Reflux esophagitis

An overview of the stomach with two doors, called cardiac import, export called Helicobacter pylori. Cardia's role is to allow food from the stomach into the esophagus, preventing food and anti-gastric esophageal flow. Cardiac function of the cardiac sphincter mainly rely on to accomplish. Once the cardiac sphincter relaxation, or when illness put cardiac surgery sphincter damage or removal, Cardiac function of the orientation will lose, gastric juice and food to enter the stomach will often counter-flow esophagus, This clinically known as reflux esophagitis. A clinical performance. As with the acidic stomach contents back to the regular anti-esophagus, esophageal mucosa to stimulate the burning sensation caused. Therefore, the "burn" is the typical symptoms of the disease, mainly the substernal burning discomfort, more particularly after the meal after meal. Can be accompanied by nausea and reflux were shown with bitterness or sourness, even with small amounts of food. Heartburn and prone to nausea in recumbent, Widespread bent over posture, but also in the wake asleep interference. 2. If the esophageal inflammation or increase with esophageal ulcer, and there may be swallowed pain, the more acid intake or too hot food after, xiphoid process involves pain, sternum, the scapular region, sometimes up to neck, ears, or even radiation to the buttocks. Further development of intermittent Dysphagia, occurred at the beginning of each meal, was substernal infarction flu, more caused by esophageal spasm. If Dysphagia was continuing, show that there is a narrow esophagus. If Dysphagia was aggravated sexual should be vigilant with esophageal cancer. 3. Affect consumption, reduce weight. Few esophageal bleeding constantly, it will be mild iron deficiency anemia. With esophageal ulcers, can cause bleeding dual. Some severe reflux esophagitis reflux can result from inhalation of chronic laryngitis, aspiration pneumonia or asthma attack. Where diagnosis often is "Heartburn", nausea, and should be suspected reflux esophagitis, but still need to be confirmed following laboratory examination choice : ① Esophagoscopy or gastroscopy : directly visualize esophageal mucosa congestion, edema, erosion, ulcers, lesions narrow, clamp can obtain tissues were examined, the highest accuracy, should be the first choice. ② esophagus, stomach swallowing barium X-ray examination : in particular, the first foot-high perspective, we can see barium reflux, esophageal mucosa rough disorder, esophageal motility, and abnormal esophageal niche, narrow lesions. Also know whether hiatal hernia and flaccid because of cardiac disease, esophageal cancer, esophageal diverticulum caused by esophagitis. ③ esophageal acid test drops to substernal pain in the differential diagnosis. ④ lower esophageal acidity (pH) Determination and esophageal manometry : may suggest whether gastroesophageal reflux, it is assumed reflux esophagitis existence. Treatment 1. Reduction of gastroesophageal reflux : Shaoshichecan and less high-fat Progressive difficult to digest food, avoid postprandial recumbent or bedside 2 -3 hours to eat, sleep or when head elevation 10-20 cm, relieve gastroesophageal reflux; obesity, constipation abdominal pressure, may increase gastroesophageal reflux, it should reduce the excess weight, Constipation should maintain purge. Smoking may promote gastric juice and bile reflux, esophageal mucosa of alcohol have a direct stimulating effect, so reflux esophagitis patients should ban alcohol. Domoic acid can also trial preparations in the stomach to form a foam adhesive material, floating in the stomach contents of the surface, play a physical barrier to reduce reflux. 2. Avoid objects stimulate reflux esophageal mucosal injury : after the meal and before bed to use enamine examination. to reduce the reflux of acid from which the esophageal mucosa damage; Selection of omeprazole, cimetidine, ranitidine, famotidine, Nepal brake for small inhibit gastric acid secretion, and other drugs, to reduce the reflux from the acidity; Selection of aluminum hydroxide gel, Magnesium and other antacids, in order to reduce the esophageal mucosa to stimulate and injury. 3. Improve esophagogastric junction sphincter function : fasting in 15 -30 minutes before bed and take domperidone, or cisapride or metoclopramide, to increase the lower esophageal sphincter contraction, strengthen stop gastroesophageal reflux barrier. 4. Critically ill patients by medical therapy, may be considered surgery, are commonly used in gastric plication. Right to esophageal stenosis esophageal dilatation.