Decreased esophageal motility
Introduction
Introduction Esophagitis can weaken the esophageal peristaltic function and is inflammation caused by edema and hyperemia caused by abnormal stimulation of the superficial or deep tissues of the esophageal mucosa. Long-term placement of nasogastric tubes or patients taking aspirin, strong acid and alkali, non-steroidal anti-inflammatory drugs or patients receiving chemotherapy or radiotherapy, stomach acid, spirits, peppers, too hot soup, overheated tea, etc. Can cause esophagitis. The clinical manifestation is post-sternal pain during swallowing, which can also cause esophageal spasm and temporary dysphagia.
Cause
Cause
Pathological causes of esophagitis:
Swallowing hot food, sharp foreign bodies or chewing bones, ingesting corrosive agents and other direct damage to the esophageal mucosa cause inflammation. When veterinarians use a gastric catheter to inject drugs into dogs and cats, the gastric catheter is used violently, which often damages the esophageal mucosa.
Physical or chemical esophagitis
Esophagitis caused by radiation exposure is called radiation esophagitis. Drugs such as quinidine, tetracycline, potassium chloride, iron, etc. stimulate the esophageal mucosa, especially tablets that are stagnant in the esophagus, can also cause esophagitis. Esophagitis caused by overheated food can quickly heal itself. Long-term use of the stomach tube, stimulate the esophagus, can also cause esophagitis.
Antibiotics are used for too long, causing infection of the esophageal mucosal fungi.
Lower esophageal sphincter function:
The lower toe of the esophagus in normal people has a high pressure area to prevent gastric contents from flowing back to the esophagus. There are many reasons for the weakening of the lower esophageal sphincter function, including hiatal hernia, which can easily cause the stomach and intestinal contents to flow back into the esophagus, which is the main cause of inflammatory lesions in the esophagus.
Increased abdominal pressure:
Such as a large amount of ascites, pregnancy, resulting in increased abdominal pressure, easy to form reflux.
Esophageal motility disorder:
Under normal circumstances, when the contents of the stomach flow back into the esophagus, the secondary peristaltic waves of the esophagus are caused by the tension, and the reflux is returned to the stomach. Esophagitis can slow the esophageal peristalsis, prolong the residence time of the reflux in the esophagus, aggravate the original esophagitis, and esophagitis weakens the function of the lower esophageal sphincter, aggravates reflux, and forms a vicious circle.
Examine
an examination
Related inspection
Esophagography esophageal barium meal perspective
Most occur in people over 40 years old. The lower esophageal sphincter of a normal person acts as a barrier, making it difficult for the stomach contents to flow back into the esophagus. In this sphincter dysfunction, such as esophageal hiatal hernia or other causes of this sphincter dysfunction, gastric contents can flow back into the esophagus. The gastric juice contains acid and may also contain bile or pancreatic juice. These substances have a detrimental effect on the esophagus, and cause long-term repeated inversion into the esophagus, causing inflammation, erosion, and even ulceration on the esophageal mucosa. Chronic repetitive damage can cause full-thickness destruction and fibrosis of the esophagus, resulting in esophageal stricture. The clinical manifestations are mainly heartburn, symptoms appear at night when lying down, and symptoms are relieved when sitting up. This is a typical performance. When the weight is raised, the abdominal pressure is increased, and reflux can also occur. Some foods, such as orange juice, can cause symptoms. X-ray barium meal imaging can be used as a basis for diagnosis if the expectorant can flow up and down between the esophagus and the stomach. Esophageal microscopy showed white flaky exudation, erosion, ulceration and bleeding. The principle of treatment is to raise the bedside, reduce the chance of reflux, inhibit gastric acid secretion or neutralize gastric acid, and enhance gastric emptying. Surgery can be considered when it is ineffective.
Viral esophagitis
Herpes simplex virus, varicella virus, cytomegalovirus, etc. can be caused. It is most common in patients with herpes simplex virus. Most people with low immune function, healthy people can also occur in the case of influenza, but it is rare. Herpes can appear in the mouth and lips at the same time. Generally it is acute, with swallowing pain and temporary esophageal fistula, difficulty swallowing. Self-healing in 4 to 10 days. Patients with malignant tumors or ulcerative colitis are also prone to this disease, often continue unhealed, and even major bleeding, but the symptoms may not be obvious. Esophageal microscopy showed white spots on the esophageal mucosa, a small ulcer of about 5 mm in diameter, and pathological examination showed inclusion bodies in the nucleus. Virus isolation revealed pathogenic viruses. Treatment is mainly symptomatic, generally no serious sequelae, the effect of current antiviral treatment drugs remains to be seen.
1, mental depression, loss of appetite or even abolished. Mucus is attached around the nose and mouth. When chronic esophagitis occurs, the body weight gradually decreases.
2, difficulty swallowing, painful when swallowing, and a lot of hooliganism. Or vomiting, vomit sometimes with blood. Refuse to eat after swallowing several times.
3, esophageal palpation sensitive, cervical anterior esophagus palpation pain. Touching the front abdomen can cause food reflux.
4, the upper abdomen or sternal pain burning sensation: the main clinical manifestations of this disease. Pain is especially noticeable when eating a lot, and is related to body position. In severe cases, it can be radiated to the neck, back, chest, and sometimes resembles the symptoms of angina.
5, reflux: often after meals, before going to bed at night, there is acidic liquid or food from the stomach and esophagus reflux to the oropharynx. There may be symptoms such as nausea, heating, snoring, heartburn, bloating, discomfort during swallowing, and severe gastrointestinal bleeding due to erosion of the esophagus.
Diagnosis
Differential diagnosis
1, spleen (heartache): chest tightness or short-term or episodes of cardio-chest pain, often after exertion after exertion, more without burning sensation after sternum and difficulty swallowing. The ECG shows ST-T as an ischemic change. The esophageal acid test was negative.
2, esophageal cancer, esophageal fistula: with sputum as the main disease, esophagoscopy and X-ray swallowing examination can be identified.
3, stomach ulcers: pain is mostly located in the gastric cavity, often chronic, rhythmic, seasonal and periodic attacks, X-ray barium meal and fiber endoscopy in the stomach or duodenal bulb can be seen ulcer lesions.
4, angina pectoris: esophageal muscle pain and angina can exist alone, sometimes at the same time, can be alleviated with nitroglycerin, identification is very difficult.
Cardiac pain often radiates laterally to the chest, while esophageal pain radiates vertically. Both types of pain can be caused by sudden movements, but when the posture is forced, reflux can occur, and continuous exercise without force can cause angina.
5, snoring ball: refers to the patient complained of a foreign body sensation in the throat, can not start swallowing, a sense of blockage, no organic lesions in clinical examination. It is believed that the high reflux of the stomach causes the upper part of the esophagus to be stimulated. Sometimes it is misdiagnosed for the only symptoms of a small number of patients.
