Esophagitis called inflammation of the mucosa of the esophagus.
The disease is uncommon, but rarely isolated. As a rule, accompanied by esophagitis and other diseases of the gastrointestinal tract.
Esophagitis is polyetiology disease and can occur at any age. Men exposed to it several times more than women, due to the more frequent use of alcohol and unhealthy diet.
Causes of esophagitis
Esophagitis can be caused by many factors which affect the mucous membrane of the esophagus. The anatomical position of the esophagus such that the mucosa may annoy him as external, exogenous factors and internal endogenous.
Exogenous causes of esophagitis include mucosal lesion as a result of exposure to chemical or thermal factors.
Chemicals - is alcohol, spicy food, the action of acid or alkali, iodine, etc. Thermal - burn hot food or drink, including chronic burns caused by the constant use of hot food too.
More common esophagitis caused by endogenous factors. The immediate cause of its development is the weakness of the cardia - the lower esophageal sphincter, which normally does not pass the contents of the stomach into the esophagus. If the cardia, for whatever reason, no longer cope with its function, the reverse casting of the acidic gastric contents into the esophagus, it is called reflux (translated from the Latin - reverse flow). Digestive enzymes and hydrochloric acid corrode the stomach mucosa of the esophagus. Inflammation of the esophagus resulting from, called reflux esophagitis.
Factors contributing to the development of reflux esophagitis following:
- Hiatal hernia;
- Damage cardia during surgery on the stomach or esophagus;
- Stomach ulcer;
- Systemic scleroderma;
- Tumors of the abdominal cavity;
- Power over gastronazalny probe.
Another reason may be esophagitis chronic infectious diseases affecting the mucous membranes, including the esophagus, e.g., tuberculosis, diphtheria, influenza.
Types of esophagitis
By the nature of the flow esophagitis can be acute or chronic.
Depending on the origin of esophagitis is:
- Alimentary (caused by food);
The morphological features the following types of esophagitis:
- Endoesophagitis. The most common form of esophagitis, an unfavorable during the transition to other forms;
- Edematous esophagitis;
- Erosive esophagitis. In this form on the oesophageal mucosa appear surface erosion. Formed by chemical burns, reflux, certain infectious diseases;
- Hemorrhagic Esophagitis. Usually this form is caused by infection;
- Pseudomembranous esophagitis. It is characterized by the appearance of fibrinous film is not tightly knit with the mucosa of the esophagus, caused by infection;
- Exfoliative esophagitis. Also causes infection in this case fibrinous exudate tightly soldered to the mucosa;
- Necrotic esophagitis. It arises from an earlier form of the reduced immunity with concomitant severe general pathology;
- Phlegmonous esophagitis. Acute purulent inflammation caused by ingestion of a foreign body.
Symptoms of esophagitis
Each species has characteristic symptoms of esophagitis, but there are symptoms common to all forms of esophagitis.
The main symptom of esophagitis is a feeling of pain and a burning sensation (heartburn) in the epigastric and retrosternal area. The pain may depend on the meal, and may not depend usually unpleasant symptoms worsen during exercise. Depending on the type of esophagitis, pain may be continuous or paroxysmal, aching, sharp, etc. The characteristic symptoms of esophagitis include burping air with a mixture of gastric contents. Nausea, vomiting, increased slyunoobrazovanie are also common symptoms of esophagitis.
Reflux esophagitis is shown increasing signs in the prone position, lying there taste acidic gastric contents into the mouth, there is a cough that is not associated with a disease of the bronchi and lungs, shortness of breath may occur.
In the acute form the symptoms of esophagitis pronounced, they are joined by the general deterioration: the body temperature rises, falls vitality, joined by other dyspepsia - frustration of a chair, flatulence. For chronic esophagitis is characterized by alternating exacerbations and remissions. However, even in remission esophagitis symptoms usually do not disappear completely, but become less bright.
Diagnosis of esophagitis
Diagnosis is suggested by characteristic symptoms of esophagitis. To confirm it conducted the following studies:
- Laboratory tests of blood and urine;
- X-ray study of the esophagus;
- Esophagoscopy - endoscopic examination of the esophageal mucosa;
- Esophageal motility study - study of esophageal motility;
- Daily monitoring of esophageal pH.
Treatment of esophagitis
Treatment of uncomplicated esophagitis conservative. In the case of prolonged unsuccessful conservative therapy, the emergence of complications (stricture, scarring, recurring bleeding), the threat of malignancy (Barrett's esophagus) and the occurrence of repeated aspiration pneumonia, surgical treatment of esophagitis.
Drug therapy involves the appointment of esophagitis antacids and tools that reduce the secretion of gastric (blockers of histamine H2-receptor) as well as drugs that stimulate the motility of the digestive tract. When severe pain prescribe painkillers, but avoid non-steroidal anti-inflammatory drugs, since they cause additional irritation. To treat acute pain with novocaine electrophoresis applied to the esophagus.
Assign physiotherapy: hyperbaric oxygenation, endoscopic laser therapy of reflux esophagitis - electrical stimulation of the cardia.
An important place in the treatment of esophagitis takes diet. At catarrhal esophagitis can be assigned to a table №5, when erosive esophagitis and the remaining forms - table №1. Also, diet stola№1 appointed for all types of acute esophagitis, as well as exacerbation of chronic, especially reflux esophagitis. Until full recovery exclude products that irritate the mucous membrane of the esophagus - coffee, strong tea, chocolate, hot and spicy food, hot food, citrus, sour fruit, soft drinks, fatty and fried foods. It is necessary to adhere strictly to the diet: eating at the same time, in small portions, at least 5 times per day.
When reflux esophagitis is necessary to observe the following recommendations: to sleep with a raised upper body, after a meal, do not tilt or lie down for one-half hour, do not wear clothes, squeezing the abdomen and chest.