Esophagitis
The reflux of stomach acid into the esophagus can lead to an inflammation of the esophagus, the so-called esophagitis. This often manifests itself as pain at the level of the breastbone and difficulty swallowing. In a gastroscopy using an endoscope, the inflammation of the oesophagus can be seen by a doctor.
It can be of varying degrees of severity and have different causes. It is caused by the backflowing stomach acid. This must therefore be treated in order to alleviate the inflammation of the esophagus.
As in the case of normal heartburn without esophagitis, antacids or proton pump inhibitors are used, depending on their severity. Since heartburn has often been present for a long period of time prior to the inflammation of the oesophagus, proton pump inhibitors are often the remedy of choice, as they are more effective and can be used for a longer period of time. In addition, the patient should also be informed about general behavioral measures that are indicated for his or her complaints.
These include the correct diet in rather small portions, avoiding coffee, alcohol and nicotine if possible, elevating the upper body in the case of heartburn, sufficient drinking quantities, etc. Under these circumstances, esophagitis can usually be well treated and the patient will quickly feel the first improvements. Heartburn is caused by the backflow of acidic stomach contents into the esophagus.
This can lead to an inflammation of the esophagus, which is called reflux esophagitis. If you suffer from heartburn now and then, medication is not really necessary. This is a physiological reflux that can occur, for example, after a very fatty meal or after drinking wine.
If symptoms occur more frequently or there is an inflammation of the esophagus, medication should be administered. 1) PPI: The most frequently used drugs end in “-prazole” (e.g. omeprazole, pantoprazole) and belong to the group of proton pump inhibitors, or PPI for short. They block a transport protein in the stomach cells, thereby inhibiting the production of stomach acid.With sufficient dosage, healing rates of around 90% are achieved.
The more common side effects include diarrhea, dizziness and headaches. Mood swings are also possible. Rarer side effects are visual and hearing disorders, an increase in liver values, kidney inflammation and skin rash.
Long-term therapy with PPI can lead to vitamin B12 deficiency if it is not replaced. 2) H2 blockers: These drugs end on “-tidine” (e.g. cimetidine) and are not used to treat heartburn and esophagitis. They have a much weaker effect than PPI.
3) Antacids: These drugs are weak and only effective for a short time. They neutralize the stomach acid present. They are recommended only for occasional heartburn without esophagitis.
