Ulcer of esophagus peptic

Ulcer of esophagus pepticULCER of ESOPHAGUS PEPTIC - ulcers wall of the lower esophagus due to the proteolytic action flows into the esophagus gastric juice failure of the cardia. In many cases it is combined with hernia hiatal or gastric ulcer and duodenal ulcer. Peptic ulcer of the esophagus in most cases, a single but may be multiple. Etiology, pathogenesis. The focus is a violation of the trophic esophageal wall and a permanent impact on her active gastric juice due to the failure of the cardia and gastro-esophageal reflux. The most often observed when the axial hernia hiatal, after operations on the area of the esophago-gastric junction, in systemic sclerosis. Concominant ulcers motility disorders of the stomach and increase the tone of the gatekeeper (which contributes to the reflux of gastric juice into the esophagus) are also some of the pathological factors of peptic ulcer of the esophagus. The symptoms for. The main symptom is pain behind the breastbone or in the epigastrium, arising or growing during a meal or immediately after it, when swallowing, sometimes in the supine position (due to reflux of gastric juice into the esophagus). Often pain in character reminds coronary. Frequent dysphagia, heartburn, belching, regurgitation of acidic gastric contents. Heartburn and regurgitation are usually worse the torso or lying position. When ray study of peptic ulcer is found in the form of niches on the contour or relief of the mucous membrane, but it is difficult to identify. The most reliable method of diagnosis is endoscopy. The study of feces often finds positive reaction occult blood. Complications: profuse or occult esophageal bleeding, perforation, ulcers, development of stricture of the esophagus at the cicatrization of the ulcer, scar shortening of the esophagus that causes the formation or gradual increase of the existing axial hernia hiatal. The differential diagnosis spend with ulcers of the esophagus different nature: cancer, tuberculosis, sifiliticski, decubital; the focus is esophagoscopy, the study of gastric juice (which should be done carefully); reliably installed achlorhydria rejects peptic nature ulcers. Treatment in the hospital. Prescribe anti-ulcer diet. Recommended position in bed with a raised upper half of the torso (prevention of gastro-esophageal reflux). Assign binding (bismuth nitrate basic 1 g or 0,06% solution of silver nitrate 4-6 times a day 30 minutes before meals; the latter drug is sometimes introduced into the esophagus through the probe drip directly on the area of ulceration) and antacid (magnesium oxide, calcium carbonate, basic, aluminum hydroxide, etc. 0.5 0-1 g 5-6 times a day after meals, Almagel, and so on). Antispasmodic and anticholinergic drugs are used only when there is a companion esophagism, as they reduce the cardiac sphincter tone and can enhance gastro-esophageal reflux. The treatment is usually long (1.5-2 months or more). Surgical treatment is indicated in the absence of effect from conservative treatment, and in the presence of complications of the disease. Patients peptic ulcer of the esophagus need for a dispensary observation and systematic (2-4 times per year) anti-relapse treatment astringent and antacids. In this case, the prognosis is less favourable: maintained a satisfactory state of health and (within limits) the health of the patient. Prevention is the prevention of the formation of a hernia hiatal and to prevent the occurrence of gastro-esophageal reflux diseases involving failure of the cardia: a high headboard bed during sleep and sleeping early dinner (for 2.5-3 hours before bedtime), avoidance of all types of works related to the tilt of the torso..

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