Hospital therapy. Treatment and prognosis of acute esophagitis (most important)

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Hospital therapy. Treatment and prognosis of acute esophagitis (most important)

Lecture notes, cheat sheets

Directory / Lecture notes, cheat sheets

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35. Treatment and prognosis of acute esophagitis

Treatment. Principles of treatment of acute esophagitis: etiotropic, pathogenetic and symptomatic.

Etiotropic treatment - treatment of the underlying disease. In infectious diseases complicated by acute esophagitis, antibiotics are used (parenterally). With pronounced necrotic and hemorrhagic changes in the esophagus, it is recommended to refrain from eating for 2-3 weeks. During this period, parenteral nutrition, intravenous administration of protein hydrolysates, mixtures of amino acids, intralipid, vitamins, and detoxification therapy are indicated. After reducing inflammation, thermally and chemically sparing foods are prescribed: warm milk, cream, vegetable soups, liquid cereals. To reduce local symptoms of inflammation - inside solutions of tannin 1%, collargol - 2%, novocaine - 1-2% before meals. Astringents are taken in a horizontal position with the head of the bed lowered low. In the absence of the effect of local administration of astringent preparations, non-narcotic analgesics are prescribed parenterally.

To reduce the effects of esophageal dyskinesia, prokinetic drugs (cerucal, raglan, cisapride) are used orally before meals. With multiple erosions, bismuth preparations (denol, vikair), injections of solcoseryl are indicated.

With hemorrhagic esophagitis, complicated by bleeding, aminocaproic acid preparations, vikasol, dicynone are used. With massive bleeding, a blood or plasma transfusion is prescribed. With purulent, necrotic esophagitis, the patient should be on parenteral nutrition for a long time, massive therapy with several antibiotics is used, and the abscess is drained.

Esophageal strictures are corrected by bougienage. In rare cases, a gastrostomy is placed.

Forecast. The prognosis of catarrhal and erosive esophagitis is favorable. Spontaneous disappearance of symptoms of esophagitis is possible, provided that the underlying disease is adequately corrected. The prognosis of pseudomembranous, exfoliative, phlegmonous esophagitis is serious. In all cases, subject to recovery from the underlying disease, esophagitis ends with the formation of cicatricial strictures, which require further correction. Patients with severe forms of esophagitis complicated by strictures of the esophagus are unable to work.

Prevention of acute esophagitis consists in adequate and timely diagnosis and treatment of the underlying disease.

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