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McKesson Clinical Reference Systems: Women's Health Advisor 2002.2
Illustration
Reflux Esophagitis
What is reflux esophagitis?
Reflux esophagitis is inflammation of the lower part of the
esophagus. The esophagus is the tube that connects the
throat and stomach. This problem causes heartburn and pain
in the area below the breastbone.
How does it occur?
Reflux esophagitis is caused by gastroesophageal reflux,
which is when the acid contents of the stomach flow back, or
reflux, into your esophagus, causing heartburn. Your
esophagus may become inflamed if the reflux of acid happens
often.
Reflux esophagitis can occur with:
- obesity
- pregnancy
- hiatal hernia
- recurrent vomiting
- scleroderma
- nasogastric tubes.
What are the symptoms?
Symptoms can appear when you lie down after eating and are
relieved when you sit upright. They include:
- heartburn
- cramping, severe pain, or pressure below the breastbone
- pain
- spitting up at night
- coughing
- shortness of breath
- fluid or vomit inhaled into the lungs.
Heartburn, the most common symptom, usually occurs 30 to
60 minutes after you eat and may be severe. The pain may
spread to your neck, jaw, arms, and back.
How is it diagnosed?
The doctor will review your symptoms and examine you, and
may order the following tests:
- x-ray
- endoscopy (using a viewing scope to look in the
esophagus)
- esophageal manometry (a test to measure pressure in the
esophagus).
How is it treated?
The doctor may prescribe:
- antacids to take after meals and at bedtime
- medicine to decrease production of acid in the stomach
- medicine to help food and acid move forward through the
digestive tract.
When your esophagus narrows from repeated inflammation and
scarring, the doctor may:
- dilate your esophagus
- use surgery to restore and anchor the stomach below the
diaphragm
- use bypass surgery to create a new segment of esophagus
from a stomach tube.
Surgery is necessary for less than 25% of those with reflux
esophagitis.
How long will the effects last?
The duration of symptoms and response to treatment varies
from person to person.
How can I take care of myself?
Follow these guidelines:
- Take medications with plenty of liquid. Swallowing
medication dry or without enough liquid can irritate the
esophagus.
- Avoid drinking alcohol and smoking.
- Avoid eating chocolate, peppermint, fatty foods,
citrus foods, caffeine, or tomato products.
- Wear loose-fitting clothes without belts.
- Sleep with the head of your bed elevated at least 4
inches.
- Maintain your proper weight.
- Keep your follow-up appointments with your doctor.
- Let your doctor know if your symptoms get worse.
What can be done to help prevent reflux esophagitis?
Follow these guidelines:
- Avoid stress, especially during meals.
- Eat frequent, small meals.
- Avoid smoking.
- Avoid lying down for at least 3 hours after meals.
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