Prolapse of the gastric mucosa into the esophagus is a fairly common disease, especially among patients over 50 years of age. They regularly begin to suffer from such dangerous and unpleasant symptoms as belching, nausea after eating, heartburn. These pathological manifestations in official medical terminology are called gastroesophageal reflux. In fact, this is the reverse reflux of food into the esophagus from the stomach. In this article, we will talk about the causes, symptoms, treatment and consequences of this disease.
Features of the disease
One of the most common mistakes in the occurrence of prolapse of the gastric mucosa into the esophagus is that patients try to fight the disease on their own. Moreover, as a rule, they try to eliminate only the symptoms themselves, without thinking about what could be the cause.this pathology. In reality, the same gastroesophageal reflux, which is also called hiatal hernia, brings them suffering. To realize the danger and insidiousness of this disease, let's get to know it better.
In fact, prolapse of the gastric mucosa into the esophagus is a protrusion or prolapse into the esophagus of part of the stomach, which occurs through the diaphragm. This pathology can be of two types - paraesophageal and sliding.
The paraesophageal view is characterized by displacement of only part of the stomach to the thoracic esophagus. But with a sliding prolapse of the gastric mucosa into the esophagus, which is diagnosed in most cases, the entire digestive organ freely begins to pass through the esophageal opening in one direction and the other.
Reasons
Surprisingly, the exact cause of this pathological condition has not yet been established. Some medical professionals believe that in some patients it develops as a result of a weakening of the diaphragmatic muscle tissue, which occurs due to some kind of damage to the internal organs.
Also, the prolapse of the gastric mucosa is promoted by a sharp increase in intra-abdominal pressure, which begins to strongly put pressure on the muscles located around the stomach. This condition is most often triggered by excessive physical activity, heavy lifting, breakthrough and prolonged vomiting, regular constipation, severe coughing, even pregnancy.
It is worth noting that there are factors that increase the likelihood of a patient developing mucosal prolapsestomach into the lumen of the esophagus. They contribute to a general weakening of the muscles of the diaphragm, their loss of elasticity, which ends with the development of this pathological condition. In most cases, this process is affected by abdominal ascites, frequent and prolonged smoking, obesity, aging of the whole organism.
People who fall into one, and especially several risk groups, are advised to be as attentive as possible to their state of he alth, and if the first signs of gastroesophageal reflux occur, which most often indicates an approaching prolapse, undergo a full diagnostic examination in order to timely establish the causes of these symptoms.
Symptoms
One of the main dangers of this disease is that it is not always possible to independently understand that prolapse has begun to develop. In most cases, the classic symptoms in a person may simply be absent. Pathology of the sphincter, which occurs between the esophagus and the stomach, is often discovered by chance during a routine or preventive examination of the gastrointestinal tract.
However, the disease is often accompanied by obvious symptoms, and there are very severe clinical manifestations that clearly indicate this disease. Gastroenterologists note which symptoms of prolapse of the gastric mucosa into the esophagus should be paid attention first of all:
- Sharp pain behind the sternum cutting or stabbingcharacter that occurs spontaneously during meals or during physical exertion. It is provoked by the fact that there is a protrusion of the folds of the gastric mucosa. Characteristically, the pain disappears as suddenly as it appeared.
- At the peak of pain, there is a feeling of severe nausea, vomiting may appear, in which the food just eaten will be present.
- Heartburn worsens when bending over and lying down.
- There are problems with the swallowing reflex.
- Against the background of prolapse of reflux disease, the patient develops extremely unpleasant and dangerous signs, for example, spitting up food. This leaves the mouth feeling sour and bitter.
Be attentive to any unpleasant painful symptoms. When they appear, seek medical attention immediately. This disease is very insidious, since pain behind the sternum is easily confused with an attack of angina pectoris or a heart rhythm disorder. In such a situation, only electrocardiography will help to make a diagnosis.
Treatment methods
Note that in most cases, specialized treatment of prolapse of the gastric mucosa into the esophagus is not required. The list of certain therapeutic measures is determined by the presence of a specific list of symptoms in the patient. With the regular occurrence of acid reflux and persistent heartburn, medication is prescribed. It is based on taking drugs that block secretions and neutralize the acid ingastric juice. In fact, they are designed to eliminate the symptoms of heartburn.
In the treatment of prolapse of the gastric mucosa, surgical intervention is required only in cases where conservative therapy does not bring any results. However, he admits that in the vast majority of cases, resorting to extreme measures is not necessary.
Sometimes it is advisable to treat excessive elasticity of the fold of the mucosa of the main digestive organ, as well as a decrease in the strength of the diaphragm. This approach is considered reasonable only if the patient is experiencing severe discomfort.
The list of therapeutic measures in this case is based on taking certain medications. These are proton pump inhibitors ("Rabeprazole"), antispasmodics ("Drotaverine"), antacids ("Phosphalugel"), prokinetics ("Domperidone").
To stop certain discomforts that can cause severe discomfort to the patient, as a rule, it is enough to apply one of the means. To completely get rid of this pathology, a surgical operation is required. Only thanks to her, the patient will be able to restore the originally existing anatomical position of the organs. However, the operation is not always considered appropriate, it is performed only in the absence of a response to drug treatment, and also when the hernia sac grows too large.
Retrograde prolapse
Let's stopin more detail on the varieties of the disease under study, which may occur at the present time. With retrograde prolapse of the gastric mucosa into the esophagus, the cardial part of the stomach passes into the abdominal segment. In this case, a scalloped formation may appear, but it will not be in the stomach itself, but in its vestibule.
A layer of contrast agent is formed between the prolapsed mucous membrane and the walls of the esophagus, which in the picture resembles a narrow ring in appearance. If at this time the esophagus is introduced into the cardial part of the stomach, its corolla becomes as clear as possible on the pictures.
Typical for retrograde gastric mucosal prolapse is x-ray variability. Note that such changes should not be confused with a hernia in the esophageal opening of the diaphragm.
Hernia
One of the common causes of this pathological condition is hiatal hernia. This condition is commonly referred to as a short internal esophagus. This is thought to be an abnormal development of the lining of the esophagus. At the same time, a gag reflex is often taken for a similar pathology in patients. According to most experts, this picture indicates an abnormal development of the submucosal layer.
To make a correct diagnosis, it is necessary to obtain a visualization of the hernial cavity. In some cases, deep breathing and additional inflation of the hernial cavity, which will cause the diaphragm to move, may be useful.
On this basis, we can conclude that for the diagnosis of a herniaesophageal opening requires a combination of several functional and anatomical features. This is the presence of a hernial cavity, a reduction in the distance from the cardia to the anterior incisors, transcardial prolapse of the gastric mucosa (all gastroenterologists have to know what this is). In such cases, dramatic changes occur that indicate a serious problem.
At medical examination
This pathological condition is often caused by serious he alth and well-being problems. In these cases, young people of military age have a reasonable question - will they be taken into the army with prolapse of the gastric mucosa into the esophagus.
As practice shows, this disease is not a sufficient reason for exemption from military service. However, in some cases, this ends in trouble. For example, a young man with this diagnosis is called up for service, and after a few weeks he has an ulcer. In this case, it has to be urgently commissioned.
Complications
It is important to start treatment of prolapse of the gastric mucosa in time. Only in this case you will be able to avoid the dangerous and unpleasant consequences of this disease.
One of the most dangerous and unpleasant complications in this situation is reflux esophagitis, that is, the reflux of acidic gastric contents into the esophagus. He poses an increased danger.
Most of the remaining complications are associated with the effects of acid, as well as other aggressive components on the wallsesophagus. If this pathology is not treated, inflammatory processes in the stomach and esophagus, bleeding, ulcers, erosion, changes in the structure of the esophageal mucosa, and anemia begin to develop.
Proper nutrition
To successfully fight this disease, an important component will be proper and balanced nutrition. Its main purpose is to prevent excess production of gastric juice and reduce acidity. Also, the diet will help prevent constipation and flatulence, which significantly increase intra-abdominal pressure.
With the indicated pathology, nutrition must be necessarily fractional. Food should be taken in small portions, chewed thoroughly. This will eliminate excess pressure on the lower esophageal sphincter and diaphragm.
Foods that provoke gas formation must be excluded from the diet. These are cabbage, legumes, mushrooms, milk, carbonated drinks, fresh bread, sweet pastries. You should also avoid fried, fatty, sour, s alty and smoked foods. Please note that hot and spicy spices can greatly irritate the esophagus and stomach lining.
As a prevention of these complications, it is recommended to strictly follow the list of simple rules that will protect you from this pathology. Here's what to start doing:
- fight constipation and excess weight;
- give up alcohol and cigarettes;
- avoid hard physical work, especially those that involve forward bending and liftingweights;
- do not eat in a horizontal position and before going to bed;
- don't sleep on your left side;
- do not be in an inclined position for a long time;
- do not wear tight clothes and tight belts.
Physical activity
Medium physical activity is of great benefit in prolapse of the gastric mucosa into the esophagus, especially if the patient is at risk and is likely to develop such a disease.
Therapeutic exercise helps many to prevent the formation of prolapse. It helps to normalize the work of the stomach, improve metabolism, strengthen the lower esophageal sphincter and diaphragm. The main thing is that the load is distributed moderately. Exercise should be performed when at least two hours have passed after eating.
The simplest, but at the same time effective way to strengthen the abdominal muscles and reduce intra-abdominal pressure is breathing exercises. Exercises should be performed in a sitting or standing position. While inhaling, stick out your stomach, fix in this position for two to three seconds, then slowly exhale and relax the whole body. To get the effect of the exercise, you should do it for several months, three to four times a day.
