Esophagitis caused by the reflux of acid gastric juices through an incompetent sphincter at the junction of the esophagus with the stomach is now recognized as a common cause of upper abdominal and thoracic symptoms frequently simulating heart, stomach or gallbladder disease.
Essentials of Diagnosis:-
• Retrosternal burning, pain and heaviness.
• Symptoms aggravated by recumbency or increased
abdominal pressure, relieved by upright position.
• Nocturnal regurgitation with cough and dyspnea in
• Hiatus hernia on X-ray.
• Common in middle aged obese females or with patients of increased intra-abdominal pressure.
• Oesophagoscopy showing hyperaemia and ulceration.
• Erosion when seen is confirmatory. Biopsy is manda- tory to exclude malignancy.
-UPPER GI ENDOSCOPY
-Advise patient not to lie down immediately after food and to sleep with head end of bed being raised 9″ to 10″.
-Weight reduction if obese and avoidance of tight belts/corsets.
-Antacid 2 tab to be chewed 1 hr after each meal and at bed time.
-Large hiatus hernia or paraoesophageal ones requires surgical correction.
-Ranitidine 150 mg twice daily for 4 to 6 weeks.
-Pantraprazole 40 mg bd before meal or syrup.Sucrofil 2tsp tid