Esophogus is a pathway that delivers food from the mouth to the stomach. The length of esophogus is about 25cm in adults, it consists of 3 muscle layers and has 4 constrictions. The lowest of these four constrictions is called the diaphragmatic constriction. The diaphragmatic constriction is the part of the esophogus that connects directly to the stomach, which is the lower esophogus sphincter.
The lower esophogus sphincter acts as a fastener that prevents food that has been lowered once back into the esophogus. However, there are cases where the lower esophogus sphincter is not well tightened. Drugs such as calcium antagonists and anticholinergic drugs, oily foods, and coffee reduce the pressure on the lower esophogus sphincter. At this time, gastric juice such as stomach acid or pepsin and other contents in the stomach pass back to the esophogus. At this time, the contents of the stomach irritate the mucous membrane of esophogus, causing inflammation. In addition, when the contents of the stomach are increased after a meal, pyloric stenosis, gastric congestion syndrome, excessive gastric acid secretion, etc., and when gastric pressure increases due to obesity, pregnancy, ascites, etc., the contents of the stomach can flow back to esophogus and cause esophogus infection. If reflux esophagitis is severe, it may cause ulcers and bleeding on the mucous membrane of esophogus. In this case, reflux esophagitis is classified as ulcerative. In addition, the case of reflux esophagitis caused by reflux of bile is divided into bile type, and the case of reflux of intestinal fluid is divided into alkaline.
A typical symptom of reflux esophagitis is a hot or sore heartburn behind the sternum of the chest. This heartburn symptom occurs when the contents of the stomach, refluxed to esophogus, come into contact with the esophogus mucosa, and appear within about 30 minutes after meals. In addition, dysphagia and dysphagia may also appear.
Test and Diagnosis
If reflux esophagitis continues, erosion, ulcer, etc. may occur, resulting in esophogus stenosis, which narrows esophogus, and esophogus tissue changes, resulting in barretts esophogus. If Barrett esophogus appears, it may gradually progress to esophogus cancer, so a gastroscopy should be performed once a year.
Reflux esophagitis is diagnosed with upper gastrointestinal contrast examination, esophogus endoscopy, esophogus internal pressure test, and 24-hour ambulatory acidity test. Among these, 24-hour ambulatory acidity test can detect reflux of stomach contents to esophogus. It is the most accurate test method available.
Treatment and Prevention
Reflux esophagitis is treated with drugs such as proton pump inhibitors (PPI). If reflux esophagitis progresses and esophogus stenosis is present, surgery such as esophogus dilatation should be performed. Reflux esophagitis can recur, so it’s a good idea to adjust your lifestyle. Avoid overeating and avoid soda, fatty foods, coffee, chocolate, alcohol, and tobacco. Also, you should change the habit of lying down or squatting right after eating.
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