Esophagitis

Ezofagit - inflammation of the esophagus. Develops with systematic irritation of the mucosa of the esophagus (acute or rough, poorly chewed food, strong alcoholic drinks), in case of acute trauma accidentally swallowed by fish or chicken bone, with some infectious diseases (diphtheria, scarlet fever, sepsis, etc.), with stagnation and Decomposition of food masses in the esophagus as a result of stenosis (narrowing) of it due to scar stricture, tumor , with burns of the esophagus by chemical substances (iodine, strong acids, alkalis), etc. The most common cause of esophagitis is reflux (throwing or flowing of gastric juice into the esophagus with insufficiency Cardia), which occurs with sliding hernia of the esophageal aperture of the diaphragm, after surgical interventions in the zone of the esophageal-gastric transition, with systemic scleroderma, etc. (reflux esophagitis).

On the clinical course, acute, subacute and chronic esophagitis is isolated. Morphological changes distinguish between catarrhal, erosive, hemorrhagic, pseudomembranous and necrotic esophagitis. With catarrhal and erosive esophagitis, pain along the esophagus during swallowing, sagging behind the sternum, and sometimes a feeling of a short delay in the swallowed food behind the sternum (dysphagia) are noted. When hemorrhagic esophagitis can be bloody vomiting . When pseudomembranous esophagitis in vomit masses, fibrin films are found. With necrotic esophagitis, there are sometimes complications such as severe bleeding, mediastinitis . In addition, abscess and phlegmon of the esophagus are possible, which are more often formed around the foreign body entering the wall of the esophagus. Abscess and phlegmon of the esophagus proceed particularly hard: unbearable pain behind the sternum, dysphagia, an increase in body temperature and other signs of severe septic intoxication are characteristic.

With reflux esophagitis leading in the clinical picture are heartburn, pain in the epigastric region or behind the sternum, arising after or during meals, belching , belching ; These symptoms intensify when the torso is tilted and in the horizontal position of the patient.

The diagnosis is made on the basis of anamnesis, clinical picture and esophagoscopy (in the absence of contraindications) or X-ray examination.

Treatment for catarrhal, erosive and pseudomembranous esophagitis consists in the appointment of a sparing diet, antacid preparations (for example, almagel). With hemorrhagic and necrotic esophagitis, suspicion of abscess and esophageal phlegmon, the patient must be urgently hospitalized in the surgical department.

In chronic esophagitis, especially with reflux-esophagitis, treatment can be carried out both in a hospital (with severe exacerbation) and outpatient. Assign a mechanically, thermally and chemically sparing diet; Almagel or other drugs with antacid, enveloping and astringent action; Tablets of vikalin or vicair 4 - 6 times a day for a long time, until the symptoms of esophagitis subsided. Before use, tablets of vikalin or vicair are crushed, poured into a glass, 1/2 filled with warm water, and shaken. The resulting suspension should be drunk in small sips, preferably when lying down, after eating and before going to bed. When reflux-esophagitis patients are advised to sleep with a high elevated head, avoid lifting weights, sharp torso torsions forward.