What are the symptoms of reflux esophagitis?

Reflux esophagitis actually poses a great threat to the patient's life and health, because reflux esophagitis not only affects the patient's absorption of food, but also causes extreme gastrointestinal discomfort. The more obvious symptoms of reflux esophagitis are upper abdominal pain, indigestion, chest pain, etc. Patients must pay considerable attention to this disease and never ignore it.

Pathogenesis

The pathophysiological basis of reflux esophagitis is esophageal and gastric motility disorder, including esophageal body motility disorder, LES function and gastric motility disorder. In addition to anatomical abnormalities (such as hiatal hernia), the causes of these dysfunctions include certain diseases (such as diabetes), drugs (such as smooth muscle relaxants) and foods (such as high-fat foods, chocolate, coffee) that may lead to LES dysfunction and cause reflux.

Clinical manifestations

Reflux esophagitis Patients with reflux esophagitis have typical symptoms of gastroesophageal reflux, but may not have any reflux symptoms and only show symptoms of indigestion such as upper abdominal pain and discomfort. There was no correlation between the severity of esophagitis and reflux symptoms. The clinical manifestations of patients with severe esophagitis are not necessarily serious.

Classic reflux syndrome refers to heartburn, regurgitation, and chest pain caused by reflux. Heartburn refers to a burning sensation behind the sternum radiating to the neck, and regurgitation refers to the reflux of gastric contents into the pharynx or mouth. Reflux symptoms often occur after a full meal, and nocturnal reflux seriously affects the patient's sleep.

1. General treatment

It is advisable to eat small meals frequently and not overeat; avoid smoking, alcohol, coffee, chocolate, acidic foods and excessive fat; avoid lying down immediately after a meal; when lying down, raise the head of the bed by 20 to 30 cm, and do not tie the belt too tightly to avoid various conditions that cause excessive abdominal pressure.

2. Promote the emptying of the esophagus and stomach

1. Dopamine antagonists: This type of drug can promote the emptying of the esophagus and anus and increase the tension of the LES. This type of drug includes metclopramide (Metoclopramide) and domperidone (Doperidone), both of which are 10-20 mg, taken 3-4 times a day before bedtime and before meals. The former, if taken in excessive doses or for long periods of time, can cause extrapyramidal neurological symptoms, so it should be used with caution in elderly patients; the latter, if taken for a long time, can also cause hyperprolactinemia, resulting in adverse reactions such as breast hyperplasia, lactation and amenorrhea.

2. Cisapride: Cisapride can release acetylcholine through the postganglionic nerves of the intestinal plexus to promote the peristalsis and emptying of the esophagus and stomach, thereby reducing gastroesophageal reflux. 10-20 mg per day for 3-4 days, with almost no adverse reactions

3. Bethanechol can increase the tension of LES, promote esophageal contraction, and accelerate the emptying of acidic food in the esophagus to improve symptoms. Take 25 mg each time, 3 to 4 times a day. This medicine can stimulate gastric acid secretion, so long-term use should be cautious.