What is chronic esophagitis

The incidence of diseases of the digestive system is steadily growing, and if earlier the first places were occupied by stomach ulcers, duodenal ulcers, now esophagitis takes the leading position. The disease is not "heard", therefore, feeling its symptoms, they often begin to treat the heart, check the lungs for pathologies. However, you need to start with the upper digestive system. What you should know about the disease "chronic esophagitis": what is it, how to recognize it, where to go, how to treat it.

What is chronic esophagitis?

Esophagitis is an inflammation of the lining of the esophagus. Normally, it is protected by a dense layer of epithelium. The formation of the mucosa begins during the period of embryonic development. The cells are constantly renewed and perform a protective function, since there is a high probability of injury to the organ due to the large volume of saliva, food, and mucous substances passing along its walls. Injury to the esophagus, the effect of infectious agents on the tissues leads to the development of inflammation - esophagitis.

Interesting! Esophageal tissues are highly regenerative. After surgery, burns and other injuries, they are completely restored.

The disease is diagnosed mainly in adults. Depending on the duration and intensity of the manifestation of symptoms, there are 3 phases of the disease: acute, subacute, chronic. The latter form develops in no more than 5% of the world population. Symptoms of the disease are observed in a patient with chronic esophagitis for more than six months.

Depending on the cause and possible concomitant diseases, esophagitis has different forms of manifestation in the form of sore throat, frequent belching, vomiting, heartburn.

Causes of chronic esophagitis, symptoms of the manifestation of the disease

It is possible to eliminate a disease that threatens to provoke cicatricial changes in the esophagus, oncopathology, only by understanding what provoked it:

Esophagitis form	Development factors
Chronic	The most common cause of chronic esophagitis is gastroesophageal (or gastroesophageal) reflux, which means the movement of food, gastric juice in the stomach back into the esophagus. The reason for this phenomenon is a violation in the work of the muscle located in the lower part of the esophagus in front of the entrance to the stomach (lower sphincter). It should block the passage to the esophagus immediately after food enters the stomach. If this does not happen, reflux is observed - the reflux of the contents back into the esophagus. Constant irritation of consumed foods, liquids and hydrochloric acid included in the composition of gastric juice, leads to irritation of the distal section, the development of inflammatory process
Spicy	Eating dry, overly hot food provokes injury to the mucous membrane of the esophagus. Regular consumption of such food deprives the organ of the possibility of complete regeneration and leads to the development of alimentary esophagitis. The inflammatory process goes into the stage of chronicity
Chemical	Work in production associated with the influence of harmful substances (acid, hot air, alkaline compounds) on the esophagus becomes the cause of professional esophagitis. Chemical esophagitis is observed in children when poisoned with potent caustic substances taken through carelessness, as well as when ingested when attempting suicide. Alcohol also causes inflammation of the esophagus, so patients with alcoholism often suffer from a chronic form.
Stagnant	With tuberculosis, systemic scleroderma (a disease in which fibrosclerotic changes in internal organs, muscles and joints, skin), fungal infections, syphilis, a specific esophagitis. Most often, people with suppressed immunity who are taking glucocorticoids and undergoing chemotherapy suffer from this form. With the formation of diverticulums in the esophagus, tumors, food stagnation occurs, and congestive esophagitis develops
Allergic	The development of allergic esophagitis occurs against the background of allergic reactions to food, bronchial asthma
Dysmetabolic	Anemia, low oxygen content in the body due to constant lack of sleep or tissue metabolism disorders, seasonal vitamin deficiency can cause dysmetabolic esophagitis
Traumatic	When the esophagus is injured by foreign bodies, its severe contamination develops a traumatic form of the disease

Important! The prevailing number of people diagnosed with chronic encephalitis are adults, but even children can have inflammatory lesions of the esophagus. It is important to exclude the diagnosis in time, to prevent the transition of the disease into a chronic form. The signal for action is the appearance of pain in the child during or after eating, vomiting or nausea during physical exertion.

Types of chronic esophagitis

The chronic form is characterized by an alternating alternation of exacerbation and remission. Symptoms of the disease are observed in patients with chronic esophagitis for more than six months.

Exacerbations are more often manifested with a decrease in immunity in the autumn-spring period. The disease can be an echo of an untreated exacerbation or appear for the first time due to mechanical injury to the larynx, exposure to chemicals. Inflammation is characterized by the alternation of several stages:

1. Intense redness, or “plethora. This stage does not require serious treatment. As a rule, it is enough to adjust the diet, use anti-inflammatory herbal decoctions.
2. Mucosal manifestations. Ulcers at this stage are small with visible bruising, edematous. Their surface is covered with serous discharge, pus. Particles of mucous membrane break out during vomiting. The area of ​​damage to the surface of the esophagus does not exceed 40%. At this stage, drug treatment is indispensable.
3. Fusion erosive processes are characterized by the unification of areas of ulcerative lesions. They are covered with exudate, periodically necrotic masses are rejected and released outward.
4. Ulceration. At this stage, the folds of the esophagus are affected. Due to the involvement of 75% of the tissues in the process, stenosis begins - a decrease in the lumen of the esophagus, leading to a decrease in its patency and dysfunction. Dysfunctions of the stomach, intestines, liver, gallbladder are also observed.

Depending on the area of ​​the lesion, proximal chronic esophagitis is distinguished, covering upper esophagus, distal, affecting the esophagus at the entrance to the stomach, total, affecting the entire organ.

Also, ulcerative idiopathic and regional stenosing esophagitis are distinguished. The first is of unclear etiology, so it is often compared with ulcerative colitis. A characteristic feature is the tendency of the mucous organ to form ulcers.

Symptomatic regional stenosing esophagitis is associated with Crohn's disease, the etiology of which is the body's immune response to its own microflora of the digestive organs path, food. They are perceived as foreign elements, against which leukocytes are directed. Unlike Crohn's disease, leukocyte accumulations are not detected when the esophagus is affected, although the manifestations of the diseases are similar.

Symptoms

Chronic esophagitis remains undetected for a long time due to the mild manifestation of symptoms that patients usually ignore.

At the first stage, it is painful sensations when swallowing: in the throat, below - in the chest area. After finishing the meal, the pain stops.

Note! Chronic esophagitis is characterized by dysphagia - difficulty in swallowing. Complaints are expressed as a feeling of a lump in the throat or a full stomach with little food intake.

With regional stenosing esophagitis, it is more difficult to swallow solid food, and with typical stenosing, it is more difficult to swallow liquid food.

When small ulcers appear on the mucous membrane, the patient begins to suffer from heartburn, belching. The unpleasant sensations are aggravated by eating, while taking a horizontal position or playing sports. The defeat of most of the esophagus, the fusion of ulcers is accompanied by pain.

Typical manifestations of chronic esophagitis:

• belching with stomach contents or empty (air);
• heartburn, worse in the evening and at night;
• nausea;
• increased salivation;
• if the disease is caused by alcohol abuse, vomiting with copious inclusions of mucus is possible in the morning.

When observing such symptoms, it is necessary to visit a gastroenterologist, endoscopist to make a reliable diagnosis.

Diagnostic and treatment methods

If chronic esophagitis is suspected, an upper GI tract x-ray is taken. This research method does not require special training, except for restricting food intake 3-4 hours before the procedure. For better visibility, contrast agents can be injected (it will be necessary to drink solutions based on barium sulfate, iodine).

When the esophagus is reflected on the roentgenogram, the doctor notes:

• thickening of the mucous surface due to swelling;
• folds are significantly enlarged or not visible;
• the contour is uneven; the surface is speckled with erosive formations.

Additionally, esophagoscopy is performed. In this case, the mucous surface is examined by introducing an optical device through the mouth into the esophageal cavity. Additionally, the stomach and duodenum are examined.

During esophagoscopy, the oral cavity is irrigated with anesthetics for more comfortable insertion of the device. The procedure is completely painless, but it causes discomfort due to the urge to vomit. Preparation involves the strict exclusion of food consumption 8-10 hours before manipulation.

Esophagomanometry is a method that allows fixing disorders of esophageal motility. To measure pressure indicators, a catheter with pores connected to a transducer is inserted into the nasal cavity. Water enters the pores; the change in its pressure is recorded by a sensor and displayed in the form of a graphic image. The resulting deviations provide information about the nature of the onset of chronic esophagitis.

Daily pH-metry is a measurement of the acidity of the esophagus, which lasts from 1 to several days.

The Bernstein test is indicative in chronic esophagitis. When it is carried out, a weak solution of hydrochloric acid is injected into the esophagus, simulating gastric juice. The reflux situation is artificially modeled. If after 20 minutes the patient feels chest pain, heartburn, the test is positive; if you feel cold, the test is considered to give a weakly positive result. If there is no discomfort, the test is negative.

Important! To differentiate chronic esophagitis with cardiac pathologies, it is recommended to make an electrocardiogram.

Treatment tactics

In chronic esophagitis, conservative treatment is preferred. The main task is to prevent the development of complications.

Treatment is performed with drugs:

• prokinetics (Cerucal, Motilium, Trimedat) - funds that stimulate the motility of the gastrointestinal tract, increase the tone of smooth muscles;
  

  Cerucal in pill form

• antacids (Phosphalugel, Almagel, Gaviscon) - means that neutralize the hydrochloric acid of gastric juice;
  

  Phosphalugel drug

• antiulcer drugs (Famotidine), which reduce the production of hydrochloric acid.
  

  Famotidine tablets

The advanced forms of the disease require surgical intervention, since the transformation of cells into foci of necrosis is regarded as a predisposing factor for the development of oncopathologies.

Medical help will give the maximum positive effect if the patient adheres to the rules:

• eat food in moderation with the exception of fatty, fried, spicy foods;
• practice fractional meals every 2-3 hours;
• stop drinking alcohol, smoking;
• bring the body mass index to a level not higher than 25;
• do not take a lying position, do not bend over after eating.

Patients diagnosed with chronic esophagitis should undergo a preventive examination at least once a year gastroenterologist, since systematic injury to the laryngeal mucosa, chronic inflammatory processes increase the risk development of oncopathologies.