When I walk, my throat and chest feel uncomfortable.

Many people experience discomfort in the throat and chest area when walking. This is most likely a symptom caused by reflux esophagitis. This symptom will cause great discomfort to the patient, and if it is not treated in time, it will put the patient in a more dangerous situation. Below, we will introduce the treatment methods of reflux esophagitis in detail.

1. Medical treatment

The goals of medical treatment are to relieve reflux and reduce the irritation and erosion of gastric secretions. Generally, asymptomatic sliding hernias do not require treatment. Medical treatment can be performed for patients with mild symptoms of reflux esophagitis or due to age, comorbidities, or unwillingness to undergo surgery. For obese patients, weight loss can reduce intra-abdominal pressure and reflux. Avoid lifting heavy objects, bending over, etc., and do not wear tight clothes. Raise the head of the bed 15 cm when sleeping, do not eat 6 hours before going to bed, and avoid smoking and drinking, all of which can reduce the onset of gastroesophageal reflux.

In terms of drug treatment, antacids can be used to neutralize gastric acid and reduce the activity of pepsin. Gastrokinetic drugs such as domperidone and itopride can be used to prolong gastric emptying. H2 receptor antagonists or proton pump inhibitors can reduce gastric acid and protease secretion. The combined use of acid-suppressing drugs and prokinetic drugs can improve the therapeutic effect for some patients.

2. Promote the emptying of the esophagus and stomach

(1) Dopamine antagonists: This type of drug can promote the emptying of the esophagus and stomach and increase the tension of the LES. These drugs include metoclopramide (Metoclopramide) and domperidone, which are taken at bedtime and before meals. The former can cause extrapyramidal neurological symptoms if taken in excessive doses or for long periods of time, so it should be used with caution in elderly patients; the latter can also cause hyperprolactinemia and produce adverse reactions such as breast hyperplasia, lactation and amenorrhea if taken for long periods of time.

(2) Cisapride can release acetylcholine through the postganglionic nerves of the myenteric plexus, thereby promoting the peristalsis and emptying of the esophagus and stomach, thereby alleviating gastroesophageal reflux.

(3) The cholinergic drug uracil can increase the tension of the LES, promote esophageal contraction, and accelerate the emptying of acidic food in the esophagus to improve symptoms. This medicine can stimulate gastric acid secretion, so long-term use should be cautious.

3. Reduce stomach acid

(1) Antacids can neutralize gastric acid, thereby reducing the activity of pepsin and reducing the damage of acidic gastric contents to the esophageal mucosa. Alkaline drugs themselves also have the effect of increasing LES tension. Aluminium hydroxide gel and magnesium oxide. Alginic acid foam contains alginic acid, sodium alginate and antacids, which can float on the surface of gastric contents and prevent reflux of gastric contents.

(2) Histamine H2 receptor antagonists such as cimetidine, furosine and famotidine can be used. This type of drug can strongly inhibit gastric acid secretion and improve gastroesophageal acid reflux. If the above symptoms cannot be improved, the dosage can be increased to 2 to 3 times.

(3) Proton pump inhibitors: This type of drug can block the H+-K+-ATPase of parietal cells. Drugs such as omeprazole and lansoprazole have been widely used in clinical practice.

4. Combination medication

The combined use of drugs that promote esophageal and gastric emptying and antacids has a synergistic effect and can promote the healing of esophagitis. Dopamine antagonists or cisapride can also be used in combination with histamine H2 receptor antagonists or proton pump inhibitors.

5. Surgical treatment

The purpose of surgical treatment is to repair the hernia hiatus, prevent reflux and correct esophageal stenosis.

6. Traditional Chinese Medicine Treatment

(1) Body acupuncture: The main acupoints are Neiguan and Zusanli, and the auxiliary acupoints are Ganshu, Weishu, Shangwan, and Gongsun.

(2) Ear acupuncture: Shenmen, stomach, and esophagus. Stimulate moderately and leave the needle in place.