Reflux – Esophagitis
First, a little anatomy. The diaphragm (muscle-tendon septum) separates the chest cavity from the abdominal cavity. Through the esophageal opening of the diaphragm, the esophagus descends into the abdominal cavity and passes into the stomach and that part of it, which is called the cardiac.
At the junction of the esophagus into the stomach, the muscle fibers form a sphincter (pulp). Normally, outside of swallowing, this sphincter is closed, which prevents the contents of the stomach and gastric juice from entering the esophagus.
If the function of the sphincter is impaired. A hernia of the esophageal opening of the diaphragm is formed. At the same time, the cardial part of the stomach is displaced through the esophageal opening of the diaphragm into the chest cavity and the contents of the stomach are freely thrown into the esophagus. And in it, as a rule, there is hydrochloric acid, which irritates the mucous membrane of the esophagus and can cause its inflammation – esophagitis. It is sometimes so pronounced that the clinical picture resembles a thermal or chemical burn of the esophagus.
Throwing the contents of the stomach into the esophagus, we doctors call reflux, which in Latin means “reverse flow”. And esophagitis, which developed as a result of gastroesophageal reflux, is called reflux – esophagitis. Actually, it is a consequence of a hiatal hernia.
Reflux – esophagitis causes considerable suffering to the patient; heartburn worries, and most importantly – burning pain in the epigastric region (under the spoon) and behind the sternum, worse after eating, especially if the patient, after eating, immediately lays down. Sometimes the pain is dull, aching, and in most radiates to the region of the heart, scapula, and the left shoulder, less often to the neck.
I want to emphasize that even a doctor can sometimes find it difficult to distinguish manifestations of reflux esophagitis from an attack of angina pectoris. This can only be done with the help of an X-ray examination.
As far back as 45 – 50 years ago, the treatment of patients with reflux esophagitis with a hiatal hernia was surgical. Currently, due to the experience gained by scientists, the indications for surgery have sharply decreased and surgical intervention is used only in cases when severe complications of reflux – esophagitis, like ulcers, bleeding. narrowing of the esophagus. Now the treatment for this disease consists mainly in following a diet and a certain diet. Such conservative therapy gives a good result in more than 80 percent of patients, provided that they strictly comply with the recommendations of doctors to get rid of reflux esophagitis.
Since overfilling of the stomach enhances reflux esophagitis, nutrition should be fractional, in small portions. You need to eat in a hurry, chewing food well. Do not drink water or any other liquid in between meals. Sometimes patients, in order to get rid of heartburn or pain, take several sips of water and feel relief. In fact, it is short-lived, and soon reflux occurs again. Only occasionally can you drink half a glass of Borjomi or a solution of drinking soda (1 teaspoon per glass of water). Borjomi or a solution of soda is best drunk in a warm form and without carbon dioxide, an hour before a meal.
So that reflux esophagitis does not progress, the diet should completely exclude spicy dishes and sauces, peppers, mustard, strong tea, coffee, marinades, pickles, smoked meats, as well as fresh and pickled cabbage, beans, beans, fresh brown bread, as they contribute to the formation of gases. Strongly contraindicated alcohol and smoking.
With reflux esophagitis from drugs, it is extremely undesirable to take acetylsalicylic acid preparations, which irritate the mucous membrane of the esophagus and increase gastric secretion.
After eating, in no case should you go to bed, it is better to stand or walk. This will accelerate the evacuation of the contents of the stomach, and thereby will prevent it from being thrown into the esophagus. Dinner should be no later than 3 to 4 hours before bedtime. Sleeping with reflux – esophagitis is recommended on two or three pillows in a half-sitting position. Throwing the contents of the stomach into the esophagus is facilitated by any work in the inclined position of the trunk: washing the floors, weeding the beds and even lacing the shoes. Therefore, try to avoid such a pose.
With reflux esophagitis, you can not wear tight corsets, belts, belts, corsages, as they can cause an increase in intra-abdominal pressure. Constipation also contributes to this. That’s why they should be combated with all means: take vegetable and salt laxatives, vegetable and petroleum jelly, 1 tablespoon 2 to 3 times a day before meals. This measure, in addition to combating constipation, is of great importance in the sense of protecting the mucous membrane of the esophagus from exposure to acidic gastric contents. It should be borne in mind that with prolonged use of a laxative, the body gets used to it, and it ceases to act. Therefore, it is necessary to alternate laxative drugs, of course, after consulting with your doctor first.