esophagitis

- Inflammation of the esophagus. There are acute, subacute and chronic esophagitis.

Etiology, pathogenesis. Acute esophagitis are caused by hot food esophageal mucosal irritation and drink, chemicals (iodine, strong acids, alkalis) - corrosive esophagitis, acute infectious diseases (. Scarlet fever, diphtheria, sepsis, etc.), accompanied by acute pharyngitis, gastritis. Subacute and chronic esophagitis are caused by repeated actions on the mucous membrane irritants: too hot, rough and spicy foods, alcoholic beverages, some production of toxic substances in the air (or in the form of dust), are swallowed and enters the esophagus, etc... chronic esophagitis often accompany chronic inflammatory diseases of the nasopharynx and stomach, in some cases, can be observed in chronic infectious diseases, tuberculosis, syphilis. Stagnant esophagitis occur at stagnation and decomposition of food in the esophagus in patients with esophageal stenosis, achalasia. The most frequent cause of subacute and chronic esophagitis is a casting of gastric juices into the esophagus due to the failure of the cardia - the so-called refpyuks esophagitis or peptic esophagitis, which occurs when the axial hiatal hernia, after surgery involving resection or damage to the cardiac sphincter in systemic sclerosis - due atrophy of the smooth muscle of the cardia region. At a stomach ulcer, cholelithiasis may be a relative, t. E. Functional, cardia insufficiency due to spastic contraction of the stomach pylorus and hypertonicity, increased intragastric pressure. Cardia insufficiency and reflux esophagitis are also observed during pregnancy, large tumors of the abdominal cavity due to a significant increase in intra-abdominal pressure.

Pathogenesis: direct irritating chemical, thermal, toxic or peptic (at cardia insufficiency and reflux esophagitis) effect on esophageal mucosa, rarely - bacterial, toxic or toxic-allergic defeat.

Symptoms within. Acute catarrhal esophagitis is manifested by pain in swallowing, the feeling of rawness in the sternum, sometimes dysphagia. In hemorrhagic ezofa-gita can be hematemesis and melena. When psevdomemb-ranoznom esophagitis (often it is observed in diphtheria, scarlet fever) in the vomit found fibrin film. Abscess and cellulitis of the esophagus occur with a picture of septic intoxication.

Subacute and chronic esophagitis appear heartburn, a burning sensation, rawness in the sternum, in rare cases, pain, dysphagia. When reflux esophagitis main symptoms are heartburn and regurgitation, worse torso and in the horizontal position of the patient. Often there is chest pain when swallowing, sometimes it resembles a coronary.

X-ray examination with reflux esophagitis reveals hiatal hernia and observe gastroesophageal reflux. Esophagoscopy allows us to estimate the degree of esophagitis, the prevalence of his character.

Complications with cellulitis and abscess, esophageal perforation may occur its walls, mediastinitis or peritonitis. In hemorrhagic erosive esophagitis and esophageal bleeding are possible. Severe acute and chronic esophagitis can lead to stricture and scar shortening of the esophagus; Recently, it contributes to the formation or increase of the existing axial hiatal hernia.

Treatment of acute esophagitis corrosivity, and abscess and cellulitis is carried out in a hospital. In acute and subacute esophagitis designate sparing diet number 1 (in some cases at nestolko days recommended fasting or tube feeding). When abscess and cellulitis of the esophagus is prescribed antibiotics. In acute, subacute and chronic esophagitis useful astringents (bismuth nitrate basic 1 g or 0.06% solution of silver nitrate and 20 ml 4-6 times daily before meals).

Treatment of reflux esophagitis is mainly carried out by conservative measures. In order to prevent ventricular-but-reflux prohibit the physical work associated with the bend of the trunk and abdominal strain. Sleep is recommended with a raised upper half of the body. From the binding of drugs prescribed and antacids (magnesium oxide, precipitated calcium carbonate, aluminum hydroxide and 1 g of 5 times per day after meals Almagelum et al.). With a pronounced companion esophagospasm shown antispasmodic and holinoliticheskie funds. When corrosive esophagitis to prevent the formation of strictures early start probing the esophagus.

When reflux esophagitis caused by hiatal hernia, and not amenable to conservative treatment, carried out an operation aimed at eliminating the hernia and reflex-recovery mechanism of the cardia.

The prognosis of acute corrosive esophagitis, esophageal abscess and cellulitis very serious, chronic ezofagitah- largely depends on timely and systematic treatment.

Employment:

refpyuks ill-zzofagitom contraindicated in all types of heavy physical work as well as work related to the bend of the trunk (digging the earth, washing floors, and so on. d.)

Prevention of corrosive esophagitis: a careful storage of concentrated solutions of alkalis and acids, vinegar to prevent accidental ingestion. Prevention of reflux esophagitis with axial hiatal hernia and other diseases involving the failure of the cardia - prophylactic treatments anta-tsidnymi and astringent (2-4 courses per year), the recommendation of the patient to avoid the provisions of the body for which there is a gastrointestinal esophageal reflux.