Symptoms and treatment of biliary reflux gastritis
Pathologies of the digestive system are often found among the population. Diseases associated with reflux are common. What are their features?
Reflux-esophagitis
The disease is chronicinflammation of the esophagus, which arises from the constant ingress of acidic stomach contents into it. Pathology is associated with insufficiency of the lower esophageal sphincter, which normally protects the esophagus from the penetration of gastric juice into it.
Acute biliary reflux-gastritis
This form is characterized by the development of acute inflammation in the mucous membrane as a result of the influence of bile in the composition of the food lump. There are several variants of acute gastritis:
- Catarrhal gastritis, the main manifestationwhich is a slight hyperemia and swelling of the stomach wall. It thickens and becomes covered with a layer of thick mucus. The mucous membrane has pinpoint hemorrhages and small erosions.
- Fibrinous gastritis, in which the wallFormed zones of necrosis of epithelium, infiltrated by fibrinous-purulent exudate. The manifestation of this phenomenon is a thin fibrin film on the surface of the affected sections of the mucous membrane. Superficial gastritis is characterized by the friability of this film, and with deep inflammation it fuses with the epithelium.
- Necrotic gastritis, which in addition to the epithelium affects other layers of the mucosa. Under necrosis is understood the death of cells under the influence of aggressive factors.
- Purulent gastritis is the most severe forminflammation. The process can involve all layers of the stomach, which is a threat to perforation. The manifestation of this variant is the presence of purulent exudate, as well as intensive infiltration of the mucous membrane with leukocytes.
Chronic biliary reflux gastritis
This type is characterized by a combination ofinflammatory and dystrophic phenomena. Regular ingestion of bile and pancreatic enzymes into the stomach leads to the development of chronic inflammation. Also this form can be the outcome of acute gastritis. As a result of alkalinization in the mucosa, the amount of histamine increases, which makes it edematic and hyperemic.
Pathogenesis
Between the stomach, its antrum, andthe duodenum has a sphincter, which was called "pylorus". The work of this muscle is aimed at moving the chyme (food lump) from the stomach into the intestine for further digestion and subsequent absorption of nutrients. Disruption of the sphincter can lead to the development of biliary reflux gastritis, the treatment of which requires a combination of medications and proper nutrition. To this disease leads untimely opening of the sphincter, resulting in a lump of food, which joins the bile, produced by the liver, returns back to the stomach. The composition of bile has a detrimental effect on the state of its mucous membrane. It contains salts, acids and enzymes, which are attributed to the factors of aggression.
Etiology
The causes of biliary reflux gastritisare associated with a disruption of the normal functioning of the sphincter - the gatekeeper. This can lead to any surgical intervention, which affects the motility of the gastrointestinal tract. Also among the etiological factors can be identified such diseases as hepatitis, cholecystitis and chronic duodenitis. Weak muscle sphincter and increased pressure in the intestines are often the causes of gastritis, and lead to this can a number of pathologies of the gastrointestinal tract. Important role of predisposing factors. For example, constant stresses reduce the protective properties of the mucosa, and it is weaker than the action of irritating factors. The same applies to non-steroidal anti-inflammatory drugs, which increases the risk of developing gastritis several times. These drugs affect the synthesis of prostaglandins, and they perform an important function - stimulating the formation of mucus goblet cells, which increases the protective properties of the mucosa. Anti-inflammatory drugs block the enzyme cyclooxygenase, resulting in a reduction in the amount of prostaglandins, and consequently, the amount of mucus.
The formation of reflux-esophagitis is caused by ascites,as a result of which the pressure in the abdominal cavity increases, the narrowing of the pyloroduodenal opening. Additional factors can be malnutrition, tight clothing, drugs, stress and tobacco smoking. This phenomenon can occur during pregnancy, then it is not associated with pathology.
Biliary reflux gastritis and reflux esophagitis: symptoms
The main symptoms of reflux esophagitis areheartburn and acidic eructations, which usually occur after eating, as well as when tilted forward. Addition to this is discomfort in the epigastric region.
A more saturated clinic differs biliaryreflux-gastritis. Symptoms of this disease include pain syndrome and other disorders. Often patients are concerned about the feeling of bursting and swelling of the abdomen, as well as the severity of the epigastric region. Pains usually appear on an empty stomach, and their intensity can be different - from strong sharp to aching. Often there is vomiting.
Diagnostics
Diagnosis of biliary reflux gastritisis carried out after carrying out of special researches and anamnesis. One complaint for this is not enough, they only help to predict the development of the disease. First of all, the patient is sent for the surrender of stool, in which specialists reveal latent blood. It is also obligatory to conduct the FGDs, which will help visually assess the condition of the mucosa, detect pathologically altered foci. Increased pressure in the duodenum can be detected by manometry.
Reflux-esophagitis is diagnosed primarilyX-ray method with the use of contrast medium. This method allows you to track the moment of casting the contents of the stomach into the esophagus. It is also recommended to carry out an endoscopy study that will assess the condition of the mucosa and take biological material for further study.
Treatment
Biliary reflux gastritis and reflux esophagitisrequire immediate treatment. This will help improve the patient's condition and avoid possible complications. If an esophagitis is found, it is necessary to abandon bad habits, as well as intense physical exertion on the abdominal area.
Medication therapy is based onthe appointment of antacid drugs that will reduce the corrosive effect of gastric juice on the mucosa of the esophagus. Among them, one can distinguish "Almagel", "Maalox", applied by the course. They envelop the walls of the stomach and reduce acidity.
In addition, it is recommended to use drugs,which reduce the secretion of gastric juice ("omeprazole"). Prokinetics can improve the tone of the sphincter, which is a protection against the casting of acidic contents. Among such preparations it is possible to allocate "Motilium" and "Motilak". If conservative therapy does not work, surgery may be required, which is done using endoscopic equipment.
How is the therapy of such a disease,as a biliary reflux-gastritis? Symptoms and treatment of this pathology are inextricably linked. Patients require a complex of pharmacological and non-medicamentous measures that will improve the condition, relieve the clinical manifestations. First of all, it is necessary to normalize the way of life - rejection of bad habits, proper nutrition. Among drug medications, histamine receptor blockers are usually prescribed, which will reduce secretion. Not to do without gastroprotectors - they will accelerate the healing of lesions of the mucous membrane. In addition, it is necessary to bind bile acids, which is produced with ursodeoxycholic acid. Prevent the casting of chyme in the stomach will help drugs such as Domperidone and Metoclopramide.
Prevention
Prevent the formation of biliaryreflux gastritis and esophagitis will help correct nutrition and timely diagnosis of pathological processes. It is recommended to conduct regular endoscopic examinations for the purpose of prevention, which will help to identify the disease at an early stage. This will increase the effectiveness of conservative therapy, avoiding surgical interventions and the occurrence of severe complications.
In addition, the protective properties should be increasedmucous membrane. To do this, it is recommended to abandon bad habits (or reduce them to a minimum), try to eat healthy foods and avoid stressful situations.
Also a predisposing factor is frequenttaking non-steroidal anti-inflammatory drugs that reduce mucus in the stomach, as a result of which the mucosa becomes vulnerable. An important role is played by prevention and timely treatment of concomitant diseases.
The problem of biliaryreflux gastritis and esophagitis is topical, as these pathologies can not only worsen the patient's condition, but also cause complications. Timely diagnosis will allow you to start treatment on time.
