Esophagitis is an inflammatory disease, the main pathological processes occur in the walls of the esophagus. The disease can be both chronic and acute.
Mainly, esophagitis affects the mucous membrane of the esophagus. This disease is the most frequent among all pathologies of the esophagus. In about 30% of cases, esophagitis occurs without vivid clinical symptoms and is detected during examination for other gastroenterological diseases.
When the disease is not treated, esophagitis progresses, affecting deeper and deeper layers of the walls of the esophagus, which may indicate the development of more serious complications.
In some cases, esophagitis develops not as an independent pathology, but as an aggravation of the main, more important disease, for example, as a result of damage to the gastrointestinal tract by infectious agents, when the contents of the stomach are thrown into the esophagus. The latter aspect takes place in such pathology as gastroesophageal reflux.
CLASSIFICATION OF ESOPHAGITIS
Like any gastroenterological disease, esophagitis has several classifications, which are formed according to different principles and properties.
The first classification is formed by the duration of the course of pathological processes:
Chronic esophagitis – the duration of the inflammatory process is more than 3 months. Symptoms have a wave-like course, periodically subsiding or worsening.
Subacute esophagitis – the duration of the inflammatory process is up to 3 months.
Acute esophagitis.
By the nature and type of pathology , the following types of esophagitis are distinguished:
The easiest is catarrhal.
Edematous. Inflammation is more pronounced than with catarrhal, but destruction of the mucous layer does not occur. The surface of the esophagus is hyperemic, edematous.
With the formation of erosions. Pseudomembranous most often occurs as a result of infection, as well as under the influence of aggressive chemicals (including stomach contents)
.
Necrotic. With the development of severe forms of infectious diseases, inflammation spreads to the underlying layers with the development of necrosis.
Phlegmonous is one of the most severe types of esophagitis.
Ecfoliative.
SYMPTOMS OF ESOPHAGITIS
The presence and nature of clinical symptoms are directly proportional to the severity and degree of lesion of the esophageal mucosa.
Thus, mild forms of esophagitis, namely catarrhal and edematous, can occur without pronounced clinical symptoms, only occasionally manifested by increased sensitivity to different temperatures of food consumed.
More severe and serious forms of esophagitis are manifested by appropriate symptoms – patients complain of intense pain behind the sternum of a burning nature, which can give to other organs and parts of the body – neck, back, shoulder blades. Sometimes such symptoms can be confused with an attack of angina pectoris – in this case, differential diagnosis of diseases of the cardiovascular system is necessary.
Also, the patient experiences the following symptoms:
Burning sensation, heartburn.
Increased salivation.
Swallowing disorder.
Difficulties with eating.
In rare (usually extreme) cases, there may be a single vomiting with an admixture of blood.
Chronic esophagitis is not so pronounced in its symptoms. The most common symptom is a burning sensation behind the sternum of moderate intensity. Errors in nutrition – the use of excessively sharp, hot or cold food provoke an increase in symptoms, the appearance of pain in the xiphoid process, behind the sternum.
DIAGNOSIS OF ESOPHAGITIS
Acute esophagitis has a typical clinical picture, so diagnosis is not difficult. The diagnosis is confirmed by the results of gastroenterological examination – esophagoscopy. In some cases, it is necessary to take the material for histology.
An additional method is radiography – this way you can determine structural changes in the wall of the esophagus, edema, the presence of ulcers.
TREATMENT OF ESOPHAGITIS
All acute esophagitis, especially those of a chemical nature, are primarily subject to gastric lavage to eliminate the effects of chemicals. Mild forms of esophagitis are effectively treated according to the following scheme:
For the first few days after the exacerbation, it is advisable to refrain from eating.
Antacids are prescribed, if necessary with an anesthetic.
After the symptoms subside, a diet is prescribed that excludes coarse, hot and cold food, as well as spicy. The diet is aimed at reducing the synthesis of gastric juice – chocolate and high-fat products are excluded.
In severe esophagitis, infusion therapy is mandatory with the use of detoxification drugs, astringents, nutrition is carried out enterally. In extremely severe cases, surgical intervention is required.
