Reflux esophagitis - symptoms, causes and treatment. What is reflux esophagitis of the first degree? Mild variant of the disease

This is a lesion of the esophagus caused by the reflux of stomach contents into reverse side. Reflux esophagitis is not a separate disease, but one of the components of the development process peptic ulcer stomach and duodenum.

Causes of reflux esophagitis

As a result of disrupted nerve connections between departments gastrointestinal tract gastric juice with hydrochloric acid, as well as bile, appear in the lower parts of the esophagus. The so-called happens. The esophageal mucosa is not suitable for exposure to acidic contents and enzymes, and therefore reacts with inflammation.

The cause of reflux can be called mechanical pressure from the peritoneum through the diaphragm. This phenomenon occurs when overeating, big belly(obesity, ascites), hiatal hernia, flatulence (bloating).

Taking medications containing sedatives and antispasmodics (papaverine, platyphylline, spasmalgon and others), which women are addicted to when menstrual pain, with migraines, can also cause reflux with subsequent inflammation.

Antispasmodics are found in many over-the-counter pain relievers.

Symptoms of reflux esophagitis in the initial stages

Classic manifestations are pain in the epigastric region, heartburn, sour or bitter belching, a feeling of “lump” in the esophagus when swallowing. Often patients themselves associate symptoms with eating large meals, heavy physical work in a forward leaning position.

Sometimes hiccups, drooling, and nausea occur.

If symptoms occur once a month, then functional disorders quickly recover on their own. For more frequent complaints, it is necessary to undergo examination by a gastroenterologist.

Diagnosis of reflux esophagitis 1st degree

Inflammation of the esophagus is visually detected by a doctor performing esophagogastroscopy.

The method is based on injection into the stomach and top part duodenum thin tube with optical device at the end. It allows you to examine all parts of the esophagus.

In the first stage of esophagitis, the esophageal mucosa is intensely red in color with erosion (crack or scratch).

Treatment of reflux esophagitis of the first degree

To eliminate the initial stages of esophagitis, no special medications are required.

It is enough to comply with some conditions:

• do not overeat, provide six meals a day with small amounts of food;
• stop drinking alcohol and carbonated drinks;
• do not eat at night;
• get rid of excess weight;
• do not lean forward after eating;
• you cannot wear tight belts and clothes;
• stop taking antispasmodics and sedatives;
• no smoking.

Folk remedies in the form of herbal decoctions and medicinal teas have a good effect.

Children love dandelion flower syrup: pour dandelion flowers and granulated sugar into layers in a glass jar, crush on top. Leave until juice forms. One teaspoon of juice is diluted in half a glass of water, taken three times a day before meals.

Brew calendula flowers, lemon balm, oregano, plantain leaves as tea, a tablespoon per glass, take 1/3 before meals.

Impaired functioning of the organ with reflux esophagitis manifests itself:

• heartburn;
• burning, discomfort in the epigastrium;
• swallowing disorders;
• distension, swelling in the projection of the stomach;
• sour belching;
• nausea, vomiting.

GERD with esophagitis implies the presence of mucosal defects of varying severity, as opposed to the non-erosive type of pathology, when external manifestations there is no inflammation. In the 1st degree of the disease, the manifestations are already systematic, although usually only the terminal part of the organ is affected.

A pathognomonic sign of combined pathology is deterioration in the supine position. The increase in symptoms directly depends on the quantity and quality of food and physical activity after eating. Often complaints overtake patients at night, especially when overeating on the eve of sleep.

Reflux esophagitis is characterized by the addition of extraesophageal manifestations. This is the main difference from other gastrointestinal diseases. The most common form of pathology is peptic esophagitis.

Depending on the predominance of signs of damage to other systems, there are:

1. Cardiac chronic esophagitis. The complaints are similar to angina pectoris: sharp chest pain radiating to the right hand. An important criterion is the absence of heart pathology on the ECG.
2. Bronchopulmonary reflux esophagitis. The patient is bothered by a constant cough, even at night. A person is often seen by a therapist with chronic bronchitis, bronchial asthma, pneumonia.
3. Otolaryngological type- chronic inflammation of the laryngotracheal tube with high reflux of acidic contents. The patient has been observed for a long time for otitis media, pharyngitis, and laryngitis.
4. Dental- manifested by a violation of the integrity of tooth enamel.

Similar to reflux esophagitis. However, the latter necessarily requires the exclusion of concomitant pathologies. There is always a risk of heart, lung, and oropharynx disease. If there are no results of therapy chronic forms angina pectoris, bronchitis, caries or pharyngitis, it is necessary to consult a gastroenterologist to exclude inflammation of the esophagus due to reflux.

Los Angeles classification of reflux esophagitis

Symptoms 1st degree

In the first degree of the disease, single linear erosions, redness and swelling of the membrane (up to 10% of the total area) are detected on the esophageal mucosa.

At this stage of the disease, symptoms are periodic and less pronounced:

• heartburn, painful sensations behind the sternum, in the region of the “heart”;
• frequent regurgitation of sour or airy substances;
• sensation of a lump in the throat, rare dry cough;
• nausea, hiccups, bad smell from mouth.

Symptoms intensify when lying on your back, or when bending sharply forward. With esophagitis, pain often occurs in the projection of the heart, behind the sternum, which easily imitates angina pectoris. Their main difference from true cardiac pain is their development after ingestion of sour, spicy foods, and the lack of effect from nitroglycerin.

Symptoms 2 degrees

The presence of the second stage of the disease indicates more extensive damage to the mucous membrane of the esophagus, when there are drainage erosions. The area of ​​inflammation reaches 50%.

At this stage of the pathology, the symptoms are more permanent and cause severe discomfort at the patient. These include:

• constant heartburn;
• sharp or aching pain behind the sternum;
• frequent hacking cough;
• feeling of difficulty swallowing, feeling of a lump in the throat;
• constant burping;
• carious lesions of teeth as a result of constant reflux of hydrochloric acid into the mouth.

Sometimes, against the background of reflux and inflammation in the esophagus, broncho-obstruction appears. This pathological narrowing bronchi, which is manifested by shortness of breath, bloating of the chest and remotely audible wheezing.

Stage 3 symptoms

The third stage of esophagitis is characterized by the presence of multiple, often bleeding, erosions. Inflammation occupies the entire distal part of the organ. Signs of the disease are constant and do not depend on food intake or body position.

At this stage, the patient experiences great difficulty swallowing food or saliva. He begins to constantly be bothered by rhinitis, pharyngitis (inflammation of the membranes of the pharynx), which are the result of a strong reflux of aggressive gastric juice.

Stage 4 symptoms

The fourth degree is established in the presence of one or more complications: ulcers, stricture (narrowing of the lumen) or Barrett's esophagus - a precancerous condition.

Such patients are often hospitalized with bloody vomiting and anemia. Against the background of strictures, eating and swallowing becomes almost impossible, vomiting occurs, body weight progressively decreases, and the person becomes exhausted.

Diagnostics

The doctor makes a preliminary diagnosis based on anamnestic data, taking into account:

• frequency of attacks;
• nature of pain;
• body position in which symptoms most often appear;
• products that provoke and soothe pain.

Since the symptoms and treatment of esophagitis vary depending on etiological factors, then additional research is necessary.

Treatment

The optimal tactics for managing patients with GERD and esophagitis is a stepwise approach to treatment. To cure a patient, it is necessary to accurately determine the shape and volume of the lesion and select the appropriate “step”. The more severe the damage to the mucosa, the more serious and lengthy the therapy.

Prohibited for use

Superficial reflux esophagitis is corrected by lifestyle changes aimed at reducing the influence of risk factors for the development of the disease and eliminating unpleasant symptoms:

1. The patient will need to exclude foods that provoke the development of gastroesophageal pathology. Detailed description diet is in the section.
2. It is necessary to follow a food intake regime: small portions, optimal temperature, early dinner. After eating, do not lie down.
3. To refuse from bad habits.
4. Adjust weight.
5. Normalize physical activity: Less bending, lifting, abdominal exercises. Special gymnastics is recommended.
6. To reduce the frequency of night attacks during sleep, the head end of the bed is raised.

Medications for GERD

At the next “steps” special medications are used. The required combination of agents is selected depending on the cause of the development of the pathology, the specific course of the disease, and individual characteristics.

Drug therapy involves the use of the following groups of drugs:

• antacids, gastroprotectors;
• proton pump inhibitors;
• H2-blockers of histamine receptors;
• alginic acid;
• prokinetics.

The recovery period for grade 2 esophageal tube defects is long. Optimal duration treatment course 8 weeks, if necessary drug regimen repeats itself. After completion of therapy, a repeat endoscopic examination is required. The criterion for recovery is complete healing of the mucous membrane and the absence of corresponding symptoms.

The last step in the treatment of esophagitis with reflux is surgery. The technique is used in complicated forms of the disease, in the absence of progress from conservative therapy.

Inflammatory damage to the mucous membrane of the esophagus. Manifestations of esophagitis can include burning pain behind the sternum, difficulty swallowing, heartburn, and increased salivation. Complications of esophagitis can include peptic ulcers, stenosis, esophageal perforation, and Barrett's disease. Diagnostic minimum consists of esophagoscopy, endoscopic biopsy and radiography of the esophagus. Treatment is prescribed taking into account the etiology of esophagitis; includes diet drug therapy, physiotherapy; if necessary, surgical treatment of narrowing of the esophagus (bougienage, dissection of scar strictures, etc.).

General information

Esophagitis is an inflammatory disease of the wall of the esophagus, acute or chronic course. For esophagitis inflammatory process develops in the inner mucous membrane of the esophagus and, as it progresses, can affect deeper layers. Among diseases of the esophagus, esophagitis is the most common; in 30-40% of cases, the disease can occur without severe symptoms.

Esophagitis can be the result of various types of damage to the esophageal mucosa or develop as a result of an infectious lesion, gastritis, or reflux of gastric juice (sometimes with bile) from the stomach. Esophagitis due to reflux (reflux) of gastric contents is identified as a separate disease - gastroesophageal reflux disease.

Classification of esophagitis

Esophagitis can be acute, subacute and chronic. According to the nature of the inflammatory process and its severity in gastroenterology, catarrhal, edematous, erosive, pseudomembranous, hemorrhagic, exfoliative, necrotic and phlegmonous esophagitis are distinguished.

Catarrhal and edematous esophagitis (the most common forms) are limited to mucosal hyperemia and swelling. With an acute infectious process, as well as chemical and thermal burns of the esophagus, erosions of the mucous membrane may develop ( erosive esophagitis). At severe course infection often develops a necrotic form. Hemorrhagic esophagitis is accompanied by hemorrhages into the wall of the esophagus. In the pseudomembranous form, the fibrous exudate is not fused with the submucosal tissue, unlike exfoliative esophagitis. Phlegmon of the esophagus, as a rule, develops when the wall of the esophagus is damaged by a foreign body.

According to the localization and prevalence of the inflammatory process, distal, proximal and total esophagitis is distinguished.

The classification of esophagitis according to the degree of damage has differences for the acute and chronic course of the disease. Acute esophagitis and burns of the esophagus are divided into three degrees:

1. superficial lesion without erosive and ulcerative defects;
2. damage to the entire thickness of the mucous membrane with ulcerative defects and necrosis;
3. the lesion spreads to the submucosal layers, deep defects are formed with the possibility of perforation of the esophageal wall and bleeding. After healing, scar strictures may form.

Chronic esophagitis, according to the severity of wall damage, is divided into 4 degrees according to the classification of Savary and Miller (classification endoscopic signs chronic esophagitis):

1. hyperemia without erosive defects in the distal sections;
2. scattered small erosive defects of the mucosa;
3. mucosal erosions merge with each other;
4. ulcerative lesions of the mucous membrane, stenosis.

Etiology and pathogenesis

Acute esophagitis develops as a result of a short-term damaging factor:

• acute infectious processes (influenza, fungal infection, diphtheria, etc.);
• physical damage (burn, injury during insertion of the probe, damage from foreign bodies);
• chemical burn (damage from caustic chemicals);
• allergic reaction to food products(usually combined with other signs of allergy).

The most severe damage to the esophagus occurs after burns.

In the pathogenesis of infectious esophagitis, the main factor in the development of inflammation is considered to be a decrease in immune properties body.

The reasons for the development of chronic esophagitis are also varied:

• nutritional esophagitis (consuming very hot, spicy food, strong alcohol);
• occupational esophagitis (work associated with inhalation of vapors of caustic chemicals);
• congestive esophagitis (irritation of the mucous membrane by the remains of accumulated food with various kinds of difficulties in the evacuation function of the esophagus);
• allergic esophagitis (develops in connection with food allergies);
• dysmetabolic esophagitis (associated with metabolic disorders - hypovitaminosis, micronutrient deficiency and tissue hypoxia, prolonged intoxication of the body, etc.);
• idiopathic ulcerous esophagitis (a special form of chronic inflammation of the esophagus unknown etiology, morphologically similar to ulcerative colitis and granulomatosis of the esophagus (nonspecific regional stenosing esophagitis).

Peptic or reflux esophagitis is distinguished as a separate disease. It develops as a result of gastroesophageal reflux (reflux of gastric contents into the esophagus). Sometimes combined with duodeno-gastric reflux. Reflux from the stomach into the esophagus can occur due to the following reasons: insufficiency of the cardia (lower esophageal sphincter); hiatal hernia (hiatal hernia); insufficient length of the esophagus.

Symptoms of acute esophagitis

The severity of symptoms in acute esophagitis is directly dependent on the severity of the inflammatory process in the esophageal mucosa. At catarrhal form esophagitis can occur without clinical symptoms, only appearing occasionally hypersensitivity esophagus to hot or cold food. Severe forms esophagitis manifests itself in pronounced pain symptom(acute, severe, burning pain behind the sternum, radiating to the neck and back), swallowing disorder (dysphagia) due to severe pain, heartburn, increased salivation.

Extremely severe cases– bloody vomiting up to state of shock. Severe esophagitis after a week can be replaced by a period of imaginary well-being (a sharp subsidence of symptoms, perhaps even eating solid food), but without adequate treatment after several weeks (up to 3 months), healing of severe defects in the esophageal wall can lead to the formation of rough scars and stenosis, which will lead to the progression of dysphagia and regurgitation of food.

Symptoms of chronic esophagitis

With reflux esophagitis, the main clinical manifestation is heartburn (burning in the epigastric region and behind the sternum). As a rule, heartburn worsens after eating fatty, spicy foods, coffee, and carbonated drinks. Overeating also contributes to the development of symptoms. Others probable symptoms may be: belching (air, sour, bitter with an admixture of bile); Regurgitation may occur at night. Respiratory disorders, laryngospasm, bronchial asthma, and frequent pneumonia are common. Symptoms of breathing problems usually appear at night, in a horizontal position of the body.

Chronic esophagitis can occur with pain behind the sternum in the area of ​​the xiphoid process, radiating to the back and neck. Chronic esophagitis is characterized by moderate pain symptoms.

In children of the first year of life, esophageal sphincter insufficiency can be diagnosed by repeated moderate regurgitation immediately after feeding in a horizontal position. With persistent regurgitation, symptoms of malnutrition may develop.

Complications of esophagitis

Complications of esophagitis can be the following diseases and conditions:

• peptic ulcer of the esophagus (often develops with Barrett's disease), characterized by the formation of a deep defect in the wall of the esophagus, which can lead to severe scarring and shortening of the esophagus;
• narrowing (stenosis) of the lumen of the esophagus (leads to disruption of the passage of food into the stomach, loss of body weight);
• perforation of the wall of the esophagus (perforation) is a life-threatening complication that requires urgent surgical intervention;
• purulent complications of esophagitis - abscess, phlegmon (usually a consequence of damage to the esophagus by a foreign body);
• Barrett's disease (with prolonged reflux esophagitis without adequate treatment, degeneration of the esophageal epithelium develops - metaplasia). Barrett's esophagus is a precancerous condition.

Diagnosis of esophagitis

If acute esophagitis occurs clinical symptoms, then the diagnosis of this disease, as a rule, is not a problem - the localization of the pain symptom is very specific and characteristic. The survey allows you to identify probable cause development of esophagitis. Used to confirm the diagnosis endoscopic examination esophagus (esophagoscopy), which shows changes in the mucosa and their severity. Carrying out endoscopic examination the esophagus is carried out no earlier than on the sixth day after the manifestation of a pronounced clinical picture. Indications for endoscopic examination are determined individually. If necessary, an endoscopic biopsy of the mucosa is taken and examined histologically.

Disturbances in the motor function of the esophagus are detected using esophagomanometry. X-ray of the esophagus can reveal changes in the contours of the esophagus, ulcerations, swelling of the wall and accumulation of mucus.

Treatment of acute esophagitis

Acute esophagitis due to a chemical burn requires urgent gastric lavage to remove the chemical agent. For the treatment of mild forms of acute esophagitis, patients are recommended to abstain from eating for 1-2 days, drug treatment consists of taking antacids and drugs of the famotidine group. After starting a diet, exclude foods that can damage the mucous membrane (alcohol, coffee, hot, spicy, rough foods) and foods that activate the production of gastric juice (chocolate, fatty foods). All patients with esophagitis are recommended to quit smoking.

At severe course diseases - careful nutrition up to the refusal of enteral nutrition, enveloping and gel antacids. In case of severe intoxication - infusion therapy using detoxification solutions. To suppress infectious process– antibiotic therapy.

For ulcerative esophagitis with severe pain symptoms, anesthesia is prescribed and gastric lavage is contraindicated. If massive antibiotic treatment of lesions fails purulent inflammation(phlegmon, abscess) – surgical sanitation. Also an indication for surgical treatment Esophagitis is the development of severe esophageal stricture that cannot be dilated.

Treatment of chronic esophagitis

In the treatment of acute esophagitis, the main importance is the elimination of the factor of its occurrence. The most important component of treatment is strict adherence to diet, nutrition and lifestyle. Recommendations for diet during acute periods clinical manifestations: consumption moderate amount soft pureed food room temperature. Exclusion from the diet of foods that have irritant effect on the mucous membrane - spicy, fatty, fried, carbonated, alcohol-containing products. Also exclude foods containing a large number of fiber.

Patients with esophagitis should stop smoking and taking medications that affect the tone of the esophageal sphincter ( sedatives, tranquilizers, theophylline, prostaglandins, etc.).

You should also avoid eating at least one and a half to two hours before bedtime, do not take a horizontal position after eating, and do not spend a lot of time bending over. It is recommended to sleep on a raised headboard. Do not tighten at the waist.

Drug therapy for chronic esophagitis:

• drugs that reduce the acidity of gastric juice (antacids - the best choice is gel antacids with anesthetics, proton pump inhibitors, H2-histamine receptor blockers);
• drugs that increase the tone of the cardia (lower sphincter of the esophagus and accelerate the movement of the food bolus from the stomach into duodenum(dopa receptor blockers and cholinomimetics).

Prevention of esophagitis involves avoiding the causes of its development - burns from hot food, chemicals, damage from foreign bodies, etc. Prevention of chronic esophagitis - regular medical examination by a gastroenterologist and, if necessary, treatment. For patients with chronic esophagitis, sanatorium-resort treatment is indicated as a preventive measure for exacerbations.

Reflux esophagitis – pathological condition, in which the patient suffers due to the constant reflux of stomach contents into the esophagus. There can be many reasons for the development of the disorder, the main ones being gastrointestinal diseases and weakness of the alimentary sphincter. Due to the constant contact of acid on the neutral mucous membrane of the esophagus, the patient experiences unpleasant symptoms in the form of pain and burning. Without treatment for this condition, erosion of the epithelial layer develops, which can grow and affect the entire esophagus.

The human stomach produces hydrochloric acid through its glands to digest food. Since it is useful only when you are in gastric cavity, V digestive system There are so-called closing devices, which are sphincters. The stomach contains two - one goes into the cavity of the esophagus, the second into the intestine.

When, under the influence of certain factors, the patient experiences weakness of the first sphincter, some of the acid and products soaked in it begin to exit into the esophagus. The mucous membrane of this section of the intestine always has neutral acidity and begins to suffer due to the slightest exposure. Already after the first cast, minor burns. With systematic penetration of gastric juice, these erosions do not go away and are chronic.

With first-degree reflux esophagitis, the burns are small in size, and with timely treatment and a transition to proper nutrition, they disappear. Usually the pathology is initial stage without further progression, it occurs during pregnancy due to toxicosis and the growing fetus putting pressure on the gastrointestinal tract.

Attention! Reflux esophagitis of the 1st degree can be temporary and quickly reversible after a slight overeating or vomiting due to poisoning. In this case, the burns go away within a few days and do not become chronic.

Reasons for the development of the disease

May cause disruption various factors, which are eliminated independently when maintaining proper nutrition or with the mandatory use of medications. The main causes of grade 1 reflux esophagitis include:

Attention! Often, the process of formation of first-degree reflux esophagitis is triggered by chronic gastrointestinal diseases, including ulcers, gastritis, pancreatitis, and cholelithiasis. They are rarely single and are almost always accompanied by the development of weakness of the sphincter of the esophagus and stomach.

Symptoms of reflux esophagitis 1st degree

The clinical picture of the disease at this stage is not pronounced. Primary symptoms occur only if the lumen of the esophagus narrows to 1 cm and multiple burns appear on it. In the initial stage, the patient is only concerned about heartburn, which patients associate with periodic overeating and do not pay appropriate attention to it.

In the first degree of reflux esophagitis, a burning sensation also appears after small loads on the abdominal cavity or at night. Taking into account the aggravation primary state patients may begin to complain of periodic belching with a sour taste and a feeling foreign body in the throat. The following disturbances in the patient’s condition may also be observed:

• feeling of heaviness in the abdominal cavity;
• periodic bloating and flatulence;
• gases, which are especially disturbing at night and 2-3 hours after dinner;
• pain in the esophagus due to constant exposure to acid;
• discomfort when swallowing.

Attention! Taking into account the complications of the disease, problems may arise in the form of diarrhea, constipation, and prolonged pain in the abdominal area. Many patients begin to lose weight due to decreased appetite and problems swallowing.

Diagnosis of the disease

Pathology can be confirmed already at the first stage of its development using appropriate diagnostic procedures. In-person examination for first-degree reflux does not give any result and requires mandatory instrumental methods.

Procedure	Why is it carried out?
	Necessary for tracking acid reflux, allows you to diagnose the presence of a hernia and severe narrowing of the esophagus.
	Necessary to assess the degree of reflux and the frequency of acid reflux into the esophagus.
	Evaluates the condition of the epithelial layer of the esophagus, determines the exact reflux esophagitis, and allows you to take biomaterial for a biopsy.

Nutrition for the first degree of reflux esophagitis

The diet is not only healthy in nature, but also allows the patient to maintain optimal body weight and becomes a prevention of possible chronic diseases. As in the presence of any gastrointestinal pathologies, you should eat at least six times a day in small portions. You should not eat 2-3 hours before bedtime.

If your meal was late, you should not go to bed for half an hour after it. During this time, the stomach will be able to process part of the incoming food and give it to small intestine. This will also reduce the load on the food sphincter and will not provoke the reflux of stomach contents into the esophagus. If the pathology has only the first degree of development, it quickly passes if these recommendations and diet are followed. During the treatment of reflux, preference should be given to the following products:

In this case, it is necessary to completely eliminate all foods that can cause flatulence, containing acid, alcohol, and fatty foods. Seasonings and large amounts of oil are harmful.

Attention! If you have grade 1 reflux esophagitis, you should not drink a lot of coffee and tea. If it is difficult to refuse them, you need to prepare a weak brew and take only natural coffee, diluting it with milk.

Unconventional methods of treatment

They are aimed at eliminating inflammation, healing wounds and restoring the epithelial layer. In the first stage of reflux, therapy is sometimes sufficient unconventional methods, if the disease is not caused by pathological factors.

Herbal collection

For treatment you need to take chamomile, flax seeds, lemon balm herb, motherwort. All herbs are taken in equal quantities and ground well in a coffee grinder. For therapy, two tablespoons of the resulting powder are poured into 0.5 liters of cold water. The mixture is brought to a boil and kept on low heat for 15 minutes. After cooling, the grass is removed. Take 50 ml 3-4 times a day 15 minutes before meals. Duration of therapy is 7-15 days.

Chamomile and calendula

Herbs are taken at the rate of 2 tablespoons of chamomile flowers and 1 tablespoon of calendula. They are also mixed and ground in a coffee grinder. One part of the resulting amount of herbs is poured with 250 ml of boiling water and kept under the lid for 2-3 hours. After infusion, the mixture is removed through a sieve. Drink 50 ml three times a day 15 minutes before meals. Duration of therapy is up to three weeks.

Buckthorn

It treats not only burns, but also digestive problems such as flatulence, gas, heartburn and constipation. Two tablespoons of the substance are finely crushed and steamed in 250 ml of boiling water for two hours. After this, the bark is removed through gauze and 50 ml of solution is taken in the morning and evening. The duration of therapy is no more than two weeks.

Rose hip

For treatment, you need to boil a tablespoon of fruit in 500 ml of water for 15 minutes. They should be stirred and kept over low heat so that the rose hips release maximum amount useful substances. After boiling, the fruits are left in water for 2-3 hours, after which they are filtered. You need to take 100 ml of the decoction twice a day; if necessary, you can add a small amount of sugar. Treatment can be continued for up to two weeks.

Drugs against reflux esophagitis 1st degree

Treatment is always comprehensive and allows stopping, among other things, the progression of chronic ulcers, gastritis, and pancreatitis. Courses of treatment are usually not long, since the disease is mild.

Prokinetics for reflux

Their effect is aimed at improving gastrointestinal motility, strengthening the sphincter, eliminating flatulence and bloating.

"Damelium"

The tablets additionally relieve the feeling of nausea and vomiting. It is recommended to take Damelium 10 mg three times a day. For better effect This should be done 30 minutes before meals, the duration of therapy is individual for each patient. In case of severe vomiting or nausea due to developing heartburn or simultaneous exacerbation of other gastrointestinal pathologies, you can take 20 mg of Damelium three times a day, also half an hour before meals.

Damelium tablets

"Domstal"

You can take the medication at any age with the permission of your doctor. If you have kidney disease, the dose can only be taken once, if severe conditions no more than two doses are taken. If the patient does not suffer from renal failure, you can take 10-20 mg of Domstal, taking into account the condition, three times a day. To consolidate the result, the same dose active substance taken before bedtime. Treatment is carried out in an individually selected course.

Domstal tablets

Antacids and proton pump inhibitors

Neutralizes the effects of hydrochloric acid and products soaked in it on the walls of the esophagus. Quickly relieve heartburn, belching and possible pain.

"Adzhiflux"

If the patient has no problems with ulcerative lesion, you need to take 2-3 tablets an hour after meals. If you have a peptic ulcer, to get rid of reflux you should take Adzhiflux 30 minutes before meals in a dose of 2-4 tablets. The duration of treatment is according to indications.

Adzhiflux tablets

"Maalox"

Quickly envelops damaged mucous membranes and neutralizes the effects of hydrochloric acid. It is better to take the medication in the form of a suspension, it gives a faster and longer-lasting effect. Single dose Maalox is 1-2 sachets of liquid. Take no more than 12 sachets per day medicinal product. It is better to drink the suspension an hour after eating. Treatment can be continued for up to 12 weeks.

Maalox tablets

"Maalox" suspension

"Omeprazole"

A combined drug that protects the mucous membrane, normalizes motility, acidity and the general functioning of the gastrointestinal tract. For the treatment of reflux esophagitis, one capsule of the active substance is prescribed, better in the morning. Treatment can last up to six months. If exposure to Helicobacter bacteria must be additionally eliminated, the dose is 2 capsules of omeprazole for a week in combination with antibiotics.

Omeprazole capsules

Antiulcer drugs

They are necessary to reduce the amount of hydrochloric acid and provide an antibacterial effect. Can be used in complex therapy With antibacterial agents to suppress Helicobacter pylori bacteria.

"Ranitidine"

For the first stage of reflux, the dose is usually 150 mg in the morning and evening, sometimes the entire daily dose is prescribed before bed. If it is necessary to eliminate the symptoms of ulcers and gastritis, against which esophagitis has developed, the dose can be increased to 150 mg four times a day. Treatment, taking into account the degree of the patient’s condition, can be continued for up to three months.

Ranitidine tablets

"Acylok"

Available in the form of solution and tablets. For reflux esophagitis, including those complicated by an ulcer or gastritis, it is taken only in solid form. The dose is 150 mg in the morning and evening; if necessary, if the symptoms bother the patient more in the evening and at night, the entire dose can be taken once before going to bed. Treatment can last up to three months.

"Acylok" solution in ampoules

"Ultop"

It is a stronger analogue of the classic Omeprazole. In the first stage of reflux esophagitis, it should be taken once a day. morning time 20 mg of the main component. If necessary, the doctor may recommend taking the drug “Ultop” on demand when the symptoms of the pathology intensify, maximum dose active substance in this case is selected for each patient. Reception is carried out at an individually selected time.

Ultop capsules

Ancillary drugs

They are used in the presence of additional symptoms such as constipation, bloating, the presence of bacteria in digestive tract. They allow you to enhance the effects of major groups of medications and speed up recovery.

"De-Nol"

Contains bismuth, which has the necessary astringent effect and prevents the spread of Helicobacter pylori. Take the tablets half an hour before meals, no more than one tablet at a time. The daily amount of the drug “De-Nol” is 4 doses. Therapy is carried out at an individually determined time.

Tablets "De-Nol"

"Espumizan"

Copes well with bloating and cramps, does not allow gases to linger in the digestive tract. It can be taken in the form of an emulsion and in tablet form. Single quantity 5-10 ml or 1-2 capsules. Daily dose taking into account the patient's condition, 25-50 ml of suspension or 5-10 capsules of espumizan. Take 30 minutes before meals.

Espumisan capsules

"Rebagit"

Protects against the effects of hydrochloric acid, normalizing the functioning of the gastric glands. It is also used in therapy for the combined elimination of ulcers, gastritis and reflux esophagitis. Treatment involves taking 1 Rebagit tablet three times a day. The medication should be taken for 14-30 days, sometimes a longer course is required.

Tablets "Rebagit"

Attention! Medicines should be taken under the supervision of a doctor, since it is necessary to create the optimal combination of drugs for a particular patient, taking into account the cause of the development of reflux esophagitis. If the patient simultaneously follows a diet and does not have chronic pathologies Gastrointestinal tract, it is possible to completely eliminate the problem and prevent its progression.

Reflux esophagitis of the first degree is rarely independent; it is more often provoked by gastrointestinal diseases. In this condition, be sure to follow a diet and take prescribed medications. If the disease has no pathological basis, it is enough to eliminate the causes of the disorder and, if necessary, undergo systematic therapy. With timely initiation of treatment, it is possible to completely restore the esophageal mucosa and eliminate pain, heartburn and intestinal disorders.

Video - Reflux esophagitis 1st degree: what is it

Reflux esophagitis of the first severity (superficial) has mild symptoms. As a result, at this stage people do not seek help from specialists, which provokes the transition of the disease to a more serious form.

Primary reflux esophagitis is mild and may present with a sore throat

Symptoms

The symptoms of reflux esophagitis may vary depending on different stages esophageal lesions. This is influenced by many factors, these are:

• patient's age;
• degree of inflammatory process;
• presence of chronic diseases;
• Lifestyle.

In childhood, reflux esophagitis manifests itself in the form of regurgitation and belching; this unpleasant ailment can occur quite often. Vomiting is also possible. When the child is in a standing (upright) position, symptoms become less severe. As a rule, after next appointment food, symptoms such as belching and nausea appear again.

To ease your child's condition before bedtime, you should raise the head of his bed.

Children in adolescence often begin to complain of heartburn and burning inside chest. Symptoms often appear at night.

In adults, erosive esophagitis manifests itself as a sensation of a lump in the throat, as well as pain in the sternum. Besides, everything possible symptoms may not signal inflammation of the esophagus. They can be confused with another disease. The list of “alien” signs includes such manifestations as:

• cough;
• hoarse voice;
• dental problems.

A feeling of a lump in the throat may be the first sign of grade 1 reflux esophagitis

The first degree of reflux esophagitis (erosive) implies the appearance of separate erosions that do not merge with each other.

The main and provoking factor in the manifestation of the erosive type of disease is an error in nutrition.

Medications such as aspirin, analgin and paracetamol also have a negative effect. During periods of exacerbation of inflammation in the esophagus, these medications are not recommended. Treatment with these drugs during inflammation may lead to complications or chronic course esophagitis.

Etiology

Provoking factors can be not only diseases of the gastrointestinal tract, but also bacteria. If the patient has an infection (herpes, candida), then there is a high chance of.

Also, signs of inflammation of the esophageal mucosa may appear when the patient often encounters inhalation of chemicals.

Diagnostics

To diagnose the disease, you need to contact a gastroenterologist. He will give directions for examination of the esophagus, after which the whole picture will become clear.

The examination is carried out using an endoscope. At the first stage of the disease, slightly smoothed, sometimes loose walls of the esophagus are visible. An X-ray examination is also prescribed; it determines changes in the contours of the mucous membrane and the volume of mucus.

Endoscopy helps identify grade 1 reflux esophagitis

If esophagitis has several severe symptoms, and at the same time there are painful sensations - making a diagnosis during a routine examination is not difficult. Treatment in this case will be short-lived and effective.

Treatment

The first step in treatment should be to eliminate the underlying cause. The inflammatory process that provoked the occurrence of reflux esophagitis should be identified in a timely manner. These include diseases such as gastritis, ulcers or even neurosis.

It is also important to choose correctly necessary medications, which will not only alleviate symptoms, but also eliminate third-party inflammatory processes.

Diet – important point in the treatment of esophagitis. Its erosive type tends to “listen” to food. Prohibited foods may aggravate the situation and increase the severity of symptoms. Coffee, alcoholic drinks, chocolate and citrus fruits should be excluded from the diet.

Drug therapy

Antacids

The medications should be taken every two hours. The main components of the composition are magnesium and aluminum. Antacids containing these ingredients are not recommended for people with renal failure. In this case, medications containing only aluminum are prescribed. Treatment with antacids is long, but quite effective.

Antadits are widely used in the treatment of reflux esophagitis.

Proton pump inhibitors

Blockers are often used and are prescribed to patients with the first degree of severity of the disease. If the esophagus is affected by ulcers, inhibitors have no effect. Treatment with blockers is assessed positively only at the first stage of the disease.

Respiratory system damage

Reflux esophagitis of the 1st degree can manifest itself in the form of hoarseness, persistent cough, laryngitis, bronchitis, etc. At the same time characteristic symptoms for reflux may not occur at all.

For accurate diagnosis carry out daily pH measurements. It can be used to determine whether there are problems in respiratory organs. Note that bronchial asthma often appears together with reflux esophagitis. If you ignore this fact, an exacerbation of asthma may occur, which will provoke pneumonia. Then the treatment will be long.

Treatment is carefully selected to eliminate the symptoms of two diseases at once. An active course of medication along with diet therapy has a positive effect on the future prognosis. Also, patients suffering from reflux esophagitis and asthma should permanently give up smoking and alcohol.

Milk with minimal fat content helps in the fight against esophagitis

• Try not to eat too much in one meal. Overeating provokes the release of acid into the esophagus, which causes an attack of esophagitis.
• It is not advisable to eat heavy food before going to bed. It is recommended to limit yourself to a light sandwich.
• You shouldn't drink milk fatty varieties. Consume dairy drinks with low content fats and in small doses. It may seem like relief comes after drinking a glass of milk. A short remission is a new surge of esophagitis.

If you drink full-fat milk with antacids, there is a high risk of developing milk-alkali syndrome.

• Eat only those foods that your doctor has approved. He knows better what's safe.
• Eliminate consumption at least for a while fresh berries. You can eat fruit (limited quantity).
• Introduce into your usual menu products containing high content fiber and carbohydrates. They eliminate increased acidity Moreover, the body accepts such food more easily.
• Alas, it is worth completely removing fatty and spicy foods from the menu. After several days without fatty and spicy foods, the patient already begins to feel an improvement, since these dishes are difficult to digest in the stomach.
• During the treatment period, you should avoid nicotine. You should also not drink alcohol. These factors only increase the production and then the release of gastric juice.
• You should go to bed no earlier than 3 hours after last appointment food.
• Do not prescribe treatment for yourself; this should be done by a specialist.

The initial form of esophagitis in children and pregnant women

Babies who have not yet learned to talk cannot explain their condition. But unpleasant phenomena for a child can be recognized during and after feeding. The child begins to shirk the spoon with food, often cries and coughs at night. Symptoms in small children differ slightly from the usual signs:

Night cough and fever in children may symbolize esophagitis

• Dyspnea.
• Nervousness.
• Increased body temperature.
• Restlessness in the evening.
• Prolonged crying.
• Night cough.
• Regurgitation, nausea and vomiting.
• Diarrhea.

If there are two signs from the above list, you should show the child to a pediatrician.

Among other things, a baby diagnosed with reflux esophagitis requires certain care. Since the baby has a spherical stomach, feeding should be done in a semi-vertical position. After eating, do not let your child fall asleep for about 2 hours. The pillow on the bed should be higher than usual (10-15 cm).

Treatment of esophagitis in young children is quite specific, since it is difficult to select a drug due to its possible toxic effect on the child’s body.

In newborn babies, regurgitation in the first three months is considered normal.

Pregnant women can also experience symptoms of reflux esophagitis. This is due to increased intrauterine pressure. Symptoms are usually observed on later gestation of the fetus. As a rule, the condition improves after childbirth.