Symptoms of chronic esophagitis

Clinical symptoms of chronic esophagitis are caused by both inflammatory changes in the mucous membrane of the esophagus, and often by concomitant dyskinesia of the esophagus and those situations that caused the development of chronic esophagitis.

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Dysphagia

Dysphagia is an unpleasant sensation experienced by the patient when food passes through the esophagus. The patient perceives dysphagia as a feeling of pressure, distension, overflow, a "stake", or a "lump" behind the breastbone. Chronic esophagitis is characterized by predominantly paroxysmal dysphagia, which is caused by concomitant esophageal hypermotor dyskinesia and manifests itself as difficulty in passing mainly liquid food; the passage of solid foods is impaired to a much lesser extent (paradoxical dysphagia). Constant (persistent) dysphagia is observed in other diseases of the esophagus (cancer, esophageal stenosis, etc.), is characterized by a violation of the passage of mainly solid food and is relieved by thoroughly chopping the food or washing it down with a significant amount of liquid.

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Pain

As a rule, pain in chronic esophagitis is localized behind the sternum. It can be constant or paroxysmal, radiating to the lower jaw, neck, and interscapular region. V. M. Nechaev (1991) describes the so-called inverted dynamics of pain development: starting, for example, in the interscapular region, it spreads to the right and left along the intercostal spaces, and then forward behind the sternum, to the neck and lower jaw. The most characteristic feature of pain in esophagitis is itsconnection with food intake and combination with dysphagia. Pain in chronic esophagitis is caused by inflammation of the esophageal mucosa.

In the presence of peptic reflux esophagitis, chest pain occurs when gastric or duodenal contents are thrown into the esophagus; this usually occurs when belching, bending the body forward, overeating, or in a horizontal position.

The paroxysmal (spastic) nature of pain in esophagitis is accompanied by hypermotor dyskinesia of the esophagus. Pain in chronic esophagitis is relieved after taking antacids.

Heartburn

Heartburn is perceived as a burning sensation, heat, warmth in the xiphoid process or behind the sternum. It is caused by irritation of the inflamed mucous membrane of the esophagus by gastric or duodenal contents during duodenogastroesophageal reflux.

Heartburn usually occurs after eating, especially after eating fatty and spicy foods, tomatoes, chocolate, alcohol, and after smoking. It can intensify in a horizontal position of the patient, when bending forward, with flatulence, lifting weights, wearing a tight belt.

Regurgitation (esophageal vomiting)

Regurgitation is a retrograde flow of esophageal contents into the oral cavity without preceding nausea and without the involvement of the muscles of the anterior abdominal wall. In fact, esophageal vomiting is a passive leakage of esophageal contents into the oral cavity. This is usually observed in congestive esophagitis and, unfortunately, aspiration of food masses may occur.

Belching

Belching is often observed in chronic esophagitis. There may be belching of sour, bitter, and also eaten food. Belching is usually observed in the presence of gastroesophageal reflux.

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Vomit

Vomiting is quite common in chronic esophagitis. It is most typical for alcohol-induced esophageal damage and usually occurs in the morning ("morning vomiting of alcoholics"). Most often, vomiting is mucus, sometimes there is an admixture of food in the vomit.

If vomiting is persistent, it predisposes to ruptures of the inflamed mucous membrane of the esophagus and bleeding. Mallory-Weiss syndrome develops - pronounced sudden esophageal-gastric bleeding due to longitudinal ruptures of the mucous membranes of the cardiac section of the esophagus and stomach against the background of vomiting (more often occurs in alcoholics).