effects are dry mouth, thirst, stool disorders, and menstrual cycle disorders in women.

Antibiotics

Since the late 80s of the last century, antibiotics have taken a leading position in the treatment of gastritis, ulcers and their consequences in the form of erosive reflux esophagitis. They fight the cause of erosive lesions of the mucous membrane - Helicobacter pylori.

Elimination of bacterial infection is carried out by the combined effects of penicillins and macrolides. Acid-fast antibiotics for inflammation of the stomach and esophagus - amoxicillin and clarithromycin. Apply 2 times a day. The dosage is calculated individually, taking into account age, weight, and concomitant diseases. It is preferable to treat reflux with the simultaneous use of PPIs and antibiotics. Reducing stomach acidity accelerates the healing of ulcers and at any stage of tissue damage.

It is treated with Nystatin, Ketoconazole, Fluconazole, Clotrimazole, Miconazole. Candidiasis occurs in weakened, elderly people suffering from autoimmune diseases.

Taking antimicrobial agents can lead to antibiotic-associated diarrhea. Abnormal stool occurs from the death of beneficial microflora in the intestine and its colonization by pathogenic microbes - clostridia. Prevent imbalance of the symbiotic flora by prophylactic use of probiotics. The most common probiotics are Linex, Eubicor, Acipol, Enterol, Bifiform. Pharmaceutical drugs are replaced by products with probiotics - acidophilus, bifilux, kefir, fermented baked milk, sauerkraut.

Enzyme preparations

A decrease in the enzyme activity of gastric juice leads to a deterioration in the digestive function of the stomach. In this case, congestion, heartburn, and belching with an unpleasant odor are observed. To digest food, enzyme medications containing pepsin, pancreatin, lipase, amylase, and chymotrypsin are prescribed.

Taking enzymes improves the digestibility of proteins, fats, and carbohydrates. Preparations are obtained from the pancreas of animals. Prescribe Pancreatin, Mezim, Festal, Creon, Penzital after meals, 2 tablets.

Healing agents

Non-atrophic superficial gastritis has a chronic course, inflammation affects the upper layer of the mucosa. You can relieve swelling and redness of the mucous membrane during exacerbation of the disease. Decoctions of medicinal herbs will gently but effectively restore the integrity of the mucous membrane. They will accelerate tissue regeneration, healing erosions and ulcers. The best herbal remedies in the treatment of reflux esophagitis are chamomile, sage, calendula, oak bark, and flaxseed. A tablespoon of dry raw material is brewed with 300 ml of boiling water in a thermos and left for 30 minutes. Warm, strained decoction is taken 100 ml three times a day 20 minutes before meals. Herbal medicine course – 2 weeks.

Nutrition and lifestyle for reflux esophagitis

Treatment of inflammation of the esophagus with medications takes place against the background of a strict diet. Nutrition rules to follow:

cooking methods - boiling, stewing in water, baking without oil;
food temperature from 30 to 50°C;
consistency of food - mashed potatoes, soufflés, pates, pureed soups, boiled porridges;
meat – chicken, rabbit, turkey, beef;
fish - cod, hake, pike perch, greenling, pink salmon;
cereals – semolina, rice, oatmeal, buckwheat;
vegetables - potatoes, pumpkin, zucchini, carrots;
fruits - bananas, apples, pears;
milk – boiled low-fat, low-fat kefir, cottage cheese;
bread - without yeast, white yesterday, dried;
cookies – dry, unpalatable, without additives;
drinks - herbal tea, rosehip decoction, dried fruit compote, still mineral table water, jelly.

Diet - even distribution of the daily diet into 5-6 modest meals. It is advisable to eat at the same time. Smoking and drinking alcohol is prohibited. Fried, spicy, fatty, salty, pickled foods, and carbonated drinks are excluded.

The mucous membrane of the esophagus and stomach is protected as much as possible from thermal, chemical, and mechanical damage. After eating, you should not bend over or lie down for an hour. You should sleep on a raised headboard.

Reflux esophagitis is treated by reducing acidity, eliminating inflammation, and regulating gastric motility. The drugs are combined to achieve optimal therapeutic effect. The effectiveness of medications is increased by diet and avoidance of harmful addictions. The immune system is strengthened by folk herbal remedies and adherence to work and rest regimes.

The information on our website is provided by qualified doctors and is for informational purposes only. Don't self-medicate! Be sure to consult a specialist!

Gastroenterologist, professor, doctor of medical sciences. Prescribes diagnostics and carries out treatment. Expert of the group for the study of inflammatory diseases. Author of more than 300 scientific papers.

- This is a fairly common disease among modern people. It is characterized by periodic pathological release of stomach contents back into the esophagus, which provokes irritation, inflammatory and erosive processes.

Modern gastroenterologists have developed several of the most effective courses of treatment in several stages, which successfully help cope with unpleasant symptoms and eliminate the cause of the pathology.

Basic principles of drug therapy

Depending on the stage of the pathology, the following standardized courses of treatment are used:

Erosive stage . At this stage, drug therapy is used for 2 months. Proton pump inhibitors, which suppress additional production of hydrochloric acid in the stomach, are used twice a day.
Non-erosive stage . Since the trauma to the esophagus is significantly less, the course of treatment is shorter by a month than in the case of the erosive stage of the pathology. Proton pump inhibitors are used only once a day. The dose is selected depending on the intensity of the acid release.

During the course of treatment, prokinetic agents are additionally prescribed to normalize gastrointestinal motility, as well as antacid drugs to reduce the concentration of gastric hydrochloric acid. This stimulates the restoration of normal functioning of the digestive system and prevents the destruction of cells and tissues of the mucous membranes of the stomach, esophagus and intestines.

Subsequently, these drugs are used as maintenance therapy to reduce the risk of remission of the pathological process.

In cases where the condition is chronic or there is a risk of esophageal cancer, maintenance medications are taken for life.

How to treat reflux esophagitis

The duration of the course of drug therapy and the dose of selected pharmacological drugs can only be selected by a doctor, based on the results obtained after a thorough diagnosis of the patient.

Experts classify the complexity of drug therapy according to several treatment regimens:

single-drug therapy (usually a prokinetic or antacid). It is effective only in cases of a one-time problem. Not suitable for long-term treatment of complex cases;
escalating therapy. It represents the gradual addition of a new drug at each stage, depending on the aggressiveness of the pathological processes. Treatment begins with normalizing the daily routine, following a diet and monotherapy with an antacid, gradually adding one pharmaceutical drug at a time if the desired therapeutic effect is not achieved;
the third scheme implies taking strong proton pump inhibitors from the first day of treatment to temporarily block the stomach from producing excessive amounts of irritating hydrochloric acid. Once the severity of symptoms has significantly decreased, prokinetic agents are gradually introduced. Restoring gastrointestinal motility is accompanied by following a diet and avoiding heavy physical activity. Returning to a normal lifestyle occurs with the use of antacids;
The fourth treatment regimen is exclusively surgical intervention due to irreversible destructive destruction of the esophagus and subsequent restorative therapy with stronger drugs.

In any method of treatment, the most important steps are neutralization of hydrochloric acid or suppression of its production by the stomach and restoration of the mucous membrane after the irritating effect of aggressive substances.

Proton pump inhibitors

The use of proton pump inhibitors is the basis of drug therapy for reflux esophagitis, especially if the problem becomes protracted and threatens a significant deterioration in the body’s condition.

For reflux disease, drugs, most often produced in capsules coated with soluble shells, are administered orally. Absorption of active substances occurs in the intestine, from where the reagents enter the liver and are metabolized in the secretory tubules, suppressing their activity and preventing the formation of gastric juice. As a result, the contents of the stomach gradually become less aggressive, the intensity of its effect on the mucous membranes decreases, and the rate of reverse release decreases.

The principle of operation of all proton pump inhibitors is the same; the absorption rates and effects of the drugs, the degree of their purification and the duration of effectiveness differ. Each drug reduces the level of acidity in the stomach depending on the dose and brand, so only a specialist doctor can select them, after first changing the pH state of the stomach contents.

The duration of taking proton pump inhibitors can range from 1 month to several years, depending on the course of the pathology and the degree of damage to internal organs. The medications are safe for the body and, which is typical, do not cause addiction.

There are several most popular drugs containing the same active ingredient:

note

Despite the positive effects of omeprazole, experts recommend using drugs of a newer generation, since they are characterized by higher purification and when taken, the risk of developing numbness of the tissues of the gastrointestinal tract is significantly reduced.

Thanks to convenient doses, these medications are used only 1-2 times a day, without causing discomfort to the patient. They have virtually no contraindications, except pregnancy, lactation, children under 12 years of age and individual intolerance to drug components.

Prokinetic drugs

Prokinetics are known for their ability to influence the motor activity of the gastrointestinal tract. They speed up the process of moving food through the stomach and intestines and stimulate emptying processes. Prokinetics are also used to eliminate pyloric and esophageal reflux, since they are able to influence the nerve endings that control the mechanical activity of the stomach.

Depending on the mechanism of action, prokinetics are divided into:

Since prokinetics affect the nervous system, they cannot be selected independently to eliminate reflux disease. They do not solve the problem of the negative effects of acid on the mucous membranes, but they can reduce the intensity of the release and normalize the motor activity of the stomach.

Antacids

Antacids are medications whose main mechanism of action is a significant decrease in the concentration of hydrochloric acid in the stomach by partially or completely neutralizing it. These medications are considered the safest, belong to the list of the most popular symptomatic drugs and have a minimal list of side effects.

Depending on the therapeutic effect provided by the drug, they are divided into:

Antacids are the drugs of choice for stomach disorders associated with a sharp increase in acidity due to their rapid and gentle action.

Gastroesophageal reflux disease (GERD) is a chronic, recurring, multi-symptom disease that is caused by a sudden, persistent reflux of stomach contents into the esophagus.

It leads to damage to the lower esophagus. Many people try to avoid using medications when treating GERD.

However, there are diseases when it is not possible to do without medications, and their absence in the treatment regimen threatens the patient with dangerous consequences.

For example, medications for GERD are certain preventive measures for surgical (surgical) therapy and oncology.

Drug treatment of GERD

To effectively combat esophagitis, it is necessary to consult a doctor about possible contraindications when using medications.

Drug therapy for GERD is carried out by a gastroenterologist. The process lasts from 1 to 2 months (in some cases, the course of treatment lasts approximately six months).

The following groups of medications are used: antacids, H2-histamine blockers, proton pump inhibitors, prokinetics and cytoprotectors.

In a situation where conservative therapy for GERD is unsuccessful (approximately 5-10% of cases), or in the process of developing adverse consequences or a diaphragmatic hernia, surgical treatment is performed.

The most important things in the treatment of GERD are:

undergoing a full diagnosis;
consultation with a doctor;
strict compliance with all specialist instructions.

Anyone who truly wants to recover must strictly follow all the doctor’s recommendations, and if adverse effects occur, it is necessary to find out how to eliminate them.

If you are allergic to any drug, you should not replace such medications with others yourself. This is done only with the permission of a specialist.

Many people wonder what medications should be used to treat GERD. General approaches to the use of such tools are as follows:

Long course of treatment. In accordance with the latest regulations, certain groups of medications (which normalize the acidity inside the stomach) should be taken for 2 to 6 months. It is necessary to change medications to others only in case of personal hypersensitivity.
Drug treatment of GERD involves the combined use of medications. There is no special monotherapy in order to completely eliminate all symptoms at once. Therefore, several subgroups of medications are prescribed that affect each of the symptoms of the disease.
Step-by-step administration of substances. At the moment, a “gradually decreasing” treatment regimen has been successfully used. Initially, it involves a therapeutic dosage of proton pump blockers. Next, people suffering from GERD are transferred to a maintenance dose of the same medication or to the use of H2 blockers.

The duration of treatment and the number of medications used varies depending on the degree of inflammation. Basically, drugs from various groups are prescribed. For example, Motilium with Almagel or Omeprazole in combination with Motilium.

Treatment should continue for at least 6 weeks. For severe inflammatory processes in the esophagus, all 3 subgroups of drugs are used. They are taken for more than 8 weeks.

Such drugs have specific differences.

The main ones are different mechanisms of action, the speed of onset of positive changes, the duration of the effect on the damaged area, different effects taking into account the time of use, and the cost of the drug.

Proton pump inhibitors (blockers)

Proton pump inhibitors are currently the most effective medications for GERD. Their advantages when used during this pathological process:

modern proton pump blockers are more likely to eliminate pain near the chest;
normalize the level of acidity of gastric juice, and can also maintain these indicators throughout the day;
long-term use of blockers has a beneficial effect on the healing of esophageal erosions in the vast majority of situations;
with proper, constant use of such medications, it is possible to count on long-term stable remission (no exacerbations).

Because of such positive characteristics, experts prefer this drug directly. Representatives of this subgroup of medications include:

"Omeprazole";
"Rabeprazole";
"Lansoprazole";
"Esomeprazole";
"Pantoprazole."

The dosage of medications is adjusted depending on the stage of development of GERD or the presence of adverse effects.

Antacids and alginates

Such medications reduce the degree of acid and protect the mucous membrane of the digestive organs. They are available as tablets or suspensions.

Representatives of this subgroup have a rapid effect (within 10–15 minutes from the moment of administration), therefore they are prescribed in the first 10 days of treatment.

The main reasons for prescribing medications from this subgroup:

speed of action;
suitability of some during pregnancy.

However, such treatment for GERD has a number of its own disadvantages:

antacids include aluminum, magnesium or calcium; as the dose increases, the balance of microelements occurs, so they are used in small courses;
The drugs have a short duration of action and must be used frequently (3–6 times a day), which causes discomfort.

The most common representatives of this group are:

"Phosphalugel";
"Renny";
"Almagel", Almagel-Neo";
"Maalox";
"Gastal."

Alginates have similar effects to antacids, but unlike the former, they do not have contraindications or side effects. That’s why they are prescribed for a long course.

A similar medicine for GERD, such as Gaviscon or Laminal, is not recommended for use only in children under 6 years of age.

H2-histamine receptor blockers

Such drugs also reduce the degree of stomach acid. Their influence and impact are similar to those of representatives of proton pump blockers.

However, recently such funds have faded into the background. H2 blockers are used to a lesser extent due to the fact that:

The treatment regimen involves 2 and 3 times the use of H2-histamine receptor blockers, which causes some discomfort to patients who are undergoing a long course of treatment.
A greater number of contraindications and side effects compared to representatives of the Omeprazole subgroup.
Drug treatment of GERD with these drugs has less effect, since after their use the proper pH level inside the esophagus remains for a short time (less than 16 hours).

Today, Ranitidine and Famotidine are often prescribed.

Prokinetics

These drugs are another equally important subgroup of medications in the fight against GERD. Their advantages include:

improvement of gastrointestinal motility.
increased tone of the lower esophageal sphincter.
ridding a person of constant nausea.

The most common representatives of prokinetics:

"Metoclopramide";
"Domperidone";
"Itopride";
"Cisapride."

Drug treatment of GERD involves the use of such drugs in short courses as an addition to basic medications or after prolonged use of blockers.

Cytoprotectors

The most popular representative of this subgroup is Misoprostol (Cytotec, Cytotec). It is a synthetic analogue of PG E2.

It is characterized by a wide range of protective effects regarding the gastrointestinal mucosa:

reduces the acidity of gastric juice;
promotes increased secretion of mucus and bicarbonates;
increases the protective characteristics of mucus;
improves blood flow to the esophageal mucosa.

This drug is prescribed 2 g 4 times a day, mainly for grade 3 GERD.

Venter (Sucralfate) is the ammonium salt of sulfated sucrose.

Helps accelerate the recovery of ulcerative defects in the gastrointestinal mucosa through the formation of a chemical complex that prevents the influence of pepsin, acid and bile.

Characterized by astringent characteristics. Prescribed 1 g 4 times a day between meals. The use of Sucralfate and antacids should be time-limited.

For GERD, which is caused by reflux of gastric contents into the esophagus, observed mainly during cholelithiasis, taking Ursofalk 250 mg before bedtime (combined with Coordinax) will be effective.

The use of Cholestyramine would be justified. Use 12-16 g per day.

Dynamic observation of detectable secretory, morphological and microcirculatory failures in GERD can confirm the various schemes for drug correction of GERD proposed to date.

Possible schemes

The first treatment regimen with the same drug. The severity of symptoms, the degree of soft tissue hyperemia, and the presence of adverse consequences are not taken into account.

This approach is not considered effective, and in certain situations can harm health.

The second treatment regimen is intensifying treatment. It involves the use of agents of different aggressiveness at different stages of inflammation.

Treatment consists of following a diet and using antacids. When the effect is not achieved, the specialist may prescribe a combination of similar medications, but more intense in impact.

The third regimen, during which the patient takes strong proton pump blockers. When the severity of symptoms subsides, weak prokinetic drugs are used.

This measure has a positive effect on the health of patients suffering from severe GERD.

Standard 4-stage scheme

With mild manifestations of GERD (stage 1), it is necessary to maintain it with lifelong use of medications (antacids and prokinetic agents).

The average severity of inflammatory processes (stage 2) requires constant adherence to a proper diet. You also need to use blockers that normalize acidity.

During severe inflammation (stage 3), the patient is prescribed receptor blockers, inhibitors in combination with prokinetic agents.

At the last stage, drugs will be powerless, so surgical intervention and a course of maintenance therapy are necessary.

Important Steps

Treatment with medications involves 2 stages. The first allows you to heal and normalize the mucous membrane of the esophagus.

The second stage of therapy helps achieve stable remission. In this scheme there are 3 approaches, selected only in conjunction with the patient according to his personal desire.

Using proton pump inhibitors for a long period of time in large quantities helps prevent relapses.

On demand. Use inhibitors in full dose. The course is short - 5 days. These medications quickly eliminate unpleasant symptoms.

In the third approach, drugs are used only during the formation of symptoms. It is recommended to take the required dosage once every 7 days.

Prevention

Primary preventive measures for GERD consist of following the specialist’s instructions regarding an active lifestyle (quitting smoking, drinking alcoholic beverages).

It is prohibited to use medications that disrupt the functioning of the esophagus and that reduce the protective characteristics of its mucosa.

Secondary preventive measures are to reduce the frequency of relapses and prevent progression of the disease.

A mandatory component of secondary preventive measures for GERD is adherence to the above instructions for primary prevention and non-drug therapy for such a disease.

In order to prevent exacerbations, if there is no esophagitis or a mild form of esophagitis is observed, timely treatment “on demand” will retain its importance.

Despite the fact that some drugs can aggravate the symptoms of GERD, the use of others causes drug-induced esophagitis, a disease during which the same symptoms appear as with GERD, but not due to reflux.

Drug-induced esophagitis occurs when a pill is swallowed but does not reach the stomach because it is stuck to the wall of the esophagus.

If GERD is not eliminated in a timely manner, it is fraught with adverse consequences. In this regard, it is necessary to consult a doctor and choose the optimal treatment.

Useful video

Esophagitis is a disease that is associated with the development of an inflammatory process in the esophageal mucosa. This pathology leads to burning pain behind the sternum, heartburn and increased salivation, and difficulty swallowing. Therefore, treatment of esophagitis involves comprehensive and effective treatment. This will avoid the development of peptic ulcers and perforation, esophageal stenosis, and Barrett's disease.

Features of therapy

How to treat inflammation of the esophagus? The treatment regimen is determined by the course of the disease (acute or chronic form), the nature of the inflammatory process (catarrhal, erosive, edematous, exfoliative, hemorrhagic, phlegmonous esophagitis). It should be aimed at eliminating the causes that provoked the development of esophagitis: smoking, excess weight, unbalanced diet, stressful situations, elimination of chemical and bacterial agents.

It is possible to cure the disease completely only with an integrated approach: the use of medications, the use of traditional medicine recipes and the transition to a gentle diet.

Treatment of acute esophagitis

If damage to the esophageal mucosa develops due to exposure to chemicals, then the patient needs urgent gastric lavage. In case of a mild form of the pathology, the attending physician may recommend refraining from eating for 2-3 days, taking antacids (Phosphalugel, Almagel) and H2-histamine receptor blockers (Famotidine, Ranitidine). This will reduce the acidity of gastric juice, preventing further irritation of the esophageal mucosa.

In severe cases of esophagitis, enteral nutrition and the use of enveloping and antacid agents may be required. If the patient shows signs of intoxication (weakness, dizziness, confusion, headache, nausea, drowsiness), then infusion therapy with detoxification drugs is recommended. If the inflammation is caused by infectious agents, then the prescription of broad-spectrum antibiotics is indicated.

If a patient develops a severe stricture of the esophagus (narrowing of the organ to critical values), which cannot be dilated, then urgent surgical intervention is necessary.

Therapy for chronic esophagitis

This form of the disease usually develops against the background of gastroesophageal reflux disease (GERD). Treatment of chronic esophagitis involves changing the patient’s lifestyle, following a strict diet and a special diet. During an exacerbation, it is recommended to eat warm pureed food, excluding from the diet foods that can increase irritation of the esophageal mucosa (spicy, fried, fatty, carbonated drinks, alcohol).

The patient should stop smoking and use drugs that can reduce cardiac tone (sedatives, prostaglandins, tranquilizers, theophylline). Dinner should be 2 hours before bedtime; after a meal, you should not take a horizontal position. Gastroenterologists recommend raising the head of the bed by 40 0 to prevent the development of reflux at night. You should avoid wearing clothes that fit around your waist.

Drug treatment involves the following:

To increase the effectiveness of drug treatment, patients with GERD are prescribed physiotherapeutic treatment (mud therapy, electrophoresis of ganglion blockers, amplipulse therapy, balneotherapy). However, during the period of exacerbation or in severe cases of the disease, it is worth abandoning the listed methods.

Features of therapy for some morphological forms:

Treatment of erosive esophagitis involves the prescription of antacids, prokinetics, and proton pump inhibitors. To relieve pain, you can use antispasmodics (Drotaverine, Papaverine, Spazmolgon). The patient must adhere to a dietary diet. If complications develop, then surgical intervention is indicated;
Therapy of acute hemorrhagic lesions of the esophagus requires the administration of hemostatic treatment. Otherwise, a standard treatment regimen is used: antacids, proton pump inhibitors, prokinetics;
treatment of candidal esophagitis involves the prescription of antifungal agents (Nystatin, Ketoconazole, Fluconazole), for heartburn, antacids and proton pump inhibitors are indicated, for sleep disturbances - B vitamins, sedatives. The patient must take immunostimulating drugs (IRS-19, Ekhingin, Imudon). Particular attention should be paid to nutrition - spices, pearl barley, sweets, mushrooms, alcohol, coffee should be excluded, because the fungus actively grows and multiplies when these products are consumed;
Therapy of phlegmonous esophagitis and abscess requires special attention. Patients require parenteral nutrition, and are also prescribed blood substitutes, antibiotics, and detoxification drugs. Pustules must be drained. If phlegmon develops, surgical intervention is indicated.

Use of traditional medicine

Treatment of esophagitis with folk remedies involves the use of the following recipes:

Therapy with folk remedies is possible if the patient has no contraindications to its implementation.

Diet therapy

In case of esophagitis, special attention must be paid to the foods taken, because there is no specific diet for the pathology. When preparing a diet, the patient should carefully monitor the body’s reaction to each dish.

However, there is a general list of prohibited products:

fresh wheat bread;
Rye bread;
fatty fish and meats;
salted, fried, smoked and spicy dishes;
conservation;
margarine and lard;
pearl barley, millet and barley porridge;
legumes;
fermented milk products;
soups using meat, fish and mushroom broths;
fresh fruits (except bananas);
vegetables: tomatoes, radishes, eggplants, raw onions and garlic, radishes;
coffee and chocolate;
ice cream;
carbonated and alcoholic drinks;
hot spices (mustard, chili, wasabi).

Esophagitis is a disease that can be completely cured if you follow a daily routine, nutrition and medication. In the absence of complications such as stenosis, perforation, bleeding, the pathology has a favorable prognosis.