What is reflux esophagitis?

 It is a disease that causes heartburn due to regurgitation of gastric fluid and food in the middle of digestion in the esophagus.

Unlike the stomach, the esophagus cannot protect the mucous membranes from strongly acidic gastric fluid, so regurgitated gastric fluid causes inflammation of the esophagus. In most cases, the mucous membrane is sore and ulcers are lost, but there are also non-erosive gastroesophageal reflux diseases that do not cause erosions or ulcers even if there are symptoms of reflux.

Reflux esophagitis is also characterized by a variety of symptoms. Typical symptoms are heartburn and acid reflux (donsan). Acid reflux may cause vomiting due to the rise of sour substances during belching. In addition, you may experience "throat discomfort," "feeling stuffy when eating," "voice swelling," "tightening chest pain," and even "coughing and asthma."


Causes of reflux esophagitis

Causes of reflux esophagitis


At the cardia, which is the joint between the esophagus and stomach, there is a muscle called the lower esophageal sphincter, which closes the esophagus and prevents gastric juice from flowing back except when swallowing food. .. In reflux esophagitis, the function of the lower esophageal sphincter is impaired and this mechanism does not work well, causing gastric fluid to regurgitate and causing inflammation of the esophagus.


In addition, reduced esophageal peristalsis (sending what comes in through the mouth to the anus) prevents the stomach contents from quickly returning to the stomach when it regurgitates, causing inflammation of the esophagus.


Other causes of reflux esophagitis include a diet high in fat and protein, overeating, aging, obesity, and poor posture, which can also be a side effect of the drug.


A diet high in fat and protein

A high-fat diet increases gastric acid secretion, which makes it more susceptible to reflux esophagitis. Protein takes a long time to digest, so if you take too much protein, acid reflux is likely to occur.


Overeating

It is believed that when a large amount of food enters the stomach, it stretches down, which loosens the lower esophageal sphincter between the stomach and esophagus, which causes regurgitation.


Aging

As we get older, our muscles weaken, but since the lower esophageal sphincter is also a muscle, its strength weakens. At the same time, the peristaltic movement also weakens, so the effect also comes out. In addition, the amount of saliva is reduced, so older people are at increased risk of reflux esophagitis.


Obesity and poor posture

Abdominal pressure is also a major cause of reflux esophagitis. If you are obese or lean forward, your abdomen will be compressed and your abdominal pressure will increase. This makes it easier for gastric fluid to regurgitate.

Clothing that tightens the abdomen, such as belts and girdles, is also a risk factor for reflux esophagitis.


Side effects of the drug

Medications taken for asthma, blood pressure control, heart disease, etc. may have side effects that loosen the lower esophageal sphincter, which causes reflux esophagitis. In addition, symptoms of reflux esophagitis may occur while receiving eradication treatment for Helicobacter pylori, but most of these are mild and temporary.


How to treat reflux esophagitis

Reflux esophagitis is becoming an easy-to-cure disease due to the advent of highly effective drugs. However, since reflux esophagitis tends to recur, it is essential to improve lifestyle habits at the same time as drug therapy in treatment. Surgery may also be considered in severe cases or when lifestyle-related changes and medications do not work as expected.


However, angina and esophageal cancer are some of the diseases that cause symptoms similar to reflux esophagitis, so it is very important to determine if these diseases are hidden. Endoscopy is essential to accurately distinguish between reflux esophagitis and esophageal cancer, especially for lesions such as erosions and ulcers of the esophageal mucosa.


After asking about the symptoms in a medical interview, a gastroscopy (gastric camera / upper gastrointestinal endoscopy) will be performed. There are two types of endoscopes, one is an oral examination that is inserted through the mouth and the other is a nasal examination that is inserted through the nose. You can also choose to use a sedative, so you can take it without any pain.


Gastroscopy allows you to directly observe the mucous membrane of the esophagus. If you have erosions or ulcers, check their color and size in detail. If the lesion may be due to another disease, such as cancer, the tissue at the lesion is collected and biopsied on the spot to confirm.


Erosion and ulcer of the esophageal mucosa due to reflux esophagitis may be difficult to distinguish from lesions of esophageal cancer. I recommend that. In addition, treatment of reflux esophagitis also helps prevent complications such as Barrett's esophagus and esophageal cancer, where the esophageal mucosa degenerates into the gastric mucosa.


In addition, in the case of "non-diffuse gastroesophageal reflux disease" that does not cause rash or ulcer, or if gastroscopy cannot be performed due to reasons such as old age, receive drug therapy for reflux esophagitis for about 2 weeks. In some cases, treatment is performed while observing changes in symptoms.


Click here for gastroscopy


Drug therapy

We mainly use medicines that suppress the secretion of gastric acid, medicines for protecting the esophageal mucosa, and medicines that neutralize gastric acid.


PPI Suppresses the action of the proton pump that secretes gastric acid and reduces the amount of gastric acid secreted. It may also be used to prevent recurrence.

H2 blocker A drug that suppresses the secretion of gastric acid. Some over-the-counter drugs use the same ingredients, but doctor-prescribed H2 blockers have different contents and effects.

Gastrointestinal motility improver Gastrointestinal motility improver includes gasmotin and nauseline. It improves gastrointestinal function and peristalsis, aids in the digestion of food, and shortens gastric retention time. It also has the effect of reducing the occurrence of gastric fluid and food reflux.

Antacids Neutralize stomach acid to relieve symptoms and reduce inflammation. Due to its short duration of effect, it is used in combination with other drugs.

Mucosal protective drug A drug that protects the mucous membrane of the esophagus and helps improve inflammation. Due to its short duration of effect, it is used in combination with other drugs.

Lifestyle improvement

By paying attention to improving your eating habits, eliminating obesity, and taking a posture that does not apply abdominal pressure, you can not only relieve symptoms but also prevent recurrence.


Eating habits Avoid eating too much fat and protein. Also, do not go to bed immediately after eating, and wait 2-3 hours after eating before going to sleep.

Avoid foods that increase stomach acid and foods that make the symptoms worse, such as:

Spices such as chili peppers, strong acidity, sweets, indigestible

Tobacco is a factor that exacerbates reflux esophagitis, so it is important to quit smoking.

Alcohol stimulates gastric acid secretion and loosens the lower esophageal sphincter, which prevents reflux from the stomach to the esophagus. Please refrain as much as possible.

Caffeine promotes gastric acid secretion, so reduce coffee and green tea.

Abdominal pressure Obesity increases abdominal pressure, so get rid of it by habituating light exercise such as walking.

Tightening clothing and stoops increase abdominal pressure, so avoid clothing that tightens your abdomen and try to keep your posture correct. Also, if you sleep with your upper body slightly raised when you sleep, regurgitation is less likely to occur.

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