Reflux esophagitis is an inflammation of the esophageal mucosa that causes acid reflux (pathological reflux of contents from the stomach into the esophagus), ICD-10 code: K21.0 .: gastroesophageal reflux disease with esophagitis, GERD. There are two types of GERD: erosive and non-erosive. The form with esophagitis belongs to the first type.

When a person swallows food, the lower esophageal sphincter that separates the stomach and esophagus opens, allowing food and liquid to enter the stomach. Then he closes again. If this process is disturbed, then gastric juice flows back into the esophagus. The constant backlash of acid into the esophagus and throat due to reflux damages the lining, causing inflammation, leading to heartburn and nausea.

Often, gastroesophagitis is accompanied by a disease such as duodeno-gastric reflux (reflux of the contents of the duodenum and bile into the stomach), which aggravates the course of GERD. The following reasons lead to this:

• Increased intragastric pressure, which increases the likelihood of reflux esophagitis.
• An increase in the aggressiveness of gastric juice and acidity, which causes.

Clinical manifestations of the disease are divided into two groups: esophageal and extraesophageal. In adults, typical symptoms of the first group include heartburn, dyspepsia, sour taste, regurgitation, and chest pain that worsens when the person has eaten, lies on their stomach or leans forward. Extraphageal (atypical) include cough, lump in the throat, mucus in the mouth, reflux pharyngitis and hoarseness, with an acute course of the disease, the temperature rises. Signs in children and infants include recurring nausea, vomiting, and coughing.

Pain that occurs with esophagitis is often confused with heart pain, due to the proximity of the corresponding nerve endings. This phenomenon is called cardiac syndrome. Against the background of the underlying disease, non-obstructive bronchitis often develops.

Diagnostics

Daily pH monitoring. A special probe is inserted into the gastrointestinal tract through the nose with a device that measures acidity for 24 hours or more. During this time, the patient leads a normal life. pH-metry accurately detects the presence of reflux, the duration and frequency of episodes, helps to determine the impact of certain actions (eating, smoking, exercise, sleep) on changes in acidity. The results help to choose the method of treatment individually.

Radiography

An X-ray method that makes it possible to visualize the structure of the esophagus, stomach and duodenum. Before passing, the subject ingests a contrast agent (Barium sulfate BaSO4). Then the person is exposed to x-rays and pictures are taken. This is a proven and safe procedure that does not require internal intervention.

Gastroscopy

type of endoscopy. The doctor inserts an endoscope into the mouth, advancing it into the stomach. Then he carefully examines the condition of the mucous membranes of the studied organs. If necessary, a biopsy is performed (taking a tissue sample for detailed laboratory analysis).

Gastroscopy is the most detailed type of diagnostics, providing accuracy that other types of studies are not able to provide. Its characteristics allow you to quickly establish an accurate diagnosis.

Gastro esophagomanometry

Manometry - measurement of intraesophageal pressure during swallowing. A thin catheter with special sensors is inserted into the esophagus through the nose. The results of the study are used to determine the pressure in the esophageal sphincters and the work of peristalsis. Gastrointestinal motility problems and lower esophageal sphincter dysfunction play a key role in the development of reflux, making manometry extremely important.

Treatment

The patient needs to change his habits, diet. Various drugs are used to relieve symptoms and normalize the work of the gastric system. Various folk recipes are also used, which can replace many types of drugs in the early stages of the disease. For serious complications, surgical treatment is used.

Diet and diet

The following dietary rules should be followed:

1. It is necessary to switch to fractional nutrition, the diet is divided into 5-6 servings per day. The break between meals should not exceed 4 hours.
2. Avoid lying down for 3 hours after eating.
3. Minimize intake of fatty foods, caffeinated drinks, mint, spicy foods, citrus fruits, tomatoes and tomato paste, alcohol. These products weaken the tone of the cardiac sphincter and increase the secretion of hydrochloric acid.
4. Increase your intake of low-fat protein foods (white meat, low-fat cottage cheese, soy). Protein increases the regenerative capacity of the body and has a beneficial effect on digestion.

Taking medications

Antacids

These include drugs whose main task is to reduce the level of acidity by neutralizing hydrochloric acid and protecting the mucous membrane. Sold in the form of tablets and gels. Modern suspension antacids have an antireflux effect. The action occurs within 10-15 minutes after ingestion, therefore, it is often prescribed for the rapid relief of exacerbations in the initial stages of treatment. Many types of drugs are not contraindicated during pregnancy. A well-known household antacid is baking soda.

A significant drawback is the acid rebound syndrome associated with drugs (the response of the stomach to a rapid decrease in acidity, as a result of which the secretion of gastric juice increases). This group of drugs is popular due to its availability.

Antisecretory agents

The mechanism of these drugs is to reduce the secretion of hydrochloric acid and digestive enzymes. Unlike antacids, this type of medication is designed for long-term therapies and can increase the protective capacity of the stomach, but they have a wider range of side effects.

Alternative medicine

Using medicinal herbs and folk remedies, you can completely get rid of reflux, heartburn and other manifestations of the disease without resorting to the help of specialized pharmacological agents. It is worth remembering that this will not be enough to cure the advanced form of the disease.

Flax seed decoction

These seeds help to reduce the level of acidity and restore the mucous membrane. They can be taken in their pure form, but in this case they are more difficult for the body to absorb. To prepare a decoction, grind a tablespoon of seeds, place in a thermos, then pour boiling water over it. After that, the broth should stand for 10-12 hours.

Sea buckthorn oil

This remedy reduces the secretion of gastric juice, has an enveloping effect. Contains vitamins A, K and E. Accelerates the recovery processes of epithelial tissue, compensating for the harmful effects of esophagitis.

herbal teas

There are many plants and herbs that are useful in diseases of the digestive system. One of the most effective recipes is tea from the leaves of plants taken in equal proportions: chamomile, lemon balm and St. John's wort. To enhance the healing properties of this tea, you should add propolis, making sure that there is no allergy.

Complications

Lack of adequate treatment, non-compliance with recommendations during an exacerbation lead to various complications associated with reflux, which can be very life-threatening.

Barrett's esophagus

A precancerous condition of the esophagus, the main cause of which is chronic. Constant exposure to acidic contents causes changes in the structure of the lower part of the esophagus - metaplasia. Tens of times increases the risk of developing cancer. Diagnosis is complicated by the fact that this disease periodically passes without heartburn, which is due to the roughening of the walls of the esophagus.

In the early stages, this disease is treated by eliminating the manifestations of reflux and other indirect causes. With complications, laser therapy and surgical treatment are used. In the most severe cases, the following operation is applied -.

Acute erosive esophagitis

Also known as hemorrhagic esophagitis. Causes esophageal bleeding, which is caused by thinning of the mucous membrane and the occurrence of erosions and hemorrhages. Manifested in the form of bloody vomiting.

Erythematous form of gastritis

Usually erythematous esophagitis precedes erosive. It manifests itself in the form of red oval rashes on the mucous membrane.

Inflammation of the small intestine

Inflammatory process, which is accompanied by functional disorders of the small intestine. Medically known as enteritis. Manifested by rumbling and bloating, stool disorders.

Dysmetabolic nephropathy

An improperly functioning gastrointestinal tract can cause metabolic disorders. The load on the urinary system increases. This is fraught with the development of a disease such as dysmetabolic nephropathy - kidney damage caused by metabolic disorders.

Prevention

Extra pounds contribute to an increase in intra-abdominal pressure (for the same reason, it is necessary to abandon too-tight clothing and tight belts), increasing the reflux of hydrochloric acid into the esophagus. Therefore, with obesity, body weight should be normalized. It is undesirable to lose more than 0.5-1 kg. per week, as this is too high a load for the body.

You should also stop smoking, as nicotine irritates the mucous membrane and increases the level of acidity, which is unacceptable for reflux esophagitis. Many medications also aggravate the disease - their intake is agreed with the doctor.

Illness and sport are compatible, only gentle exercises are shown. Breathing exercises are recommended as they help reduce intra-abdominal pressure. You should avoid strenuous exercise after meals and stop training with weights.

Lifestyle changes and a correct diet help reduce the frequency of reflux, prevent new exacerbations and forget about this disease forever.

Almost any of the symptoms described in the article can be provoked by a banal overeating in a healthy person, but if any of them does not go away for a long time, then this is a good reason to see a doctor. Timely provided therapy will help to avoid complications with reflux esophagitis. This means that it is impossible to treat the disease and avoid diagnostics exclusively at home.

Due to the constant reflux of gastric contents (sometimes along with the contents of the duodenum), the mucous membrane of the esophagus is injured. A serious disease develops - reflux esophagitis. It is dangerous with severe bleeding from and erosion, degeneration into Barrett's esophagus,. With reflux esophagitis, treatment is long, since it is necessary to eliminate not only the symptoms, but also the cause of gastroesophageal reflux.

Symptoms of reflux esophagitis

One of the characteristic symptoms of reflux esophagitis is heartburn.

Inflammation of the esophagus, caused by irritation of the mucous membrane with the acidic contents of the stomach, is manifested by esophageal dyspepsia. The most characteristic symptoms for reflux esophagitis are:

1. . Describing this condition, patients put their hand on the sternum, indicating the location of the burning sensation. Sometimes it radiates to the neck, shoulder blade. If the heartburn is mild, it goes away 3 to 5 minutes after taking antacids. It is possible to eliminate it by drinking a glass of milk. Increases with overeating, bending over, after taking alcohol, carbonated drinks.
2. Belching. Patients complain of regurgitation. An unpleasant sour or bitter taste appears in the mouth. Belching indicates the development of stenosis of the esophagus. Especially dangerous is nocturnal regurgitation during sleep (the contents of the esophagus enter the respiratory tract).
3. Pain behind the sternum. It is burning, intense, aggravated in the lying position, with the torso leaning forward. Irradiates to the interscapular region, neck, lower jaw. According to the clinical manifestation, pain with reflux esophagitis is similar to.
4. Dysphagia. At the initial stages, patients complain of difficulty swallowing solid food (bread, meat). If the disease progresses, the lumen of the esophagus narrows significantly (becomes less than 13 mm), then even saliva is difficult to swallow.
5. Esophageal bleeding. This is an extremely dangerous symptom that requires urgent surgical intervention.
6. The appearance of foam in the mouth. An extremely rare sign of reflux esophagitis. It occurs due to the intensive production of secretions by the salivary glands (up to 10 ml per minute), in response to the esophago-salivary reflex.

In addition to the standard clinical esophageal manifestations, patients complain of other symptoms. Sometimes a completely different disease is treated for a long time and persistently, since dysphagia, heartburn are less pronounced than extraesophageal symptoms:

1. Dental. Due to the ingress of gastric juice into the mouth, erosions appear on the tongue, teeth are destroyed, develops,. Patients complain of salivation.
2. The ENT organs become inflamed (nasopharyngitis, rhinitis, etc. develop). Patients are concerned about the feeling of a lump, spasm in the throat. Ulcers, granulomas, polyps appear on the vocal cords. The patient's voice becomes hoarse, rougher. Reflux esophagitis contributes to the development of cancerous lesions of the pharynx, vocal cords, and larynx.
3. bronchopulmonary symptoms. With reflux esophagitis in 6–10% of patients, the disease manifests itself with an exceptionally persistent cough, asthma attacks, which occur mainly at night.
4. Pseudocardial. Pain behind the sternum with reflux esophagitis is difficult to distinguish from "angina pectoris". It even irradiates in the same way as with angina pectoris. This is due to the innervation of the esophagus and the heart by the same nerve. These symptoms occur in 70% of patients. They initially turn to a cardiologist, but do not show deviations.
5. Cardiac symptoms. Patients, especially the elderly, complain of tachycardia, with attacks of pain caused by reflux. Due to the pathology of the esophagus, reflex angina pectoris, myocardial ischemia develops.
6. Signs of damage to the stomach. Patients complain of pain and heaviness in the abdomen, aggravated after eating, rapid satiety, nausea.

People with reflux esophagitis often have hiccups. They even complain about and unsuccessfully treat the spine.

Diagnostics

The doctor makes the final diagnosis based on the results of FGDS.

It is possible to identify the entry of bile into the esophagus according to the patient's complaints of a bitter taste in the mouth, especially in the morning, a yellowish coating on the tongue. Duodenal reflux is finally determined by analyzing the scraping of the tongue for the presence of bile acids.

Some clinical manifestations are not enough to establish the diagnosis of "reflux esophagitis". This disease is accompanied by serious changes in the mucous membrane of the esophagus. Therefore, before treating reflux esophagitis, it is necessary to differentiate it from other diseases. The doctor prescribes such additional studies:

• , esophagus, stomach;
• test with proton pump inhibitors.

The final diagnosis is made after the procedure, if appropriate histological and morphological changes in the esophageal mucosa are detected. In the presence of ulcers, erosion, a biopsy is necessary.

Treatment

Medicines

If the disease is not started, complications (bleeding, ulcers, etc.) are not detected, conservative treatment is carried out. Prescribe medications:

• prokinetics;
• antisecretory agents;
• antacids.

Prokinetics improve the functioning of the lower esophageal sphincter, reduce the number of refluxes.

Among antisecretory drugs for healing erosions, proton pump inhibitors (PPIs) are preferable. Only they must be taken correctly (half an hour before meals), otherwise the effect of their use will be minimal.

With resistance of patients to PPIs, monotherapy with antacids is carried out. In severe cases, a complex is prescribed:

• blockers of H 2 -histamine receptors;
• antacids.

Occasionally, PPI resistance occurs in patients with esophageal hypersensitivity. Therefore, proton pump inhibitors are prescribed with drugs that reduce sensitivity:

• tricyclic antidepressants (amitriptyline);
• selective serotonin reuptake inhibitors (fluoxetine, paroxetine).

Antacids reduce the effect of hydrochloric acid and other components of the reflux on the mucosa of the esophagus.

If it is revealed that, in addition to gastric juice, the contents of the duodenum enter the esophagus, drugs that neutralize bile acids are prescribed:

• ursodeoxycholic acid;
• antacids;
• cholestyramine.

Tablets, so as not to damage the esophagus even more, should be taken sitting or standing, washed down with plenty of water (100-150 ml).

Diet and lifestyle

In addition to medication, patients with reflux esophagitis must definitely change their lifestyle. There are certain rules that must be followed in order to reduce the number of refluxes:

1. Skip the afternoon break. Do not eat 3 hours before bedtime. After eating, it is better not to take a horizontal position, but to take a walk in the fresh air or just sit, walk around the room for half an hour.
2. Do not wear tight clothing. Underwear that tightens the stomach is strictly contraindicated. No pulling belts, tight belts, corsets.
3. You need to go to bed so that the head of the bed is raised by 15 cm.
4. Reduce the load on the abdominal muscles, especially after eating. It is impossible to destroy the extra calories eaten instantly by pumping the press, making forward bends. Set aside these exercises for 2 hours.

Mandatory for reflux esophagitis diet. With an exacerbation of the disease, treatment table No. 4 is shown. As you recover, most of the restrictions are removed, but the following remain banned:

• alcohol;
• carbonated drinks;
• strong tea with coffee;
• spicy, salty.

Sometimes patients with reflux esophagitis do not tolerate citrus fruits, tomatoes, apples - they cause heartburn. It is also better to refuse these products.

Surgery

Surgical treatment is necessary for:

• strictures of the esophagus;
• frequent bleeding;
• relapses of aspiration pneumonia;
• transformation of the disease into Barrett's esophagus;
• ineffectiveness of drug therapy.

For surgical treatment, they resort to fundoplication - circular suturing of the bottom of the stomach to the esophagus. This method is necessary so that in the future food from the stomach does not fall back into the esophagus.

According to 2010 data, about 5 million people in Russia suffer from reflux esophagitis, and only 2 out of 10 people receive the correct treatment. Often, the symptoms of this disease become habitual and are included in the daily norm. A person does not pay attention to a small after-dinner heartburn, which disappears after a tablet of Almagel or water with soda. Because of this approach, the disease continues to progress and often leads to the development of severe complications such as bleeding or cancer.

GERD and reflux esophagitis

In Internet resources, on television, and even in medical literature, these two concepts are often confused. They must be distinguished, since treatment depends on the diagnosis. To explain the subtleties of terminology, it is enough to study the table below:

	GERD (Gastroesophageal reflux disease)	Reflux esophagitis
What it is?	A disease that develops when food is thrown from the stomach into the lower esophagus. Accompanied by damage to the mucosa of the organ.
Is there a change in the walls of the esophagus?	With a mild course, the mucosa may be normal.	Inflammatory changes are always determined.
How to make a diagnosis?	At the first examination by a doctor.	Only after endoscopic diagnosis - fibrogastroscopy (FGS).
The difference in treatment	Medicines are taken only when necessary.	Regular therapy with pharmacological preparations is necessary to prevent stenosis (narrowing of the organ), bleeding, cancer, etc.

In short, esophagitis is an inflammation of the esophagus that is detected after FGS. You can have GERD without esophagitis, but you can't have reflux esophagitis without GERD.

Causes

In a healthy person, there is a muscular flap (lower esophageal sphincter) between the stomach and esophagus that prevents partially digested food from moving backwards. During the day, there may be several episodes of reflux of acidic contents, and this is considered normal. The disease develops when the number of these casts increases significantly or the concentration of acid increases in them.

The causes of reflux esophagitis can be divided into several groups, depending on the mechanism of the development of the disease. This is important, since for effective treatment, pathological chains must be broken, and harmful factors must be eliminated.

Cause	Mechanism	Conditions that lead to GERD and esophagitis
Increased pressure on the lower esophageal sphincter	Increased pressure in the abdominal cavity "forces" food through the muscular valve.	Obesity; Pregnancy; Regular overeating; Accumulation of fluid in the abdominal cavity (ascites); Stenosis of the pyloric sphincter is a violation of the movement of food from the stomach into the intestines.
Weakness of the esophageal valve	The failure of the sphincter leads to frequent refluxes.	hiatal hernia; Taking certain pharmacological preparations: nitrates (isosorbide mononitrate or dinitrate); calcium channel blockers (Amlodipine, Nifedipine, Verapamil, etc.), beta-blockers (Propranolol, Carvedilol, Metoprolol and others); Muscle injury after injury, chemical burn or surgery.
High aggressiveness of gastric juice	Even infrequent reflux of stomach contents can damage the esophagus when high acidity or concentrations of digestive enzymes are present.	Hyperacid gastritis; peptic ulcer; Ellison-Zollinger syndrome; stress ulcers.

Symptoms

Manifestations of the disease are divided into two large groups: esophageal and extraesophageal. The first group includes typical symptoms associated with damage to the mucosa. The most characteristic of them are:

• . It can occur at any time, worse after physical work, bending over, drinking alcohol or eating a lot. Its intensity depends on the severity of mucosal damage and the presence of concomitant diseases (gastritis, peptic ulcer, and others);
• Pain . With reflux esophagitis, they are located behind the sternum or slightly higher. In most cases, they are combined with a feeling of heartburn. A distinctive feature from "heart pain" is the improvement after taking antacid drugs (Almagel, Gaviscon, Rennie, etc.) and the connection with food intake;
• Sour belching. It is a typical symptom of the disease, often accompanied by regurgitation of a small amount of food;
• Swallowing disorder. The symptom develops with a prolonged course of pathology. It can be accompanied by both difficulty in passing the food bolus, and the occurrence of painful sensations when swallowing.

In addition to the listed symptoms of reflux esophagitis, the patient may show signs of damage to the bronchi, lungs, vocal cords and trachea. Acid reflux can enter the respiratory tract and cause inflammation of these organs. As a result, a person can be treated for a long time and unsuccessfully for chronic bronchitis, asthma, laryngitis, recurrent pneumonia, etc.

In this case, chronic reflux esophagitis can manifest itself:

• Hoarseness or change in the timbre of the voice;
• Persistent cough. It will be dry with damage to the trachea and wet, against the background of inflammation of the bronchi or lung tissue;
• Sore throat;
• Prolonged runny nose.

It should be remembered that damage to the esophagus and surrounding organs can lead to minor bleeding. They do not manifest themselves outwardly, but a person may feel weakness, weakness, craving for specific odors (gasoline, paint, glue, etc.), peeling of the skin and brittle nails.

Diagnostics

Before treating reflux esophagitis, the doctor must confirm the diagnosis and determine the extent of the disease. This can be done only with the help of additional diagnostics. Laboratory methods are practically uninformative for this purpose - they only allow assessing the state of the patient's body and suspecting the presence of complications. When a person is contacted, they must perform three tests: general analyzes of urine, feces and blood. Against the background of esophagitis, changes can be noted only in the last study.

The final diagnosis can be made only on the basis of the results of one examination - Fibrogastroscopy (FGS).

How is FGS carried out?

This is a special study in which a thin device in the form of a small elastic tube is inserted through the oral cavity, with a camera and a working instrument at one end. Preparation for it is quite simple - 3-4 hours before the study, you should not eat, and 30-40 minutes it is not recommended to drink.

Before the FGS, the person may be asked to bring a small towel and a disposable tissue, which is sold in any pharmacy. The procedure is performed in the “lying down” position, usually on the left side. To facilitate its implementation, the patient may be sprayed with a solution of an anesthetic drug on the soft palate (in the region of the tongue). Next, the patient is asked to hold the mouthpiece in his mouth, through which the device will move.

Fibrogastroscopy is an unpleasant procedure, but it lasts no longer than 3-7 minutes. During this time, the doctor manages to examine the mucous membranes of the esophagus, stomach and, if necessary, take a small “piece” of tissue for examination under a microscope. The laboratory assistant will determine the presence of bacteria, cancer cells or areas of thinning of the epithelium in the material.

The doctor gives the first results of the FGS immediately after the study. They describe the data that he was able to see through the endoscope. The conclusion of the laboratory comes within 1-2 weeks.

Interpretation of FGS results

If the doctor detects pathology during endoscopic examination, he necessarily describes the nature of the damage to the walls. The doctor may find:

1. Catarrhal reflux esophagitis. The easiest option, in which the mucosa of the organ is full-blooded, loose, but does not have obvious signs of damage. The stage of the disease is not set in the diagnosis;
2. Erosive reflux esophagitis. This diagnosis implies the presence of ulcers or areas of thinning of the mucous membrane on the wall of the organ. If an erosive process is detected, treatment should be started immediately, as it can cause bleeding, lead to narrowing or complete obstruction of the esophagus, and cause cancer. The stage and degree of the disease must be set, a section of the mucosa (biopsy) is taken for examination;
3. Signs of bleeding. This complication is often observed in the erosive form. It is often the cause of anemia, due to which the patient feels constant weakness, decreased performance and taste perversion. It is treated at home, as it does not lead to life-threatening conditions. The exception is bleeding in oncology;
4. presence of fibrin. The formation of fibrin plaque, in most cases, indicates prolonged inflammation. Does not affect the tactics of therapy and the severity of the disease.

Sore throat after FGS

This is the most common complication of fibrogastroscopy, which worries 70-90% of people after the procedure. It can occur even with the correct advancement of the apparatus and the technique for performing FGS. Pain occurs due to additional damage to the mucosa, its intensity and duration depends on the strength of this damage. The pain syndrome can persist from several days to 2 weeks, which corresponds to the timing of the complete recovery of the epithelium.

To make sure that there is no serious damage to the organ wall, it is enough to go to the clinic, where a person should have a fluorography / chest X-ray. The detection of free air will indicate a rupture of the wall, which requires urgent surgery. It should be noted that such cases are casuistic in nature and practically do not occur.

Sore throats do not require additional treatment - the epithelium will recover on its own without medical intervention. To eliminate pain, you can take an NSAID tablet, after consultation with the doctor. More preferred are Meloxicam or Nimesulide, as they have less side effects on the digestive system.

Degrees and stages of esophagitis

With an erosive form, the endoscopist must describe the pathology in detail in the diagnosis. He does this with the help of alphabetic (A-D) and numeric (I-V) signs, which reflect the degree of reflux esophagitis and its stage. To decipher this data, you can use the tables below.

Degree	Los Angeles classification of esophagitis	Stage	Classification of esophagitis according to Savary-Miler
A	Thinning of the mucosa 1-5 mm long	I	The presence of single areas of thinning (erosion) of the mucosa.
D	Erosion more than 5 mm	II	Confluent erosions that do not cover the entire circumference of the esophagus.
C	Erosions cover ¾ of the circumference of the organ	III	The erosive and inflammatory process is spread over the entire circumference of the organ.
D	The affected area is more than 3/4	IV	On examination, the doctor found severe complications: changes in length, narrowing of the walls, ulcers, etc.
		V	Detection of signs of precancer in the lower part of the organ - "Barrett's esophagus"

Careful interpretation of the results of the study is not required for the patient. The main thing to know is that the higher the stage / degree of the disease, the longer the duration of therapy and the higher the risk of complications.

Treatment

The insidiousness of esophagitis is the absence of pronounced symptoms, which is why most patients neglect the recommendations of doctors. As a result, the disease continues to develop and causes dangerous complications. To prevent this outcome, it is necessary to start treatment of reflux esophagitis in a timely manner, which consists not only in the regular intake of drugs, but also in lifestyle changes.

General events

Before you start taking medications and correcting your diet, you need to make certain changes in your lifestyle. Following a few simple guidelines has been shown to significantly reduce reflux and muscle valve damage. For patients with inflammation of the esophagus, it is fundamentally important to perform the following activities:

1. Give up smoking. Nicotine not only increases the acidity of gastric juices, but also has a relaxing effect on the muscles of the digestive tract. The combination of these effects leads to increased symptoms of esophagitis;
2. Do not lie down after eating. Within 30 minutes after eating, it is recommended to sit in a comfortable position or take a leisurely walk. Lifting weights, running and even brisk walking should also be avoided immediately after dinner;
3. Limit physical activity. To reduce the severity of symptoms, women should not lift more than 3 kg, and men more than 5 kg;
4. It is necessary to exclude eating and drinking alcohol-containing drinks 2-3 hours before bedtime;
5. It is necessary to sleep on a high pillow or with the head end raised by 15-20 cm;
6. Refuse to wear tight clothing, including belts, corsets, belts, etc.;
7. In the presence of concomitant diseases (obesity, gastritis, peptic ulcer, Ellison-Zollinger syndrome and others), it is necessary to carry out their full treatment. Otherwise, the treatment of reflux esophagitis will be ineffective.

Diet

Nutrition is an important component of therapy and prevention of complications. For most people, dieting is associated with tasteless food and constant restrictions. Indeed, with this disease, there is a need to eliminate certain foods from the diet. However, with the help of simple culinary techniques, almost any dish can be made from permitted products. We will show you how to make a diet for reflux esophagitis pleasant, complete and tasty.

What products are not allowed?

To reduce the number of casts and the acidity of gastric juice, it is necessary to exclude from the diet:

• Caffeine-containing drinks: energy drinks, coffee, Coca-Cola, some cocktails, etc.;
• Carbonated drinks;
• Alcohol;
• Any flour dishes, as they increase the secretion of acid in the stomach;
• Limit the intake of chocolate and sweets;
• Dairy products;
• Olive and linseed oil, animal fats;
• "Sour" fruits and vegetables: citrus, radish, pomegranate, radish, etc.;

What is the best way to cook food?

First of all, you should abandon fried foods with vegetable or animal oils. Such products lead to a massive release of gastric juice and the appearance of aggressive reflux. Preference should be given to boiled food, steamed or stewed in its own juice. For this purpose, you can use not only classic cooking methods, but also modern gadgets.

Here are some tips on how to cook delicious and low-fat meat dishes:

1. Wrap. In almost any chain store you can buy special sets with paper bags / sheets. Their use allows you to cook almost any meat dish without a drop of oil. Instead of the spices that come with the kit, it is possible to use a sufficient amount of salt, fresh or dried herbs (dill, parsley, basil) and natural chopped vegetables (bell peppers, cucumbers, eggplant, zucchini, a small amount of onion and garlic);
2. Baking in the oven. This is the best way to cook any dish for the patient. The absence of additional oil, in addition to that available in meat, allows you to cook any low-fat dish. The water that is poured into the ingredients makes them soft and easy to digest. The ability to cook side dishes and main dishes in the same pan/pan saves a lot of time. However, it should be remembered that the minimum duration of such baking is 60-70 minutes. The recommended temperature is 180-200 o C.
3. Microwave cooking. Modern models allow you to cook almost any kind of meat or fish using only wave radiation. Contrary to popular belief, it does not affect the quality and safety of food in any way, which is confirmed by scientific studies by Western doctors. At the same time, the food turns out to be low-fat and quite tasty. The main thing is to observe the regime during cooking, which is described in the instructions. This will protect food from harmful microorganisms and save time on choosing the optimal cooking scheme;
4. Using a double boiler / multicooker. To prepare a tasty and healthy dish with these gadgets, you need to add juicy vegetables such as carrots, onions, tomatoes or pumpkin pieces to meat or side dishes. Thanks to steam processing, they give a rich juice that soaks the food and gives it a pleasant taste. Also, do not forget to add salt to food to taste and add herbs (dill, coriander, parsley, etc.);
5. Cooking on an open fire. This method is not suitable for daily use, but when you get out into nature, it will be indispensable. Since all excess fat is evaporated from the products on fire and no additional oil is added, the meat is lean and quite tasty. It is suitable for a patient with esophagitis under one condition - if spicy marinade was not used for its treatment.

When dressing dishes, you should limit the amount of mayonnaise and oils. You should also refrain from ketchup, mustard and hot sauces. They not only damage the mucosa, but also increase acid secretion in the organ. The food consumed should be at room temperature - too hot or cold food also has a negative effect on the digestive organs.

Pharmacotherapy

Medications to reduce acid reflux

For the treatment of reflux esophagitis, various groups of drugs can be used, but one of them is prescribed to almost all patients - these are proton pump inhibitors (abbreviated as PPIs). These drugs effectively reduce the acidity of gastric juice. Influencing the cells that produce hydrochloric acid, they reduce its concentration. Due to this effect, reflux of gastric contents damages the mucous membrane less.

At the moment, there are 5 main types of PPIs: omeprazole, esomeprazole, lansoprazole, rabeprazole, pantoprazole. To choose the best drug for yourself, you need to contact a competent therapist or gastroenterologist. He will assess the condition of the body and the course of the disease, after which he will prescribe therapy.

According to current research (2014-2016), some pump inhibitors have specific effects that are important to consider before taking them. We list the most important of them below:

Patient Feature	Optimal drugs	Why these drugs?
The need to take drugs that reduce the activity of the AP enzyme (enalapril, captopril, lisinopril, ramipril, etc.)	pantoprazole, rabeprazole.	Doctors have determined that people with heart disease or high blood pressure have an increased risk of heart attacks and strokes after taking omeprazole or esomeprazole. Subsequently, it was found that these drugs neutralize the protective effect of drugs that reduce the concentration of AP-enzyme.
During pregnancy (after the 13th week)	Lansoprazole, Pantoprazole.	The American Physicians Association (FDA), which assesses the safety of drugs, has not found any toxic effects of these drugs on the fetus and mother. However, before the 13th week of pregnancy, their use is not recommended, since at this time all the main organs of the child are formed. Omeprazole, rabeprazole and esomeprazole are prohibited during pregnancy.
In the presence of bronchial asthma	esomeprazole, Omeprazole	There is no doubt that reflux esophagitis and asthma are interrelated. There is a study proving the positive effect of these drugs on the course of respiratory disorders.
In case of violation of liver functions (hepatitis, cirrhosis, alcoholic or fatty hepatosis, etc.)	It is possible to use any PPI, but it is better to use rabeprazole.	The minimum dosage of rabeprazole is 10 mg, which is half that of other pharmacological preparations from this group. According to some scientists, its use can reduce the load on the liver cells.
Requires rapid and sustained deacidification	Lansoprazole, pantoprazole, rabeprazole.	Scientific studies have shown that the maximum effect of omeprazole and esomeprazole develops only on the 3rd-4th day of administration. The listed medicines realize their effect within one day.

Only with intolerance or ineffectiveness of PPIs, a group of histamine H 2 blockers is used to reduce acidity. They have been shown to be less effective and require higher doses, so they are only used as a last resort. These include famotidine, ranitidine, nizatidine, roxatidine.

Medications to improve gastrointestinal motility

In addition to reducing the aggressiveness of refluxes, it is necessary to reduce their number. Not only a change in lifestyle, but also some pharmacological preparations can help in this. They belong to the group of prokinetics - drugs that improve the motility of the digestive tract and facilitate the movement of the food bolus. These include:

• Domperidone (motilium, motilak, motonium) - is the best remedy for inflammation of the esophageal mucosa. Allows you to improve the work of sphincters, peristalsis of the stomach and intestines;
• Cisapride (Coordinax, Peristil) - the drug has a targeted effect on the lower esophageal sphincter and stomach, increasing their tone and reducing the frequency of refluxes;
• Metoclopramide (raglan, perinorm, cerucal) - is used when other drugs are ineffective and there are frequent casts. Not recommended as a starter drug due to frequent side effects such as constant fatigue, weakness, muscle twitching, etc.

The drug for treatment can only be prescribed by the attending doctor. Each of them has its own contraindications and side effects, which must be considered before starting therapy.

Antacids

For instant relief of heartburn or esophageal pain, this group of drugs is perfect. Antacids do not cure the disease, but they can temporarily eliminate its symptoms. They have practically no contraindications, so they can be taken without a doctor's prescription.

Almagel is the most famous antacid, which appeared one of the first on the market. At the moment, it is significantly inferior in effectiveness to such drugs as:

• Gaviscon;
• Rennie;
• Maalox;
• Megalac.

According to recent studies, the listed pharmacological preparations begin to act faster, retain their effect longer and reduce the acidity of gastric juice more strongly.

A few words must be said about an aqueous solution of soda, which is widely used to relieve heartburn. Such treatment with a folk remedy has only a negative effect on the organs. With the first passage of alkali through the esophagus, irritation of the mucous membrane occurs. In response to the instant alkalization of the stomach, a strong release of acid occurs and refluxes become more aggressive. Doctors strongly do not recommend using soda, but using conventional antacids.

When is an operation needed?

Esophagitis is almost always treated without surgery. Surgical intervention is an extreme measure that is used in the development of severe complications. Consultation with a surgeon, determination of the need and extent of surgery is recommended in the following situations:

• In the event of persistent bleeding from the esophageal vessels;
• Against the background of persistent narrowing of the esophageal tube (stricture), which prevents the passage of food;
• With irreversible damage to the esophageal sphincter;
• The precancerous condition of the mucosa is the degeneration and disorderly reproduction of cells. This condition is called "Barrett's esophagus";
• Cancer of the esophagus 1-2 stages.

In each of these cases, the decision on the type of operation is made individually. Removal of a pathological formation, removal of a part of the esophageal tube, restoration of the integrity of the organ using the remaining part of the esophagus or intestines can be carried out. These operations combine two common features - they are all carried out according to vital indications and each is quite difficult for patients to tolerate.

FAQ

Question:
How to detect reflux esophagitis in a young child?

Normally, in children, the number of casts is 2-3 times more than in adults. His digestive organs are adapted to this condition, so they rarely develop esophagitis. The onset of the disease may be indicated by "unreasonable" crying or anxiety, especially after eating. A slight temperature may appear, the child may point to the middle of the chest to indicate the place of pain.

Treatment of esophagitis in infants is carried out, as a rule, without the use of medications. First of all, it is recommended to conduct "position therapy". During feeding, the child is held more vertically - at an angle of 50-60 about. This helps to reduce the number of casts. If this measure is ineffective, the baby is transferred to feeding with adapted mixtures, which have a thicker consistency. These include Nutrilon, Enfamila, Frisovoy, Lemolaka.

The feeding regimen, the type of mixture and other therapeutic purposes are determined exclusively by a pediatrician or neonatologist. It is strongly not recommended to influence the health of a small patient without consulting a doctor.

Question:
How long should therapy continue?

Lifestyle and dietary recommendations should be followed consistently throughout life. The need for drugs is determined individually, depending on the severity of the disease and the presence of concomitant diseases. With a moderate course, as a rule, a course of PPI is prescribed for 2-4 weeks, 2 times a year.

Question:
What is biliary reflux esophagitis?

With a combination of a disease of the biliary system and weakness of the muscular septa, reflux into the esophagus from the initial section of the intestine, the duodenum, may occur. In this case, bile, and not gastric juice, has a damaging effect on the mucous membranes. Biliary reflux is often accompanied by severe gastritis or ulceration. The principles of treatment of this form are the same as in the classical course of the disease, however, it is important to eliminate the cause of the pathology - that is, to cure the disease of the biliary system.

Question:
Can esophagitis lead to esophageal ulceration, esophageal cancer, or other complications?

With a long course of pathology or high aggressiveness of refluxes, the likelihood of complications is quite high.

- the disease is not easy, so patients need to be attentive to the appearance of symptoms of this disease and be sure to undergo an examination by a specialist.

Only complex therapy will help get rid of reflux esophagitis, so it will be useful for every person who suffers from this disease to know how this disease should be properly treated with the help of a competent doctor.

So let's get started.

Can reflux esophagitis be cured permanently? You can, if you turn to a competent doctor and get modern treatment.

Doctors identify several effective and efficient treatment regimens for reflux esophagitis. All of them are selected strictly on an individual basis for each patient after receiving the results of the examination.

1. Therapy with one drug. This does not take into account the degree of soft tissue damage, as well as complications. This is the least effective treatment regimen for patients, which can lead to poor health.
2. Reinforcing therapy. Doctors prescribe different drugs to patients, which differ in the degree of aggressiveness. Patients need to strictly follow a diet and take antacids.
3. Taking strong proton pump blockers. When the symptoms begin to disappear, patients are prescribed prokinetics. This treatment regimen is suitable for patients diagnosed with severe reflux esophagitis.

Reflux esophagitis: treatment regimen

The classical scheme of treatment of the disease is divided into 4 stages:

1. First degree reflux esophagitis. Patients should take antacids and prokinetics for a long time ().
2. 2 degree of the inflammatory process. Patients need to adhere to proper nutrition and take blockers. The latter contribute to the normalization of the level of acidity.
3. 3 degree of the inflammatory process of a severe form. Patients are prescribed the use of receptor blockers, inhibitors and prokinetics.
4. The last degree of reflux esophagitis is accompanied by pronounced clinical manifestations. Treatment with medicines will not bring a positive result, so patients undergo surgery in combination with a course of maintenance therapy.

How to cure reflux esophagitis permanently? The duration of therapy depends on the degree of damage to the gastrointestinal tract. The initial stage of reflux esophagitis can be cured with a proper and balanced diet. The course of therapy is calculated for each patient individually.

How to treat reflux esophagitis

If the process of digestion of food is disturbed, then the contents of the stomach during a long stay in it causes an inflammatory process and irritation of the walls.

Patients feel heaviness in the intestines, a feeling of fullness in the stomach, nausea and bitterness in the mouth. After eating, the pain becomes severe and becomes acute.

There are several effective methods of treating reflux esophagitis, which are prescribed only by the attending physician after diagnosis and study of the patient's history.

Note! Vitamins for reflux esophagitis are not always prescribed: the need for this is determined by the doctor when choosing therapy, when he decides what to take for reflux esophagitis for you.

Medical treatment

How to get rid of reflux esophagitis? Depending on the form of the course of the disease, doctors prescribe patients to take proton pump blockers or H2-histamine receptor inhibitors. The first group of drugs helps to normalize the work of the glands of the stomach and the mucous membrane of the digestive system. These medications are prescribed to patients for additional protection of the walls of the esophagus, duodenum and stomach.

With the correct use of blockers, damaged areas of the mucous membrane begin to recover faster. Medicines taken for a long time, and if the patient is diagnosed with a severe form of reflux esophagitis, then they are prescribed a double dosage at the initial stage of treatment.

The most effective drugs include:

Features of antacids

These substances help to quickly and effectively cope with the manifestations of heartburn. After using antacids, their main components begin to act on the body after 15 minutes. The main task of such therapy is to reduce the amount of hydrochloric acid, which causes burning and soreness in the chest.

The most effective drugs are:

• Rennie;
• Maalox;
• Gastal;
• Phosphalugel;
• other.

Alginates

Gaviscon is an effective and safe new generation alginate. After taking this remedy, hydrochloric acid is neutralized, an additional layer is formed to protect the stomach and the functioning of the gastrointestinal tract is normalized.

Prokinetics

The main task of prokinetics is to improve the motor function of the stomach, muscles and upper small intestine. Physicians advise their patients to use metoclopramide and Domeridon. These medicines will reduce the amount of time the esophagus comes into contact with hydrochloric acid.

Physiotherapy procedures

Amplipulse therapy has been used for a long time to treat reflux esophagitis.

The procedure is carried out in a physiotherapy room and is aimed at relieving pain, eliminating foci of inflammation, improving gastric motility and blood circulation.

If the patient has severe acute pain, then electrophoresis is performed with ganglioblocking agents. Microwave therapy is indicated for patients who, along with reflux esophagitis, have been diagnosed with pathological disorders in the liver, gastric and duodenal ulcers.

Also, the most effective methods of physiotherapy treatment include applications with sulfide silt mud and electrosleep.

Medical nutrition and diet

It is important for patients to review the diet and diet. Food should be boiled, steamed or stewed with a minimum amount of oil. An important condition is fractional nutrition in small portions. Patients are not allowed to lie down immediately after eating. Compliance with this rule helps to reduce the intensity and number of attacks at night.

Important! It is unacceptable to eat smoked, fried and salty foods. Under the ban are alcoholic beverages, soda, chocolates, citrus fruits, tea, coffee, garlic, tomatoes and onions.

Patients should not overeat, because when the stomach is full, there is an increase in the reflux of contents into the esophagus.

You can learn more about what medical nutrition should be for this disease.

Surgery for reflux esophagitis

Surgical treatment of reflux esophagitis is carried out in the event that when drug therapy fails. The main goal of surgery is the complete cessation of the reflux of stomach contents into the esophagus. Before the operation, patients undergo a complete comprehensive examination, and only after that a fundoplication is performed.

Access to the stomach can be open or laparoscopic. During surgery, the bottom of the stomach is wrapped around the esophagus to create a cuff. The least traumatic method of the operation is laparoscopic, which has a minimum number of complications.

Treatment with folk remedies

maybe only after consultation with your doctor. It is possible to use collections of plant components only at the initial stage of the development of the disease.

Aloe juice is an effective remedy that envelops the mucosa of the esophagus, reduces inflammation and contact with food.

A decoction of flax seeds acts on the body in a similar way to antacids. After taking such a drug, the level of acidity in the stomach decreases, the esophagus is enveloped and protected.

Breathing exercises for reflux esophagitis

The main feature of this treatment is proper breathing. This technique is independent or used in combination with physical exercises.

Breathing exercises for reflux esophagitis are performed according to the following scheme:

1. Patients take a comfortable position for themselves - sitting or standing. Take a deep breath and slowly exhale. A person needs to engage the muscles of the abdominal cavity. The optimal number of such approaches is 4 times.
2. A calm breath is taken and a quick exhalation by the abdominal muscles (up to 10 approaches).
3. Patients take a deep breath, hold their breath and squeeze the abdominal muscles strongly. It is necessary to make every effort and pause for up to five seconds. After that, a calm breath is taken.

During breathing exercises, pauses are necessary, because some patients begin to feel dizzy. It is important not to rush and do the exercises consistently. How long reflux esophagitis is treated, so much time and it is recommended to perform these exercises, and in most cases even longer, to ensure the stability of the results.

Gymnastics

The following features of gymnastic exercises for reflux esophagitis can be distinguished:

1. Gymnastics does not help patients get rid of excruciating heartburn. During exercise, the recovery process is accelerated, periods of exacerbation and the number of spasms are reduced.
2. Each patient will be able to choose for himself the optimal set of gymnastic exercises that will provide real help.
3. Classes do not belong to the main method of treatment, so they must be combined with drug therapy.

Yoga for reflux esophagitis

Patients diagnosed with reflux esophagitis can practice yoga. Such exercises bring great benefits to the body and internal organs. Static postures or asanas will fully activate the circulatory system, as well as strengthen the muscle mass of the body.

You can combine static postures with slow movements of the limbs, which will help improve blood circulation in the muscles and internal organs. This unique technique provides patients with the most effective therapeutic effect.

During yoga, all respiratory centers are activated, the saturation of the body with useful oxygen increases, metabolism accelerates, the functioning of internal organs improves, and absolutely all muscle groups are worked out.

Should you sleep on your left side with GERD or not?

Scientists who have studied the physiological characteristics of the body argue that with reflux esophagitis it is best to sleep on the right side.

This will minimize pressure on the stomach, intestines and liver.

To prevent the reflux of food from the stomach into the esophagus at night in patients it is recommended to sleep on a high pillow.

The scheme of treatment of different types of reflux esophagitis

There are several important rules for the treatment of different forms of the disease, which may differ from each other. How long is reflux esophagitis treated depending on this?

Treatment of reflux esophagitis with low acidity

The main treatment for patients is to take stomach acid tablets with meals. Such drug therapy helps food move faster into the intestines.

It is important to remember that you should not overdo it with taking pills and take them without a prescription from your doctor, because such an attitude towards your own health can lead to a deterioration in overall well-being. This is due to the fact that the acidic contents of the stomach will not be neutralized with the available amount of bicarbonates.

With this form of the disease, it is important for patients to adhere to a strict diet in order to prevent further progression of the disease and serious complications.

Treatment of reflux esophagitis during pregnancy

Pregnant girls need to take care to prevent constipation, follow a strict diet, eat small portions and not overeat. Fried foods, chocolate, red peppers and spicy foods are excluded from the diet. As a drug therapy, antacids are prescribed, which are not absorbed into the blood and envelop the stomach. Surgical treatment during pregnancy is not carried out.

Distal reflux esophagitis: treatment

It occurs as a result of inflammation of the esophagus after the penetration of viral and bacterial infections. In bacterial pathology, patients are prescribed antibiotics.

Only a doctor can select treatment after diagnosing patients, which takes into account the sensitivity of the body to antibiotic drugs. In the complex, patients are prescribed immunostimulating substances and antiviral drugs.

Reflux esophagitis is a serious disease that requires urgent treatment and therapy. Patients are forbidden to self-medicate and buy medicines without a doctor's prescription.

In principle, any factor can lead to the reflux of gastric contents into the esophagus. Sometimes just bending over is enough to cause discomfort.

Read more about gastritis, gastric ulcer and duodenal ulcer in the article:

Symptoms of reflux esophagitis

The most common symptom is heartburn, a burning sensation in the upper esophagus. Heartburn appears after eating, especially after foods such as: coffee, alcohol, spices, fatty foods, hot foods. Appears when tilted forward or in a horizontal position.

• Belching with air or sour contents- is the second most common symptom of the disease.
• Feeling of difficulty swallowing and passing food(dysphagia). Pain during the passage of food through the esophagus is more often observed with severe inflammation of the esophageal mucosa. It should be noted that there are also extraesophageal manifestations (masks).
• "Pulmonary mask"- against the background of reflux esophagitis, bronchial obstruction develops (blockage of the bronchi with a viscous secret) and it manifests itself as a chronic (lasting for a long time) cough. Cough appears most often at night. The mechanism of the appearance of bronchial obstruction is microaspiration (ingress of small particles) from the esophagus into the bronchi. Currently, reflux esophagitis is considered as a trigger (triggering mechanism) of bronchial asthma. The presence of reflux disease often explains the nocturnal attacks in asthma.
• "Cardiac mask" manifests itself behind sternum pains similar to angina pectoris (pain in the heart). Unlike angina pectoris, pain in the "cardiac mask" esophagitis reflux appears after overeating, eating acidic, spicy foods.
• "Otolaryngological mask"- manifested by the development of rhinitis (inflammation of the nasal mucosa), pharyngitis (inflammation of the pharyngeal mucosa). The appearance of rhinitis and pharyngitis is explained by the frequent contact of the acidic contents of the stomach, which again enters the larynx through reflux.
• "Dental mask"- appears due to the reflux of acid from the esophagus into the oral cavity. Acid destroys tooth enamel, thereby providing all the conditions for the development of caries.

The most unpleasant thing is that patients do not even suspect that reflux disease can be masked in this way. Sometimes patients are treated for completely different diseases, which are mentioned above. But naturally, the treatment does not work. You can't do it without the help of a doctor. Therefore, when the above symptoms appear, it is strongly recommended that you consult a general practitioner or gastrologist.

The course of reflux esophagitis
The disease itself lasts for years. Without appropriate treatment, the manifestations of the disease increase over time.

I would like to note that this disease is successfully treated, but after stopping treatment, relapses (return of symptoms of the disease) quite often occur, especially if the patient does not change his lifestyle.

For more information about other causes of heartburn, read the article:

After the examination, the doctor prescribes instrumental examinations.

Consultations of a dentist and an otolaryngologist in the presence of "dental and otolaryngological masks".

Treatment of reflux esophagitis

Treatment should always begin with the elimination of possible causes: quit smoking, get rid of excess body weight, avoid stress. Most often you need to adjust the diet.

Without diet correction, the effect of drug treatment will be minimal. The diet must be kept all the time, especially strictly observe it during the presence of symptoms of the disease.

Dietary lifestyle of a patient with reflux esophagitis

1. The daily routine should be built in such a way as to exclude nervous overload at work or at home.

2. Sleep. It is important to get enough sleep (if possible, 7-8 hours a day). Moreover, it is desirable to sleep on a small pillow so that the head is 25-30 degrees higher than the body. This position is necessary to reduce the number of refluxes at night.

3. The diet should be designed in such a way that food intake occurs at least 4-5 times a day and in small portions. It is important that in the evening food is taken no later than 2-4 hours before bedtime.

When eating, try not to overeat and eat slowly (the saturation center is activated 20 minutes after the start of the meal), so if a person eats quickly, it seems to him that he is still hungry, continuing to eat, although this is no longer necessary.

After eating, you can not be in a lying or sitting position. It is recommended to take a walk after eating, which allows food to be absorbed faster and move faster from the stomach to the intestines.

5. Try not to lift weights, and also strain your abdominal muscles less

6. Avoid taking drugs that reduce the tone of the lower esophageal sphincter (nitrates, β-blockers, aminophylline, sedatives, hypnotics, and others).

Diet for reflux esophagitis

Let's start with foods that are not recommended for reflux esophagitis.

With reflux esophagitis should be excluded:

• Alcohol (increases the acidity of gastric juice, thereby increasing its aggressiveness, and also relaxes the lower esophageal sphincter even more)
• Carbonated drinks (getting into the stomach, gases irritate the gastric mucosa, causing an increase in the secretion of hydrochloric acid)
• Coffee and strong tea
• Chocolate (causes relaxation of the lower esophageal sphincter)
• spicy seasonings
• Mushrooms
• Legumes (beans and peas) - increase intra-abdominal pressure leading to an increase in the number of refluxes
• Marinades, smoked meats
• Any canned food
• Fatty foods
• sour juices
• Cabbage (fresh and sauerkraut)
• Black bread
• Mayonnaise, ketchup
• Chips and similar products
• Chewing gum
• Fast food (hamburgers, french fries, hot dogs, etc.)
• Fried meat, fish, vegetables

Foods that can be used in food for reflux esophagitis:

• Milk and sour cream with low fat content
• Fresh chicken or quail eggs boiled soft-boiled
• Fat-free mashed cottage cheese
• Crackers or soaked white bread
• All kinds of porridges boiled in water
• Steamed veal cutlets
• Baked non-sour apples
• Oven baked vegetables
• Boiled vegetables can also be used to make various salads or stews.
• Boiled and baked non-fatty fish
• Of course, this is not the whole list of possible dishes.

Medical treatment of reflux esophagitis

Reflux esophagitis can be cured with a diet only in a mild form. In other cases, medical treatment is also required.

There are several groups of drugs prescribed for reflux disease.

1. Prokinetics- drugs that increase the tone of the lower esophageal sphincter. The active substance is called dopiridone, it is part of drugs such as (motilium, motilak). Or another active ingredient, itopride (genaton).

• Motilium - adults 20 mg. (2 tablets) 3 times a day, 20-30 minutes before meals, when symptoms are present and at night, then at bedtime.

2. Antacids- drugs that reduce acidity by neutralizing it.

A typical representative of this group is Almagel.

• Almagel - 5-10 mg. (1-2 measuring spoons) 3-4 times a day 10-15 minutes before meals.

In case of severe pain after eating, Almagel A is recommended, since in addition to neutralizing the acid, it also relieves pain. The duration of treatment with Almagel A is not longer than 7 days, after which they switch to regular Almagel.

3. Antisecretory drugs- drugs that reduce acidity by suppressing its formation.

• Omeprazole - 20-40 mg (1-2 capsules per day), drinking a capsule with a small amount of water. The capsule must not be chewed.
• Famotidine 20 mg. 2 times a day.

The duration of treatment and the number of drugs depends on the severity of the disease. On average, treatment is carried out with at least 2 groups of drugs (Motilium + Almagel, Motilium + Omeprazole). The duration of treatment is 4-6 weeks. In severe cases, 3 groups of drugs are prescribed for more than 6 weeks.

Complications of reflux esophagitis

Esophageal ulcer- occurs with prolonged and frequent reflux. Often an ulcer is complicated by bleeding, in which case endoscopic surgery is required (a tube is inserted through the mouth into the esophagus and the bleeding vessel is cauterized using a special coagulator)

Stenosis (narrowing of the lumen) of the esophagus- due to chronic inflammation of the esophagus, its walls thicken and stenosis appears. Complaints: pain when swallowing, as well as a feeling of a lump in the throat (food does not pass through the esophagus). The treatment is surgical and rather complicated.

Barrett's esophagus- the epithelium of the esophagus changes to the epithelium of the stomach, thereby increasing by 10 times the likelihood of a malignant tumor of the esophagus.

It is much easier to treat mild reflux esophagitis than complications. Seeing a doctor earlier means faster and more effective treatment.

Prevention of reflux esophagitis

The best prevention of any disease, including reflux esophagitis, is a healthy lifestyle:
1. avoiding stress
2. moderate consumption of alcoholic beverages
3. stop smoking
4. proper nutrition especially avoid spicy, sour, smoked and of course fast foods.
5. observance of the correct diet (3-4 times a day and little by little).
6. You can not lie down immediately after eating, but it is better to take a walk.