Erosive esophagitis: symptoms and treatment

Erosive esophagitis is a gastroenterological disease characterized by an acute inflammatory process with damage to the mucosa of the esophagus. In most cases, this ailment is secondary after acute or chronic inflammation of the esophagus.



In contrast to the catarrhal form of esophagitis, erosive flows in a more acute form, characterized by severe pain, nausea and vomiting with blood. To distinguish one form from another, only by clinical signs, is quite difficult for a simple person, therefore it is strongly recommended not to compare symptoms and treatment yourself.

In the absence of treatment, erosive esophagitis can become a stomach ulcer, in some cases an oncological process also develops.

According to the International Classification of Diseases of the Tenth Revision, the erosive form of esophagitis refers to diseases of the digestive system. The code for the ICD-10 is K20-K31.

Etiology

The formation of erosive-ulcerative esophagitis, as a rule, is caused by the following etiological factors:


  • congenital malformation of the esophagus;
  • infectious diseases of the gastrointestinal tract
  • mechanical damage to the esophagus;
  • long and uncontrolled use of medicines
  • Complications after surgery in the area of ​​the gastrointestinal tract or thorax
  • use of substances that can cause a burn of the esophagus mucosa
  • throwing acidic contents from the stomach into the esophagus. This is possible with hyperacid gastritis, gastric ulcer, reflux esophagitis
  • gastroesophageal reflux disease (GERD).

In addition, a predisposition to such a gastroenterological disease is systematically malnutrition, alcohol abuse and frequent food poisoning.

Classification

Based on the localization of the pathological process, the following classification of erosive esophagitis is distinguished:


  1. erosive distal esophagitis — erosions are located in the lower esophagus, one of the most common forms of the disease
  2. proximal — the inflammatory process affects the mucosa of the upper esophagus;
  3. total is the most severe form of the ailment, as the formation of ulcers and erosions is observed throughout the entire length of the esophagus.

By the nature of the flow, they are distinguished:


  • acute form
  • subacute;
  • Chronic.

There are also several degrees of development of this gastroenterological disease:


  1. first — erosion is single, no more than 5 mm, the pathological process is localized only in one part of the esophagus
  2. second — single or multiple ulcers and erosions are diagnosed;
  3. third — ulcers and erosions begin to group together, resulting in a third of the esophagus;
  4. Fourth — a lesion greater than 75% of the esophagus, is in most cases complicated by chronic ulcer or stenosis of the esophagus

Significant complications can be avoided by starting treatment at the first stage.

Symptoms

The danger of erosive esophagitis is that at the initial stage of development, its clinical picture is similar to that of the work of the gastrointestinal tract in an easy form. That is why, quite often, it is diagnosed in an already neglected form, which significantly complicates treatment and worsens further forecasts.

In general, the clinical picture is represented by the following symptoms:


  • a lump in the throat and a dry cough that is not accompanied by throat swelling and fever
  • heartburn;
  • pain behind the breastbone and in the epigastric region — this is the most characteristic sign for erosive esophagitis
  • nausea and vomiting. As a rule, it is observed only after eating, which irritates the inflamed esophagus. At the same time in the vomit masses there may be impurities of blood;
  • decreased appetite
  • weakness, lethargy
  • children have moodiness and anxiety, the temperature can rise.

Since such a clinical picture is typical for other gastroenterological diseases, it is impossible to independently carry out treatment. It can be prescribed only by a doctor, after carrying out all the necessary diagnostic procedures and making an accurate diagnosis.




Diagnostics

The gastroenterologist can preset the diagnosis before the initial examination of the patient. However, it is possible to determine the stage of development of the gastroenterological disease and localization of erosions and ulcers only through diagnostic procedures, namely:


  1. X-ray examination of the esophagus with a contrast agent
  2. esophagoscopy
  3. esophageal manometry
  4. Determination of pH.

Laboratory tests are assigned as needed, based on the current clinical picture, the personal history collected during the initial examination.

Treatment

To treat such a gastroenterological disease only complex. In addition to drug therapy, the patient is required to prescribe a diet that is aimed at improving well-being and speeding up the recovery process.

Medication may include the following drugs:


  • proton pump inhibitors;
  • antacids;
  • antispasmodics
  • alginates;
  • histamine receptor blockers
  • Prokinetics.

The duration of the dosing, dosage and regimen of prescriptions is prescribed only by the attending physician, making adjustments to the course of therapy at its discretion may lead to the development of complications.

Nutritional regimen with this form of ailment, the same as with fibrinous esophagitis. GERD, means a sparing diet, which is aimed at improving the patient’s well-being.

The diet for erosive esophagitis consists in the following recommendations:


  1. Excluding food that irritates the intestines, provokes fermentation and elevated flatulence
  2. the patient should eat often, but in small portions and with a time interval of 2.5-3 hours;
  3. the optimal cooking mode — cooking, steaming, stewing or baking without fat and fried crust
  4. the consistency of the dishes is liquid, mushy or puree
  5. the food should only be warm;
  6. Alcohol, sweet fizzy drinks and coffee are excluded. As an alternative — a green loose tea with milk, cocoa in milk.

The exact program of dietary nutrition is prescribed only by the gastroenterologist, based on clinical parameters, the age of the patient and the characteristics of the organism.

Treatment with folk remedies for erosive esophagitis is not excluded, but it must necessarily be agreed with the attending physician and used only as a supplement to the main course of treatment. It is advisable to use such drugs as a prophylaxis or prolongation of the stable phase of remission in the chronic form of the disease.

In this case, you can use decoctions of these herbs:


  • Sage
  • Eucalyptus
  • Calendula
  • Chamomile;
  • Oak bark.

The course of treatment should be completed completely, even if at some stage there is an improvement in well-being and the symptomatology disappears completely.

Possible complications

Lack of adequate treatment is fraught with such complications:


  1. chronic ulcer
  2. perforation of the esophagus walls
  3. erosion scarring
  4. dysphagia;
  5. Barrett’s disease — in this case, the cells degenerate into malignant cells, which leads to an oncological process.

This can be eliminated if, at the first manifestations of the above described symptoms, see a doctor and start therapeutic measures.

Prevention

Preventive measures against this gastroenterological disease are as follows:


  • adherence to the optimal diet for the body
  • moderate exercise;
  • moderate drinking and total elimination of smoking;
  • taking only medications prescribed by a doctor, in case of self-administration of medications to relieve certain symptoms — only strictly according to the instructions
  • timely treatment of gastrointestinal ailments




In addition, it is advisable to undergo a full medical examination every year.