GeneralReflux esophagitis is an inflammation of the lining of the esophagus due to the reflux of gastric contents into the esophagus (gastroesophageal reflux). The mucosa of the esophagus is not protected against these aggressive substances, so the contact with them causes epithelial damage, inflammation and causes pain. One of the main causes of reflux esophagitis is a hiatal hernia. In this disease there is a displacement of the stomach into the chest cavity through an enlarged hiatal.
Causes of reflux esophagitisAperture is a muscular partition between the chest and abdominal cavity. For the passage of various organs from one cavity to another in the diaphragm are special holes (including and hiatal). In the case of thinning or hypoplasia of muscle tissue in combination with increased intra-abdominal pressure may be offset abdominal organs into the chest. It thus developed a hiatal hernia. A small offset inlet and the upper part of the stomach is called a sliding hernia. The incidence of these hernias increases with age in people over 50 years it is 60%. As a rule, the only manifestation of a sliding hernia is a gastro-esophageal reflux disease, leading eventually to the reflux esophagitis.
The symptoms of reflux oesophagitisThe main symptom of reflux esophagitis is heartburn. It can be observed both in the daytime and at night, may be exacerbated after meals and taking the horizontal position of the body in space, accompanied by belching and hiccups.
Some of the patients have chest pain that resembles the pain in my heart. At the same time, reflux esophagitis can occur without heartburn and chest pain, and manifest violation of swallowing. Generally, swallowing disturbances associated with the transition of the disease on a more serious stage with the development of rumen narrowing of the esophagus.
Diagnosis of reflux esophagitisIf you suspect a hiatal hernia conduct the following studies:
1) X-ray examination of the esophagus with a barium suspension (research carried out on an empty stomach, a series of X-rays done after the patient swallowing the contrast mixture, spontaneous casting of contrast agent from the stomach into the esophagus shows pronounced reflux)
2) esophagoscopy (endoscopic examination of the esophagus)
3) biopsy (taking a small section of the esophageal mucosa for histological examination, conducted during esophagoscopy)
4) esophageal pH-meter (measure of acidity in the lumen of the esophagus and the stomach contents of the esophagus due to acid casting acidic contents of the stomach).
In some cases, your doctor may prescribe additional methods of research and special tests. When a patient complaints of chest pain the patient is sent to a cardiologist for examination to rule out coronary heart disease.
ComplicationsThe most dangerous complications of reflux esophagitis and esophageal ulcer is cicatricial narrowing of the esophagus (stricture). Long duration esophagitis can promote malignant transformation of cells of the mucosa and the development of cancer. The most dangerous complication of hiatal hernia is the infringement. Suspected infringement should be when a sharp pain in the chest in conjunction with the violation of swallowing.
What you can do?To reduce gastro-oesophageal reflux should lose weight, sleep on the bed with a raised 10-15 cm head end, try to keep the time between eating and sleeping. It should give up smoking, eating fatty foods and chocolate, coffee, alcoholic beverages, orange juice, and wash down the food habits of a large amount of liquid.
Compliance with the above rules in combination with drug therapy, in most cases, reduce the incidence of gastroesophageal reflux esophageal mucosa and protects against the harmful effects.
What will the doctor?The treatment begins, usually with drug therapy. Its main areas is to reduce gastric acidity, esophageal mucosal protection from harmful influences, increased contractile activity of the lower esophageal sphincter and increase the rate of esophageal emptying. Applied histamine H2-receptor antagonists, proton pump inhibitors, prokinetics, antacids and others.
Surgical intervention may be required in complicated forms and the failure of drug therapy gastroduodenitis.