Below, we discuss common oversights in the medication process for patients with reflux esophagitis.
1. Neglecting the existence of individual differences in medication use. For most patients, a once-daily dose of a proton pump inhibitor (a strong acid suppressant) is sufficient to effectively control esophageal acid reflux. However, some patients have “evening acid breakthrough” (heartburn, chest pain, belching symptoms that occur between midnight and 6 a.m.).
In these patients, such medication does not solve the problem. Proton pump inhibitors in these patients may be metabolized faster than the average person, then, it is necessary to add a proton pump inhibitor in the evening or H2 receptor inhibitor before bedtime.
2, neglect to effectively protect the damaged esophageal mucosa. Has been damaged esophageal mucosa need to repair and protection. Aluminum thiosulfate or aluminum magnesium carbonate preparations can effectively protect the esophageal mucosa, but pay attention to the use of methods.
These drugs should not be taken in large quantities with water, but should be distributed evenly to the esophageal mucosa in a gel form, with the help of its own gravity and esophageal peristalsis. In addition, in the treatment of esophagitis, it is advisable to take these drugs half an hour after a meal, which will be more conducive to the stay of the drug in the esophagus and play a protective and restorative role. This is different from the regular use of the drug instructions.
3, ignore the use of pro-gastric power drugs. Some patients believe that as long as the strong stop gastric acid secretion can reduce acid reflux and eliminate esophageal inflammation, so as long as the use of strong acid suppressants can be. In fact, acid reflux is not caused by stomach acid, but other components of the gastric juice including bile refluxed from the duodenum into the gastric juice are also the cause of esophagitis. Gastric stimulants play an important role in maintaining pressure in the lower esophageal high-pressure band. Although some patients experience mild abdominal pain and diarrhea when gastroprokinetic drugs are first administered, most patients tolerate them. It will disappear with continued medication or dose adjustment.
4, neglect to eradicate H. pylori at the appropriate time. Many patients with reflux esophagitis, when they know they have H. pylori infection at the same time, they strongly urge their doctors to eradicate it immediately. Unbeknownst to them, H. pylori produces ammonium, which has the effect of neutralizing the local acid environment at the esophageal junction of the fundus of the stomach and may reduce the corrosion of the esophagus by acid. Instead, immediate eradication of H. pylori may aggravate acid reflux. Therefore, the appropriate time to kill H. pylori should be chosen after the basic control of esophagitis.
5, ignore the impact of systemic diseases. Gastrointestinal motility is affected by many factors, such as diabetes, scleroderma can slow down the emptying of the esophagus and stomach, aggravating acid reflux; the presence of diaphragmatic hernia makes the subesophageal high-pressure band disappear, even with the use of pro-gastric power drugs, it is difficult to recover. At this point, reflux esophagitis is very difficult to cure without effective treatment for these primary diseases.
6, ignore the impact of lifestyle habits. Some patients smoke, drink alcohol, eat a lot of vinegar or drink strong tea and coffee during treatment as usual. Other patients are too full for dinner and have to eat late night snacks. Some patients like to drink milk before going to bed. Some patients do not sleep with the head of the bed elevated 30 degrees, all of which gives the opportunity for acid reflux to take advantage of.
In conclusion, there are many reasons for the unsatisfactory treatment of reflux esophagitis, and patients should be careful and specific in their analysis and targeted treatment.
Ancient Chinese medicine answers
First of all, reflux esophagitis is not equivalent to gastric disease, and secondly, it is not recommended that you use your own medication, morpholine to promote gastric and esophageal emptying, lansoprazole tablets to reduce stomach acid, rabeprazole sodium enteric capsules for the treatment of gastric ulcer – esophageal reflux, the problem is not big when taken in the short term, but should not exceed 4-6 weeks, long-term use has side effects, you are advised to seek medical treatment for symptomatic treatment, can be combined with Chinese herbal medicine treatment can be cured.
How should reflux esophagitis be prevented?
1, avoid alcohol and quit smoking. As tobacco contains nicotine, it can reduce the pressure of the lower esophageal sphincter, leaving it in a relaxed state, plus reflux; the main component of wine is ethanol, which not only stimulates gastric acid secretion, but also relaxes the lower esophageal sphincter, which is one of the causes of gastroesophageal reflux;
2, pay attention to a small number of meals, eat a low-fat diet, can reduce the frequency of reflux symptoms after eating. On the contrary, a high-fat diet can promote the release of cholecystokinin from the small intestinal mucosa, which can easily lead to reflux of gastrointestinal contents;
3, dinner should not be eaten too much, avoid lying down immediately after the meal;
4, obese people should reduce weight. Because excessive obesity increased abdominal pressure, can promote gastric reflux, especially lying position more serious, should actively reduce weight to improve reflux symptoms.
5, to maintain a relaxed mood, increase the appropriate physical exercise;
6, the overall head of the bed should be raised 10 cm to 15 cm when sleeping, to reduce the night reflux is a proven method;
7, minimize the activities that increase intra-abdominal pressure, such as excessive bending, wearing tight-fitting clothes and pants, tightening the belt;
8, should be used under the guidance of a doctor, to avoid the side effects of indiscriminate drug use.