How to deal with reflux esophagitis causing palpitations and a feeling of panic?

Written by Wu Hai Wu
Gastroenterology
Updated on September 16, 2024
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Patients with reflux esophagitis, if experiencing palpitations or a feeling of heart flutter, are advised to complete an electrocardiogram to rule out the possibility of heart disease. If heart disease causing these symptoms has been ruled out, then one may visit the hospital and consider taking oral proton pump inhibitors to suppress stomach acid secretion, reducing the erosive impact of acid reflux on the esophagus. Additionally, one can take protective agents for the stomach and esophageal mucosa, such as magnesium trisilicate, etc. The specific choice of medication and dosage should be used under the guidance of a doctor. Patients with reflux esophagitis should avoid alcohol, strong tea, coffee, etc.

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Reflux esophagitis is divided into several grades.

Reflux esophagitis can be classified into four grades based on the extent of esophageal mucosal damage: Grade A, B, C, and D. Grade A mainly involves damage to the folds of the esophageal mucosa, generally not exceeding 5 millimeters. Grade B refers to damage greater than 5 millimeters. Grade C indicates that the damage to the esophageal mucosa reaches 75% of the entire circumference of the esophagus; any damage below 75% falls into Grade C. Grade D, on the other hand, is quite severe, with extensive damage around the entire circumference of the esophagus, mainly divided into these four grades.

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Which severity level of reflux esophagitis is "abcd"?

Reflux esophagitis is divided into four grades: ABCD, with grade A being the least severe and grade D being the most severe. Grade D indicates that the esophageal mucosa shows damage and fusion, involving at least 75% of the esophageal circumference. The symptoms of reflux esophagitis mainly include reflux and a burning sensation in the stomach, and some patients may also experience heartburn, nausea, vomiting, and other symptoms. Reflux esophagitis can occur during nighttime sleep in some patients and is caused by the chemical irritation of sensory nerve endings beneath the esophageal epithelium due to acidic or alkaline reflux material.

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Written by Wang Hui Jie
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Reflux gastritis and reflux esophagitis are not the same.

It's different. Gastroesophageal reflux disease (GERD) refers to the abnormal reflux of stomach or duodenal fluids into the esophagus, causing a series of symptoms. Under endoscopy, severe esophageal inflammation and erosion can be seen, along with ulcers, fibrosis, etc. Prolonged episodes can lead to the development of Barrett's esophagus. On the other hand, reflux gastritis generally refers to bile reflux gastritis, which as the name suggests, is caused by the reflux of bile into the stomach. Endoscopically, swelling of the gastric mucosa can typically be seen, along with the presence of residual bile in the stomach, bile staining, and intestinal metaplasia, among others. Both conditions have clinically similar symptoms, including heartburn, acid reflux, and pain.

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Can reflux esophagitis be cured?

Reflux esophagitis can be cured, however, the recurrence rate of reflux esophagitis is more than 80%, and generally requires maintenance treatment. The treatment principles are acid suppression, enhancing the pressure of the lower esophageal sphincter, and protection of the mucosa. Next, let's specifically introduce non-drug treatments. Dietary therapy is very important, mainly involving reasonable dietary intake and good eating habits, which play a significant role in prevention. Another is positional therapy, mainly avoiding lying down immediately after meals, as well as quitting smoking and alcohol, reducing negative pressure, and taking some related medications or undergoing surgical procedures, etc. Generally, a combination of treatments is used to improve efficacy, and the treatment course should not be less than three months.

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Do you always need to take medication for reflux esophagitis?

Gastroesophageal reflux disease (GERD) doesn't necessarily require continuous medication. If symptoms are effectively relieved, and patients no longer experience recurrence for four to eight weeks following adjustments to their diet and lifestyle, then it might be considered appropriate to temporarily discontinue medication. However, if symptoms recur after these treatments, prompt pharmacological treatment should be administered to prevent worsening of the condition. Treatment might include the use of proton pump inhibitors such as omeprazole and lansoprazole to suppress gastric acid secretion, as well as antacids like aluminum magnesium carbonate and sucralfate to protect the gastric mucosa. Additionally, medications like mosapride or itopride may be used to enhance motility in the esophagus and gastrointestinal tract. (Medication should be taken according to medical advice.)