Symptoms and treatment of reflux esophagitis in children and adults

Reflux esophagitis is an inflammation of the esophagus mucosa that develops due to prolonged or frequent pelting of the stomach contents. Food along with gastric juice enters the esophagus, irritating and traumatizing its mucous membranes. First it manifests itself with such a symptom as heartburn, later the patient begins to suffer severe pain in the area of ​​the stomach.


Contents:
  • reasons
  • Symptoms
  • Forms
  • How dangerous
  • Diagnostics
  • Treatment
  • Drug
  • Operative
  • Diet
  • Treatment folk
  • funds from
  • children during pregnancy

reasons

The appearance of reflux esophagitis generally leads disruption of the lower food sphincter and easingits muscular tone, because of which the sphincter opens completely or partially and the contents of the stomach freely penetrate into the esophagus. The reasons for the decrease in tone are nervous loads, increased pressure in the peritoneum, as well as food and chemical factors.

In addition, the following factors contribute to the development of reflux disease:

  • Excess weight.
  • Smoking, alcoholism.
  • Prolonged body in a position with a slight inclination forward. Excessive consumption of spices, chocolate and coffee.
  • Abuse of certain medications, such as Nitroglycerin, Metoprolol, etc.
  • Peptic ulcer or gastritis.
  • Inadequate salivation( for this reason the disease mainly develops in children).
  • Incorrect power.
  • The underdeveloped neuromuscular device, in particular, the cardiac department of the esophagus( typical for young children).
  • Pregnancy Period.

The development of reflux esophagitis in a newborn can increase the pressure inside the abdominal cavity. In older children, the disease can manifest itself as a result of the negative impact on the child's body of a stress factor.

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Symptoms of

The main symptom of reflux esophagitis is heartburn, which reminds of itself when a person is hungry or just ate. It can also be manifested when the patient goes to bed, lifts the weights. In a neglected state, heartburn persists man constantly.

This disease is also characterized by pain in the chest. They can give to the neck, back, lower jaw, the left side of the chest. Elderly people often confuse reflux esophagitis with angina pectoris.

In addition to heartburn, reflux esophagitis has such characteristic symptoms:

  • Sour eructation.
  • Nausea.
  • Vomiting.
  • Heaviness in the abdomen.
  • Sore throat while swallowing.
  • Painful sensations in the upper stomach.
  • Damage to tooth enamel, inflammation of the gums, bad breath.
  • Chronic cough.
  • The hushed voice.
  • Smack of bitterness in the mouth in the morning after sleep.
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Forms of

There are several forms of the disease:

  • Acute - accompanied by pain only during meals, with a symptom located in the upper area of ​​the sternum, along the esophagus. There is also a painful swallowing and general malaise.
  • Catarrhal( superficial) - swelling of the esophagus mucosa without irreversible tissue destruction, characteristic symptoms: severe pain while swallowing and a constant sensation of foreign matter in the throat.
  • Ulcerous( erosive) - a complicated form, in which small erosions( ulcers) appear on the esophageal mucosa. With this form all of the above symptoms become stronger and more pronounced.
  • Chronic - a prolonged inflammation of the walls of the esophagus, which manifests itself by a constant increase in symptoms, alternating with periods of rest. The patient can feel a burning sensation behind the sternum, pain "in the pit of the stomach," etc. In the absence of treatment, chronic esophagitis can lead to irreversible consequences.
  • Distal - characterized by inflammation of the lower part of the esophagus, which connects to the stomach.

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Than

is the most unpleasant consequence of chronic esophagitis reflux-narrowing of the esophagus( stricture), which gradually leads to difficult swallowing of food and requires surgical intervention. Without treatment, an even more serious complication develops-an ulcer of the esophagus.

In approximately 15% of cases, the disease leads to the development of the Barrett's esophagus, in which the internal surface of the esophagus, in response to frequent irritation with acidic gastric juice, changes its structure and becomes similar to the intestinal mucosa that threatens esophageal cancer.

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Read also about what drugs are used in the treatment of stomach gastritis, ulcers, to eliminate heartburn http://woman-l.ru/kakie-lekarstva-prinimayut-pri-gastrite-zheludka/
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Diagnostics

To detect reflux esophagitis, doctors use several effective diagnostic methods:

  • Radiography of the esophagus allows you to see whether the contents of the stomach have penetrated into the esophagus, and also to detect a hernia of the diaphragm.
  • Biopsies of the esophagus.
  • Esophageal pH-metry, by means of which the level of acidity in the lumen of the stomach and esophagus is determined.
  • Esophagoscopy - examination of the esophagus by the endoscopic method.
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Treatment of

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Medical

The treatment of reflux esophagitis is primarily focused on eliminating the causes that caused it, that is, diseases such as gastritis, neurosis, etc. In severe cases, pharmacotherapy is prescribed. The basis of modern therapy is considered secretolitics( antisecretory drugs), reducing the production of gastric juice. The decrease in acidity practically neutralizes the harmful effect of refluxtate on the mucosa of the esophagus. Antisecretory drugs include:

  • H2 blockers - Roxatidine, Nizatidine, Ranitidine, Cimetidine, Famotidine).
  • Proton Pump Inhibitors - Dexlansoprazole, Lansoprazole, Omeprazole, Pantoprazole, Rabeprazole, Ezomrazole).
  • M-cholinolytics( Platyphylline, Metacin,

) Depending on the stage of the diagnosed esophagitis reflux, the presence of precancerous transformations and erosions, the recommended therapy may last 1 month, several years or a lifetime

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If erosive forms of reflux esophagitis 1 degree are detectedProkinetics are connected to the scheme of the prescribed treatment: Itopride( Ganaton), Metoclopramide( Cerukal, Reglan), Domperidone( Motoniks, Motilium, Passagex, Motilak)

If the content of reflux is bile,(Ursosan, Urdoksa, Ursofalk, Ursodex)

Alginates( Gaviscon, Topalcan, Topaal) and antacids( Riopan, Rennie, Milanta, Gastal, Almagel, Maalox, Relzer, Rutatsid) are used to neutralize harmfulhydrochloric acid, adsorb bile acids, lysolecithin and inactivate pepsins, but their effect is short-term and in most cases insufficient, therefore they are prescribed as additional symptomatic drugs for treatment in adults.

To increase the stability of the mucosa of the esophagus, the doctor may prescribe Sucralfate, Misoprostol, decoction or flaxseed oil.

In case of erosive-ulcerative reflux-esophagitis at the end of the course of treatment, it is recommended to undergo a control endoscopic examination, since the disappearance of symptoms does not always indicate a complete recovery, and not completely cured ulcers and erosion can provoke bleeding.
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Operative

In the absence of the expected effect of drug treatment and frequent relapses, endoscopic treatment may be recommended to a patient. It consists of stitching the lower esophageal sphincter or inserting into it special polymer substances leading to the normalization of its barrier function.

With pre-cancerous conditions of the mucosa, laser or photodynamic destruction, electrocoagulation, thermal destruction, local endoscopic resection can be prescribed.

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Diet

Adults, in order to reduce the symptoms of reflux esophagitis, you need to eat right, learn to control yourself and your weight, adhere to a diet that the doctor advises, try to eat in small portions at regular intervals. Patients need to get rid of bad habits, try not to eat fatty foods, chocolate, orange juice, coffee. During food intake and another hour after eating, it is not recommended to drink water or other drinks.

For severe heartburn, it is advisable to limit the use of milk. Despite the fact that it brings noticeable relief for heartburn, the consumption of milk in large quantities increases the production of gastric juice and provokes the re-occurrence of heartburn.

It is useful to introduce more food products containing fiber and complex carbohydrates into the diet: bread with bran, cereals, potatoes, pasta. This food neutralizes excess acidity and helps to get rid of heartburn and other unpleasant symptoms of reflux esophagitis.

In addition, the menu for reflux should include boiled eggs, steam or baked low-fat varieties of meat, sour-milk products( low-fat kefir, yogurt).It is desirable to extinguish all fruits and vegetables, bake, cook in light soups. You can not eat too cold or hot food - it traumatizes the esophagus and causes a vasospasm.

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Treatment with folk remedies

In folk medicine, for the treatment of reflux esophagitis, we use collections of herbs that take at least 2 months to be taken. In this case, use the fees, you need to alternate them for 2 weeks.

  • Collection number 1: 2 tablespoons of chamomile inflorescences and flax seeds, 1 - motherwort, lemon balm and licorice root.2 tablespoons mixture pour 0.5 liters of hot water and hold in a water bath for 10 minutes. The broth is infused for 2 hours, filtered and consumed 75 ml four times a day. The medicine removes the inflammation of the mucosa of the esophagus, lowers gastric acidity and reduces pain.
  • Gathering number 2: 1 tablespoon root of ayr marsh, anise fruits, white clearweed, oregano, mint leaves, calendula and caprice inflorescences. All the ingredients are mixed, crushed, 2 tablespoons of the mixture pour warm boiled water 400 ml. After 25 minutes, heat the infusion in a water bath and leave for another hour, strain, take warm 100 ml 6 times a day. The last reception of a folk remedy should be before bedtime.

A good result with reflux-esophagitis gives a reception of potato juice of 15 ml for 30 minutes before meals.

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In children

The main cause of reflux esophagitis in children is gastroesophageal reflux. In young children who can not explain what is bothering them, reflux can manifest themselves with the following symptoms:
  • Severe anxiety, nervousness.
  • Causeless and strong crying.
  • Withdrawal from food.
  • A night cough.
  • Attacks of shortness of breath.
  • Regurgitation, etc.

If you have these symptoms, you should definitely show the baby to the pediatrician for the diagnosis and the treatment you need.

To get rid of the symptoms of the disease in older children, you must first eliminate the cause of its appearance - gastritis, peptic ulcer, gastroduodenitis, neurosis. It is also necessary to reduce manifestations of the disease, reduce the harmful effects of substances in the stomach, increase the stability of the mucosa of the esophagus and increase the possibility of its purification. To do this, children in the right dosages are prescribed the same drugs as adults: antacids, secretolytics, prokinetics, etc.

In addition, children with reflux esophagitis should be properly cared for. Breastfeeding can only be done in a semi-vertical position, and after the feeding is complete, hold it for several minutes in an upright position. Doctors recommend part of the bed, which is the head of the baby during sleep, raise 10-15 centimeters higher. You can not allow a child to go to bed immediately after lunch or dinner, you need to limit it to eating chocolate, fatty foods, tomatoes.

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In pregnancy

Reflux-esophagitis and concomitant heartburn are often observed during pregnancy. This is due to the fact that future mothers increase intra-abdominal pressure, relax the muscles that block the transition from the stomach to the esophagus. After birth, the normal functioning of the sphincter is restored independently, so treatment in pregnant women is directed exclusively at eliminating heartburn.

  • May 08, 2018
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