Esophagitis is an inflammatory disease of the esophagus mucosa that occurs in a chronic or acute form. The inflammatory process in this disease develops on the inner (mucosa) of the esophagus, and in case of further progress it affects already deeper layers of the esophagus
Causes of esophagitis
и пр.), при термических ожогах (горячим питьем, пищей ), вследствие раздражения пищевода различными химическими веществами (щелочи, йод, кислоты), в результате аллергических реакций на пищевые продукты и после физических повреждений (ожоги, повреждения инородными телами и травмирование слизистой при введение зонда). Acute esophagitis develops as a result of acute infectious diseases (sepsis, scarlet fever, diphtheria, influenza , etc.), with thermal burns (hot drink, food), due to irritation of the esophagus with various chemicals (alkali, iodine, acids), as a result of allergic reactions to food products and after physical damage (burns, foreign body injuries and mucous injury during the introduction of the probe). The most severe are the damage to the esophagus after a burn.
Chronic and subacute esophagitis can develop due to the following reasons:
- The use of spicy, very hot food, as well as strong alcoholic beverages
- Food allergy
- Inhalation of vapors of various corrosive chemicals
- Prolonged intoxication of the body, tissue hypoxia, inadequate quantity of microelements
Also, the emergence of this disease can lead to a violation of the evacuation functions of the esophagus, resulting in the remains of accumulated food irritate the mucous membrane. Sometimes chronic esophagitis accompanies chronic inflammatory diseases of the stomach and nasopharynx, as well as such chronic infectious diseases as syphilis and tuberculosis
Symptoms of Esophagitis
In catarrhal form, the disease can occur without obvious clinical symptoms, with the exception of the sometimes manifested hypersensitivity of the esophagus to cold or hot food.
In severe forms, severe pain symptoms manifest (severe burning pain behind the sternum, often giving back and neck). There is a breakdown of swallowing, heartburn and increased salivation. In extremely severe forms, there may be bloody vomiting, sometimes leading to a shock state.
The main clinical manifestation of this form of the disease is heartburn, which is usually intensified after eating carbonated drinks, coffee, fatty and spicy food, and also in case of overeating. Among other symptoms may be sour or bitter belching with an admixture of bile, respiratory, pneumonia and laryngospasm. It is also possible to regurgitate in a horizontal position or with torso torsos; retrosternal pain when swallowing, resembling a coronary.
Complications to which esophagitis can lead:
- Stenosis: narrowing of the lumen of the esophagus, leading to disturbances in the passage of food into the stomach, which leads to a decrease in body weight
- Peptic ulcer of the esophagus: the formation of a deep defect in the esophageal wall, leading to its shortening and gross scarring
- Flegnoma, abscess (if the esophagus is damaged by foreign bodies)
- Perforation of the esophagus wall: due to the great danger to life, immediate surgical intervention is required
- Barrett's Disease
Treatment of esophagitis
In the event that the acute form has arisen due to a chemical burn - an urgent rinsing of the stomach is necessary to remove the chemical agent.
For the treatment of mild acute forms of this disease, it is recommended to refrain from meals for the first two days. It is prescribed medicamentous treatment with drugs of the famotidine group, as well as the use of antacids. After the period of fasting and the beginning of nutrition, it is necessary to completely eliminate from the diet products that can damage the mucous (rough, hot and spicy pizza, alcohol and coffee), as well as food that can activate the production of gastric juice (any fatty foods and chocolate). It is also necessary to completely get away from smoking.
With ulcerative esophagitis with severe pain manifestations prescribe analgesics (gastric lavage is strictly prohibited).
In cases of severe disease, it is necessary to eat very carefully and carefully, and in some cases, to complete rejection of enteral nutrition. Gel antacid and enveloping drugs are prescribed. In case of severe intoxication, with the help of detoxification solutions, infusion therapy is performed. To eliminate the infection, antibiotics are prescribed. In case of failure of treatment of foci of suppurative inflammation with antibiotics, surgical sanitation is performed.
Patients with this form of the disease should refuse to take medications that affect the esophageal sphincter (prostaglandins, tranquilizers, theophylline, sedatives), and completely give up smoking. The last daily intake of food is recommended at least two hours before bedtime, and after eating do not take a horizontal position.
Drug therapy includes the use of drugs that enhance the tone of the cardia (holinomimetiki and blockers of the dopa receptors), as well as drugs that reduce the acidity of gastric juice (H2-histamine receptor blockers, proton pump inhibitors, gel antacids with anesthetics).
Physiotherapy includes electrophoresis, amplipulse therapy, balneotherapy and mud therapy.
The prognosis for this disease in the absence of complications is quite favorable, provided that the diet is maintained and a healthy lifestyle is maintained.