Atrophic gastritis and distal catarrhal esophagitis. Catarrhal esophagitis

Catarrhal esophagitis is a lesion of the mucous membrane of the esophagus that is of inflammatory origin. In this case, the formation of hyperemia and swelling is noted. The disease can be provoked by a variety of factors: from injuries to infectious components. Taking this into account, it is strongly recommended to carry out diagnosis in a timely manner and not forget about the importance of the rehabilitation course.

Briefly about the condition

The presented condition is one of the most common forms of esophageal pathologies. We are talking specifically about conditions that are characterized by hyperemia, the formation of edema, and other symptoms. There is no exact number regarding the prevalence of the disease, because the diagnosis must be confirmed by a biopsy, which, in turn, is not performed in every case.

It should be noted that catarrhal esophagitis is a secondary form of the disease. Thus, it is formed against the background of other pathological conditions associated with the organs of the gastrointestinal tract. We can talk about infectious or somatic diseases that must be treated separately. In this regard, some experts classify catarrhal esophagitis, including distal, as a pathological syndrome, and not as a separate disease.

Reasons for development

There are many factors that in one way or another influence the development of catarrhal esophagitis. We are talking about the effects of chemical or thermal factors, alcohol abuse. In addition, the list includes superficial damage to the shell due to medical procedures. No less often, catarrhal esophagitis occurs after an infectious disease, namely diphtheria, scarlet fever and some others.

A special place is occupied by factors such as massive reflux of stomach contents with GERD, persistent vomiting, and prolonged intubation. A separate category includes forms of the disease that develop in patients with immunodeficiency.

In this case, the cause of the development of the condition may lie in viruses or Candida fungi.

Among other things, catarrhal esophagitis can be a consequence of acute stomatitis, gastritis, allergic diseases and other conditions. The heterogeneity of the presented factors fully determines the differences in the mechanisms of origin. Considering this, I would like to pay special attention to the manifestations of the condition.

Symptoms of esophagitis

The leading symptoms of the condition include a lack of comfort and a burning sensation in the chest area. In this case, sensations can have varying degrees of severity, which directly depends on the depth and extent of the damage. In some cases, heartburn is noted, but most often the symptoms are not pronounced. As inflammation increases and worsens, the burning sensation intensifies more and more.

No less rarely, pain, indicating specifically catarrhal esophagitis, radiates to the area of the shoulder blades, the cervical part. One of the characteristic symptoms should be considered a significant increase in painful sensations in the process of eating food, in particular this applies to hard names. In addition, symptoms of the condition include regurgitation of mucus, excessive salivation and nausea.

The sudden onset of symptoms is likely, characterized by a high degree of effectiveness. In this case, the disease lasts from several days to two to three weeks, gradually regressing on its own. With a prolonged negative effect on the mucous membrane of the esophagus, the development of chronic inflammation is likely. All diagnostic features associated with catarrhal esophagitis will be presented below.

Diagnosis of the disease

First of all, you need to make an appointment with a gastroenterologist, who, based on the main symptoms, will be able to make a diagnosis. You should pay attention to the following features:

Laboratory tests usually do not show any changes. Slight neutrophilic leukocytosis may be detected;
An obligatory step should be considered the implementation of intraesophageal pH-metry, which makes it possible to establish the presence of GERD, as well as some features of the condition;
Radiography also has little information, which only in some cases makes it possible to identify uneven contours or swelling in the area of the folds.

Most often, X-ray examination is used to exclude various oncopathies or narrowing in the esophagus. To correct the diagnosis, for example, if there is a suspicion of a distal process, some additional measures are taken.

Differential diagnostics may be required; in addition, to correct the rehabilitation course and determine the degree of effectiveness, specialists insist on repeat examinations.

The treatment of catarrhal esophagitis will be discussed below.

Treatment options

In the process of restoring the body, great importance is given to eliminating provoking factors and minimizing the load on the organ. It is imperative to apply diet No. 1, because it involves minimizing the negative impact on the body. This applies to the effects of chemical, thermal and mechanical factors. Any dishes must be prepared in the form of purees - in this case, catarrhal esophagitis, including distal, will be eliminated much faster.

It is strongly recommended to take food only warm. In addition, in case of severe acute injury (burn in the esophagus), it is necessary to completely limit oral intake of food and liquids. In the event that the disease develops against the background of another pathological condition for which treatment has already been carried out, it is advisable to replace tablet dosage forms with parenteral ones.

Literally from the first days, treatment involves the use of astringent medicinal components and enveloping agents. In order to reduce the intensity of pain, anesthetics that are characterized by local effects are used, for example, novocaine. Improving the contact of any of the presented components will be possible solely by using them warm, preferably in a horizontal position without water.

If a pronounced painful syndrome is present, non-narcotic analgesics should be taken, and this must be done parenterally. In the case where catarrhal esophagitis is of infectious origin, etiotropic treatment is prescribed, namely antibiotics, antiviral and antifungal drugs. Treatment of the secondary form of esophagitis consists of treating the leading disease.

Severe widespread damage to the mucous membrane of the esophagus can be restored with the use of reparatives. They are administered as injections.

In the same situation, when there is a violation of esophageal motility, it is necessary to correct the condition.

How prevention is carried out and what the prognosis is for any form of the disease, even if it is distal, will be discussed further.

Prognosis and prevention

A condition such as catarrhal esophagitis is characterized by a favorable prognosis. In the vast majority of cases, spontaneous regression of the disease is possible. This happens within a few days. At the same time, transformation into a chronic form or the formation of some complications and critical consequences is possible. In order to avoid this, it is highly recommended to consider certain preventive measures.

We are talking about following a certain diet, proper nutrition, as well as avoiding drinking alcohol or using the nicotine component. An important element of prevention should be considered timely diagnosis and early initiation of a recovery course for any diseases of the digestive system - be it gastritis, GERD or any other condition. It is in this case that it will be possible to talk about maintaining 100% of the function of the entire gastrointestinal tract system, even if distal esophagitis was detected.

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1.Can cancer be prevented?
The occurrence of a disease such as cancer depends on many factors. No person can ensure complete safety for himself. But everyone can significantly reduce the chances of developing a malignant tumor.

2.How does smoking affect the development of cancer?
Absolutely, categorically forbid yourself from smoking. Everyone is already tired of this truth. But quitting smoking reduces the risk of developing all types of cancer. Smoking is associated with 30% of deaths from cancer. In Russia, lung tumors kill more people than tumors of all other organs.
Eliminating tobacco from your life is the best prevention. Even if you smoke not a pack a day, but only half a day, the risk of lung cancer is already reduced by 27%, as the American Medical Association found.

3.Does excess weight affect the development of cancer?
Look at the scales more often! Extra pounds will affect more than just your waist. The American Institute for Cancer Research has found that obesity promotes the development of tumors of the esophagus, kidneys and gallbladder. The fact is that adipose tissue not only serves to preserve energy reserves, it also has a secretory function: fat produces proteins that affect the development of a chronic inflammatory process in the body. And oncological diseases appear against the background of inflammation. In Russia, WHO associates 26% of all cancer cases with obesity.

4.Do exercise help reduce the risk of cancer?
Spend at least half an hour a week training. Sport is on the same level as proper nutrition when it comes to cancer prevention. In the United States, a third of all deaths are attributed to the fact that patients did not follow any diet or pay attention to physical exercise. The American Cancer Society recommends exercising 150 minutes a week at a moderate pace or half as much but at a vigorous pace. However, a study published in the journal Nutrition and Cancer in 2010 shows that even 30 minutes can reduce the risk of breast cancer (which affects one in eight women worldwide) by 35%.

5.How does alcohol affect cancer cells?
Less alcohol! Alcohol has been blamed for causing tumors of the mouth, larynx, liver, rectum and mammary glands. Ethyl alcohol breaks down in the body to acetaldehyde, which is then converted into acetic acid under the action of enzymes. Acetaldehyde is a strong carcinogen. Alcohol is especially harmful for women, as it stimulates the production of estrogens - hormones that affect the growth of breast tissue. Excess estrogen leads to the formation of breast tumors, which means that every extra sip of alcohol increases the risk of getting sick.

6.Which cabbage helps fight cancer?
Love broccoli. Vegetables not only contribute to a healthy diet, but they also help fight cancer. This is also why recommendations for healthy eating contain the rule: half of the daily diet should be vegetables and fruits. Particularly useful are cruciferous vegetables, which contain glucosinolates - substances that, when processed, acquire anti-cancer properties. These vegetables include cabbage: regular cabbage, Brussels sprouts and broccoli.

7. Red meat affects which organ cancer?
The more vegetables you eat, the less red meat you put on your plate. Research has confirmed that people who eat more than 500g of red meat per week have a higher risk of developing colorectal cancer.

8.Which of the proposed remedies protect against skin cancer?
Stock up on sunscreen! Women aged 18–36 are especially susceptible to melanoma, the most dangerous form of skin cancer. In Russia, in just 10 years, the incidence of melanoma has increased by 26%, world statistics show an even greater increase. Both tanning equipment and sun rays are blamed for this. The danger can be minimized with a simple tube of sunscreen. A 2010 study in the Journal of Clinical Oncology confirmed that people who regularly apply a special cream have half the incidence of melanoma than those who neglect such cosmetics.
You need to choose a cream with a protection factor of SPF 15, apply it even in winter and even in cloudy weather (the procedure should turn into the same habit as brushing your teeth), and also not expose it to the sun's rays from 10 a.m. to 4 p.m.

9. Do you think stress affects the development of cancer?
Stress itself does not cause cancer, but it weakens the entire body and creates conditions for the development of this disease. Research has shown that constant worry alters the activity of immune cells responsible for triggering the fight-and-flight mechanism. As a result, a large amount of cortisol, monocytes and neutrophils, which are responsible for inflammatory processes, constantly circulate in the blood. And as already mentioned, chronic inflammatory processes can lead to the formation of cancer cells.

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Catarrhal reflux esophagitis is the most common form of pathology. As a result of the development of the disease, multisystem damage occurs. They negatively affect not only the esophagus, but also the adjacent organs of the digestive system.

Reflux esophagitis is inflammatory changes in the distal lobe of the esophagus that occur as a result of the release of duodenal or gastric contents. As a result of this process, a change in the environment is observed. When the body is healthy, the pH of the lower part of the esophagus is 6.0. Catarrhal reflux esophagitis is diagnosed if there is a decrease in pH below 4.0 (this change is formed due to the release of acidic stomach contents into the esophagus) or an increase in pH higher than 7.0 (in this case, the entry of pancreatic juice and bile is noted).

The human body develops protective mechanisms that prevent the development of esophageal pathology:

The muscles of the lower alimentary sphincter are characterized by high tone, due to which it is in a closed position in a calm state. During the swallowing movement, there is a decrease in the activity of the sphincter muscles, and food masses overcome the esophagus and penetrate the stomach. After this, complete closure of the sphincter occurs - an anti-reflux barrier function.
Clearance.
Mucosal resistance.
Removing stomach contents and controlling acid formation.

When protective mechanisms are violated, pathology develops.

Causes

Decreased tone of the lower alimentary sphincter or more frequent spontaneous relaxations cause catarrhal reflux esophagitis.

Reasons causing hypotension of the orifice and the formation of pathology:

frequent consumption of foods that include caffeine (tea or coffee) and medications (caffeamine or borimed);
eating peppermint;
the use of medications that reduce sphincter tone (papaverine, no-spa, metamizole sodium and others);
pathology of the vagus nerve (development of vagal neuropathy in diabetes mellitus);
consumption of nicotine, which reduces sphincter tone;
intake of alcoholic beverages, which causes not only a decrease in tone, but also a direct pathological effect on the healthy state of the lining of the esophagus;
pregnancy period (in this case, the development of hypotension occurs due to endocrine changes - increased levels of estrogen and progesterone; and due to increased pressure in the peritoneal region).

Reasons that can cause spontaneous weakening of the esophageal opening:

esophageal dyskinesia – a violation of contraction, resulting in the formation of reflux esophagitis during swallowing;
digestive hernia;
fast, hasty eating, which leads to the swallowing of a significant amount of air and an increase in pressure inside the stomach, causing relaxation of the sphincter;
bloating;
development of ulcerative pathology (most often duodenal ulcer);
violation of the patency of the duodenum;
Eating fatty foods, baked goods, and fried foods causes inhibition of food mass in the stomach, which provokes an increase in intragastric pressure.

All these factors influence the release of gastric contents, which include aggressive agents (pepsin, bile acids and hydrochloric acid), leading to disruption of the integrity of the esophageal mucosa.

Symptoms

The clinical picture of reflux esophagitis covers two types of symptoms.

Esophageal symptoms:

The main symptom of the development of catarrhal reflux esophagitis is heartburn. The patient experiences a burning sensation behind the sternum, spreading upward from the xiphoid process. Heartburn occurs after taking certain foods, alcohol, cigarettes; bending the body forward, strong physical activity; after clamping the stomach area.
After the contents of the stomach enter through the lower esophageal opening into the esophagus, and then into the oral cavity, belching occurs. Belching is accompanied by the presence of bitterness and sour taste. Most often it is formed in a horizontal position or when the body is tilted forward. Belching of food that has been eaten may occur. With very low sphincter tone, gastric contents may enter the oral cavity along with belching.
The development of dysphagia, or difficulty swallowing food, which occurs due to esophageal dyskinesia or dry mucosa.
Rarely, along with heartburn, a feeling of excessive presence of saliva in the oral cavity occurs.
Feeling of a lump behind the sternum.
Painful movement of food through the esophagus - odynophagia, occurs with a strong process of inflammation.
When the phrenic nerve and diaphragm are excited, hiccups develop, causing great discomfort to the patient.
Severe vomiting.

Extraesophageal symptoms include:

The severity of the disease is determined using endoscopic examination:

All of the above symptoms are an indication for detailed diagnostics. It is very important to take a correct history to distinguish catarrhal reflux esophagitis from other diseases of the digestive system.

Diagnostics

There are a large number of diagnostic techniques that allow not only to accurately determine the presence of pathology, but also to name the cause of the development of reflux esophagitis.

Esophagogastroduodenoscopy is performed only after an ECG examination. As a result of the examination, it is possible to detect not only the presence of esophagitis, but also erosion of the mucous membrane or peptic ulcer of the esophagus, which has similar symptoms.
X-ray of the esophagus and stomach. This examination is carried out after using a special contrast mass in a vertical position and evacuating barium sulfate. After this, the patient lies down horizontally, as a result of which barium returns to the esophagus, which is a symptom of catarrhal reflux esophagitis. In addition, signs such as an enlarged lumen of the esophagus, altered relief of the mucous membrane, uneven contours, and weak contraction are detected.
Esophagomanometry is a technique that allows you to measure pressure in the esophagus. The examination is carried out using special balloon probes. With the development of pathology, low pressure is observed in the area of the lower esophageal opening.
Twenty-four-hour intraesophageal pH monitoring followed by computer processing is the most sensitive technique for detecting diseases of the esophagus. Using this technique, it is possible to establish the daily dynamics of gastroesophageal emissions and their duration.
Probing of the stomach using methylene blue. Using a special gastric tube, a small amount of dye is injected into the stomach. After this, rinsing with a NaCl solution (isotonic to blood plasma) is performed and the contents of the esophagus are suctioned with a syringe. If the resulting contents turn blue, then we can talk about esophagitis.
Using a standard acid reflux test, which is performed by injecting hydrochloric acid into the stomach and recording the pH with a pH probe.
Ultrasound diagnostics of the gastrointestinal tract.

Tests such as OAM, UAC and coprogram, Gregersen’s reaction, and LHC are also mandatory.

Treatment methods

Based on the individual characteristics of the body (other diseases, allergic reactions, contraindications to procedures), the doctor prescribes a comprehensive treatment of the pathology, which includes proper nutrition, drug therapy, and sometimes traditional medicine. If there is no positive effect, surgery may be required.

Diet therapy

Diet is considered one of the first points in the treatment of pathology. The patient is recommended:

eat five to six times a day, in small portions;
displacement from the diet of fatty, fried, spicy, salty, sour foods that can act as irritants;
exclusion of alcoholic and carbonated drinks, tobacco products, coffee and strong tea.

The menu must include the following food products:

lean varieties of meat, poultry and fish;
non-sour natural juices;
baked goods of the second day in small quantities;
mineral waters that do not contain gases;
non-acidic vegetables and fruits;
cereals;
jelly;
low fat dairy products.

If you follow simple nutritional rules, you will feel better after seven to ten days.

Drug therapy

Drug treatment is prescribed by a doctor based on the cause of the disease.

Therapy is carried out with antispasmodics, enveloping agents and drugs that are included in the group of antacids. In exceptional cases, antibacterial or antifungal drugs are prescribed.

Drug therapy includes the following medications:

lowering the acidity level of gastric juice;
increasing the tone of the lower esophageal sphincter.

After a month of therapy, repeat examinations are prescribed to assess the dynamics of the disease.

This is followed by taking medications for six months to consolidate the results. In the absence of positive dynamics, the use of cytoprotectors and prokinetics is started. The patient must maintain therapy with H2-histamine receptor blockers, especially in the event of an acute relapse.

There have been cases where relapse occurred after stopping medication treatment. This is most often observed due to the use of alcohol, nicotine during therapy, or with early withdrawal of drugs.

Surgical intervention

In severe cases of the disease, when strictures, ulcers, and stenoses form, surgery is prescribed. As a result of the operation, endoscopic dissection of the stricture, dilation and bougienage of the esophagus are performed. For certain indications, resection or plasty of the esophagus may be prescribed.

The best results are achieved by comprehensive treatment, which helps to get rid of acute symptoms and then finally transfer the disease into remission.

Traditional medicine recipes

Traditional medicine recipes can be used as additional treatment. But first of all, you need to consult with your doctor.

To alleviate the acute phase of the disease, an infusion prepared from aloe and dill juice is used. Having anti-inflammatory properties, 1 tablespoon per day will help relieve pain.

The human esophagus reacts to any changes that are important to correct in a timely manner. Late diagnosis leads to the transition of the pathology to an aggressive form.

Carrying out gastroscopy will prevent the process from becoming chronic

Kinds

This is a dangerous and unpleasant pathology. Its symptoms can go unnoticed, so it often becomes chronic.

The acute form of catarrhal reflux occurs when the esophageal mucosa is simultaneously exposed to hot food or spicy seasoning.

The chronic stage () develops due to the regular impact of adverse factors on the soft tissue of the esophagus. In this case, treatment is mandatory.

Distal reflux often changes the color of the mucous membrane. The walls of the esophagus become red, pronounced vascular patterns appear.

Each stage of distal esophagitis has different symptoms

Stages

The soft tissues of the esophagus in the lower places become loose. Inflammatory foci are weakly expressed. Pathology is detected only with the help of special studies.
The second stage involves the appearance of one or more ulcerative formations. There is no merger. Antacids are recommended.
At the penultimate stage, the ulcers are covered with exudate. Inflammatory foci begin to merge with each other. 50% of the lower esophagus is affected. A strict diet is prescribed along with drug treatment.
The last stage is dangerous. Erosion fills a large area. Inflammation is observed in an area of more than five centimeters. In some cases, surgery is possible.

Taking medications can cause esophagitis

Causes

There are many factors for development. This is not only poor nutrition, but also mechanical effects:

Activity after eating promotes development.
A fish bone left in the esophagus.
Medicines provoke the occurrence of distal reflux.

There are also physiological reasons that contribute to the appearance of symptoms, these are:

a broken valve system that closes the passage to the stomach after eating;
presence of stenosis;
infections in the gastrointestinal tract;
pregnancy and obesity.

Infections in the gastrointestinal tract provoke esophagitis

Symptoms of the disease

Catarrhal reflux is accompanied by pain in the lower abdomen and chest. Often the spasms are aching in nature. Painful attacks behind the sternum (increased when bending over), heartburn (a constant companion), increased salivation, belching with a sour taste, nausea, and a feeling of a lump in the throat are also observed. Hoarseness, coughing with attacks of suffocation may occur. Often with catarrhal lesions of the esophagus, increased nervousness is noted.

Diagnostic procedures

To make a diagnosis, the doctor collects all the information - the patient’s complaints, previous studies, test results. You will also need to perform fibrogastroscopy - taking a piece of tissue for a biopsy.

Esophagoscopy is used to examine the esophageal mucosa, assess external areas of the digestive tract, the severity of the inflammatory process, and clarify its localization.

Performing esophagoscopy on a patient

If visualization is poor, a more accurate study is used - the introduction of a barium contrast agent. To do this, the patient takes medicine, and after a while the radiologist takes pictures. The results are then sent to the doctor for evaluation.

Therapy

The disease is treated using several methods. Therapy begins with medication and diet. If no improvement is observed after the allotted course, doctors resort to surgery.

Diet is an important component of treatment. The diet should include low-calorie foods. It is unacceptable to eat foods high in fat, generously seasoned dishes, alcohol, coffee drinks, pastries, tomatoes, oranges.

Alternative treatment should be resorted to only when combined with medications. But herbal decoctions to relieve symptoms should only be recommended by a specialist. Medicinal plants have the ability to relieve inflammation, heal erosions on the mucous membrane, and eliminate harmful bacteria.

Medicines and herbs are used in treatment

The second approach is drug treatment. Don’t think that a specialist prescribes one pill that gets rid of unpleasant symptoms. A number of drugs are prescribed that act on different areas. This approach is considered effective for relieving esophagitis. The therapy involves enveloping drugs and antispasmodics. In rare cases, antibiotics and agents are prescribed that have a detrimental effect on harmful fungi inside the esophagus.

If the form of the disease is severe and intoxication is observed, droppers are prescribed. If an infection enters the esophagus, antibiotics are required. Also, difficult treatment will be for those whom nature has endowed with a narrow esophagus - in such cases, only surgery is indicated.

People suffering from a lack of cardia with distal catarrhal esophagitis should avoid an active lifestyle, sports, forget about sudden movements, and do not lift heavy objects.

Allowed products for distal esophagitis

Fish and meat – low-fat varieties.
Juices (except sour ones).
Second day baking.
Still mineral water.

Herbal products will help in the treatment of distal esophagitis

Fruits (fresh), vegetables.
Steamed dishes.
Cereals (except millet).
Omelet (steam).
Kissel (exclude cranberry).
Low fat dairy products.
Any food that envelops the walls of the stomach.

Conclusion

Cardiac insufficiency can occur in young children. A patient with this factor needs special care. Feeding should only be done in a standing position, half-sitting; after eating, it should not be placed in the crib; it is better to hold it upright for several minutes.

What is reflux esophagitis and how to cope with it - see below:

Everyone is accustomed to the fact that esophagitis is a common inflammatory process that occurs in every second person when the delicate mucous membrane of the esophagus is exposed to spicy or too hot food.

But of all the variants of inflammatory diseases of the organ, catarrhal esophagitis is the most common. And the reason for this is often not only liberties in nutrition, but also diseases of surrounding organs, infections of certain parts of the digestive system.

Causes of catarrhal inflammation

The inflammatory process on the mucous membrane of the esophagus is a common phenomenon. This is a specific reaction of the body to something that does not suit it. To one degree or another, every person is daily exposed to foreign agents to the digestive system. These include:

bacterial and viral infections;
dry food, spicy and hot dishes, alcohol, strong coffee drunk on an empty stomach;
drugs that weaken the protection of the esophagus;
constant nervous stress.

With different intensities of exposure to aggressive substances, the shells react differently. So what is catarrhal esophagitis? This disease of the esophagus is characterized by the appearance of inflammation of the mucous membrane. In this place, the mucous membrane is swollen; during examination, areas of hyperemia (redness) are observed. This is a completely normal reaction of the body to inconvenience, any tissue reacts this way.

Normally, the mucous membrane of the esophagus is pink in color with slight folding. With catarrhal inflammation, the entire tissue or its individual sections have a bright red poured color, the tissue is slightly increased in volume, since in the submucosal layer there is a large accumulation of blood cells - the reaction of blood cells to irritation in the form of edema, which is clearly visible on x-ray examination.

Catarrhal reflux esophagitis

One of the varieties of the disease is catarrhal reflux esophagitis. As for this variant of the course of the disease, it occurs due to the reflux of gastric or intestinal contents back into the esophagus, that is, due to reflux. Normally, the esophagus has an alkaline environment; the contents of the stomach have an acidic environment, which has a detrimental effect on the upper parts of the digestive system.

What can cause reflux?

Increased intra-abdominal pressure due to wearing tight clothing, bending the body forward after eating, pregnancy and increased body weight.
Weakening of the lower esophageal sphincter (the muscle at the border of the esophagus and stomach).
Poor nutrition.
Diseases of the digestive system.

Symptoms of catarrhal esophagitis

The painful process is not always noticeable. Often the disease does not manifest itself in any way until more serious lesions of the mucous membrane appear. Or the symptoms of catarrhal esophagitis are so rare that it is difficult to determine the disease from them.

Common signs of catarrhal esophagitis include the following manifestations of the disease.

A burning sensation behind the sternum that occurs after eating food. Heartburn is more bothersome after spicy or dry food. Sometimes it's just a sensation of scratching or rawness in the throat.
Pain in the chest area caused by spasm of the esophageal muscles.
Excessive salivation appears as a protective reaction of the body to the entry of acidic stomach contents into the esophagus.
Belching and nausea.

Diagnostics

To make a diagnosis of catarrhal reflux esophagitis, you need to undergo the following necessary studies:

esophagoscopy;
X-ray of the esophagus;
pH level monitoring;
esophagomanometry or studies of the motor function of the organ.

Treatment of catarrhal esophagitis

Treatment should always begin with the right diet. The diet for catarrhal esophagitis includes several key points.

Frequent split meals in small portions.
The last meal should be at least 3 hours before bedtime.
Food for the entire period of treatment includes only gentle dishes that do not irritate the mucous membrane of the esophagus. It is necessary to completely exclude spicy, fatty foods, coffee and carbonated drinks, and alcohol. Flour and sweet dishes are limited.
Proper processing of products is important. Only boiled, steamed and baked dishes are allowed.

Use of drugs

It seems that this is just a normal inflammatory process, so treatment can be avoided or just following a diet will suffice. For mild cases of the disease, diet and minor lifestyle adjustments are sufficient. But in the case when the symptoms bother you every day, without stopping even a long time after the meal, this means that it is time to begin more serious treatment of catarrhal esophagitis. In addition to the diet, medications are prescribed.

Preparations that protect the mucous membrane from stomach acid: Solcoseryl, alginates, flax seed decoction.
Sometimes antacids are used to quickly and effectively relieve heartburn; after meals, they use Rennie, Phosphalugel, Almagel, Maalox and other means.
When spastic pain occurs, depending on the indications, No-shpa or Papaverine is prescribed intramuscularly.
In addition to symptomatic treatment, agents are used that normalize excess gastric acid. Their appointment is mandatory for catarrhal reflux esophagitis. Treatment of this type of esophagitis is carried out over a long course of at least a month. They use Omeprazole, Pantoprazole, Lansoprazole, Famotidine.

The treatment regimen for catarrhal esophagitis is prescribed individually, taking into account symptoms and drug tolerance.

Despite the fact that catarrhal esophagitis is a common process, it requires close attention. Once neglected, the disease can lead to complications, examples are narrowing and ulcers of the esophagus, bleeding. Therefore, if this diagnosis is made, it is worth not only visiting a therapist, but also undergoing a full course of treatment.

Catarrhal esophagitis is a disease of the gastrointestinal tract, which is an inflammation of the mucous membrane of the esophagus. Most often, this disease occurs as a result of exposure to mechanical or chemical agents, infections, or the development of certain somatic pathologies.

Catarrhal esophagitis of the esophagus is the most common pathology of this organ of the digestive system. Morphologically, it is characterized by hyperemia, swelling and leukocyte infiltration of the mucous membrane of this organ of the digestive system.

What does superficial catarrhal esophagitis mean?

The disease catarrhal esophagitis, with timely and adequate treatment, as well as adherence to a therapeutic diet and compliance with all recommendations of specialists, has a favorable outcome. Many people do not know what catarrhal esophagitis means, what causes it and how it manifests itself.

Catarrhal esophagitis is characterized by inflammation of the upper layers of the mucous membrane of the esophagus; submucosal and muscle tissues are not involved in the pathological process. This disease is also known as catarrhal superficial esophagitis, since its development damages the surface layers of the mucous membranes of the digestive organs.

As a result of the action of unfavorable factors that irritate the already inflamed mucous membrane of the esophagus, epithelial cells are damaged in catarrhal esophagitis.

More often, the pathological process is diagnosed in men, which is explained by their tendency to drink alcohol and smoke. It is these factors that act as the main irritants of the mucous membranes of the digestive organs.

Catarrhal reflux esophagitis: what is it, what are the symptoms and how to treat

Not everyone knows what it is - catarrhal reflux esophagitis - and how it differs from ordinary esophagitis. It represents one of the varieties of this pathological process. Its development occurs as a result of regular reflux of gastric or intestinal contents back into the esophagus. In a healthy person, in the absence of disturbances and abnormalities in the functioning of the digestive system, the esophagus has an alkaline environment, and the contents of the stomach have an acidic environment, which has a detrimental effect on the upper gastrointestinal tract.

The patient is concerned about the following symptoms with catarrhal reflux esophagitis:

indigestion;
chest pain;
heartburn.

As a result of regular spontaneous reflux of stomach or intestinal contents into the esophagus, its lower section is inevitably damaged. This process is accompanied by characteristic symptoms in the form of pain and heartburn. Another symptom that allows you to recognize the development of a digestive disorder is sour belching, attacks of nausea and vomiting. The characteristic symptoms of the disease make it possible to understand what catarrhal esophagitis is and how to treat it at different stages of development.

Forms of catarrhal esophagitis of the lower third of the esophagus

Most often, during examination of the digestive system, patients are diagnosed with catarrhal esophagitis of the lower third of the esophagus; it can be distal or terminal.

Catarrhal esophagitis occurs in two main forms:

acute, when the inflammatory process occurs due to a sharp adverse effect, often this occurs due to infection or injury to the mucous membrane;
chronic, when the mucous membrane is constantly under the influence of a pathological factor - regular consumption of cold, hot, spicy, sour, salty, spicy, rough foods.

Catarrhal reflux esophagitis I, II, III and IV degrees

This disease of the digestive system can have several degrees of severity with characteristic changes and symptoms:

First degree. Catarrhal esophagitis of the 1st degree is characterized by the appearance of small localized foci of inflammation on the mucous membrane of the esophagus or stomach. There may be several or one with a diameter of up to 5 mm. At stage 1 of catarrhal reflux esophagitis, fusion of foci is not observed. Often at this stage of development the pathology is asymptomatic.
Second degree. There are several defective zones larger than 5 mm in diameter. Over time, the disease gradually merges, but they do not yet affect the entire mucosa. The first symptoms of catarrhal esophagitis of the 2nd degree are heartburn and burning pain in the chest.
Third degree. At this stage of the inflammatory pathological process, damage to ¾ of the entire mucous membrane of the organ is noted. Symptoms of inflammation become more pronounced and occur regardless of food intake.
Fourth stage. More than 75% of the mucosal surface is affected. At this stage of the disease, pathological complications such as chronic ulcers or cicatricial strictures of the esophageal lumen often occur.

Causes of catarrhal fibrous and other types of esophagitis

This type of pathological process of the digestive system can have various causes. Based on this, taking into account the origin of the disease, the following types are distinguished:

Nutritional. This form of pathology occurs as a result of abuse of alcohol, strong tea or coffee, spicy or sour foods, smoked meats, marinades, pickles, too hot and cold dishes and drinks, heavy and coarse foods.
Stagnant. Usually develops against the background of the action of food debris on the mucous membrane of the esophagus.
Professional. This form of the disease is caused by the penetration into the organs of the digestive system of various aggressive substances with which a person comes into contact in production conditions. Such irritants include acid vapors, iodine, caustic alkalis, and heavy metal salts.
Allergic. This type of inflammatory process can be caused by changes in the body's reactivity. Often occurs in children against the background of bronchial asthma or food allergies.
Fibrinous. Catarrhal-fibrinous esophagitis is accompanied by the formation of a fibrous film. This pathology usually develops against the background of scarlet fever and diphtheria.
Alcoholic. With prolonged use of alcohol, burns occur on the mucous membrane, which also lead to a disorder such as esophagitis. In this case, alcoholic catarrhal esophagitis is diagnosed.

In addition, catarrhal esophagitis of the stomach and esophagus can be caused by the following reasons:

increased pressure inside the abdominal cavity, which occurs when large tumors form in the peritoneum, as well as during pregnancy;
surgical interventions aimed at removing part of the stomach or sewing in an ulcer;
long-term use of medications that significantly weaken the protective properties of the digestive organs;
constant strong psycho-emotional experiences and stressful situations;
bacterial and viral infections.

Causes of catarrhal reflux esophagitis

Experts name the following causes of catarrhal reflux esophagitis:

increased intra-abdominal pressure as a result of wearing tight clothing, sudden bending of the body forward immediately after eating, pregnancy and excess body weight;
weakening of the lower esophageal sphincter;
poor nutrition;
some diseases of the digestive system;
scleroderma;
carrying out esophagogastrostomy, castrectomy.

Signs of catarrhal esophagitis in acute and moderate form

Acute esophagitis is characterized by a pronounced course. The following signs of catarrhal esophagitis in its acute form are known:

discomfort when swallowing food;
burning pain in the esophagus, increasing as food moves through it;
neck pain;
heartburn with sour, unpleasant belching;
white coating on the surface of the tongue;
excessive salivation;
fever, chills, malaise.

The acute form of the disease can be complicated by abscesses, perforation of the esophagus, purulent mediastinitis, esophageal stricture, and focal dysplasia.

In gastroenterology, specialists use the term “moderate catarrhal esophagitis” to designate the form of this inflammatory process, which is relatively considered normal and does not belong to the pathologies. As a rule, with such an inflammatory process, gentle nutrition is prescribed for 2-3 days, after which, in most cases, impaired digestive functions are restored without taking medications.

Signs of chronic catarrhal esophagitis

Chronic catarrhal esophagitis in most cases occurs against the background of an advanced acute form of this disease. However, in the presence of other gastrointestinal pathologies, chronic catarrhal esophagitis can appear as an independent disease without a preceding acute form.

The disease is manifested by the following symptoms:

soreness, discomfort and a burning sensation in the chest, intensifying while eating;
pain and heartburn during physical activity, regardless of the meal;
attacks of pain when lying on your back, which radiate to the back, heart, neck;
belching, hiccups;
nausea, which often ends with vomiting;
excessive salivation;
respiratory dysfunction.

Alimentary chronic esophagitis occurs with the systematic consumption of food that irritates the mucous membrane of the digestive organs - hot, cold, spicy, salty, sour.

When examining the mucous membrane during the examination, it is loose, edematous, hyperemic, covered with mucus, has dilated veins, and hemorrhagic rashes are observed.

Terminal and distal catarrhal esophagitis

There are two types of reflux esophagitis: distal and terminal. Terminal catarrhal esophagitis is mainly diagnosed in newborns who suffered asphyxia during childbirth. This form of disease of the gastrointestinal tract is caused by a lack of oxygen supplied to organs and tissues. The surface of the mucous membrane of the children's esophagus is covered with small erosive bleeding spots.

As the pathological process progresses, the following changes are observed:

the child refuses to eat;
regurgitates swallowed food;
weight loss is noted;
frequent hiccups;
poor and restless sleep due to pain and discomfort in the abdominal area.

This form of reflux esophagitis can also develop in adults. The symptoms of the disease are similar - heartburn, belching, nausea, vomiting, pain and burning in the sternum. Nausea and vomiting are significantly worse when lying down and when bending the body forward.

Distal catarrhal reflux esophagitis is characterized by damage to only one end of the esophagus; the inflammatory process is observed in the part adjacent to the stomach. Manifestations of the pathological process are especially intensified when the patient assumes a horizontal position. Distal catarrhal esophagitis, as a rule, has vague symptoms, which often complicates diagnosis and leads to neglect of the disease. In most cases, they learn about the development of pathology only after endoscopy and X-ray examination. The reason for visiting a specialist’s office are complaints of weakness, frequent belching, nausea, dizziness, suffocating cough, hoarseness, pain and burning in the peritoneal area.

Treatment of distal catarrhal esophagitis

Treatment of distal catarrhal esophagitis at the initial stage of development of the disease is often limited to diet. By adjusting your diet, it is usually possible to eliminate the unpleasant symptoms of distal esophagitis. Infants who have been diagnosed with this pathology require special care. Babies with such a dysfunction of the digestive system must be kept in an upright position for at least three minutes immediately after feeding. To reduce the manifestation of unpleasant symptoms, lying down feeding is strictly prohibited. During the treatment period, it is important to reduce the harmful effects of contents on the esophagus that enter during gastric reflux.

If symptoms are regular, diet alone will not be enough to restore gastrointestinal functions. For a complete recovery, your doctor may prescribe the following medications:

Antispasmodics – No-shpa, Papaverine

Antacids – Rennie, Almagel, Maalox

Medicines that coat the gastric mucosa - Solcoseryl, Alginate

Drugs that normalize the level of hydrochloric acid in the stomach - Omeprozole, Famotidine, Pantoprazole

The treatment regimen for each patient is selected individually by a specialist, taking into account the stage and severity of the disease, concomitant diseases, age and causes of the pathology. In addition to drug treatment, the simultaneous use of electrophoresis, the introduction of novocaine into the epigastric part of the stomach, laser therapy and electrical stimulation of the inside of the esophagus are recommended.

If conservative treatment does not bring positive results, surgical intervention becomes inevitable. Surgery for reflux esophagitis is indicated in the following situations:

development of a tumor in the esophagus;
bleeding and other complications of esophagitis;
aspiration chronic pneumonia.

Catarrhal-erosive reflux esophagitis: symptoms and how to treat

Catarrhal-erosive esophagitis is considered by specialists in the field of gastroenterology as one of the stages of gastroesophageal reflux disease. The gastric contents consist of substances such as food bolus, hydrochloric acid, mucus, digestive enzymes, and sometimes pancreatic juice and bile acid. The reflux of this gastric content into the esophagus is catarrhal reflux esophagitis.

This process can occur in an absolutely healthy person, but only with a frequency of no more than twice a day. If the problem occurs much more often, you should visit a specialist’s office to examine and restore the impaired functions of the digestive system. Reflux lasts about 5 minutes and occurs more often during the daytime, which is caused by food intake. Often a person does not even feel the reflux of gastric contents into the esophagus, as a result of which the disease becomes chronic.

If a patient has catarrhal reflux esophagitis during diagnosis, its symptoms will differ depending on the form of the disease. There are non-erosive and erosive forms of the pathological process. If non-erosive reflux esophagitis develops, during an endoscopic examination, a specialist will detect signs of inflammation such as swelling and redness of the walls of the esophagus. With erosive esophagitis, in addition to redness and swelling, erosions of varying lengths will also be noticed.

Signs of the disease depend on the degree of organ damage. The pathology can occur in a latent form, which is dangerous for the patient, since in such cases esophagitis takes on an advanced form. However, most often the disease makes itself felt with pronounced symptoms, which cause a person discomfort and pain. All clinical manifestations of erosive reflux esophagitis are conventionally divided into esophageal and extraesophageal. Typically, signs make themselves felt after overeating, drinking alcohol, eating errors, stress and physical activity.

Esophageal symptoms are:

heartburn – occurs in 75% of cases of the disease;
intense salivation;
nausea, dizziness, vomiting attacks;
bitter and sour belching;
unpleasant taste in the mouth in the morning, usually bitter or sour;
problems swallowing food as a result of the esophagus contracting.

With the development of erosive gastroesophageal disease, the patient experiences burning pain in the epigastric region. Often a person confuses the pain of esophagitis with a heart attack, heart pain and angina. Soon the pain spreads to the neck, chest and area between the shoulder blades. All these symptoms are classic. They can appear in combination or separately.

There are also extra-esophageal signs of reflux esophagitis, which do not indicate the development of this disease and often a person is not even aware of the existence of problems with the digestive system. Such signs include hoarseness of the voice, a feeling of a lump in the throat that persists for a long time, the formation of ulcers and granulomas on the vocal cords. The patient coughs for a long time with the release of sputum and mucus, sometimes attacks of suffocation may occur, in some cases inflammation of the gums occurs, and damage to tooth enamel occurs much less often. Sometimes patients complain of feeling slight pain in the lower part of the mouth, and a slight disturbance in heart rhythm may occur. Usually, close people notice that the patient has bad breath. Erosive reflux esophagitis is often accompanied by vomiting with blood.

Treatment of erosive reflux esophagitis should be started as early as possible. First of all, gastroenterologists recommend that all patients make lifestyle adjustments, review their diet, and proper nutrition plays an important role in therapy. In most cases, restoration of the functions of the digestive system is impossible without the use of special medications. In extremely difficult situations, when the disease has been advanced or complicated by other pathologies, surgery becomes inevitable. Mostly, treatment of the erosive form of gastroesophageal disease is carried out on an outpatient basis under the strict supervision of the attending physician. In severe cases, hospitalization of the patient in a medical facility is required.

Drug therapy is mandatory, which involves the use of two directions. In the first referral, fairly powerful, effective drugs are first prescribed, but over time, the intensity of drug treatment decreases. The second strategy, on the contrary, is an increase in the pharmacological effect.

If there are erosions on the mucous membrane of the esophagus, drugs that have an antisecretory effect are prescribed. Such medications reduce the intensity of the secretion process in the stomach. As a result of taking such drugs, acidity is reduced and the irritating effect of gastric contents on the mucous membrane is eliminated. These drugs include proton pump inhibitors. You also need to take H-2 blockers and M-anticholinergics. The duration of therapy with these agents is determined by a specialist for each patient individually, but it lasts at least a month.

How to treat catarrhal reflux esophagitis of the erosive form? Therapy for erosive reflux esophagitis also involves taking prokinetics. Medications such as domperidone and metoclopramide may be prescribed; they improve motor skills. To neutralize the effect of hydrochloric acid, alginates and antacids are prescribed.

Distal catarrhal reflux esophagitis with cardia failure

Insufficiency of the gastric cardia is a disruption of the entrance sphincter. With the development of such a pathological process, reflux occurs, which is considered by gastroenterologists as a complication of cardia failure.

In a healthy stomach, the cardia allows food into the gastric cavity with minimal pressure. In order for food to pass in the right direction, the pressure should not exceed 3.5 mmHg. When reflux esophagitis occurs, the pressure increases 20 times. Such a high level is formed as a result of fermentation and overeating.

Cardia failure in catarrhal esophagitis occurs in the presence of the following factors:

systematic overeating;
being overweight;
chronic form of gastritis;
sedentary lifestyle;
eating before bed.

Catarrhal reflux esophagitis with cardia insufficiency has the following manifestations:

burning pain in the esophagus;
constant heartburn;
belching with the smell of stomach contents;
frequent vomiting.

Catarrhal reflux esophagitis due to cardia insufficiency can be treated with a balanced diet. In this case, it means following a diet and small portions. You should not rush while eating, and after a meal it is not recommended to lie down for an hour; it is better to sit or walk. With this diagnosis, the diet should consist of liquid porridges and low-fat soups.

Therapy for distal catarrhal reflux esophagitis with cardia insufficiency is based on the following principles:

first of all, measures are taken aimed at curing the underlying disease that caused the development of cardia failure;
if you are overweight, you should get rid of it;
with ascites it is important to reduce intra-abdominal pressure;
strict adherence to the diet prescribed by a specialist.

Diagnosis of “catarrhal reflux esophagitis of focal form”

Focal catarrhal reflux esophagitis is a type of disease in which irritation of the mucous membrane of the esophagus occurs with gastric juice in the form of foci of various sizes. A burning sensation behind the sternum, discomfort and pain when swallowing are the main symptoms of this pathological process. Soon, these primary symptoms are joined by heartburn and a feeling of acidity in the mouth.

In gastroenterology, the following forms of focal gastroesophageal disease are distinguished:

Spicy. Accompanied by acute pain in the chest while eating. The acute form of the disease is also manifested by impaired swallowing and general malaise.
Catarrhal. Characterized by swelling and inflammation of the mucous membrane of the esophagus. When swallowing, the patient experiences unbearable pain and a sensation of the presence of a foreign object in the throat.
Erosive. It is considered a complicated form of the disease when ulcers begin to form on the mucous membrane.

To confirm the diagnosis of focal catarrhal esophagitis, an X-ray examination is required. With this diagnostic method, irregularities, focal dysplasia, accumulation of mucus and swelling of the folds will be detected.

When diagnosing the disease, a method such as esophagoscopy is also used. During this study, specialists are able to establish hyperemia of the mucous membrane of the esophagus, the presence of exudate and pustules, minor hemorrhages and erosions. With the help of esophagomanometry, it is possible to determine the presence of motility disorders in the esophagus.

How to treat superficial catarrhal esophagitis and gastroduodenitis

With this form of complicated catarrhal reflux, bile produced by the liver is released into the digestive organs. The reason for the development of this pathological process is a malfunction of the sphincters.

How to treat superficial catarrhal esophagitis and gastroduodenitis, or gastroduodenal reflux? When making an accurate diagnosis, specialists prescribe treatment, consisting of basic therapy and diet therapy. To achieve positive results, it is recommended to use two methods of therapy simultaneously.

Distal catarrhal esophagitis with columnar cell metaplasia: signs and treatment

Columnar cell metaplasia of the esophagus can lead to the development of catarrhal reflux esophagitis. In gastroenterology, this pathological process is also known as “Barrett’s syndrome” or “Barrett’s esophagus”.

Cylindrical cell metaplasia of the esophagus is a spasm that represents a failure of the pathological process of the digestive system. It is characterized by pinching of the squamous epithelium by columnar cells. As a result of this violation, they begin to collapse under the influence of highly acidic juice. In 25% of patients, this pathology is asymptomatic; in other cases, the disease manifests itself with smoothed symptoms.

The signs of distal catarrhal esophagitis with columnar cell metaplasia are as follows:

burning behind the sternum;
regular belching with a sour taste and unpleasant odor, which appears soon after eating;
nausea and vomiting after eating; at a late stage of the disease, blood admixtures are observed in the vomit;
violation of the swallowing reflex, which is accompanied by discomfort and pain;
substernal pain radiating to the neck and jaw.

Sometimes non-esophageal symptoms may be observed - hoarseness of the voice, sore throat and a feeling of dryness in it, cough.

Catarrhal distal esophagitis and metaplasia are treated by taking medications that prevent the reflux of gastric contents into the esophagus. Treatment of catarrhal esophagitis and cylindrical metaplasia is carried out with medications from the following pharmacological groups:

Antacids – “Phosphalugel”, “Maalox”, “Gastal”, “Omeprazole”

Proton pump inhibitors:

"Pantoprazole"

"Famotidine"

"Alfogel" and"Betamax"

"Gastratcid"

Prokinetics – “Ganaton”, “Motilium”, “Motilak”

Treatment of symptoms of catarrhal esophagitis with metaplasia is carried out only at the initial stages of the development of pathology or before surgery.

It is not always possible to get rid of foci of Barrett's syndrome using a conservative method; surgery may be necessary to remove them. This can be done in several ways:

Laser removal. At the first stage, a low-frequency laser beam is used to remove columnar epithelium.
Photodynamic therapy. The destruction of metaplasia is carried out by exposure to light of a certain wavelength using photosensitizers.
Fundoplication. This technique involves suturing the fundus of the stomach to the diaphragm to create an acute angle with the esophagus. This therapy prevents the reflux of gastric contents into the esophagus.
Free surgery. During the operation, the affected area of the esophagus is removed. Such manipulations are indicated for maximum and irreversible progression of the pathology.

Treatment of catarrhal reflux esophagitis of an infectious nature is carried out with the help of antibacterial and antiviral drugs, depending on the infectious agent.

Diet for catarrhal reflux esophagitis: sample menu

The basis for the treatment of acute and chronic catarrhal reflux esophagitis is diet therapy. The diet for catarrhal esophagitis is based on the following principles and rules:

The frequency of meals should be 5-6 times a day. You should eat every 3-4 hours.
You can only eat freshly prepared food.
It is strictly forbidden to drink food with water or other liquid.
You should avoid eating foods that stimulate the production of gastric juice - chocolate, coffee, fatty broths, cabbage, fresh fruit and tea.
It is necessary to stop drinking alcohol and smoking.
Meals should not be eaten later than two hours before bedtime.

Almost all patients with the development of this disorder of the digestive system are prescribed dietary table No. 1 for the duration of treatment. A diet for catarrhal reflux esophagitis can be based on the following foods and dishes:

mashed potatoes;
green soft vegetables;
bananas, applesauce;
liquid porridges from white and brown rice, oatmeal, buckwheat, semolina, pearl barley;
egg whites;
lean meat, chicken;
soups, broths;
water, weak tea.

Approximately the diet menu has the following option:

Breakfast: a glass of green or weak black tea or kefir, porridge with fruit.