Reflux – Esophagitis
Initially, a little anatomy. The diaphragm (muscle-tendon septum) separates the chest cavity from the abdominal. Through the esophageal opening of the diaphragm, the esophagus descends into the abdominal cavity and passes into the stomach of the part of the cardiac.
In the place of transition of the esophagus into the stomach, the muscle fibers form a sphincter (bagasse). Normally, outside the swallowing, this sphincter is closed, which prevents the contents of the stomach and gastric juice from entering the esophagus.
If the sphincter function is impaired. A hernia of the esophageal opening of the diaphragm is formed. At the same time, the cardiac part of the stomach is displaced through the esophageal opening of the diaphragm into the chest cavity and the contents of the stomach are freely thrown into the esophagus. And, as a rule, hydrochloric acid is present in it, which irritates the mucous membrane of the esophagus and can cause its inflammation – esophagitis. It is sometimes so pronounced that in the clinical picture it resembles a thermal or chemical burn of the esophagus.
Throwing the contents of the stomach into the esophagus we, the doctors, call reflux, which means “reverse flow” in Latin. And esophagitis, which developed as a result of gastroesophageal reflux, is called reflux – esophagitis. Actually, it is a consequence of a hernia of the esophageal opening of the diaphragm.
Reflux – esophagitis causes considerable suffering to the patient; heartburn worries, and most importantly, burning pain in the epigastric region (under the spoon) and behind the sternum, aggravated after eating, especially if the patient eats, immediately falls down. Sometimes the pain is dull, aching, and most radiates to the region of the heart, shoulder blade, and the left shoulder, less often to the neck.
I want to emphasize that even a doctor sometimes finds it difficult to distinguish between manifestations of reflux esophagitis and angina pectoris attack. This can be done only with the help of radiological examination.
45 to 50 years ago, all over the world, the treatment of patients with reflux esophagitis with a hernia of the esophageal opening of the diaphragm was surgical. severe complications of reflux esophagitis, like ulcers, bleeding. narrowing of the esophagus. Now the treatment of this disease is mainly in compliance with the diet and a certain diet. This conservative therapy gives a good result in more than 80 percent of patients, provided that they strictly follow the recommendations of doctors to get rid of reflux – esophagitis.
Since gastric overflow contributes to increased reflux esophagitis, nutrition should be fractional, in small portions. You need to eat slowly, chewing food well. Do not drink water or any other liquid between meals. Sometimes patients, to get rid of heartburn or pain, take a few sips of water and feel at the same time relief. In fact, it is short-lived, and soon reflux arises again. Only occasionally can you drink half a glass of Borjomi or a solution of baking soda (1 teaspoon per glass of water). Borjomi or soda solution is better to drink in the form of heat and without carbon dioxide, one hour before meals.
To prevent reflux esophagitis from progressing, spicy dishes and sauces, pepper, mustard, strong tea, coffee, pickles, salting, smoked meat, as well as fresh and sauerkraut, beans, beans, fresh black bread should be completely excluded from the diet. promote the formation of gases. Strongly contraindicated alcohol and smoking.
When reflux – esophagitis of drugs is extremely undesirable to take drugs of acetylsalicylic acid, which irritate the mucous membrane of the esophagus and increase gastric secretion.
After eating, you should never lie down, it is better to stand or walk. This will speed up the evacuation of the stomach contents, and thus prevent it from being thrown into the esophagus. Dinner should be no later than 3 to 4 hours before bedtime. It is recommended to sleep with reflux esophagitis on two or three pillows in a half-sitting position. Throwing the contents of the stomach into the esophagus contributes to any work in the tilt position of the body: mopping, weeding the beds and even laced shoes. So try to avoid this posture.
When reflux – esophagitis can not wear tight corsets, belts, belts, corsages, because they can cause an increase in intra-abdominal pressure. Constipation also contributes to this. That is why they should be fought with all means: take vegetable and salt laxatives, vegetable and liquid paraffin and 1 tablespoon 2 – 3 times a day before meals. This measure, in addition to combating constipation, is of great importance in terms of protecting the esophageal mucosa from exposure to acidic gastric contents. It should be borne in mind that with prolonged use of a laxative, the body gets used to it, and it ceases to act. Therefore, it is necessary to alternate laxative medicines, of course, after consulting with your doctor.
With a pronounced inflammatory process of reflux – esophagitis, in the mucous membrane of the esophagus a good effect has a decoction of chamomile (1 tablespoon per glass of water), which should be drunk in small portions of not more than 1 cup per day.
If you have severe chest pain, you must take validol or nitroglycerin, as it can be caused by an attack of angina.