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"code": "K20",
"name": "Эзофагит",
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"lead": "Нарушение здоровья, относящееся к группе болезни пищевода, желудка и двенадцатиперстной кишки",
"description": "Эзофагит - заболевание пищевода, сопровождающееся воспалением его слизистой оболочки, представляет одно из очень распространенных заболеваний пищеварительного тракта. \r\n\r\nРефлюкс-эзофагит представляет собой воспаление слизистой оболочки пищевода, обусловленное забросом желудочного содержимого в пищевод (желудочно-пищеводный рефлюкс). ",
"etiology": "<p>Причины острого эзофагиты: </p>\r\n<ul>\r\n<li>острые инфекционные процессы; </li>\r\n<li>физическое повреждение (ожог, травмирование при введении зонда, повреждение инородными телами); </li>\r\n<li>химический ожог; </li>\r\n<li>аллергическая реакция на пищевые продукты. </li>\r\n</ul>\r\n<p>Причины развития хронических эзофагитов: </p>\r\n<ul>\r\n<li>алиментарный эзофагит (употребление очень горячей, острой пищи, крепкого алкоголя); </li>\r\n<li>профессиональный эзофагит (работа, связанная с вдыханием паров едких химических веществ); </li>\r\n<li>застойный эзофагит (раздражение слизистой остатками скопившейся пищи при разного рода затруднениях эвакуационной функции пищевода); </li>\r\n<li>аллергический эзофагит); </li>\r\n<li>дисметаболический эзофагит (связан с нарушениями обмена – гиповитаминозами, недостаточностью микроэлементов и тканевой гипоксией, продолжительной интоксикацией организма и т. п.).</li>\r\n</ul>\r\n<p>Рефлюкс-эзофагит развивается вследствие гастроэзофагеального рефлюкса (заброса желудочного содержимого в пищевод). Рефлюкс из желудка в пищевод может возникать по следующим причинам: </p>\r\n<ul>\r\n<li>недостаточность кардии (нижнего пищеводного сфинктера); </li>\r\n<li>грыжа пищеводного отверстия диафрагмы; </li>\r\n<li>недостаточная длина пищевода. </li>\r\n</ul>",
"pathogenesis": "<p>Механизм развития эзофагита обусловлен непосредственным раздражающим химическим, термическим, токсическим или пептическим (при недостаточности кардии и рефлюкс-эзофагите) воздействии на слизистую оболочку пищевода, в редких случаях - бактериальным, токсическим или токсико-аллергическим поражением.</p>\r\n<p> </p>",
"diagnostics": "<p>Диагностика эзофагита включает: </p>\r\n<ul>\r\n<li>Рентгенологическое исследование с контрастным веществом. Наблюдаемый заброс контрастного вещества из желудка в пищевод свидетельствует о выраженном рефлюксе.</li>\r\n<li>Эзофагоскопия - эндоскопическое исследование пищевода.</li>\r\n<li>Эзофагоманометрия — фиксирует различные по характеру нарушения моторики пищевода. </li>\r\n<li>Мониторная рН-метрия пищевода - измерение кислотности в просвете пищевода и желудка; содержимое пищевода будет кислым из-за заброса кислого содержимого из желудка.</li>\r\n</ul>",
"treatment": "<p> Консервативное лечение показано больным с неосложненным течением заболевания. Оно включает в себя: </p>\r\n<p>Общие рекомендации: </p>\r\n<ul>\r\n<li>после принятия пищи избегать наклоны вперед и не ложиться в течение 1,5 часов </li>\r\n<li>спать с приподнятым не менее чем на 15 см головным концом кровати, </li>\r\n<li>не носить тесную одежду и тугие пояса, </li>\r\n<li>ограничить потребление продуктов, агрессивно действующих на слизистую оболочку пищевода (жиры, алкоголь, кофе, шоколад, цитрусовые и т.п.), </li>\r\n<li>отказаться от курения. </li>\r\n</ul>\r\n<p>Медикаментозная терапия: </p>\r\n<ul>\r\n<li>Приём антацидов и производных альгиновой кислоты - препараты снижающие кислотность посредством её нейтрализации. </li>\r\n<li>Антисекреторные препараты - препараты, снижающие кислотность посредством подавления её образования. </li>\r\n<li>Прокинетики - препараты, которые увеличивают тонус нижнего пищеводного сфинктера. </li>\r\n<li>Антибиотикотерапия - применяется для подавления инфекционного процесса. </li>\r\n</ul>\r\n<p>Физиотерапевтическое лечение: </p>\r\n<ul>\r\n<li>при рефлюкс-эзофагите хороший результат дает амплипульстерапия; </li>\r\n<li>снижение болевого синдрома электрофорезом; </li>\r\n<li>грязелечение и бальнеотерапия. </li>\r\n</ul>\r\n<p>При тяжелом течении рефлюкс-эзофагита со стриктурами, язвами и стенозом физиотерапия противопоказана. Операции при стенозе пищевода заключаются в эндоскопическом рассечении стриктур, расширении или бужировании пищевода. По показаниям проводится резекция и пластика пищевода. </p>",
"prevention": "<p>Профилактика эзофагитов подразумевает избегание причин его развития – ожогов горячей пищей, химическими веществами, повреждений инородными телами и т. п. </p>\r\n<p>Профилактика хронического эзофагита – регулярное диспансерное обследование у гастроэнтеролога и при необходимости – лечение. Больным хроническим эзофагитом в качестве профилактики обострений показано санаторно-курортное лечение.</p>",
"clinical_picture": "<p>Острый поверхностный эзофагит проявляется болями при глотании, ощущением саднения за грудиной, иногда дисфагией. При геморрагическом эзофагите могут быть кровавая рвота и мелена. При псевдомембранозном эзофагите в рвотных массах обнаруживают пленки фибрина. Особенно тяжело, с картиной септической интоксикации, протекают абсцесс и флегмона пищевода. </p>\r\n<p>Подострые и хронические эзофагиты проявляются изжогой, чувством жжения, саднения за грудиной, в редких случаях — болью, дисфагией. При рефлюкс-эзофагите основными симптомами являются изжога и срыгивание, усиливающиеся при наклоне туловища и в горизонтальном положении больного. Нередко наблюдаются загрудинные боли при глотании.</p>",
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