Once suffering from reflux esophagitis, patients must maintain a firm and positive attitude, because this disease is more recurrent, the treatment cycle is longer, and the chance of recurrence is also higher in normal times. However, this disease is usually treatable. As long as the patient adopts the doctor's treatment method correctly and specifies a more scientific diet in life to cooperate with the doctor's treatment, I believe that the disease can be cured quickly. 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, avoid smoking and drinking, all of which can reduce the onset of esophageal 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 (Metoclopramide) 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 (Motilium), 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 intestinal 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. Reduces 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. |
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