Can reflux esophagitis be cured? What treatments are commonly used?

Reflux esophagitis is a common gastrointestinal disease, which is mainly caused by the reflux of substances from the stomach and duodenum into the esophagus, leading to esophageal inflammation. Treating reflux esophagitis takes a lot of time and requires attention to conditioning methods. Common treatments include internal medicine treatment and promoting the emptying of the esophagus and stomach.

1. Medical treatment

The goals of medical treatment are to relieve reflux and reduce the irritation and erosion of gastric secretions. Generally, asymptomatic sliding hernias do not require treatment. Medical treatment can be performed for patients with mild symptoms of reflux esophagitis or due to age, comorbidities, or unwillingness to undergo surgery. For obese patients, weight loss can reduce intra-abdominal pressure and reflux. Avoid lifting heavy objects, bending over, etc., and do not wear tight clothes. Raising the head of the bed by 15 cm when sleeping, not eating 6 hours before going to bed, and avoiding smoking and drinking can all reduce the onset of esophageal reflux.

In terms of drug treatment, antacids can be used to neutralize gastric acid and reduce the activity of pepsin. Gastrokinetic drugs such as domperidone (Metoclopramide) and itopride can be used to prolong gastric emptying. H2 receptor antagonists or proton pump inhibitors can reduce gastric acid and protease secretion. The combined use of acid-suppressing drugs and prokinetic drugs can improve the therapeutic effect for some patients.

2. Promote the emptying of the esophagus and stomach

(1) Dopamine antagonists: This type of drug can promote the emptying of the esophagus and stomach and increase the tension of the LES. These drugs include metoclopramide (Metoclopramide) and domperidone (Motilium), which are taken at bedtime and before meals. The former can cause extrapyramidal neurological symptoms if taken in excessive doses or for long periods of time, so it should be used with caution in elderly patients; the latter can also cause hyperprolactinemia and produce adverse reactions such as breast hyperplasia, lactation and amenorrhea if taken for long periods of time.

(2) Cisapride can release acetylcholine through the postganglionic nerves of the intestinal plexus, thereby promoting the peristalsis and emptying of the esophagus and stomach, thereby alleviating gastroesophageal reflux.

(3) The cholinergic drug uracil can increase the tension of the LES, promote esophageal contraction, and accelerate the emptying of acidic food in the esophagus to improve symptoms. This medicine can stimulate gastric acid secretion, so long-term use should be cautious.