Esophagitis

Esophagitis is called the inflammation of a mucous membrane of a gullet.

Disease it meets quite often, but seldom happens isolated. As a rule, the esophagitis is accompanied also by other diseases of digestive tract.

The esophagitis is a polietiologichny disease and can arise at any age. Men are subject to it several times more, than women that is connected with more frequent alcohol intake and improper feeding.

Esophagitis reasons

The esophagitis can be caused by a set of factors which influence a mucous membrane of a gullet. Anatomic position of a gullet such is that irritate its mucous can as external, exogenous factors, and internal, endogenous.

Refer damage of a mucous membrane as a result of influence of chemical or thermal factors to the exogenous reasons of an esophagitis.

Chemical are an alcohol, spicy food, effect of acid or alkali, iodine, etc. Thermal – a burn hot food or drink, including the chronic burn caused by the constant use of too hot products.

The esophagitis caused by internal causes meets more often. Weakness of the cardia – the lower sphincter of a gullet which normal does not pass stomach contents in a gullet is a proximate cause of its development. If the cardia for any of several reasons ceases to cope with the function, there is the return throwing of a part of acid gastric contents in a gullet, this phenomenon carries the name a reflux (in translation from Latin – a contraflow). Digestive enzymes and hydrochloric acid of a stomach corrode a mucous membrane of a gullet. The gullet inflammation resulting is called a reflux an esophagitis.

The factors promoting development an esophagitis reflux, the following:

• Hernias of an esophageal opening of a diaphragm;
• Damage of the cardia during stomach or gullet operation;
• Zhelchekamenny disease;
• Peptic ulcer of a stomach;
• System scleroderma;
• Tumors of an abdominal cavity;
• Obesity;
• Pregnancy;
• Vomiting;
• Food via the gastronazalny probe.

The chronic infectious diseases affecting mucous membranes including a gullet, for example, tuberculosis, diphtheria, flu can become one more reason of an esophagitis.

Types of an esophagitis

On character of a current the esophagitis can be acute or chronic.

Depending on an origin the esophagitis happens:

• Alimentary (caused by food);
• Allergic;
• Congestive;
• Professional;
• Infectious.

On morphological features distinguish the following types of an esophagitis:

• Endoesophagitis. The most common form of an esophagitis, at an adverse current passes into other forms;
• Edematous esophagitis;
• Erosive esophagitis. In this form on a mucous membrane of a gullet superficial erosion develop. It is formed at a corrosive burn, a reflux, some infectious diseases;
• Hemorrhagic esophagitis. Usually this form is caused by an infection;
• Pseudomembranous esophagitis. It is characterized by emergence of the fibrinous film which is not soldered densely to a mucous membrane of a gullet, is caused by an infection;
• Exfoliative esophagitis. Also is caused by an infection, in this case the fibrinous exudate is densely soldered to a mucous membrane;
• Necrotic esophagitis. Arises from one of the previous forms because of decrease in immunity at the accompanying heavy general pathology;
• Phlegmonous esophagitis. The acute purulent inflammation arising at hit of a foreign body.

Esophagitis symptoms

Symptoms has each appearance of an esophagitis characteristic, but there is a symptomatology, the general for all forms of an esophagitis.

The main symptom of an esophagitis is the feeling of pain and burnings (heartburn) in epigastric and retrosternal area. Pain can depend on meal, and can not depend, as a rule, unpleasant symptoms amplify during an exercise stress. Depending on a type of an esophagitis, pain can be constant or pristupoobrazny, aching, sharp, etc. The eructation air with impurity of gastric contents belongs to characteristic symptoms of an esophagitis. Nausea, vomiting, the raised slyunoobrazovaniye are also frequent symptoms of an esophagitis.

The reflux an esophagitis is shown by strengthening of symptoms in a prone position, in a prone position smack of acid gastric contents in a mouth appears, there is a cough which is not connected with a disease of bronchial tubes and lungs, short wind can develop.

In an acute form symptoms of an esophagitis are brightly expressed, the general aggravation of symptoms joins them: body temperature increases, the tone falls, other dispeptic phenomena – frustration of a chair, a meteorism join. Alternation of aggravations and remissions is characteristic of a chronic esophagitis. However even in the remission period esophagitis symptoms usually do not disappear completely, only become less bright.

Diagnosis of an esophagitis

The diagnosis is supposed on the basis of characteristic symptoms of an esophagitis. For its confirmation conduct the next researches:

• Laboratory blood analyses and urine;
• X-ray inspection of a gullet;
• Ezofagoskopiya - an endoscopic research of a mucous membrane of a gullet;
• Ezofagomanometriya – a research of motility of a gullet;
• Daily monitoring of pH of a gullet.

Treatment of an esophagitis

Treatment of uncomplicated forms of an esophagitis conservative. In case of long unsuccessful conservative therapy, emergence of complications (strictures, hems, the repeating bleedings), threat of an ozlokachestvleniye (Barret's gullet) and developing of repeated aspiration pneumonia resort to surgical treatment of an esophagitis.

Drug treatment of an esophagitis assumes purpose of the antiacid means and means reducing secretion of a stomach (histamine H2 receptors blockers) and also the drugs stimulating motility of a digestive tract. At severe pains appoint anesthetics, however avoiding non-steroidal anti-inflammatory drugs as they cause additional irritation of mucous. Apply an electrophoresis with novocaine to the area of a gullet to removal of an acute pain.

Appoint physiotherapeutic treatment: hyperbaric oxygenation, endoscopic laser therapy, at a reflux an esophagitis – electrostimulation of the cardia.

The important place in treatment of an esophagitis is taken by a diet. At an endoesophagitis the table No. 5 can be appointed, at an erosive esophagitis and other forms – a table No. 1. Also the diet стола№1 is appointed at all types of an acute esophagitis, and also an aggravation chronic, especially an esophagitis reflux. To an absolute recovery exclude the products irritating a mucous membrane of a gullet – coffee, strong tea, chocolate, spicy and spicy food, hot food, citrus, acid fruit, carbonated drinks, greasy and fried food. It is necessary to adhere to a diet strictly: meal at the same time, small portions, not less than 5 times a day.

At a reflux an esophagitis observance of the following recommendations is necessary: to sleep with the raised upper part of a trunk, after food not to bend and not to lay down within one-one and a half hours, not to wear the clothes squeezing an abdominal cavity and a thorax.