Diseases of the gastrointestinal tract in the modern world are gradually becoming the most common. And this is not surprising - fast food, snacks on the go are popular, junk food is sold in supermarkets. Diseases such as gastritis or ulcers are well known today. But the symptoms of reflux esophagitis are no less common. According to statistics, millions of people in Russia suffer from it.
This is the name of the release of bile into the oral cavity, esophagus, stomach. The disease progresses quite quickly and leads to dangerous complications if it is not treated on time. Therefore, it is necessary to know the symptoms of this disease, its causes, the method of therapy.
Movement of bile in the body
The release of bile into the oral cavity is a physiologically abnormal phenomenon. But why is this happening?
Bile is produced by the liver. Then it rises to the gallbladder with the help of the sphincter of this organ due to the contraction of the bile ducts. Accordingly, bile accumulates in this bladder. As soon as a person begins to eat, it enters the stomach through the sphincter of Oddi. In the stomach, juices, bile,the digestion process begins.
But as a result of certain factors, the sphincter of Oddi relaxes. They can occur the following: removal of the gallbladder, impaired liver function, biliary dyskinesia. As a result, the discharge of bile into the stomach is no longer dependent on impulses emanating from the brain. The sphincter begins to contract voluntarily. Then there is the release of bile into the stomach and further into the esophagus, oral cavity. Injuring the mucous membranes of these organs, not intended for contact with bile.
What is reflux?
The release of bile into the oral cavity is a pathological condition. But reflux itself is not. This is the name of the processes of moving the contents of one hollow organ to another, but in the opposite direction to the normal physiological one. Hence, reflux can be observed not only in the digestive system, but also, for example, in the genitourinary system.
However, most often people experience symptoms of gastroesophageal reflux. What does it mean? The contents of the stomach are thrown back into the esophagus, and then into the oral cavity. With the normal functioning of the body, this should not happen: food passes on the way back - from the oral cavity through the esophagus to the stomach.
To prevent gastroesophageal reflux, our body has a special organ - the lower esophageal sphincter. It shrinks after food passes into the stomach and does not let it back.
Pathological and non-pathological reflux
Reflux will notpathological, if some part of the contents of the stomach back into the esophagus. Here it is called belching. A person may encounter this phenomenon, for example, after a hearty meal. But if the release of bile or stomach contents into the oral cavity occurs regularly, this is a reason to be wary.
Delicate mucous membranes of the esophagus and oral cavity are damaged by contact with bile, gastric juice. Systemically recurring reflux causes inflammatory processes in them. Such a syndrome, in which there is damage to the esophagus by regular reflux of the contents of the stomach, duodenum into it, is called reflux esophagitis. Or GERD - gastroesophageal reflux disease, when bile, gastric juices cause ulcerative, erosive damage to the mucous membranes, the development of their inflammation.
Calling this disease just reflux is wrong. After all, it can be non-pathological - in the form of a rare eructation. According to statistics, GERD affects adults more often. Moreover, men suffer from reflux esophagitis more often than women, 2 times.
If treatment is not started on time, then as a result of such an aggressive effect on the esophagus, its functional epithelium begins to be replaced by a cylindrical analogue. The patient is diagnosed with Barrett's esophagus. And this is already a dangerous precancerous condition.
Why is it harmful?
The release of bile into the oral cavity at night or during the day is a physiologically abnormal phenomenon. After all, the mouth, esophagus are intended only for eating, and not the contents of the 12 duodenum or stomach.
Exception hereare only gagging. By their nature, they are not reflux. This is an emergency measure when the stomach needs to be cleansed of toxic contents. Thus, it saves the entire body, preventing the intestines from absorbing harmful substances from this mass into the bloodstream.
Hydrochloric acid, bile, pancreatic secretions are aggressive in nature. They need to break down food. Accordingly, only the mucous membranes of certain organs of the gastrointestinal tract can withstand their impact. In order not to damage other tissues of the body, the lower digestive sphincter works. It does not allow the contents of the stomach to rise back. But for a number of reasons, it cannot always perform its functions.
Non-pathological causes
As gastroenterologists who give advice to patients say, reflux of bile into the stomach is not always pathological. Consider the most common causes of this process that do not require treatment:
- Violation of the usual diet. Eating a large number of foods that stimulate increased bile secretion - fatty or smoked foods, strong tea or coffee.
- Abuse of highly carbonated drinks.
- A side effect of certain medications. In particular, relaxing the lower esophageal sphincter.
- Tobacco addiction.
- Drinking alcohol.
- Severely stressful situation.
- Return to increased physical activity immediately after a heavy snack.
- Beding before bed.
- Pregnancy.
- Accepting the inconvenientpositions in a dream when you pinch the organs of the digestive tract. Therefore, reflux of bile into the esophagus often occurs at night.
Pathological causes
What to do with the release of bile into the oral cavity? If you suffer from this systematically, then you need to urgently contact a gastroenterologist. After all, this phenomenon causes quite serious pathological causes:
- Obesity of the second or third degree.
- Enterocolitis of various origins causing bloating.
- Bile duct dyskinesia.
- Pyloric insufficiency.
- Hernia of the esophageal zone of the diaphragm in the lower esophagus.
- Ascites in case of damage to the respiratory organs or the cardiovascular system.
- Pathological processes affecting the duodenum.
- Diseases of the intestines, stomach, and other organs of the digestive tract. Common causes here are gastritis and peptic ulcers (for example, an ulcer of the small intestine).
- Chronic constipation.
- Obstruction of the duodenum.
- Pathologies of the vagus nerve.
- Benign and malignant tumors.
- Infectious diseases affecting the gastrointestinal tract.
- Chronic pancreatitis or cholecystitis.
- Hereditary predisposition.
Symptoms
Inflammatory processes in the esophagus caused by bile reflux can be recognized by the following characteristic symptoms:
- Heartburn. You get the feeling that behind the sternum, "underspoon "bakes something, burns. An unpleasant sensation rises from the bottom up. Most often appears at night, after a sudden movement.
- Bitterness in the mouth along with a burning sensation in the larynx. Again, the feeling grows after a sharp movement, tilt, when moving the body to a horizontal position from a vertical one and vice versa.
- Gagging after eating. Bitter taste of vomit.
- Severe pain in the diaphragm.
- Hiccups after eating.
Possible Complications
According to the advice of gastroenterologists, when bile is thrown into the stomach, in no case should one wait for an exacerbation of this condition. The disease that caused it will not go away by itself, but will only continue to progress. This is fraught with the following:
- Angina and tachycardia attacks.
- The appearance of adhesions on the walls of the esophagus due to its constant irritation with bile.
- Replacing the normal mucosal lining of an organ with scar tissue.
- All changes in the lining of the esophagus can trigger the development of cancer of both itself and the stomach.
Diagnosis
If you constantly notice bile reflux into your esophagus, you should make an appointment with a general practitioner, a gastroenterologist. To confirm the diagnosis of "reflux esophagitis", the patient is prescribed FGS. On this diagnostic procedure, you can immediately establish the presence of bile in the stomach, take a fragment for examinationmucosal lining of an organ for biopsy.
In some cases, an additional endoscopic examination is prescribed. The following diagnostic procedures may also be needed:
- Echography.
- Ultrasound examination.
- Ultrasonography.
- Stained X-ray.
Treatment directions
In most cases, drug therapy, conservative. The goals of reflux treatment are as follows:
- Protection of the mucous membranes of the esophagus from aggressive influences.
- Neutralization of aggressive components of gastric juice, bile.
- Increase in the speed of passage of a lump of food through the esophagus.
- Increased tone of the pylorus (lower esophageal sphincter).
- Increased activity of the cardiac gastric zone.
Surgical treatment is used only in difficult cases:
- Correction of complex complications causing reflux of bile. For example, a hernia of the esophagus.
- Cases where the disease has reached the last stage. When diagnosing Barrett's esophagus.
Drug therapy
In most cases, the conservative treatment regimen consists of taking the following drugs:
- Proton pump inhibitors. These are drugs such as Omez, Gastrozol, Ranitidine, Pepticum.
- Antacids (protect mucous membranes from damage, reduce the secretion of secretions by the digestive tract). Almagel, Maalox, Gastrofarm.
- Selective drugs that enhance evacuation functions, accelerating the flow of bile. It's Cisapride, Motilium.
- Ursosan, Ursofalk, Ursoliv are used to eliminate bitter belching and normalize bile secretion.
- To save the patient from pain, doctors prescribe well-known antispasmodics (painkillers). These are "Baralgin", "No-shpa", "Spazmalgon". In particular, they are prescribed as injections to reduce the load on the stomach.
Lifestyle recommendations
Non-drug treatment is also shown. First of all, it is aimed at correcting the diet of the patient. He must exclude the following from his menu:
- Spicy food.
- Soda drinks.
- Coffee and cocoa.
- Alcoholic drinks.
- Fatty, fried foods.
- Spices and spices.
- Food too cold or too hot.
- Mushrooms.
- Beans.
- Reducing the consumption of fresh fruits and berries.
On the contrary, it will be useful to increase the number of the following products in your menu:
- Low-fat cottage cheese.
- Crackers.
- Soft-boiled eggs.
- Compotes.
- Low-fat meatballs.
- Dairy products.
- Boiled, stewed food.
There are also dietary recommendations:
- The patient switches to fractional meals - frequent, but in small portions.
- You need to protect yourself from overeating, eating food just before bedtime.
- There must be at least two hours between the last meal and going to bed.
- After eating, do not sit or lie down. It is better to take a leisurely walk, do light household chores.
So that this disease does not return to you, you need to change your lifestyle. Get rid of excess weight, build the correct mode of "rest / wakefulness" (at least 8 hours of sleep per day), reduce the number of stressful situations. Give up heavy physical work, lifting large loads.
Try not to wear tight, tight clothes with belts, corsets. Arrange a place to sleep - the headboard should rise at least a few centimeters above the entire bed. Do not forget and treat diseases that cause reflux esophagitis in a timely manner.
