10 Pastries, candy, nuts, raisins
11 Spicy foods and highly seasoned foods.
b. Reflux Esophagitis.
(1) Definition. Reflux esophagitis is inflammation of the esophagus which
spreads through the lining of that organ. Inflammation is caused by stomach or
duodenal contents flowing back up into the esophagus. The sphincter muscle has
relaxed and allowed this backward flow. This condition is often accompanied by hiatal
(2) Etiology. The cause of the inflammation, as mentioned in the previous
paragraph, is that the sphincter muscle has relaxed and allowed stomach and duodenal
contents to flow back into the esophagus. These contents contain acids and pepsins
not normally found in the esophagus; these substances sitting in the stomach cause the
inflammation. Additionally, the esophagus is temporarily unable to generate secondary
peristaltic waves which would normally prevent stomach and duodenal contents from
being in contact with the esophageal lining for any length of time.
(3) Signs/symptoms. The most common symptom is heartburn which is
frequently severe and occurs about 30 to 60 minutes after eating. Heartburn begins,
becomes worse when the person lies down but better when the person sits up. Pain at
the lower sternal or xiphoid level frequently radiates into the interscapular area, neck,
jaw, or down the arm. Pain down the arm is sometimes confused as cardiac pain.
Aspiration, breathing into the trachea of some of the regurgitated stomach contents,
may cause coughing, bleeding, or abnormal narrowing of the trachea. Other symptoms
include water brash (combination of regurgitation and increased salivation), dysphagia
(difficulty in swallowing), odynophagia (painful swallowing), hematemesis (vomiting of
blood) occur if reflux esophagitis becomes very severe. Eventually, a person may
develop iron deficiency anemia if there is chronic bleeding which is not evident.
(4) Preventive therapy. Have the patient with a tendency to have reflux
esophagitis follow these measures:
(a) Lose weight, if the patient is heavy. Obesity is associated with this
condition, and obesity sometimes helps cause reflux esophagitis.
(b) Avoid tight belts, girdles, or any tight clothing. Reflux esophagitis is
aggravated by abdominal pressure.
Avoid lying down immediately after meals.
(d) Sleep with the head of the bed elevated 20 to 25 centimeters.
Wooden blocks can be used to elevate the head of the bed.