What to do if you have esophageal pain? Beware of inflammation!

The most common cause of esophageal pain is esophagitis. Patients with esophagitis may have difficulty swallowing, and severe cases may cause vomiting, accompanied by blood and reflux symptoms. Esophageal pressure measurement can be performed to confirm the condition. Rough, hard and irritating foods are prohibited.

1. Esophagitis examination method

1. Esophageal pressure measurement: When a normal person is at rest, the lower esophageal sphincter has a certain pressure. The pressure is reduced in patients with gastric and esophageal reflux.

2. Esophageal pH measurement: measure the esophageal pH value and observe its reflux situation. If necessary, a 24-hour esophageal pH monitoring test can be performed to understand the circadian rhythm changes of esophageal pH.

3. Acid instillation test: The acid instillation test is used to stimulate the patient's symptoms as one of the diagnostic methods.

4. Esophageal diet examination: The esophageal motility is weakened, the mucosal walls of the lower esophagus are rough and disorderly, and sometimes small niches and stenosis can be seen.

5. Endoscopic examination and biopsy: Endoscopic and biopsy can be used to determine whether there are pathological changes of reflux esophagitis, whether there is bile reflux, and the severity of the pathology of reflux esophagitis. According to the Savary and Miller grouping criteria, the inflammatory lesions of reflux esophagitis can be divided into 4 grades: Grade I is a single or several non-confluent lesions manifested as erythema or superficial erosion; Grade II is a confluent lesion but not diffuse or circumferential; Grade III lesions are diffuse and circumferential with erosion but no stenosis; Grade IV is a chronic lesion manifested as ulcers, stenosis, fibrosis, esophageal relaxation, shortening and Barrett's esophagus.

2. Treatment of esophagitis

1. Eliminate the cause of the disease and give soft liquid food. Avoid feeding coarse, hard, dry, powdery and other irritating foods.

2. For antacid and antiemetic, take 0.1-0.3 mg of aluminum hydroxide or 0.2 mg of magnesium oxide per kilogram of body weight. If antacids are not effective, you can take cyanamide orally, 5-10 mg per kilogram of body weight, twice/gl. In case of vomiting, take metoclopramide orally, 0.2-0.5 mg per kilogram of body weight, 2-3 times/day.

3. For antibacterial and anti-inflammatory treatment, intramuscular injection of penicillin and streptomycin, twice a day; dexamethasone, 0.125-1.0 mg per kilogram of body weight, once a day. In case of fungal infection, intravenous amphotericin B is administered at 0.5 mg per kg of body weight once every other day.

3. Dietary conditioning for esophagitis

1. Eat regularly and avoid overeating. Patients should chew their food slowly and thoroughly when eating, and avoid drinking strong tea, liquor, strong coffee, and eating spicy, too cold, too hot, and rough foods, such as strong tea, coffee, cocoa, chocolate, chili, etc.

2. The diet should be light, easily digestible, and soft. Avoid eating greasy food to avoid stimulating increased bile secretion, aggravating reflux and the condition. In addition, you should pay attention to using less fat, butter and cooking oil in your diet. You should mainly boil, stew, blanch, braise and steam, and eat less or no fried food.

3. Avoid drinking and smoking. Nicotine contained in tobacco can reduce the pressure of the lower esophageal sphincter, making it relaxed and aggravating reflux. Smoking can also reduce the blood flow to the esophageal mucosa, inhibit the synthesis of prostaglandins, reduce the body's resistance, and make it difficult to recover from inflammation. The main component of alcohol is ethanol, which not only stimulates gastric acid secretion, but also relaxes the lower esophageal sphincter and causes gastroesophageal reflux.