Cardia insufficiency is treated. What is gastric cardia insufficiency and why is it dangerous? The pathology is also characterized

Many patients are interested in the question: stage 2 cardiac insufficiency, what is it? Cardia insufficiency refers to a pathology of the digestive system that occurs when gastric juice enters the esophagus. This condition causes a lot of discomfort and is also fraught with the development of more serious diseases of the digestive system, as a result of which it is advisable to begin treatment as quickly as possible.

What it is?

The cardia of the stomach is a ring-shaped sphincter, localized between the esophagus and stomach. In turn, the sphincter is a valve that prevents gastric contents from entering the esophagus. In the absence of pathological conditions, the sphincter opens, allowing food to pass into the stomach, after which the valve closes again. With cardia insufficiency, the work of the sphincter is disrupted and it stops closing. Thus, the cardia of the stomach loses its ability to retain gastric juice, as a result of which it does not enter the esophagus.

Since the stomach contains an acidic environment, and the esophagus is predominantly neutral, the entry of gastric juice into the esophagus can damage the walls of the organ, causing ulcers and burns. In the absence of a treatment process, there is a high probability of the formation of malignant tumors.

Causes

The exact causes of cardiac failure remain unknown. There are many theoretical assumptions regarding this disease, but none of them has practical confirmation. At the same time, there are two practically opposite theories:

1. The first asserts that cardia insufficiency is a multi-etiological disease, the development of which may be associated with the action of many factors.
2. The second theory is based on the impossibility of the occurrence of similar diseases under the influence of various factors, for which reason cardia failure should be considered as a whole complex of diseases with similar common symptoms.

However, among the most likely causes of the pathological condition in question, the following should be answered:

• infectious pathogens of viral origin that can cause inflammatory changes in the nerve trunks with subsequent disruption of the stomach and esophagus;
• deficiency in the body of various mineral components and vitamins;
• psychogenic disorders;
• various diseases of the digestive tract, which are characterized by increased gas formation and overdistension of the stomach.

Degrees

Symptoms of cardia insufficiency tend to increase. In accordance with the dynamics of changes in the esophagus, there are 3 degrees of cardia insufficiency:

• 1st degree. This stage is characterized by the absence of closure of the valves. It is functional in nature with periodic occurrences. In this case, there are no changes in the mucous membrane of the esophageal tube and other morphological dynamics;
• 2nd degree. Here there is a lack of complete closure of the sphincter of the upper stomach. The diameter is closed only halfway. It is also possible for the folds of the esophageal mucosa to fall out in the gastric lumen;
• 3rd degree. At this stage, there is complete absence of closure of the sphincter walls. In this case, gastric perilstatics persists, but pronounced inflammatory and erosive lesions of the organ mucosa are noted.

According to the nature of motor activity disorders, there is the following classification of cardia insufficiency:

1. Hypermotile. It is caused by excessive perilstatics, aimed at pushing the food bolus.
2. Hypomotile. Characterized by a significant decrease in the intensity of perilstatic movements. Food masses can remain in the esophagus for a long time and spill out through the gag reflex.
3. Amotylic. There is a lack of perilstatics of the esophageal tube.

Symptoms

The most characteristic sign of cardia insufficiency is pain in the chest, accompanied by a gag reflex and heartburn. Sometimes the severity and combination of some symptoms correspond to the stage of the disease:

1st degree

Cardia insufficiency of the 1st degree is caused by the following symptoms:

• belching of air, which tends to increase with the rapid process of eating food;
• heartburn of moderate intensity, occurring at regular intervals;
• painful sensations in a characteristic area that are not permanent.

2nd degree

Stage 2 disease is characterized by the following symptoms:

• constant belching, regardless of the nature of the nutritional diet;
• high intensity of pain and severity of heartburn, which increase regardless of meals.

At stage 2, the symptoms of cardia insufficiency are combined with some signs detected on FGDS.

3rd degree

At the last stage, pronounced signs of dysfunction and structure of the digestive organs are observed:

• the sphincter completely lacks the ability to close, resulting in constant reflux of food from the stomach into the esophagus;
• as a result - a constantly present feeling of heartburn and pain in the gastric region;
• the above symptoms intensify in the lying position, causing sleep disturbances.

Treatment

Treatment of cardia insufficiency must be carried out necessarily, since the constant effect of gastric juice on the esophageal mucosa is dangerous for the development of precancerous or oncological conditions. Therapy should be carried out in a comprehensive manner:

1. Diet food

First, a fractional power system is installed. Every day, food intake should coincide in time intervals. After finishing a meal, do not lie down for a couple of hours.

It is also important to avoid consuming foods that irritate the mucous membrane. The basis of the diet should consist of low-fat soups and foods with a low percentage of fat.

2. Drug therapy

In this case, it is inappropriate to talk about any specific treatment, since the prescription of certain medications corresponds to the cause of the disease. However, medications are almost always prescribed, the action of which is aimed at eliminating unpleasant symptoms. As a rule, these are antiemetics and painkillers, as well as medications that suppress heartburn.

To combat the disease directly, medications are used that:

• normalize acid levels and secretory function;
• normalize the tone of the cardia and bring it into normal functioning.

3. Surgery

As a rule, the need for surgery occurs when the disease is advanced, when hernial tumors are observed. In the case of complete opening of the muscle ring, the surgical method becomes relevant for the purpose of suturing the cardiac muscles.

To enlarge the picture, click on it.

For a successful and speedy recovery from cardia insufficiency, it is important to observe and implement the following rules:

• avoiding heavy physical activity and interaction with chemical components;
• minimizing physical activity;
• refusal to wear tight and tight clothing;
• limitation of inclined movements;
• use of traditional methods of treatment.

Insufficiency of the esophageal cardia ─ the lower esophageal sphincter leads to the development of gastroesophageal reflux disease (GERD). GERD is a condition that causes stomach contents to back up into the esophagus. As a consequence of this, characteristic symptoms of heartburn appear, which causes discomfort to the patient, and in the area of ​​​​contact of the delicate mucous membrane of the esophagus with the acidic contents of the stomach, an inflammatory process ─ reflux esophagitis can develop.

Anatomical aspects

The lower esophageal sphincter (cardia) separates two elements of the digestive system: the esophagus and the stomach. Each of them has its own environment: in the esophagus ─ slightly alkaline, in the stomach ─ acidic. This sphincter is designed in such a way that food moves through it in one direction - towards the stomach. This is confirmed by the fact that to get from the esophagus into the stomach, a pressure of 5 mm of water is sufficient in the first. Art., and to return it back to the esophagus, with a healthy cardia, there must be a pressure in the stomach of at least 100 mm of water. Art.

What predisposes

There are many factors predisposing to the development of GERD:

• family history of the disease;
• connective tissue dysplasia syndrome;
• increased intra-abdominal pressure: pregnancy, excess weight, presence of space-occupying formations in the abdominal cavity, prolonged stay in a bending position, increased gas formation in the intestines;
• hormonal characteristics: high levels of progesterone, which has an antispasmodic effect;
• slow passage of food from the stomach to the duodenum;
• decreased esophageal peristalsis;
• dietary habits (abundance of fried, smoked, excessively salty foods);
• eating in a hurry, as it is accompanied by swallowing a large amount of air;
• bad habits: smoking.

Does it happen to healthy people?

The cardiac sphincter periodically relaxes and even in completely healthy people gastroesophageal reflux can occur.

But, due to the small volume of contents thrown into the esophagus, as well as the body’s effective defense mechanisms, there are no clinical manifestations of normal peristalsis ─ such reflux is physiological.

How it manifests itself

If the functioning of the lower esophageal sphincter is disrupted, the first concern is:

• pain in the epigastric region;
• heartburn ─ burning behind the breastbone, most often after eating;
• belching.

Manifestations intensify with errors in diet, taking a horizontal position, especially immediately after eating, or lying down for a long time.

In addition to the described local symptoms, other manifestations of cardiac dysfunction are possible:

• Cough that occurs at night ─ during regurgitation at night, belching (aggressive, coming from the stomach) can burn the epiglottis, even partially enter the respiratory tract and provoke a cough reflex. As a consequence of this, such patients will develop pneumonia, prone to relapses, until the fact of reflux of gastric contents into the respiratory system is established and corrected.
• Retrosternal pain, and they can imitate angina pectoris. These patients will describe the clinical picture of angina pectoris ─ “angina pectoris”, but the cause may be hidden precisely in regurgitation of gastric contents and burning of the esophagus.
• A variety of neurological, dental and other manifestations are also possible; each case is individual, and establishing the correct diagnosis can sometimes be difficult even for an experienced doctor.

How to diagnose

The attending physician needs to differentiate gastroesophageal disease both from other diseases of the digestive tract: peptic ulcer, esophageal cancer, and from pathology of other body systems - pulmonary, cardiovascular.

Although it is necessary to rely on the clinical manifestations described by the patient, instrumental methods remain the standard in diagnosing cardiac insufficiency, namely:

Endoscopic examination. In this case, the endoscopist observes the damaged mucous membrane in the lower part of the esophagus.
Often, when visualizing the mucosa, no changes are found on it. But symptoms may still be present. This is the so-called “endoscopically negative” version of GERD and it needs treatment no less than the “endoscopically positive” version.

It also happens, on the contrary, that severe esophagitis during endoscopy may not manifest itself clinically.

• pH-metry: catheter, catheterless, impedance. Determination of acid exposure of the esophagus.
• X-ray examination. The study of the esophagus is carried out using barium porridge. Its lumen, folds, the presence of foreign bodies, constrictions, motility, and the work of the lower esophageal sphincter are assessed. Gastroesophageal reflux can also be detected during this study. Once it occurs, it helps diagnose GERD, but can also be a false positive and a false negative.

If we draw conclusions regarding the diagnosis of lower esophageal sphincter insufficiency, then the main thing in making a diagnosis is an integrated approach to examining the patient. Only a look that includes both the patient’s complaints and objective data can help to correctly identify the disease.

How to treat with medications

Drug treatment of cardiac sphincter insufficiency includes the following:

• proton pump inhibitors;
• H2-histamine blockers;
• antacids;
• prokinetic drugs.

The specific set of medications and treatment regimen is selected by the attending physician.

If necessary (ineffectiveness of treatment or development of complications), surgical treatment is possible.

Folk remedies

Traditional medicine offers many recipes that can help cope with heartburn using folk remedies.

To relieve its manifestations, milk, honey, various herbal decoctions and teas are used.

You should especially avoid taking soda solution to relieve heartburn. Due to its violent reaction with the hydrochloric acid of the stomach, an active release of carbon dioxide occurs, which, stretching the walls of the stomach, will cause a second wave of hydrochloric acid secretion and the pain will return with renewed vigor.

There is no need to self-medicate. It is better to consult a doctor about all the remedies with which you want to treat heartburn.

Non-drug therapy

In order to cope with the disease you need to change your lifestyle:

• do not overeat;
• monitor your nutrition, namely: diet ─ reduce the amount of fried, smoked foods in the diet, speed of food intake ─ it is important to eat at the same time in a calm environment, without rushing;
• maintain normal weight;
• do not lie in a horizontal position immediately after eating;
• do not stay in a bent position for a long time;
• sleep on a high pillow;
• fight bad habits and much more.

All of the above, when applied correctly, can help many patients significantly improve their health and improve their quality of life.

You may also be interested

Anatomically, the esophagus is separated from the stomach by the cardiac sphincter, which is considered a structural block for the return passage of food. If this important element of the gastrointestinal tract is relaxed, unable to hold food or is half closed, serious pathology has occurred. The affected party has a question about how to treat insufficiency of the gastric cardia.

Gastric cardia insufficiency - causes

Such a pathological process does not arise out of nowhere. Gastroenterologists identify those provoking factors that become the main cause of an acute attack. Studying the etiology of the pathological process and collecting anamnesis data helps to quickly and correctly determine the diagnosis and begin treatment in a timely manner. So, the main causes of gastric cardia insufficiency are as follows:

• overeating, eating disorder;
• obesity;
• the presence of fatty foods in the daily diet before bedtime;
• adynamia;
• hiatal hernias;
• increased intra-abdominal pressure;
• peptic ulcer, gastritis, tumors, gastric hypertonicity and other pathologies of the gastrointestinal tract;
• increased pressure in the stomach cavity;
• complication after resection of the cardiac sphincter;
• previous surgical interventions of the gastrointestinal tract;
• pregnancy, ascites;
• long-term physical activity as an indirect factor in gastric cardia insufficiency;
• pyloric spasm.

Gastric cardia insufficiency - symptoms

The disease is considered acquired and develops in several successive stages. In the first degree, insufficiency of the lower esophageal sphincter is accompanied by short-term bouts of belching, which only become more frequent as the pathological process progresses. There is a moderate non-closure of the cardia, which in the second degree of the disease is supplemented by prolapse of the gastric mucosa. But with the third degree of gastric cardia insufficiency, persistent symptoms of esophagitis occur. In this way, the degree of pathology can be determined and a treatment regimen can be determined.

If we talk about pronounced symptoms, the characteristic signs of gastric cardia insufficiency can be confused with other extensive lesions of the gastrointestinal tract. In any case, the patient should pay attention to specific changes in general health, and then promptly seek help from a gastroenterologist. The symptoms of the disease are:

• pain in the epigastric region;
• frequent dizziness;
• bitter taste in the mouth;
• spasms of the pyloric valve;
• vomiting with bile;
• general weakness;
• belching with a sour taste;
• nausea, lack of appetite;
• increased heartburn;
• rumbling in the intestines;
• burning pain behind the sternum;
• functional disorders of the digestive system.

Gastric cardia insufficiency - treatment

The disease tends to be chronic, i.e. There are no single attacks, gastroenterologists do not rule out repeated relapses, which only become more frequent each time. Effective treatment of gastric cardia begins with finding the root cause of dysfunction of the digestive organs. In addition, it involves correction of excess weight, a therapeutic diet, normalization of intra-abdominal pressure, taking medications and folk recipes to relieve pain. Cure the disease is problematic, but prolonging the period of remission is quite possible using conservative methods.

Insufficiency of cardiac sphincter requires a certain lifestyle and compliance with the rules established by doctors. If the cardiac sphincter stops closing, its contents partially or completely fall out. The patient has to constantly sleep with his head elevated, get rid of tight clothes, control the daily menu, avoid frequent bending of the body and excessive physical exertion, and take multivitamin complexes.

The main purpose of the patient taking medications is to significantly increase the tone of the muscular apparatus of the stomach, to productively suppress acute attacks of pain during recurrent insufficiency of the gastric cardia. To achieve this goal, the complex treatment regimen includes representatives of the following pharmacological groups:

• parkinetics: Reglan, Perinorm, Metoclopramide, Metamol;
• painkillers: Ibuprom, Ibuprofen, Analgin, Tempalgin;
• antibiotics: if increased activity of Helicobacter pylori is suspected;
• coating drugs: Omeprazole;
• medications against heartburn: Smecta, Gaviscon, Almagel, Ranitidine.

Diet for gastric cardia insufficiency

To alleviate the condition when cardia socket failure progresses, you need to eat in small portions, preferably at the same time of day. Do not overload the stomach, otherwise the sphincter will stop closing. Non-closure may be incomplete, but this does not mean that pathology is absent. Therapeutic nutrition for gastric cardia insufficiency has the following features:

1. The patient must remain in an upright position for 2 hours after eating - you can sit and walk, but not lie down.
2. Semi-liquid porridges and low-fat soups are the basis of the diet when the disease chalazia cardia is detected.
3. Sour, fatty, salty, fried, spicy foods, coffee and chocolate are prohibited so that cardia hypotension does not worsen.
4. The patient needs to completely abandon destructive habits and eliminate the consumption of carbonated water.
5. It is forbidden to eat too cold or hot foods, or systematically overeat before bed.
6. The patient should have a feeling of an incomplete stomach after each meal; moreover, it is recommended to exclude late dinners and night snacks.

Exercises for gastric cardia insufficiency

The lack of cardiac sphincter can be eliminated by moderate physical activity. Carry out training daily, thereby ensuring normal muscle tone. The proposed exercises for gastric cardia insufficiency should be selected individually, based on the patient’s physical fitness and the characteristics of the pathological process. The need for such activities is as follows:

• development of abdominal muscles;
• strengthening the spinal muscles;
• long walks in the fresh air to maintain the tone of the whole body.

Cardia insufficiency - treatment with folk remedies

If the cardia does not close, not all patients choose the means of official medicine for successful treatment. In case of insufficient cardiac sphincter, you can use alternative medicine recipes, but first consult with a gastroenterologist to avoid the development of an allergic reaction. A preliminary diagnosis based on an FGDS is required for a more detailed study of the focus of pathology on the monitor screen. After the final diagnosis is made, treatment of cardial insufficiency with folk remedies includes the following areas:

1. Combine the herbs of St. John's wort, valerian and motherwort in one container in equal proportions, steam a tablespoon of the raw material in a glass of boiling water. Infuse, strain, take orally with the addition of honey.
2. Squeeze plantain juice from fresh leaves and take it in concentrated form, a teaspoon before each meal during the acute stage. This way, the progressive insufficiency of the gastric cardia will disappear - the patient will forget for a long time what it is.
3. If the stomach cardia is gaping, you can use dandelion flower juice, a decoction of calamus root, caraway tincture, and water infusions of medicinal herbs for treatment.

Video: what is gastric cardia insufficiency

Pathologies of the gastrointestinal tract account for 40 to 60% of the total number of diseases of the human body. This alarming figure is growing every year. Patients often ignore the appearance of the first alarming symptoms, which leads to irreversible pathologies. Among diseases of the digestive system, cardia insufficiency of the 1st degree occupies not the last place. Read on to find out what it is and what diagnostic methods exist.

The digestive system is a multifunctional mechanism responsible for processing food, assimilation of elements formed during decay, and their subsequent exit from the body. At any stage of this complex process, a failure can occur, leading to the occurrence of functional diseases. This category of ailments includes cardia insufficiency.

Cardia insufficiency or chalazia is a pathology in which the sphincter located between the stomach and esophagus does not close tightly.

There are many sphincters located in the human body. They are valve mechanisms, reminiscent of valves in a plumbing system.

What you need to know about sphincters:

1. The valve acts as a circular muscle that closes during contraction. Together with the vessels and folds of the mucous membrane, it forms the sphincter apparatus. One of these mechanisms acts as an inlet valve from the esophagus to the stomach and is called the cardia.
2. The norm is that the cardia opens during meals and closes at rest. During the process of absorption of food, the valve opens to ensure its passage into the stomach. Closing the sphincter prevents the release of food mass back into the esophagus. If the valve does not close properly, it is unable to retain the contents of the stomach, including gastric juice and hydrochloric acid. Instability of the valve is called insufficiency, and the resulting pathology is called chalasia.
3. Reflux is the release of food into the esophagus and is not considered a disease. It happens several times during the day. The mucous membrane of this organ softens the effects of acids, and the blood supply restores the membrane from damage.

The disease occurs with repeated “unauthorized” food releases. This leads to serious damage to the mucosa and the development of esophagitis.

Etiology

In most cases, cardia failure occurs against the background of functional disorders. Less commonly, the cause is organic abnormalities.

Table 1. Causes of cardia failure

This disease can also appear for more “prosaic” reasons:

• eating disorder;
• obesity;
• decreased immunity;
• eating a lot of food before bedtime;
• sedentary lifestyle;
• excessive physical activity.

Tumors of the stomach, ulcers, gastritis and abdominal surgery are also at risk.

General symptoms of cardia failure

Cardia insufficiency at any stage of its manifestation is characterized by certain symptoms. With their help, you can timely detect the disease at the first stage of development:

• nausea;
• dizziness and weakness accompanying any activity of the patient;
• constant heartburn that occurs regardless of the meal schedule;
• vomit;
• pain in the epigastric region;
• belching air;
• rumbling in the intestines.

As the disease progresses, these symptoms will intensify.

Cardiac insufficiency: stages of the disease

Cardia insufficiency occurs in the human body through 3 stages.

Table 2. Stages of the disease

The first degree of cardia insufficiency is mild. If belching occurs, you should immediately consult a specialist doctor.

Diagnosis of the disease

Due to mild symptoms, determining the stage of chalazia by external signs is quite problematic. The most effective way is endoscopic examination.

Cardiac insufficiency can be detected using endoscopy

Endoscopy is a technique that is widely used to diagnose diseases of the gastrointestinal tract. An endoscope is a device consisting of a probe equipped with a camera and a monitor showing an image of the internal organs.

In addition to endoscopy, FGDS, ultrasound diagnostics, radiography with the use of a contrast agent and pH-metry are prescribed to make an accurate diagnosis. A comprehensive examination allows the gastroenterologist to adequately assess the condition of the esophageal mucosa, determine the degree of cardia insufficiency and identify concomitant pathologies.

Treatment

First of all, it is important to direct efforts to eliminate the disease that provoked cardia failure. For example, if a patient is overweight, you need to adjust your diet and adhere to a therapeutic diet. After this, it is necessary to reduce the pressure in the peritoneum. This measure is especially relevant in the development of ascites.

Treatment of the disease is carried out in several areas:

• taking medications. The doctor prescribes antacids, antispasmodics and agents that coat the mucous membranes;
• diet therapy. An individual diet is selected, based on the exclusion of fried, spicy, salty foods, smoked foods, lard, fatty dairy and meat products, coffee and alcoholic beverages;
• use of folk remedies. Seeking help from the gifts of nature is possible only after consultation with your doctor;
• surgical intervention. In the event of a hernia formation that contributes to the development of chalazia, a tissue suturing procedure is performed.

To prevent a surgical method of combating the disease, it is necessary to recognize cardia failure at stage 1.

Traditional medicine

Pharmacists have in their arsenal a large number of drugs aimed at treating chalazia. Depending on the stage of the disease, appropriate medications are prescribed.

Table 1. The most common drugs

You should take medications only as prescribed by your doctor. In addition to taking medications, it is important to lead a healthy lifestyle and adhere to a diet.

Diet therapy for cardia insufficiency

Diet therapy is a method of organizing nutrition based on the use of foods for medicinal purposes.

Depending on the stage of the disease and the symptoms present, the doctor prescribes the time and sequence of meals, and also draws up a menu.

The main tenets of therapeutic nutrition:

• the energy value of therapeutic nutrition should be determined by the body’s energy consumption;
• the diet should be formulated so that it can provide all the necessary nutrients;
• don't overeat. After each meal there should be a feeling of slight hunger;
• the gastronomic component must be diversified with various dishes;
• It is advisable to steam food. This will help preserve the taste and beneficial properties of the products;
• It is important to strictly adhere to a nutritional schedule and eat at the same time every day.

The diet is tailored individually for each patient. The nature of symptoms, body type and appetite, availability of free time and work schedule - each of these factors affects the characteristics of the diet. With the recommended 5 meals a day, a second breakfast and an afternoon snack should be included. If the disease is accompanied by an increase in body temperature, meals should be taken during the period when the temperature drops.

Folk remedies

The use of traditional medicine is possible only with the agreement of the attending physician. Medications fight the disease in an aggressive way, while herbal teas solve problems in a gentler way.

Traditional medicine offers many recipes:

1. Plantain juice. Before meals you should drink 1 tbsp. l. drink To prepare it, you will need fresh leaves of the plant, which must be infused in alcohol in a ratio of 4:1.
2. A decoction of marsh calamus root. Take 100 g 30 minutes before meals. For 1 glass of boiled water - 25 g of chopped roots.
3. Cumin infusion. Drink throughout the day like regular tea. For 1 cup of boiling water - 25 g of dry herb.
4. Dandelion syrup. Take 1 tsp diluted in a glass of water once a day before breakfast. Prepare as follows: cook 1 kg of sugar, 500 ml of drinking water and 500 g of dandelion flowers until a thick mass forms.

There are many other recipes, but the ones listed are the most effective. Since cardia insufficiency is accompanied by other diseases, such as hernia, gastritis or obesity, treatment should not be limited to the use of herbal remedies alone.

Chalazia never occurs spontaneously: it is a consequence of serious pathologies of the gastrointestinal tract. If any abnormalities related to the digestive system are detected, you should undergo an examination. Frequent burning sensations in the esophagus and pain in the stomach are alarm bells. You should not engage in self-diagnosis and self-treatment. Only a qualified specialist using an endoscope can make the correct diagnosis.

Video - Gastric cardia insufficiency

Cardia insufficiency is also called gastroesophageal reflux disease (GERD). Today it is generally considered to be the cause of erosive esophagitis and esophageal cancer. The article discusses diagnostic measures, symptoms and treatment of GERD.

Mechanism of GERD

Insufficiency of the cardiac sphincter of the stomach (non-closure of the cardia) provokes the reflux of its contents into the esophagus. Since the disease is chronic, the symptoms of GERD are recurrent and bother the patient several times a week (less often a month).

Main manifestations of GERD:

1. Severe heartburn (burning sensation localized behind the breastbone).
2. Belching sour and unpleasant taste in the mouth.
3. A burning sensation in the epigastric region itself.
4. Retrosternal pain (pain in the back of the chest), which can radiate to the lower jaw, the area between the shoulder blades, the neck and the left side of the chest. These symptoms mimic an angina attack.

Main symptom of the disease

There are also extraesophageal manifestations of acid reflux:

• shortness of breath appears;
• Frequent non-productive cough bothers you;
• bronchospasm attacks occur;
• sore or sore throat;
• the voice becomes hoarse;
• There are signs of dyspepsia: nausea, vomiting, flatulence and a feeling of rapid satiety with food.

An important distinguishing feature of all of these symptoms is that they appear or intensify when bending forward, in a horizontal position, and are also relieved by taking a soda solution or alkaline mineral waters. This helps to differentiate GERD from angina, bronchial asthma, and laryngitis.

Diagnosis of pathology

An important step in diagnosing the disease is collecting complaints. A thorough and competent interview with the patient will allow the doctor at this stage to weed out many pathologies with similar symptoms, as well as prescribe the necessary examinations.

Necessary studies to make a diagnosis of GERD:

1. Biochemical blood test.
2. FEGDS– an invasive method of examining the upper parts of the digestive system, which allows you to reliably detect the presence of reflux of gastric contents into the esophagus, identify inflamed mucous membranes and erosions, stenosis, and measure pH.
3. X-ray examination of the esophagus with contrast. With its help, it is possible to record the return passage of the contrast agent into the lumen of the esophagus, to detect a hernial protrusion in the area of ​​the esophageal opening of the diaphragm; assess the degree of stricture, if present, and exclude a tumor process.
4. Daily pH changes inside the esophagus– the most reliable method for diagnosing reflux disease.

The main method for diagnosing reflux

An electrocardiogram, ultrasound of the heart, spirometry, and plain chest radiography are prescribed, rather, with the aim of excluding other organic pathologies (angina pectoris, bronchial asthma, etc.).

Medicines used to treat GERD:

1. Histamine receptor blockers Type 2 (roxatidine, famotidine, nizatidine).
2. Antacids– used to neutralize hydrochloric acid and relieve heartburn attacks.
3. Proton pump inhibitors(rabeprazole, lansoprazole, omeprazole) - effectively reduce the concentration of hydrochloric acid, are easily tolerated and have a minimal number of adverse reactions.
4. Prokinetics(domperidone, metoclopramide) - increase the tone of the cardiac and lower esophageal sphincters, improve the evacuation of food masses from the stomach.

An effective drug for weak sphincter of the esophagus and stomach

They can be used as additional methods of treating gastroesophageal reflux disease, but the possibility of their use must be discussed with the attending physician.

Possible complications and prognosis

If treatment is started in a timely manner, the disease has a favorable prognosis. In most cases, it is not possible to completely cure it, and after entering a state of remission, it is necessary to continue monitoring with a doctor in order to prolong the period of remission. Without adequate treatment, the risk of developing severe complications from the affected organ increases.

These include:

1. (an inflammatory process in the inner wall of the esophagus due to reflux), which can also be complicated by erosions and ulcers.
2. Esophageal stenosis and stricture– pathological narrowing of its lumen.
3. Barrett's esophagus– a precancerous condition characterized by local metaplasia of the epithelium (when instead of squamous, normal for a given organ, intestinal or gastric appears).

And adults are different. The same applies to the various forms of the disease and the individual characteristics of each patient. Therefore, it is important that the treatment is carried out by a gastroenterologist.

Answers on questions

How to cure gastric cardia insufficiency if medications do not help? Alexey 28 years old, St. Petersburg

Hello! I don't drink, don't smoke, and play sports. About 6 months ago I began to experience the following symptoms: heartburn, pain in the esophagus when swallowing water and food, constant belching, nausea and hiccups with pain. I began to worry very much about this, anxiety, panic and fear for my health appeared. After 2 weeks of suffering, I underwent examination:

• FGDS. Conclusion: Cardia failure. Superficial gastritis. Duodenogastric bile reflux.
• Ultrasound of the abdominal cavity (liver, gall bladder, pancreas, spleen). Conclusion: S-shaped bend of the gallbladder. Ultrasound signs of biliary dyskinesia.

I took a course of medications (Pariet, De-nol and Motilium), slept on a bed with the head of the bed raised, and followed a diet almost all my life, but the symptoms of GERD did not go away, perhaps because because of this disease I was in constant nervous tension.

I decided to undergo FGDS again with a different doctor, but I was given the same diagnosis. I started taking pills again, only this time I replaced Pariet with Nexium and added Novopassit for anxiety, but again to no avail.

Today I feel even worse, in addition to the above symptoms I have also added:

• chest pain appeared;
• pain in the esophagus when inhaling sharply through the nose, when bending forward;
• it became very painful to lie on the right side (at this moment the esophagus seemed to be pulling something, and when inhaling, the pain intensified);
• a constant cough or coughing has appeared, which is accompanied by pain in the same place, somewhere in the area of ​​the esophageal sphincter.

In general, I feel like I’m getting worse, because of these symptoms I’m constantly nervous, anxious, in no mood, and nothing helps. Tell me, how can I cure this disease? Why doesn't anything help me, but it only gets worse?

Hello, Alexey!

If cardia insufficiency is determined, then this condition is associated with impaired motility of the upper gastrointestinal tract: both with the lower esophageal sphincter and with the pressure inside the stomach, as well as general intra-abdominal pressure.

Treatment can be long-term, up to several weeks (antisecretants such as Nexium and prokinetics), it is important to achieve complete healing of the mucosa. The presence of biliary dyskinesia can support the process; these changes also need to be treated (here, along with medications, physiotherapy and sanatorium treatment are usually needed).

In terms of sports, it is important to avoid exercises associated with a sharp increase in pressure inside the abdomen (for example, lifting weights).

However, the described picture corresponds to and. It turns out to be a “vicious circle”, the symptoms increase anxiety, anxiety results from the activation of the nervous system, the release of adrenaline. As a result, the symptoms intensify.

I recommend contacting (along with treatment from a gastroenterologist) a psychotherapist for non-drug correction (face-to-face or via Skype). The support of a professional and stabilization of the internal psychological state will help to quickly cope with functional (and this is exactly what they are, there is no serious organic pathology) disturbances in the functioning of the gastrointestinal tract.

What does a gaping gatekeeper mean? Konstantin, Moscow

Tell me, after my mother’s FGS they wrote that the pylorus was gaping, what could this mean? How can she be cured, because she has been suffering from stomach problems for a very long time, and not a single doctor can cure her?

“The pylorus is gaping” - this is how insufficiency of the lower gastric sphincter, the area of ​​transition from the stomach to the duodenum, is designated. Refers to motor dysfunction and gastric sphincter insufficiency. The consequence may be reflux of bile into the stomach (with a feeling of heaviness, nausea) and early discharge of stomach contents into the duodenum (this may cause problems with digestion and absorption of nutrients).
Treatment is long-term, under the supervision of a gastroenterologist. Ongoing maintenance therapy may be necessary. The regimen includes prokinetics (increasing gastrointestinal motility) and other drugs (protecting the mucous membrane from the aggressive effects of bile, improving digestion, reducing pressure in the lumen of the duodenum).
And in addition to the described pathology, it is necessary to diagnose and correct the condition of the duodenum itself. Without normalizing its functioning, the treatment effect in this case is extremely difficult to achieve.