Esophagitis is a condition where there is inflammation and swelling of the esophagus. Esophagitis is caused by stomach acid reflux, fungal or viral infection of the esophagus, certain medications and weakened immune system. If esophagitis is left untreated, it can lead to ulcers and difficulty in swallowing. This can lead to scarring of the esophagus and a situation where food may stick in the area (dysphagia). Often Hiatus Hernia causes Esophagitis since the distension of the stomach through the diaphragm muscle hampers the draining of food and stomach acid. This results in the damage of the esophageal tissue. Candida yeast infection can develop in the esophagus and lead to esophagitis. It attacks when the immune system is weakened and is treated with anti-fungal drugs.
A person suffering from esophagitis has difficulty in swallowing and nausea and vomiting. There are mouth sores. Heartburn involves acid reflux into the esophagus as a burning sensation with a bitter-tasting liquid that may regurgitate into the mouth. A patient can reduce the symptoms of esophagitis by eating smaller meals and avoiding eating for 2 hours before going to bed. Avoid too much spices and acidic food and beverages. Take small bites and chew food thoroughly before swallowing. Place your head at an elevation while sleeping to prevent regurgitation and stomach acid reflux. Smoking, alcohol, caffeine, chocolate, peppermint and fatty foods can aggravate the condition.
The physician can view the esophagus with an endoscope to look for scarring and inflammation. A biopsy can be taken for diagnosis. A Barium swallow involves use of a special dye to facilitate x-ray of the esophagus and check for abnormalities. Antacids can help in reducing stomach acid reflux. Medication to improve the strength of the LES muscle can help in treating esophagitis. Antibiotics or anti-fungal drugs may be prescribed to treat the infection. Inflammation can be reduced with the help of Corticosteroid medication. Surgery is resorted to in cases where there is a hiatus hernia or to remove the damaged part of the esophagus.
One of the common stomach disorders encountered is gastro esophageal reflux also known as heartburn. The stomach contains hydrochloric acid which helps in digestion of the food and subsequently killing ingested microorganisms. The acidity of the gastric HCl is 2M and any increase in the acidity leads to reflux, in which the gastric HCl travels through the cardiac sphincter muscle to the esophagus causing burning sensation and discomfort. Antacids are common choice of drugs which are administered in these conditions as they reduce the acid reflux and peptic ulcer.
Antacids act locally in the stomach region to neutralize the effect of the gastric HCl in order to prevent the onset of peptic ulcer. Most antacids are not absorbed and they are easily excreted in the stool. The predominant forms of chemicals used in the preparation of antacids include sodium bicarbonate, potassium bicarbonate, aluminum hydroxide, aluminum carbonate, magnesium carbonate, magnesium oxide and calcium carbonate. The natural forms of antacids include ginger, bananas, aloe vera, chamomile (used along with tea), carrots and turmeric. The action of antacids on the stomach is carried out throughout the wall to prevent ulcer formation.
Types of antacids
Antacids are recommended depending upon the intensity of the gastric disorder. In normal or mild conditions of acidity, non systemic antacids are recommended as they do not cause much damage. Prolonged administration of systemic antacids may lead to a condition called alkalosis in which the PH of the blood is raised leading to renal failure. Some of the common types of antacids used in the treatment of reflux and peptic ulcers are:
Sodium bicarbonate: It is recommended by many doctors to treat acid reflux and also reduce the acidity of urine and blood. Antacids which contain sodium bicarbonate also contain baking soda and hence it is not recommended for patients having congestive heart failure, hypertension, kidney disorders and gastrointestinal bleeding. Antacids containing sodium bicarbonate should be taken only after meals on a partially full stomach. The side effects include nausea, flatulence, weakness, increased thirst, black stools and irritability.
Aluminum hydroxide: Aluminum hydroxide is widely used as a non-systemic antacid and in most cases is available without prescription. The side effects of aluminum hydroxide include constipation and abdominal discomfort. In order to avoid constipation and abdominal stress, aluminum hydroxide is given in combination with magnesium hydroxide which has laxative properties along with antacid effects The combination of two such compatible antacids helps in sustained action in relieving peptic ulcers and protecting the wall of the stomach.
Calcium Carbonate: These antacids are mainly used in the treatment of indigestion, flatulence along with acidity and more commonly used as it is less expensive than other types of antacids. They are mostly recommended for children below the age of 12. In patients who have a previous history of osteoporosis or any other type of calcium deficiencies, the intake of calcium carbonate in case of acidity also helps in balancing the calcium requirement. If patients have a history of renal calculi or any other allergic reaction, calcium carbonate antacids should be avoided. The major side effect of this antacid is that it interacts with cardiac drugs. Calcium carbonate based antacids usually disintegrate and dissolute in forty minutes.
Drug side effects
Antacids react with many medications; digoxin, isoniazid, quinidine, pseudoephedrine and tetracycline. The potency and absorption of the drug reduces when the antacids interact with the corresponding drugs.
Bariatric surgical procedures are major gastrointestinal operations that seal off most of the stomach to reduce the amount of food one can eat and rearrange the small intestine to reduce the calories the bodies can absorb. This procedure is called Vertical Banded Gastroplasty (VBG) or Stomach Stapling. Gastric Stapling is a restrictive surgery used to treat morbid or malignant obesity. Usually stomach stapling is performed on individuals who have made numerous, unsuccessful attempts with traditional methods of losing weight. Stomach stapling involves the use of surgical stapler to create an upper-stomach pouch about the size of a small egg. The surgeon then inserts a polypropylene band to control the size of the pouch exit to the lower part of the stomach and prevent stretching. Stomach stapling severely limits the intake of patients. However, the success of stomach stapling strictly relies on the patient compliance with post operative dietary guidelines.
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Bibliography / Reference
Collection of Pages - Last revised Date: November 22, 2019