Reflux esophagitis, is a relatively common disease in our life. Therefore, there are many people who suffer from reflux esophagitis. What are the symptoms of reflux esophagitis? How should reflux esophagitis be treated?
Depending on the distribution of the vagus nerve, it can sometimes radiate to the neck, palate or ears. Commonly, it radiates to both sides of the back between the scapulae. The burning sensation can be relieved by drinking water or taking acidulants or sugar cubes to stimulate salivary secretion and primary peristalsis of the esophagus. It is most likely to occur especially after eating certain spicy foods, and can be caused by bending, exertion or lying down, and alleviated in the upright position, which is due to the role of taking an upright position to walk around to promote esophageal clearance. If a patient experiences an increase in postural burning pain, it may be caused by reflux. If the patient is acid deficient, the burning sensation is mainly caused by bile reflux, and the effect is not obvious if the patient takes acid suppressants. The severity of the burning sensation does not necessarily correspond to the severity of the lesion. In severe cases of esophagitis, especially in those with scarring, there may be no or only a mild burning sensation.
Symptoms of reflux esophagitis.
1. Gastric and esophageal reflux
Acidic fluid or food reflux from the stomach and esophagus into the pharynx or mouth after a meal, when lying in forward bending or sleeping in bed at night. This symptom mostly occurs before the onset of burning sensation or burning pain behind the sternum.
2.Swallowing pain
Caused by food mass irritating the inflamed esophagus or esophageal spasm. The spasmodic pain is the same as the distribution and radiation site of heartburn. The food mass causes acute dilatation of the esophagus in the area of esophagitis and in the area of partial stricture or motor incoordination, and a third contraction or spasm occurs. Patients with reflux esophagitis may feel that food or liquid stays above the esophagus and needs to be washed down with water, and if the food stays above the esophagus, then the patient will have painful symptoms.
3. Difficulty in swallowing
In the initial stage, intermittent dysphagia may occur due to esophagitis secondary to esophageal spasm. In the later stage, it may be replaced by permanent dysphagia due to narrowing of the esophageal scar, burning sensation and burning pain, and blockage or pain at the glabella when eating solid food.
4.Gastric regurgitation
Reflux of stomach acid or bile into the back wall of the mouth indicates reflux in the gastroesophagus. Stomach contents may be spit out or swallowed, leaving a sour or bitter taste in the pharynx and mouth, causing bad breath or taste impairment, and there may be a burning sensation in the lips of the mouth that is chronically irritated. Regurgitation can occur after eating, exertion or change in position. It is often accompanied by gastrointestinal distention and eructation. Nocturnal reflux may also cause coughing, aspiration pneumonia or asphyxia.
5. Bleeding and anemia
Severe esophagitis may result in bleeding due to esophageal mucosal erosion, mostly chronic bleeding in small amounts. Long-term or heavy bleeding can lead to iron deficiency anemia.
6.Other symptoms
Refluxed material entering the pharynx through the cricopharyngeal sphincter can cause laryngeal and tracheal aspiration, inflammatory vocal fold polyps, and asthma in susceptible patients. Diffuse esophagitis or invasive ulcers can occur vomiting blood and chronic blood loss. A small number of penetrating ulcers may result in esophageal perforation.
How is reflux esophagitis treated?
1.Promote the emptying of the esophagus and stomach
1) Dopamine antagonists such drugs can promote the emptying of the esophagus and stomach and increase the tension of the LES.
2)The release of acetylcholine through the postganglionic nerve of the intestinal muscular plexus promotes the peristalsis and emptying of the esophagus and stomach, thus reducing gastroesophageal reflux.
3) The cholinergic drug ura choline can increase the tension of the LES, promote esophageal contraction, and accelerate the emptying of acidic food in the esophagus to improve symptoms. This mouth can stimulate the secretion of gastric acid, and should be taken with caution for a long time.
2.Reducing gastric acid
(1) Acidulants can neutralize gastric acid, thereby reducing the activity of pepsin and reducing the damage to the esophageal mucosa from acidic gastric contents. Alkaline drugs themselves also have the effect of increasing LES tension. Aluminum hydroxide gel and magnesium oxide. Alginic acid foam contains alginic acid, sodium alginate and acid making agent, which can float on the surface of gastric contents and can stop the reflux of gastric contents.
(2) Histamine H2 receptor antagonist metacycline, furosemide and famotidine can be used. These drugs can strongly inhibit gastric acid secretion and improve acid reflux in the gastroesophagus. If the above symptoms do not improve, the dose can be increased to 2 to 3 times.
(3) Proton pump inhibitors can block the H+-K+-ATPase of mural cells.
3.Co-medication
The combination of esophageal and gastric emptying drugs and acidulants has a synergistic effect and can promote the healing of esophagitis. Dopamine antagonists or cisapride can also be used in combination with histamine H2 receptor antagonists or proton pump inhibitors.
4.Surgical treatment
The purpose of surgical treatment is to repair the hernia fissure and correct the esophageal stricture with anti-reflux.
5.Chinese medicine treatment
(1) The main points of body acupuncture are Neiguan and Feosanli, and the preparation points are Liver Yu, Stomach Yu, Epigastrium and Gongsun.
(2) Ear acupuncture is used for Shen Men, stomach and esophagus, with moderate stimulation and retention of needles.
The above treatment methods are only recommended treatment, please refer to the clinical prescription for specific medication and treatment.