Superficial reflux esophagitis 1 degree. How to deal with superficial reflux esophagitis

Having heard the diagnosis of grade 1 reflux esophagitis, many patients do not understand what it is. This pathological condition is not a separate disease, but one of the main components of the development of gastric and duodenal ulcers. This is just a lesion of the esophagus, which is caused by the reflux of the contents of the stomach in the opposite direction. It is quite easy to cure it in the initial stages.

The causes of reflux esophagitis

The development of reflux esophagitis is associated with the fact that the work of the lower esophageal sphincter is disrupted. It is he who protects the esophagus from the ingress of acidic gastric juice. The cause of the failure of the lower sphincter is mechanical pressure on it through the diaphragm from the peritoneal side. This most often occurs when:

(bloating);
overeating;
obesity;
hernia of the esophageal diaphragm.

Also, the lower sphincter does not cope with its function if the patient takes large quantities of antispasmodics (Spazmalgon, Papaverine, Platifillin, etc.).

Grade 1 reflux esophagitis symptoms

The first symptoms of reflux esophagitis are pain in the epigastric region and. Also, the patient may experience a feeling of "coma" when swallowing. Most often, patients associate these signs of a pathological condition with the intake of heavy or prolonged physical work in a forward tilt position or an abundant intake of food.

With chronic reflux esophagitis of 1 degree, sometimes there is:

nausea;
hiccups;
salivation.

If symptoms appear no more than once a month, then all functional disorders are restored on their own. With frequent complaints, it is necessary to urgently undergo an examination, as the disease will progress.

Diagnostics of the 1st degree reflux esophagitis

To diagnose inflammation and understand how quickly grade 1 reflux esophagitis progresses, esophagogastroscopy should be done. This is a research method based on the introduction into the stomach of a very thin tube with an optical device. With its help, you can examine absolutely all parts of the esophagus. At the first stage of esophagitis, the mucous membrane always has a bright red color, scratches and cracks.

Treatment of reflux esophagitis 1 degree

Noticing the first symptoms and diagnosing grade 1 reflux esophagitis, you must immediately begin treatment. In most cases, in order to eliminate this pathology at the initial stage of development, no medicines... It is enough to follow a few rules:

Do not drink alcohol or carbonated drinks.
Don't overeat.
Do not eat at night.
Do not bend forward immediately after eating.
Do not wear tight belts.
No smoking.
Do not take antispasmodics or sedatives.

With distal reflux esophagitis of 1 degree, a good effect is also exerted by folk remedies treatments such as dandelion flower syrup.

Syrup recipe

Ingredients:

fresh dandelion flowers - 150 g;
granulated sugar - 150 g.

Preparation and application

Place dandelion flowers and granulated sugar in layers in a glass jar. Press down a little on top and leave until juice forms. Take such a syrup three times a day, diluting one teaspoon in 100 ml of water.

Grade 1 erosive reflux esophagitis can be treated with herbal tea.

Tea recipe

Ingredients:

Preparation and application

Mix herbs with boiling water. After 5 minutes, strain the tea. Take 75 ml of this tea three times a day.

If these methods of treatment do not give results, the patient is prescribed antisecretory drugs that reduce the acidity of gastric contents (Omeprazole) and improve gastrointestinal motility (Metoclopramide).

Grade 1 reflux esophagitis is a regular and repeated reflux of gastric juice into the esophagus. In this case, the mucous membrane of the esophagus is irritated, which leads to the development of the inflammatory process. Reflux at the initial stage manifests itself in the form of small erosions on the esophageal mucosa.

In medical practice, reflux esophagitis is not an independent disease. may be a symptom of a disease of duodenal ulcer or stomach ulcer. The degree of damage to the esophagus depends on the frequency and duration of exposure to gastric juice on the esophageal mucosa. The main reasons for the development of reflux include:

excess weight;
pregnancy;
stress;
diaphragmatic hernia;
gastritis.

The causative factor of reflux disease can be the volume of gastric juice. The frequency of the discharge of stomach contents into the esophagus also depends on the volume of juice. With a low rate of gastric secretion and gastric emptying, the likelihood of developing reflux esophagitis is quite high.

Ulcers of the pylorus and duodenum, slow evacuation of stomach contents due to neuromuscular disorders can become the causes of the development of reflux disease.

The reflux of gastric contents into the esophagus can occur as a result of a relaxed sphincter. Reception can also cause reflux drugs, which reduce the tone of the sphincter, or frequent forward bends of the trunk.

Increased pressure inside the abdominal cavity, surgery or the use of a large number of spicy foods, chocolate and alcoholic beverages can provoke the development of the disease. In some cases, reflux disease results from an incorrect sleeping position. A low head position can provoke the reflux of gastric contents into the esophagus.

In case of violation of the protective function of the esophagus, small erosion is formed. Smoking may be the cause of this pathological factor.

Symptoms

The clinical manifestations of grade 1 reflux esophagitis are mild. The first symptoms appear if the lumen of the esophagus is narrowed to 12 mm. The main symptom of reflux disease is heartburn. As a rule, many patients do not pay attention to its presence and consider this sensation normal. Heartburn, burning in the epigastric region are observed after a heavy meal or during tilting of the body. In some cases, heartburn can also be troublesome at night. Acidic eructations and a lump in the throat are considered accompanying symptoms. A glass of warm water helps to get rid of this discomfort.

With reflux disease of the first degree, symptoms may appear similar to signs of diseases of the gastrointestinal tract. Patients may complain of heaviness and bloating in the abdomen. If you do not start treatment in a timely manner, then reflux disease will begin to progress. In the second and third stages of development, reflux esophagitis can lead to difficulty swallowing. In this case, the patient experiences severe pain when swallowing. At first, the patient refuses solid food and switches to soft puree. Over time, it begins to cause difficulty in swallowing. As a result, patients lose weight significantly.

At the initial stage of the development of gastroesophageal disease, patients may experience profuse salivation. IN oral cavity a large amount of clear and salty liquid accumulates.

Treatment

Gastroesophageal reflux disease at the initial stage of development is treated comprehensively. In addition to drugs, doctors prescribe physical therapy and diet. In combination with the main therapeutic measures, you can take medicinal decoctions or infusions. Surgery 1 degree of the disease is not carried out.

As drug treatment the patient is prescribed 3 groups of drugs: antisecretory and inhibitors, antacids and prokinetics.

Inhibitors help reduce the amount of hydrochloric acid. Antacids help to neutralize the acidity level of gastric juice. Prokinetics are prescribed to restore the tone of the esophageal sphincter and to prevent the release of stomach acid from the stomach.

Particular attention in the treatment of reflux disease is given to a healthy diet. It is necessary to exclude fried and fatty foods, smoked meats, spices, sour fruits, pickles and canned food, sweets, strong coffee and tea, sweet carbonated drinks and alcohol from the diet. Doctors recommend eating porridge in water, steamed meat and fish, boiled vegetables, low-fat dairy products. Soups, low-fat broths, jelly, pasta and still mineral water are considered useful. When treating reflux disease, it is best to stop smoking.

Therapeutic exercises at the initial stage of development of gastroesophageal disease helps to get rid of heartburn and speed up the healing process. To exercise, you need to take a comfortable position and wear comfortable clothing.

Take a deep breath and then exhale. Try to inhale with the help of the abdomen, in this case the respiratory muscles work better. The exercise should be repeated at least 3-4 times. Then take a deep, slow breath in through your nose and a sharp, quick breath out through your mouth. Do 2 sets of exercises 5-7 times.

The collection based on chamomile flowers, flax seeds, lemon balm, licorice and motherwort roots will help relieve pain and reduce the focus. Take 1 tbsp of each herb. l., chop and mix thoroughly the herbal collection. Pour 2 tbsp. l. mixture of 500 ml of water. Place the container in a water bath and boil for 10-15 minutes. After the broth has cooled, it can be filtered through cheesecloth or a sieve. Take 4 times a day for 1/3 cup.

Frequent heartburn, belching, sore throat are attributed to neglect of nutrition. Most people try to cope with unpleasant symptoms on their own, not considering that such signs can hide a serious inflammatory disease of the esophagus - reflux esophagitis.

Heartburn is a sign of reflux esophagitis

General characteristics of pathology

The esophagus, having a muscular structure, facilitates the unhindered passage of food into the stomach. This process is one-sided. The contents of the stomach are unable to return back due to the obturator-esophageal-gastric mechanism. This ability is provided to the body by negative intrathoracic and positive intraperitoneal pressure, nervous regulation, as well as muscle tissues of the esophagus and stomach walls, which form the lower esophageal sphincter at their junction.

Under the influence of internal pathologies or external stimuli, this mechanism can malfunction and the masses from the stomach, without encountering obstacles in their path, enter the esophagus.

Considering that an acidic environment is constantly maintained in the stomach, gastric contents, when penetrating into the esophagus, irritate the delicate mucous membrane accustomed to alkaline flora. With severe irritation, inflammation begins to develop, manifested by burns, ulcers, swelling, erosions of the mucous membrane, which is diagnosed as reflux esophagitis.

Pathology, affecting only the surface layer of tissues in the esophagus, has a catarrhal form. If timely treatment is started, the esophagus is quickly restored with this form of inflammation.

The structure of the stomach

With systematically recurring episodes of mucosal damage, reflux esophagitis becomes chronic.

Attention! A constant pathological effect on the tissues of the esophagus leads to their degeneration.

Causes of the pathological process

Reflux esophagitis is a multifactorial pathology. Irritation of the mucous membrane occurs when substances unusual for this department penetrate into the esophagus:

pepsin and gastric hydrochloric acid;
bile acids of the duodenum;
pancreatic enzymes.

This process is facilitated by factors in the form:

insufficiency of the esophageal sphincter;
decrease in the functional abilities of the stomach, esophagus;
decrease in the immune defense of the mucosa.

The development of pathology is possible with an imbalance in the protective and aggressive abilities of the body. This combination appears:

with hernias of the diaphragm located close to the esophagus;
with congenital physiological anomalies of the esophagus;
under the influence of long-term intake of alkaline substances;
as side effect taking certain medications from the group of NSAIDs, corticosteroids, beta-blockers;
with prolonged use of sedatives or hypnotics;
under the influence of psychoemotional disorders;
due to an increase in intra-abdominal pressure that occurs with constipation, during pregnancy, in obese people;
with connective tissue failure.

Diaphragmatic hernia

As a result of a long-term combination of unfavorable factors, favorable conditions are created for the occurrence of inflammatory processes in the esophagus.

How does the disease manifest

Initial minor damage to the mucosa can go unnoticed for a long time. There is no logical relationship between symptomatic signs and the degree of mucosal damage. In each patient, the manifestation of esophagitis has an individual duration and severity. However, with the progress of pathology, the symptomatology increases and manifests itself:

Heartburn, which is felt by the patient as a burning sensation, spreading heat in the sternum. Aggravated by bending and lying.
Pain in the sternum, similar to attacks of angina pectoris, myocardial infarction. Such pain is not relieved by coronary artery drugs, but goes away after taking drugs that reduce the acid content in the stomach.
Belching that occurs with increased pressure in the stomach. This belching is sour and may be accompanied by regurgitation of food. Belching is one of the first signs of esophageal pathology.

Less commonly, patients may experience pathological symptoms in the form of:

feelings of rapid satiety;
painful sensations in the abdomen;
profuse salivation;
problems with swallowing;
sense of presence foreign body and a coma in the sternum or pharynx.

Manifestation of esophagitis with heartburn in the esophagus

What treatment is needed

With initial and uncomplicated forms, to eliminate negative symptoms, it is enough to change the lifestyle and adjust the diet. If the disease is chronic, treatment involves the use of symptomatic, basic, supportive and behavioral methods.

Nutritional treatment

When diagnosing reflux esophagitis, treatment begins with adjusting the patient's habits and nutrition. For this, the patient is recommended a therapeutic diet:

To eliminate the irritating effect of food on the mucous membrane, spicy and salty foods are excluded from the diet. It is recommended to eat food at a neutral temperature.
Thorough grinding and chewing of food facilitates the movement of food masses along the damaged esophagus.
A fractional diet helps to reduce a one-time production of gastric juice. Patients are advised to break the diet into small portions.
Reduce dairy and citrus intake to prevent heartburn.
In order to exclude fermentation and gas formation, dishes to which the patient has an individual reaction are removed from the menu.
To facilitate the work of the stomach and reduce the formation of acid, fatty and high-protein foods are excluded from the diet.
The diet aims to neutralize excess acidity, for which the emphasis is on foods that are high in fiber.

Attention! With inflammation of the esophagus, smoking and drinking alcoholic beverages are strictly prohibited.

To prevent unwanted release of gastric masses into the esophagus, the patient helps:

refusal from tight clothing, especially shaping underwear, belts;
avoiding physical exertion, bending over after eating;
exclusion of eating an hour before bedtime;
rest overnight on a raised pillow so the esophagus is above the stomach.

Reflux develops from eating before bed

Conservative treatment

With an exacerbation that causes painful and unpleasant sensations in the patient, reflux esophagitis is treated with medication. Treatment allows the use of:

Antacids, which regulate acidity downward, which helps prevent heartburn, belching, unpleasant burning. Due to the enveloping properties of drugs such as Almagel, Maalox are able to quickly eliminate heartburn.
Antiseketorny drugs that reduce acid formation. For the treatment of esophageal pathologies, proton pump blockers in the form of Omez or blockers of histamine H2 receptors in the form of Ranitidine are prescribed.
Prokinetics affecting sphincter muscle tone. Preparations Motilium, Motilaka contribute to the restoration of the locking mechanism.
Antispasmodics for severe pain during exacerbations. Let's admit the reception of No-Shpa, Drotaverin, Baralgin.

Caution! The use of analgesics for pathologies of the esophagus associated with the reflux of gastric masses is prohibited.

Drug treatment is complemented by minimally invasive methods of therapy effective for reflux esophagitis in the form of:

laser endoscopic therapy;
intraesophageal electrical stimulation of the cardia;
hyperbaric oxygenation.

Surgical intervention

Chronic esophagitis caused by a pathological structure of the sphincter is treated with surgery. The operation is recommended even in case of complete loss of his functional abilities. In such cases, fundoapplication is performed, in which the tissues of the fundic part of the stomach are used to form a cuff around the esophagus in the lower part. The operation is less traumatic, as it is performed by the laparoscopic method.

Do not ignore a disease such as reflux esophagitis. The minimum efforts made to treat pathology in the initial stages allow not only to get rid of unpleasant sensations in the form of heartburn, belching or burning, but also prevent serious complications.

Published: 24 July 2015 at 14:35

Overeating, obesity, wearing tight clothing and belts create high pressure in the stomach, which provokes a spontaneous release into the esophagus of its contents with a high content of hydrochloric acid. This process causes inflammation of the esophageal mucosa and leads to the occurrence of grade 1 reflux esophagitis. Treatment does not start immediately.

Of the natural, non-pathological causes that provoke the appearance of the inflammatory process, are pregnancy and immaturity of the muscles of the esophagus in its lower part in infants. Sometimes it happens that with a strong and prolonged cough the patient also develops reflux esophagitis. There is also such a reason as the consequence of the transferred infectious diseases or disorders of gastrointestinal motility. Treatment here should be aimed at eliminating the root cause. In any case, if you are in one or more categories of people from risk groups, then you definitely need to know about reflux esophagitis in order to prevent the development of this disease. Indeed, without proper treatment, it can turn into cancer and lead to death.

Reflux esophagitis classification

Disease of the esophagus has such unexpressed symptoms in the initial stages (1-2 degrees) that patients very rarely seek medical help during the first three years of the development of the disease and do not carry out any treatment. Therefore, the real cause of the onset of the disease, and how it proceeded, no one in fact can restore.

Grade 1 (Art. A) - an area of \u200b\u200bthe esophagus with an area of \u200b\u200babout 5 mm is affected, and the lesion has the appearance of folds;
Grade 2 (B) - it is possible to identify from one to several defective mucosal changes over an area with a diameter of more than 5 mm, also in the form of folds;
3 (C) - the lesion can already be up to 75% of the circumference of the esophagus from two folds or more;
4 (D) - More than 75% of the circumference of the esophagus is affected.

The disease can be acute or chronic.

The most important thing to notice is reflux esophagitis at 1 tbsp. Then the treatment is completely uncomplicated, short-lived and can take place even without taking medication.

How to recognize grade 1 reflux esophagitis?

Symptoms of this disease are found in about half of the population. The very first of these is heartburn. Often, no one takes this symptom seriously and does not take any measures for examination. The actions of most patients are aimed at eliminating this symptom, they do not even try to find out its cause and begin treatment of the underlying disease that caused heartburn.

After 1-2 degrees of reflux esophagitis, there may be pain in the sternum, radiating to the back, nausea, vomiting. Even at a later stage, it is difficult to swallow, which leads to a decrease in food intake, weight loss, dry skin and anemia.

In the supine position, the symptoms are worse, especially if you lie down immediately after eating. Better to wait at least an hour.

Treatment of reflux esophagitis Art. AND

As a treatment for grade 1 reflux esophagitis, nutrition is. First, in order to avoid overeating and overfilling the stomach, food should be taken in large portions 5-6 times a day in the form of basic receptions, slightly larger in volume, and snacks. It is always important, but at the 1st stage. especially to avoid stagnation of food in the stomach and intestines. You should not eat less than 3-4 hours before bedtime.

If you do not go to bed within an hour after eating, then it will have time to leave the stomach and move to the intestines. Therefore, there will be no release of food masses into the esophagus, inflammatory process already at 1-2 degrees will be stopped.

Another aspect is sticking to a diet. If the disease is still identified at grade A, then the exclusion of products that irritate the mucous membrane will prevent the further development of grade 1 reflux esophagitis to a more severe condition and relieve inflammation.

Having got rid of the habit of transmitting at the beginning, you can forget about the overcrowding of the stomach and about flatulence, which increases the pressure in the abdominal cavity, weakens the sphincter and increases the likelihood of reflux. Therefore, excluded from the diet: beans, sauerkraut, mushrooms, soda, black bread, dried apricots, spicy dishes, alcohol and spices. After eating, do not bend over and lie down for a while. If there are any individual products that cause 1st stage reflux esophagitis, which can be recognized by heartburn, they should also be excluded.

Observing all these simple rules, you can limit yourself to them in the treatment of reflux esophagitis of the 1st degree and prevent the development of more complex forms.

When the contents of the stomach are thrown back into the esophagus, pain, nausea, and other unpleasant symptoms occur. This disease worsens a person's life, prevents him from eating properly and fully. The disease is called reflux esophagitis. In medical circles, it is rather considered a concomitant pathology of gastric ulcer or duodenal ulcer. Among the adult population, this malaise occurs in about 50% of the population of Europe, as well as the United States and Russia. At the same time, doctors noticed that the number of cases of grade 1 reflux esophagitis has increased in just the past few years. This is due to frequent stress, nutritional problems, and bad habits of people.

Symptoms

Most often, the malaise manifests itself due to severe heartburn, as well as pain in the upper part of the esophagus. This condition worries after eating spicy food with a lot of spices, fatty foods. If you lean forward or take a strictly horizontal position, the discomfort will increase dramatically.

Grade 1 reflux esophagitis has other symptoms. Among them are:

Belching with sour contents;
Difficulty swallowing
Pain during the passage of food through the esophagus.

Also, a person has the so-called "masks":

Pulmonary. The bronchi gradually become clogged with a viscous secretion. The person develops a severe cough. He is especially worried at night, over time it can develop into bronchial asthma.
Otolaryngological. Due to reflux, acidic stomach contents enter the larynx, thereby provoking the development of rhinitis and pharyngitis.
Cardiac. The patient feels discomfort in the region of the heart. It becomes especially strong after overeating, eating sour and spicy foods.
Dental. The reflux of acid from the esophagus leads to the accumulation of large amounts in the mouth. Gradually, the enamel of the teeth is destroyed, foci of caries are formed.

Symptoms of this nature are perceived by many as a natural reaction of the body. For a long time, a person may not attach importance to pain, heartburn, burning sensation behind the breastbone. This leads to the fact that the malaise passes into another stage, more severe.

Lit .: Great Medical Encyclopedia, 1956

The lower esophageal sphincter is supposed to protect the esophagus from the ingress of gastric juice into it. If its work is disrupted, reflux occurs. TO possible reasons diseases also include:

Surgical intervention;
Pregnancy;
Smoking large amounts;
Excessive consumption of coffee;
Hernia in the area of \u200b\u200bthe diaphragm;
Pyloroduodenal stenosis;
Stomach or duodenal ulcers.

Medicines also contribute to the development of such pathology. They gradually lower the tone of the esophageal sphincter, which is why it cannot cope with its work. Obesity is also a danger. People who are overweight are more likely to be at risk of developing gastrointestinal pathologies.

Which doctor treats grade 1 reflux esophagitis?

With reflux esophagitis of the 1st degree, you need to see a doctor, what it is, such experts know:

After the examination, the doctor will prescribe the necessary diagnostics in your case. Some diseases are difficult to diagnose as they say "by eye". Therefore, you need to trust your doctor when ordering research. After all the tests, the doctor will be able to draw up the correct course of treatment. Remember: accurate diagnosis and correct diagnosis - already 50% of treatment success!

Effective treatments

The doctor in the hospital should choose the means to normalize the work of the esophagus and all organs of the gastrointestinal tract. Most likely, after talking with the patient and studying the analyzes, he will voice such measures.