Treatment of reflux esophagitis

  Reflux esophagitis is a digestive inflammation of the esophageal mucosa caused by the reflux of stomach and duodenal contents into the esophagus.  The disease is mainly due to various causes of anti-reflux dysfunction in the high pressure zone of the esophagus and gastric junction, or due to local mechanical anti-reflux mechanism disorders, which cannot prevent the reflux of gastric and duodenal contents into the esophagus, resulting in gastric acid, pepsin, bile salts and pancreatic enzymes entering the esophagus and damaging the esophageal mucosa, causing inflammation, erosion, ulceration or stricture, bleeding, and in severe cases, progression to esophageal cancer. Patients may also develop recurrent lung infections due to accidental inhalation of digestive juices. The disease often co-exists with chronic gastritis, peptic ulcer or esophageal foramen ovale cancer. It can also exist alone. The main symptoms are acid reflux, eructation, burning discomfort or pain behind the sternum, and dysphagia.  For treatment, besides changing fasting habits (eating fewer meals, avoiding turning over after eating, avoiding snacks at night), changing recipes (avoiding fatty foods, limiting the intake of chocolate, onion, mint, alcohol, reducing the intake of citrus fruits, coffee and tomato products), reducing body weight, changing the position at bedtime (head high and feet low), adjusting the medications being taken and quitting smoking, the main medications used are acid reducers, mucosal protectors and gastric motivators. In addition to adjusting the medications being taken and quitting smoking, the main treatment is with medications such as acid reducers, mucosal protectors and gastric power drugs. However, medication often only controls symptoms and is difficult to completely cure the disease. For moderate to severe reflux esophagitis, the symptoms and inflammation of the esophagus are still very serious after medical treatment, long-standing esophageal ulcers and bleeding, combined with obvious esophageal hiatal hernia, peptic esophageal strictures and recurrent episodes require surgical treatment.  The most commonly used surgical procedures are fundoplication and laparoscopic fundoplication. In particular, laparoscopic fundoplication has been widely used in the treatment of reflux esophagitis because of its obvious advantages such as less trauma, shorter hospital stay, better anti-reflux effect and surgical safety.