Erythematous gastropathy: causes, symptoms and treatment

Types of exudative erythema multiforme

There are a large number of forms of pathology in medicine, but the most common ones are distinguished:

Other types of exudative erythema multiforme (in the photo you can see the symptoms of each type):

A dermatologist will be able to establish an accurate diagnosis with the help of additional laboratory examination.

Other types of gastropathy

In addition to erythematous, there are other types of gastropathy that take a more serious turn. They are all characterized by lesions of various categories and areas of the gastric mucosa. Each type is capable of developing into a more severe form.

Antral

Gastropathy of the antrum affects the lower region of the stomach, which is responsible for breaking down digested food. The disease slows down the passage of food into the duodenum. Difficulty in movement causes congestion. Characteristic erythema appears in the antrum of the stomach. Most often, lesions in this area have a focal form. We also recommend that you read: diet for antral gastritis.

Gastropathy of the antrum of the stomach often accompanies chronic inflammatory processes of the diseased organ. Symptoms and identification of lesions mimic other diseases of the gastrointestinal tract. Diagnosis of gastropathy affects only the areas of the superficial antrum.

Ignoring the symptoms of damage leads to deeper inflammation, leading to serious illnesses. It is easy to imagine what antral gastritis is by studying gastropathy of the lower stomach. The symptoms are similar, but studying the nature of the inflammation is different.

Antral gastropathy or gastritis against the background of mucosal atrophy is detected in the later stages. The patient did not come for examination on time, the lesions progressed.

Papular

The localization of papular gastropathy usually affects the antrum of the stomach. Its characteristic feature is the formation of erosive lesions. They are called papules and are not dangerous. Affects the superficial layers of the gastric mucosa. Appears mainly due to increased production of hydrochloric acid and cardia insufficiency.

Stagnant

One of the common types is congestive gastroduodenopathy. Signs of damage are manifested by erosive and ulcerative wounds on the surface of the gastric mucosa. The protective functions of the diseased organ in the stagnant form are weakened, the blood supply is deteriorated.

There are no painful symptoms, the disease manifests itself in the form of belching, nausea, bloating, and discomfort after eating. It develops in conjunction with other diseases of the gastrointestinal tract (liver, pancreas). Indicates the presence of problems in the gastrointestinal tract.

Erosive

A form of gastropathy in which the lesions have the appearance of lumpy inflammation. The tip of the damage is concave. It has acute and chronic forms. The sizes of erosions of erythematous gastroduodenopathy range from 2 to 7 mm. The lesion often causes exudative gastritis (superficial). It is easily confused with erosive gastropathy due to mild inflammation and the absence of clear symptoms.

Any form of gastropathy can be accompanied by erythematous bulbitis. It is provoked by eating disorders and gastritis. The lesion causes a more dangerous form of inflammation - erosive.

Erythematous bulbopathy is a bright red, oval-shaped inflammation that affects the lower stomach and upper duodenum. The disease develops very slowly, progressing for years in the latent stage.

What is erythematous gastropathy, its symptoms and treatment

Gastropathy: causes, types, symptoms
After an endoscopic examination, the doctor can make a conclusion: erythematous gastropathy is a pathological condition, is not an independent clinical disease, but acts as an alarming symptom, mainly superficial gastritis.

What is

With erythematous gastropathy, hyperemia (redness) of the upper layer of the gastric mucosa occurs. This happens due to inflammatory processes, which usually do not affect the deep layers of tissue, which provoke swelling and blood flow caused by the expansion of capillaries.

Inflammation with gastropathy is usually less pronounced than with true gastritis, and affects only the superficial layers, therefore it is often referred to as superficial gastritis.

It occurs in diffuse and focal forms.

• The focal form is also called erythematous antral gastropathy and is most often found in the antrum of the stomach. It mainly differs in the local nature of the damage, inflammation and swelling are mild.
• Diffuse (common) gastropathy covers a large part of the mucosal surface in different parts. In the absence of adequate treatment, it leads to gastritis and stomach ulcers.

According to the degree of severity, the first and second stages are conventionally divided. They differ in the degree of damage to the epithelium.

Symptoms

Since gastropathy is an inflammation, it is accompanied by typical symptoms of digestive disorders:

• Heaviness in the hypochondrium.
• Epigastric pain.
• Belching air.
• Nausea and vomiting after eating.
• Permanent white coating on the tongue.

At the initial stages it is completely asymptomatic, then either goes away on its own (if the provoking factors had a short-term effect), or worsens and passes into the second, more dangerous stage.

Treatment

In order to properly treat gastropathy, before starting therapy, the factors that caused hyperemia are determined; these can be various medications or constant poor nutrition. The faster the cause is eliminated, the faster the recovery will come.

An important point in treatment is the detection of concomitant diseases, they are often chronic or erosive gastritis, gastroduodenitis, GERD.

Medicines

If it is determined that the cause of gastropathy is the medications you are taking, it is advisable to ask your doctor to change them. If this is not possible in this situation, medications are used to protect the stomach from harmful factors.

Medicines that can be prescribed for erythematous gastropathy:

1. Antisecretory (Omeprazole, Nolpaza, Kvametel, Pariet). Reduce the production of the main irritant of the mucous membrane - hydrochloric acid.
2. Gastroprotectors (De-nol, Vikair, Vikalin). Due to the bismuth contained in the composition, they have an astringent and anti-inflammatory effect, protecting the walls of the organ. Helps fight bacteria that cause stomach ulcers.
3. Antacids (Almagel, Maalox, Gastal). Reduce acidity, therefore, the aggressiveness of the stomach environment. Binds and removes pathogenic substances.
4. Regulating motor skills (Ganaton, Itopride). Can be prescribed in case of stagnation in the stomach and subsequent fermentation and rotting.

Comprehensive treatment with folk remedies gives good results. Herbs are used: gastric herbs, chamomile, fennel. They are mainly aimed at mildly relieving inflammation and improving digestion. Flax seeds and oat jelly are used as an enveloping, stomach-protecting home remedy.

You need to be especially careful with drugs from the NSAID group; due to their ulcerogenic effect, they often cause stomach pathologies.

Nutrition

Proper nutrition remains an important component of treatment. Foods that irritate the mucous membrane are excluded: sour, spicy, salty, smoked, fried, soda, alcohol, coffee and others.

It is recommended to cook in a double boiler and pay more attention to dishes such as porridge, jelly, and broth. Eating hot or cold food is contraindicated.

Forecast

Gastropathy of the erythematous type is not dangerous, but requires timely treatment, otherwise it can worsen and, without medical treatment, lead to gastritis, ulcers or gastroduodenopathy.

When the first symptoms appear, timely drug therapy and a proper diet can quickly and completely get rid of the disease.

Symptoms

Since gastropathy refers to inflammation, it is accompanied by typical symptoms of digestive malfunction:

• pain in the epigastric region;
• Nausea and vomiting are possible after eating;
• feeling of heaviness in the hypochondrium;
• presence of putrid taste in the mouth;
• belching air;
• constipation and diarrhea;
• white coating on the tongue.

In the first stages, the disease is completely asymptomatic, later it goes away on its own (when the provoking factors affected the body for a short time), or it worsens and goes into the second stage.

The pathology is accompanied by hyperemia of the gastric mucosa, which is one of the symptoms of the disease.

With a decrease in appetite, general weakness of the body and a decrease in body weight may be observed; symptoms of erythematous gastropathy may be present, such as fatigue and the presence of increased anxiety. The occurrence of these symptoms is considered a reason to perform an endoscopic examination.

Kinds

Gastroduodenopathy: erythematous, congestive, erosive, hyperemic, superficial, chronic

Based on the form of manifestation, two types of erythematous gastroduodenopathy are distinguished: focal and diffuse (widespread).

Focal

The focal form of the malaise is manifested by redness concentrated in one area of ​​the mucous membrane. This is a fairly safe type of hyperemic gastroduodenopathy, which develops with minor dietary disturbances and rarely turns into independent gastritis.

Diffuse

The diffuse type of erythematous gastroduodenopathy is characterized by damage to large areas of the mucosa. The advanced form of the disease is often complicated and requires drug treatment.

Types of disease

The classification of erosive reflux-esophagitis is carried out depending on the phase and nature of the course.

1. Sharp look. This type is quite common and is detected by superficial or deep lesions of the mucous membrane. The disease occurs suddenly, the clinical picture is pronounced. With timely treatment, when the treatment tactics are chosen correctly, recovery occurs quickly and complications do not arise.
2. Chronic appearance. Fixed in most cases, characterized by periods of exacerbation and remission. The chronic type of pathology occurs as a result of prolonged exposure to negative factors and therefore at this stage there is a risk of the formation of irreversible complications. The treatment course for erosive esophagitis is about 6 months.
3. Ulcerative appearance. Erosive formations in this form affect the deeper layers of the mucous membrane of the esophagus. The ulcerative form requires long-term therapy.
4. Peptic appearance. When the contents of the digestive organ penetrate the esophagus, swelling and inflammation of the mucous membrane of the organ develop, this is a prerequisite for this type of pathology.
5. Catarrhal appearance. Damage to only the upper layers of the mucosa is observed. Characterized by redness and hyperemia of the mucous membrane.

The pathological process can affect different parts of the organ and, depending on the localization zone, the following are distinguished:

• Total. The entire esophagus is affected;
• Proximal. The upper parts of the esophagus are affected;
• Distal. The pathological process is localized in the lower part of the esophagus, as well as near its junction with the stomach. This type of lesion occurs in patients more often than others.

Erosive reflux esophagitis occurs in several phases:

1. First phase. Single erosive formations appear on the mucosa, the size of which does not exceed 5 mm;
2. Second phase. It is possible for erosive formations to merge with each other, which are located on the surface layer of the mucosa and do not penetrate into its deeper layers;
3. Third phase. Characteristic of this stage is the spread of the inflammatory process to the entire mucous membrane. Small erosive foci merge to form ulcers;
4. Fourth phase. The presence of chronic ulcers of the distal zone of the esophagus and narrowing of its lumen are observed.

Diagnostics

Diagnosis of erythematous gastroduodenopathy consists of a detailed interview with the patient and the appointment of laboratory and diagnostic tests.

Among the tests, they most often recommend a general analysis of stool, urine and blood, blood biochemistry, a test for Helicobacter pylori and a coprogram.

Instrumental diagnosis of erythematous gastroduodenopathy includes:

• endoscopy;
• manometry;
• fluoroscopy;
• electrogastroenterography;
• pH-metry;
• esophagogastroduodenoscopy.

If concomitant pathologies of the gastrointestinal tract are suspected, radiation methods of examination - scintigraphy or ultrasound - may be prescribed.

Diagnosis of pathology

Gastropathy is detected more often during examination for the presence of other disorders.

Endoscopic examination can sometimes also cause erythematous gastropathy, it is called endoscopic syndrome, but this condition usually does not require special treatment.

Fibrogastroduodenoscopy is considered the main diagnostic method for gastropathy. During the examination, the doctor uses an endoscope to examine the esophagus, duodenum and stomach. Sometimes it becomes necessary to take tissue samples for histology.

Before conducting this type of diagnostic examination, it is advised to follow some recommendations. A few days before the study, exclude alcohol, carbonated drinks, fatty foods from the diet, and do not smoke.

In addition to fibrogastroduodenoscopy, the following types of examinations and laboratory tests are performed:

• blood and urine tests;
• gastroscopy;
• Ultrasound of the gastrointestinal tract;
• CT.

Treatment

Treatment of erythematous gastroduodenopathy begins with diet correction. For an uncomplicated disease, a gentle diet is prescribed that is not capable of injuring the irritated mucous membrane. The menu limits smoked meats, fats, canned food, spices and foods containing large amounts of coarse fiber (cabbage, apples, legumes). With hyperemic gastroduodenopathy, it is undesirable to eat whole grain bread and whole grain cereals, radishes, fresh onions and garlic, mushrooms, and dark chocolate.

All dishes should be comfortably warm, steamed or boiled. For irritated mucous membranes, soft milk porridges with butter, pureed soups, purees, jelly, and low-fat cottage cheese are suitable.

Drug treatment of erythematous gastroduodenopathy is prescribed if, during the examination, concomitant gastrointestinal diseases are revealed or the patient complains of feeling unwell.

Most often, the following groups of medications are used for irritated mucous membranes:

• inhibitors of gastric juice secretion - Omeprazole, Gastrozepine, Famotidine, Ranitidine;
• antacid (acidity-reducing) agents - Almagel, Maalox, Phosphalugel;
• medications that stimulate gastrointestinal motility - Ganaton;
• drugs that have a protective effect on the mucous membrane - Gastrocepin, Gastrofarm.

If Helicobacter pylori was diagnosed simultaneously with hyperemic gastroduodenopathy, antibacterial treatment is prescribed: Amoxicillin, Clarithromycin, Amoxiclav, Flemoxin, Solutab, Levofloxacin, Klacid, Sumamed. In addition to antimicrobial drugs, the patient is prescribed proton inhibitors: Nolpaza, Omez, Pantoprazole, Omeprazole.

For erythematous gastroduodenopathy, it is a good idea to supplement drug treatment with alternative medicine recipes. These can be herbal decoctions and infusions with an enveloping effect - oatmeal jelly, tea from marshmallow, herbs and mallow flowers, flax seeds. Cabbage juice helps with low acidity.

Drug treatment

Cardia failure is a chronic disease. It is difficult to cure it completely. But it is possible to reduce the relapse rate.

First of all, you need to eliminate the cause of sphincter weakness. If you are overweight, then diet and exercise are necessary to reduce body weight. Lifestyle changes are required: proper nutrition, refusal to wear tight clothes. It is recommended to sleep with your head elevated. Excessive physical exertion and sudden bending of the body should be avoided.

Drug treatment is aimed at strengthening the sphincter and relieving pain attacks. The following drugs are prescribed:

• means for increasing motility and tone of the digestive organs: “Metamol”, “Motilium”, “Propulsid”, “Reglan”, “Perinorm”, “Metoclopramide”;
• painkillers: “Ibuprofen”, “Tempalgin”;
• medications that coat the gastrointestinal mucosa: “Almagel”;
• Heartburn relievers: Ranitidine, Smecta.

Prevention

Prevention of erythematous gastropathy is very simple and includes several basic rules:

• fractional meals;
• adherence to diet;
• elimination of stress and mental overload.

It is very important to monitor the quality of food you eat. Dishes should not be excessively hot, cold or irritating to the gastrointestinal mucosa

By and large, the detection of erythematous gastroduodenopathy is not such a serious problem. Timely measures taken will help to completely get rid of the ailment and eliminate the likelihood of developing more severe forms of gastrointestinal damage.

Surgical treatment of cardia failure

Surgical treatment is used in advanced cases. Sometimes surgical methods help get rid of the cause of cardia insufficiency, for example, a hernia.

To eliminate sphincter weakness, the following operations are performed:

1. The wall of the esophagus is sutured to the stomach.
2. Additional folds are surgically made in the esophagus.
3. The muscles are sutured and the cardia ring is narrowed.

The surgeon decides which method to eliminate cardia insufficiency in each specific case.

Prevention

Erythematous gastroduodenopathy quite often develops into a more dangerous disease, so it is easier to prevent it than to treat it. The most important method of prevention is adherence to the principles of a healthy diet. Portions should be small, meals should be frequent, and unhealthy foods should be completely excluded from the menu.

In addition, it is important to avoid stressful situations that can provoke excessive production of gastric juice. It is also necessary to normalize the work and rest regime, to prevent overwork, which can lead to the development of inflammation

Another method of prevention is to take medications only as prescribed by a doctor and strictly adhere to the dosage. Non-steroidal anti-inflammatory drugs, hormonal drugs and some other groups of drugs provoke inflammation of the gastric mucosa, so uncontrolled use leads to complications.

Experts strongly recommend that patients give up cigarettes and reduce the amount of alcohol consumed to a minimum. Additionally, contact with toxic substances should be avoided. If a patient suffers from any diseases of the digestive system, it is necessary to visit a doctor in a timely manner and undergo an examination to detect complications at an early stage.

Stages of the disease

There are several degrees of gastric cardia insufficiency. What it is? Depending on how much the sphincter loses its ability to close, there are 3 stages of the disease:

• Stage 1. Incomplete closure of the cardia rosette occurs. Patients complain of frequent belching. During endoscopic examination, a small gap (about 1/3 of the diameter) can be seen in the cardia when the patient breathes deeply.
• Stage 2. With deep breathing, the gap increases to 1/2 the diameter. The patient complains of nausea and a feeling of heaviness in the digestive organs.
• Stage 3. The sphincter completely stops closing. If the patient suffers from liver pathologies, this aggravates the development of cardia failure. Symptoms of esophagitis (inflammation of the esophagus) become pronounced.

In the photo you can see endoscopic changes in the cardia with insufficiency: gaping gaps and inflamed areas.

General symptoms of the disease

Among the symptom complexes of the described pathology, the most pronounced are the following:

• Loss of appetite. Occurs frequently, but not in all patients. It all depends on the shape and size of the lesion. Doctors say that this phenomenon occurs due to disturbances in the peristaltic function of the damaged organ.
• Stomach disorders, diarrhea syndrome. It manifests itself during changes in the processes of the secretory ability of the stomach. At the same time, the movement of chyme into the subsequent lower parts of the digestive canal is accelerated.
• Heartburn. Appears due to an increase in the secretory function of the stomach, in which insufficiency of the cardiac sphincter may develop, which leads to reverse reflux (reflux) into the esophagus of acidic stomach contents, which causes irritation of the nerve endings mainly in the distal esophagus;
• Belching. This disease is rare, most often if the provoking factor of the disease is stress. Appears when the muscle function of the esophageal sphincter is impaired.

• Nausea. It can appear due to food poisoning, exposure to poisons, damage to poorly processed and chewed food. Often precedes vomiting.
• Vomit. A common symptom of this pathology. With the help of vomiting, the stomach tries to independently remove pathological substances from the body. It is a reflex defense mechanism.
• Painful sensations in the upper floors of the abdominal cavity. Appear when overeating. As a result of overstretching of the stomach wall with food, the organ's pain receptors begin to fire. Impulses from these receptors enter the center of the brain, and the person begins to feel pain.
• Dyspnea. Feeling short of air or having trouble breathing.
• Bitter taste in the mouth;
• Feeling and sensation of excess coating on the tongue.

In addition to gastrointestinal disorders, erythematous gastropathy occurs with symptoms of changes in general condition, such as:

• weakness,
• rapid onset of fatigue, lethargy,
• periodic pain in the head together with intestinal manifestations,
• pale skin,
• pressure surges,
• decreased immune reactivity,
• sophistication of taste preferences and appetite.

What is cardia?

The digestive tract contains circular muscles that act like valves. They help food move through the esophagus, stomach and intestines. Such muscles are called sphincters, they are able to contract when necessary and close the passage.

The cardia of the stomach is one of these muscles. It is located between the stomach and esophagus and regulates the flow of food. The sphincter is closed when a person is not eating and opens when eating so that food can enter the stomach. This happens during normal muscle functioning. The cardia prevents food and gastric juice from flowing back into the esophagus.

But sometimes the sphincter malfunctions, and then gastroenterologists diagnose “cardia insufficiency.” What it is? The pathology is that the muscle stops contracting or does not close completely, and food, along with gastric juice, is thrown into the esophagus. In medicine this is called reflux.

But if the protection of the esophagus is reduced, then the reflux of acid and food leads to burns and inflammation of the mucous membrane. This disease is called reflux esophagitis, and it requires immediate treatment. In advanced cases, ulcerations appear on the lower part of the esophagus.

Externally, the cardia resembles a round rosette. In a healthy body it closes in a circle. With its pathology, gastroenterologists talk about insufficiency of the cardia rosette.

Erythematous gastroduodenopathy - what is it?

A verdict such as erythematous gastroduodenopathy sounds very ominous. As a rule, this conclusion is made based on the results of examination of the gastrointestinal tract using endoscopic equipment. There is a reasonable fear that not everything is in order with the body. This difficult issue requires more detailed consideration.

Definition

It should be noted that the above diagnosis does not exist in the international classification of diseases. This term refers to a condition that is a precursor to gastritis or duodenitis.

In other words, the mucous membrane of the stomach and duodenum is not yet clearly inflamed, but such a danger exists. Another name for this condition is also used in the medical lexicon.

The diagnoses of erythematous and hyperemic gastroduodenopathy are absolutely identical - they are synonyms. The term “hyperemia” means increased blood flow to tissues.

Symptoms

The symptoms of gastroduodenopathy are quite diverse.

In particular, this problem makes itself felt as follows:

• discomfort and mild pain in the epigastric region;
• nausea and vomiting;
• dyspepsia, which is difficult digestion with a feeling of heaviness, early satiety, and fullness of the stomach;
• decreased appetite or lack thereof;
• white coating on the tongue, especially in the morning;
• disorders of the intestines, in particular constipation, diarrhea;
• bloating, belching, increased gas formation;
• heartburn;
• general weakness and loss of strength.

Therapy and prevention

Treatment of gastroduodenopathy should, first of all, be aimed at eliminating unpleasant symptoms and preventing the development of more serious diseases. In particular, it is recommended to follow some simple recommendations:

1. Compliance with diet. To eliminate signs of gastroduodenopathy, it is recommended to avoid the above products that irritate the gastrointestinal mucosa.
2. Food should be easily digestible, preferably steamed or boiled, not too hot. You should also temporarily exclude chocolate and fresh baked goods from your diet. Herbal teas and berry fruit drinks will bring significant benefits to the body.
3. Decoctions of medicinal plants. Treatment with decoctions of marshmallow, yarrow, chamomile and calendula inflorescences will help quickly eliminate discomfort in the epigastric region.
4. Taking antacids. These medications have the ability to reduce the level of acidity in the stomach, while enveloping and soothing the irritated mucous membrane.

Treatment of manifestations of gastroduodenopathy can be carried out using the following drugs:

• Maalox;
• Gastal;
• Almagel;
• Phosphalugel.

The drug Gaviscon, which belongs to the group of alginates, has a similar effect. It not only creates a protective shell on the irritated mucosa, but also promotes its repair.

Proton pump inhibitors. Treatment with these drugs is usually prescribed in more severe cases, when gastroduodenopathy is complicated by severe inflammation or erosion. PPIs reduce stomach acid production over the long term, giving the mucous membrane an opportunity to repair itself. The most commonly prescribed drugs include:

• Omeprazole;
• Pariet;
• Nexium;
• Sanpraz.

Drugs to improve gastrointestinal motility. They promote faster digestion of food, eliminate the feeling of heaviness in the stomach and prevent the occurrence of duodenogastric reflux. In this case, the following are usually prescribed:

If gastroduodenopathy occurs due to infection with the Helicobacter pylori bacterium, it is additionally recommended to prescribe the drug De-Nol, as well as certain antibiotics.

In conclusion, it should be noted that the exact treatment regimen for gastroduodenopathy should be prescribed by a gastroenterologist based on the existing symptoms and the disorders that have arisen.

How to treat pathology

To select the correct treatment regimen, it is necessary to establish the factors that provoked the onset of the disease. Another important point when prescribing treatment is the presence of concomitant pathologies, this could be erosive or chronic gastritis, gastroduodenitis.

When it is determined that the cause of gastropathy is the medications used, it is recommended to replace them. If this is not possible, medications are used that protect the stomach from the influence of negative factors.

Medicines prescribed for erythematous gastropathy:

• antisecretory agents - “Kvamatel”, “Nolpaza”, “Omeprazole”, “Pariet”. They reduce the synthesis of the main irritant of the mucous membrane - hydrochloric acid.
• gastroprotectors – “Vicair”, “De-Nol”, “Vikalin”. They protect the walls of the organ, have an astringent and anti-inflammatory effect.
• antacids - “Maalox”, “Almagel”, “Gastal”. These drugs help lower acidity, reduce the aggressiveness of the gastric environment, bind and remove pathogenic substances.
• regulating motor skills - “Itoprid”, “Ganaton”. They are prescribed in case of stagnation, fermentation and rotting in the stomach.

When the bacterium Helicobacter pylori is present, antibiotic therapy is prescribed.

In very rare cases, there is a need for surgical intervention. To do this, resection of the affected areas is performed.

Therapy for erythematous gastropathy will not be effective without diet correction.

Compliance with the following rules will help normalize nutrition and get rid of irritating effects on the organ:

• It is recommended to steam food;
• it is important to avoid eating irritating foods, such as: spices, smoked foods, spicy foods, pickles;
• It is prohibited to drink carbonated drinks, coffee, or alcoholic drinks. It is recommended to replace black tea with green, herbal infusion or plain water;
• The basis of nutrition consists of lean meats and fish, lean broths, liquid porridges, and jelly. It is allowed to eat jelly, cottage cheese, egg whites;
• All dishes should be eaten at room temperature. Too cold or hot dishes can cause irritation of the mucous membranes and lead to spasm of smooth muscles;
• It is recommended to eat at intervals of several hours;
• portions should be small - no more than 350 g. This helps to avoid increased stress on the digestive organs;
• you should not overeat. Excessive food volume contributes to the onset of rotting in the stomach. This causes a feeling of heaviness, nausea, and belching.

The presence of pronounced negative symptoms or deterioration of the patient’s condition requires adherence to a strict “Table No. 1” diet.

Folk remedies can be used as complementary to drug treatment. Traditional methods of treatment include the use of herbal infusions, decoctions, freshly squeezed juices, etc. For example, oat decoction has an enveloping effect. For low acidity, it is good to drink fresh cabbage juice.

You can use various herbs and medicinal plants: chamomile, fennel. The use of these remedies is aimed mainly at gently relieving inflammation and improving digestion.

Treatment of the disease

Due to the fact that erythematous gastropathy is a traumatic disease, you should follow a fasting diet for the first two days. Then a gentle diet is included in the diet: pureed and mushy food, not spicy, little salty, without excess acidity. As this happens, etiological factors are eliminated.

Once the diagnosis is made, the following procedures are necessary:

• With exogenous etiology, an important therapeutic measure is gastric lavage. This must be done in order to stop the negative impact of the damaging factor on the organ and the removal of toxic compounds. Gastric lavage is done so many times that the contents of the organ become clean without food residues or other impurities.
• If the previous medical manipulation cannot be carried out for one reason or another, then they resort to the method of artificial vomiting. This can only be done when the patient is conscious and there are no disturbances in the central nervous system. For example, in case of poisoning with toxic poisons, this should not be done under any circumstances.
• Drink plenty of fluids, replenish body fluids through infusion therapy in the form of droppers.
• If difficulties arise with washing the organ and inducing artificial vomiting, then only under the strict supervision of a doctor and according to indications, the emetic apomorphine is administered. Its independent use poses a threat to life and health.
• Adsorbents are widely used. These are medicinal active substances that remove toxic agents from the body and block their further absorption into the bloodstream. Activated carbon, polysorb.
• Laxatives are used to accelerate the removal of damaging factors from the body.
• For the first two days after diagnosis, bed rest and complete rest should be observed.
• You can drink warm, not strong tea.

Treatment of erythematous gastropathy with folk remedies

To treat this pathology, herbal remedies that have anti-inflammatory and wound-healing effects are most often used.

One of these traditional medicines is honey. It must be taken especially - one teaspoon of candied honey is placed in the mouth and dissolved until completely dissolved, gradually swallowing it. This manipulation is carried out 3 times a day.

Especially famous for the treatment of this pathology is a decoction of three herbs: oak bark - has astringent properties, chamomile flowers - anti-inflammatory effects, nettle leaves - wound healing properties.

All three dried components are mixed in equal proportions - 1 tablespoon each, pour 250 ml of boiling water, leave for 2-3 hours, strain and drink cooled after each meal.

Exclusively all diseases of the digestive tract fall under the general medical term “gastropathy”. Erythematous gastropathy, despite its frightening name, implies the initial stage of inflammation of the gastric mucosa.

Focal redness of the mucous surface is determined as a result of an endoscopic examination, when it becomes necessary to confirm any gastroenterological diagnosis for diseases of the digestive system. Thus, patients should understand that erythematous gastropathy is just a type of morphological change in the human stomach.

Endoscopy of the gastric mucosa for erythematous gastropathy

Obviously, before treating the antrum of the stomach, the cause-and-effect factor in the occurrence of erythematous gastropathy should be determined. There are several clinical versions of the development of a gastroenterological problem.

In most cases, redness of the mucous membrane is associated with the negative effects of external factors:

When considering the causes of erythematous gastropathy, a possible hereditary predisposition should be taken into account. As a rule, if even one of the closest relatives suffers from a similar form of stomach inflammation, this means that erythematous gastropathy is nothing more than a family diagnosis.

In addition, there are etiological reasons for redness of the mucous surface, for example, others and the stomach.

Complex treatment

To get rid of erythematous gastropathy, you should review your diet, eliminating heavy foods for the stomach. In most cases, changing your diet will help quickly restore the gastrointestinal tract.

The main treatment for erythematous gastropathy is a rational and balanced diet.

Experts recommend using fractional, easily digestible meals, which allows the stomach to digest food faster. The optimal portion should not exceed 350 grams of food. The following dietary recommendations must also be followed:

• The temperature of food consumed should be no lower than 40 degrees. This will provide a gentle regime for the stomach. Food that is too cold or hot will irritate the mucous surface.
• Of course, you need to avoid consuming fatty, spicy, fried and salty foods. All food products must undergo high-quality heat treatment.
• Gastronomic preferences should be given to complex carbohydrates, which are contained in sufficient quantities in buckwheat, rice or wheat porridge.
• It is recommended to include fresh vegetables and fruits in your daily diet.

Protein is an essential ingredient of the dinner table, which is found in lean meat, fish, egg whites, nuts, cottage cheese, and legumes. You should forget about smoking and drinking alcohol. By following the diet recommended by your doctor, you can observe positive dynamics of recovery within a few days.

Healthy food for the stomach

However, each individual case should be considered individually, since the gender, age and physical condition of the patient are important. It is possible that the doctor will recommend not only a diet, but also pharmacotherapy and treatment of erythematous gastropathy with folk remedies.

Drug treatment

Medications will help restore the health of the gastric mucosa. The most effective for this type of disease are Gastrofarm® and Gastrocepin® .

These drugs have a protective effect on the mucous membrane of not only the stomach, but also the intestines. Gastrofarm® contains biologically active additives - lactic, malic, nucleic acid, polypeptides and polysaccharides, which will provide a protective effect to the digestive organs, thereby restoring regeneration in the stomach and duodenum. A dosage form with a high protein content will provide an antacid and analgesic effect. The recommended dosage is determined by the attending physician.

Gastrozepin® from the German manufacturer BOEHRINGER INGELHEIM INTERNATIONAL GmbH, contains the active ingredient - pirenzepine, which actively reduces the formation of sulfuric acid and increases the pH level in the stomach. The dosage form has certain contraindications for use. Therefore, the maximum permissible daily dose of the drug is determined by a consulting gastroenterologist.

Traditional treatment

Therapy at home should be agreed with a doctor. Basically, if there is no allergic reaction to natural components, then experts advise drinking medicinal herbal infusions and decoctions. However, the acidity level should be taken into account. Increased stomach acidity , characterized by frequent and severe heartburn, can be treated with birch bark infusion. The crushed natural ingredient (2 tbsp) is poured with 400 ml of boiling water and infused for 2.5-3 hours in a warm place. Take half a glass of homemade medicine 3 times a day. The course of treatment is 10-14 days.

Acidic stomach contents

Low stomach acidity causes nausea and unpleasant rotten belching. An effective alternative treatment can be cabbage juice, ½ glass 3-4 times a day. The course of treatment is 7-10 days.

See also: How to determine stomach acidity at home?

Etiology of occurrence

To get rid of erythematous gastropathy (gastroduodenopathy), it is necessary to identify and eliminate the damaging factor that caused it. The occurrence of this pathology is provoked by the following reasons:

poor nutrition: excessive consumption of spicy, fried, salty, smoked foods, abuse of fast food, carbonated drinks, etc. ATTENTION! Eating such food before the FGDS procedure provokes the appearance of foci of hyperemia on the endoscopic picture;

taking certain types of medications that affect the condition of the digestive tract mucosa (NSAIDs, glucocorticosteroids, antibiotics, anticoagulants, etc.); infectious factor. The development of this gastropathy is promoted by certain bacteria, in particular Helicobacter pylori, and fungal pathogens; reflux of bile into the stomach, exposure to hydrochloric acid during long intervals between meals; stress factors: anxiety, lack of sleep, nervous and physical overload; bad habits: smoking, alcoholism; hormonal dysfunction and metabolic disorders; congestion in the digestive tract; hereditary factor; concomitant diseases can trigger the etiological mechanism for the appearance of gastropathy (pancreatitis, cholecystitis, enteritis, etc.); ischemic manifestations in the gastric wall; food and drug allergies.. A century ago it was believed that “chronic catarrh of the stomach is also observed in habitual drunkards, gluttons, and in general in people leading an immoderate lifestyle...” (A.P.

Chekhov, “Life’s adversities”). Today the list of reasons is much more extensive:

A century ago it was believed that “chronic catarrh of the stomach is also observed in habitual drunkards, gluttons, and in general in people leading an immoderate lifestyle...” (A.P. Chekhov, “Everyday Adversity”). Today the list of reasons is much more extensive:

• poor nutrition - violation of the regime; fried, spicy, fatty, smoked, pickled food. Stale food, food that is too hot or too cold;
• alcohol, especially strong alcohol, dissolves the barrier mucus, allowing aggressive enzymes access to the defenseless surface of the stomach;
• smoking increases the secretory activity of the digestive glands;
• chronic gastritis with improper treatment or lack thereof;
• entry of bile from the duodenum through a loosely closed pylorus;
• long-term use of medications, including non-steroidal anti-inflammatory drugs (NSAIDs), which include Aspirin, Diclofenac, Ibuprofen, Ketorolac, Indomethacin;
• chronic congestion occurring against the background of pancreatitis, pathologies of the liver, kidneys, gastric ulcer;
• injuries, chemical and thermal burns of the gastrointestinal tract;
• poor blood circulation in the stomach;
• gastrointestinal infections (Helicobacter) and helminthiases (roundworms, pinworms);
• An increase in pressure in the portal vein leads to dilation of the arteries, veins, capillaries of the stomach, and their overflow with blood. Possible rupture of blood vessels with bleeding.

Causes of the disease

Erythematous gastropathy can be caused by the following reasons:

1. Disruption of the circulatory process.
2. Presence of pathogenic microorganisms or fungal infection. More often, the cause of the disease is the active activity of the bacterium Helicobacter pylori. In this case, treatment is aimed at getting rid of the provoking factor.
3. Chemical burns.
4. Infectious diseases.
5. Medicinal (medicinal gastritis). The causes of this type of gastropathy include taking aspirin and non-steroidal anti-inflammatory drugs.
6. Heredity.
7. Poor nutrition.
8. Excessive drinking and smoking.
9. Daily routine and stress resistance are of no small importance. Under the influence of psychotraumatic factors, the synthesis of adrenaline increases. It affects the growth of hydrochloric acid production, and its prolonged exposure leads to irritation of the mucous membrane of the digestive organ, provokes redness, inflammation, and in some cases causes the formation of ulcers and erosions.

Pathogenesis

Gastroduodenopathy includes two completely different diseases: gastritis and duodenitis. These diseases have different pathogenetic mechanisms, but they also have a lot in common, and therefore they rarely occur separately and in most cases are combined in many patients.

Both pathologies can be attributed to acid-dependent conditions that develop when there is an imbalance of aggressive and protective factors affecting the mucous membrane of the stomach and intestines. One of these aggressive factors is the bacterium Helicobacter pylori. It affects the occurrence of chronic gastritis. Its role in the development of chronic duodenitis has not been proven. In the development of the latter, the acidity factor and enzymatic imbalance are of great importance.

Most likely, there is a common pathogenic process leading to the development of gastritis and duodenitis. In this regard, gastroduodenitis is considered as a whole.

Characteristic

Erythematous gastroduodenopathy is an overflow of blood vessels on the inner surface of the stomach walls. Pathology usually affects only the outer layer, without reaching the deeper levels. It is detected using fibrogastroduodenoscopy (FGDS). This study is carried out using a special device in the form of a hose, equipped with a camera and a lighting apparatus. The procedure is carried out only on an empty stomach.

The areas affected by the device are first treated with an anesthetic. The probe is swallowed, and within a few minutes the device records the condition of all areas of the stomach cavity, esophagus, and duodenum. In addition to visible disorders, endoscopy determines the acidity of the affected organ and the presence of dangerous bacteria.

It is important to know! Endoscopic examination can cause characteristic lesions.

In other words, erythematous gastropathy is a phenomenon that characterizes redness and swelling of the gastric mucosa. Mild inflammation does not pose a particular danger to the body, although it can be diagnosed as superficial gastritis. If the pathology is detected as a separate phenomenon without extraneous diseases, then the treatment method is significantly simplified. Redness of the gastric mucosa cannot be neglected. You can get rid of it only by following the correct diet prescribed by your doctor.

Erythematous gastropathy has certain symptoms:

• discomfort in the stomach after eating or drinking;
• belching, nausea, feeling of satiety;
• lethargic state;
• decreased hemoglobin;
• troubles with stool, digestion, heartburn, flatulence;
• yellowish, white coating on the surface of the middle of the tongue.

Signs of inflammation are revealed gradually. At the first manifestations of discomfort in the stomach, it is not recommended to delay a visit to a gastroenterologist.

Should you be concerned if you have been diagnosed with erythematous gastroduodenopathy?

You will not come across the term erythematous gastroduodenopathy in the office of a gastroenterologist, since this condition is not actually a diagnosis.

Rather, a frightening phrase will appear in the conclusion of the endoscopy result, to which this very doctor referred you. We invite you to figure out together what pathology is hidden under a complex and incomprehensible name.

What does diagnosis mean?

To clearly understand the meaning of the term, let us turn to the literal translation. So:

• Erythema (erythema, Greek) - means redness, redness. Most often, the term is used to refer to redness of the skin and mucous membranes. If in the conclusion of your EGD the description begins with the word “erythematous,” it means that the internal mucous membranes of the organ have a bright red color, which corresponds to inflammation.
• Gastro (gaster, Greek) – stomach. The names of all diseases associated with this organ begin as follows - gastritis, gastroduodenitis, etc.
• The prefix duodeno - (duodena, Greek) denotes a connection with the 12 duodenum. If it is present in the name, it means that the pathology affects the area of ​​the duodenum 12.
• Pathia – (páthos, Greek) – means illness, suffering.

Thus, erythematous gastroduodenopathy means redness (inflammation) of the mucous membrane of the stomach and duodenum.

To worry or not?

Pathology is not considered an official diagnosis; rather, it denotes endoscopic syndrome, that is, it describes the condition of the superficial tissues of the stomach and duodenum, which does not extend to deeper layers. The condition can be acute or chronic.

Acute inflammation may be associated with temporary irritation of the mucous membranes, which occurs after overeating, drinking alcohol, spicy and spicy foods, and marinades. Persistent irritation is also observed in patients who smoke. Fans of too hot food also periodically suffer from gastropathy, but these symptoms quickly pass.

A chronic form of inflammation is observed in patients with other diseases of the digestive system. Also, endoscopists detect the syndrome of erythematous gastroduodenopathy during or at the recovery stage after acute or chronic gastritis or peptic ulcer.

You should not ignore the pathology, because in the presence of provoking factors, it will not slow down to spread into the deeper layers and transform into a new, acquired disease.

Degrees and types

Endoscopist doctors distinguish 2 forms of pathology:

1. Focal erythematous gastroduodenopathy - the term refers to the presence of redness in a limited (local) area of ​​the mucous membrane. In this case, the EFGDS conclusion will contain an exact indication of the department where there is inflammation. This may be the antrum, cardia, fundus of the stomach, duodenal bulb or part of the intestine.
2. The diffuse form is diagnosed if the redness is widespread and visible in many areas of the gastric and duodenal mucosa.

The syndrome is also divided into degrees:

• Grade 1 pathology is common and is associated with temporary, shallow irritations of the mucous membranes. Stage 1 responds well to therapy, sometimes to eliminate it it is enough just to correct the diet; you do not need to take medications;
• Grade 2 means that the process has a chronic course, that is, redness and inflammation of the mucous membranes is always present. Grade 2 occurs in patients with chronic gastritis and other diseases of the digestive tract.

About the reasons in detail

The cause of erythematous gastroduodenopathy is not always a diet disorder or an existing disease of the digestive system. The condition may have a different origin. The following factors provoke hyperemia of the mucous membrane:

1. Microbial or fungal infections of the mucous membrane.
2. Taking nonsteroidal anti-inflammatory medications. Hormones, anticoagulants for a long time.
3. Chronic metabolic disorders.
4. Vitamin deficiencies.
5. Constant stress and overwork, high physical activity.
6. Hereditary factor.
7. Increased acidity of the stomach contents.
8. Starvation diets.
9. Bad habits.

At grade 1, gastroduodenopathy does not manifest itself sharply - clinical symptoms appear periodically and disappear as soon as the diet is normalized. Grade 2 erythematous gastroduodenopathy is characterized by a more pronounced clinical picture, which is similar to the manifestations of chronic gastritis.

Important! The condition is not a reason for hospitalization of the patient, and does not exempt him from military service.

Symptoms of erythematous gastroduodenopathy

The most common symptom of erythematous gastroduodenopathy is heaviness in the stomach that occurs after eating. Moreover, for the symptom to appear, the patient does not have to overeat; heaviness occurs even after a snack.

Sometimes this condition is accompanied by severe nausea, which is difficult to cope with.

This is due to the fact that when the mucous membrane becomes inflamed, the production of enzymes is disrupted, food digestion proceeds slowly, causing discomfort.

If the foci of redness are located in the antrum and spread to the area of ​​the duodenal bulb, peristalsis suffers: the food bolus has difficulty moving through the digestive tract, stagnates in the lower parts of the stomach, causing the patient bloating, unpleasant belching of air, heaviness in the epigastrium and disorders intestinal activity. Pathology in this case provokes constipation or diarrhea.

If erythematous gastroduodenopathy with an erosive component is detected, pain syndrome is added to the above symptoms. This condition is dangerous due to its rapid degeneration into erosive gastritis or peptic ulcer.

Therefore, the doctor must explain to the patient the need to follow a gentle diet. When hyperemia is combined with atrophy, the prevailing symptom is heaviness in the epigastrium and flatulence.

In this case, the doctor prescribes enzyme preparations (Omez, Festal, Mezim) to stimulate the activity of the stomach.

The common symptoms of erythematous gastroduodenopathy include the following:

• weakness, fatigue, increased irritability;
• lack of appetite, stomach discomfort;
• anemia associated with impaired absorption of nutrients;
• weight loss;
• periodic vomiting not associated with poisoning;
• plaque on the mucous membranes of the mouth, especially on the tongue.

Painful symptoms disappear if the patient’s regimen and diet are normalized. If you ignore periodic ailments, the pathology will quickly develop complications and first transform into gastritis, and later into peptic ulcers.

The signs of erythematous gastroduodenopathy in the acute stage or during initial detection are similar to the symptoms of exacerbation of chronic gastritis.

Therefore, treatment and nutrition for acute conditions are similar to treatment recommendations and diet for chronic gastritis.

Treatment and diet

Drug treatment for erythematous gastroduodenopathy is rarely prescribed. The main therapeutic method in this case is diet. Don't be alarmed and think that your diet should be reduced to diet soup and cereals, this is not so. On the contrary, the daily food set should be varied in order to provide the body with the necessary substances.

The restrictions apply only to frankly unhealthy foods - smoked meats, marinades, too hot and too cold dishes. You should not drink alcoholic and carbonated drinks, overeat heavily, or “sit” on coffee alone throughout the day. A sick stomach should not be empty, so carefully consider your daily diet.

To help, we suggest you familiarize yourself with the material, where we examined in detail the principles of nutrition for superficial gastritis. Dietary recommendations for this disease and erythematous gastroduodenopathy are identical.

A simple collection to relieve inflammation

The main component of this collection is yarrow. 50 grams of dried crushed yarrow flowers and herbs are poured into 400 ml of water and boiled over low heat for 40 minutes. After the broth has cooled, it is filtered and taken warm, a third of a glass, before main meals.

Composition for stimulating digestion

To prepare this decoction, prepare a mixture of the following components:

• centaury;
• yellow gentian;
• chicory flowers;
• fumaria officinalis;
• yarrow;
• St. John's wort.

Do not be alarmed by such variety - the raw materials for preparing the decoction are sold in any pharmacy. Mix the ingredients in equal quantities, take 3 tablespoons of the prepared mixture and pour 400 ml of boiling water. Seal tightly and leave for 4 hours. Strain the broth and take it warm before your main meals - breakfast, lunch and dinner.

These recipes are given in the “Newest Therapist's Handbook”, written by the famous Russian doctor, E. A. Nikolaev.

We invite you to watch a video about healing herbs for the stomach.

Before starting treatment with herbal remedies, it is better to consult with your doctor.

In each case, it is important to take into account the individual characteristics of the body, allergies, the presence of concomitant diseases and other factors.

Be attentive to yourself, do not neglect visiting the clinic. And remember: with erythematous gastroduodenopathy, your main task is proper and healthy nutrition.

Source: https://MedBrat.online/zheludok/eritematoznaya-gastroduodenopatiya.html

Treatment of reflux esophagitis

Treatment of reflux esophagitis is aimed at eliminating the cause of the disease. Properly organized therapy can make the symptoms of the disease less pronounced, help reduce the negative effect of gastric juice on the esophageal mucosa, and increase the resistance of the mucosa.

Complex therapy for reflux esophagitis includes:

• Use of medications;
• Following a special diet;
• Use of folk remedies;
• Surgery if necessary.

Treatment of the patient also includes adjusting the daily routine. It is necessary to exclude nervous overload. You need to maintain a sleep schedule. It is recommended to sleep on a small pillow so that your head is 30 degrees higher than your body, which will help reduce the number of refluxes at night.

Tension of the abdominal muscles should be avoided, and medications that reduce the tone of the lower esophageal sphincter (nitrates, amino acid, sedatives and hypnotics) should be avoided. It is necessary to avoid tight clothing, which can cause an increase in intra-abdominal pressure.

You need to eat about 6 small meals a day. The last meal should be 2 – 4 hours before bedtime. Walking after eating is useful, since in this way the food taken is quickly absorbed and moves more quickly from the stomach to the intestines.

Authorized Products

The diet for erythematous gastropathy includes:

• Soups made from non-concentrated broths with the addition of pureed cereals/vegetables.
• Low-fat varieties of red meat/fish - chicken, rabbit, veal, turkey, beef, cod, pike perch, pollock, hake.
• Soft-boiled eggs/steam omelet.
• Dried white bread, white bread croutons.
• Puree porridges cooked in water with milk/cream (oatmeal, semolina, rice), a little later - buckwheat.
• Vegetables/fruits that can be consumed in boiled and pureed form are beets, zucchini, potatoes, carrots, and pumpkin. Fruits - sweet/ripe baked/boiled.
• Whole milk, cream, pureed calcined cottage cheese, curd soufflé.
• Sweet dishes include marshmallows, marshmallows, berry jelly, honey, jam, fruit mousses.
• For drinks, it is recommended to drink infusion of rose hips, juices with pulp (apricot, pear, peach), fruit jelly, weak tea with milk.

In medicine, it is customary to distinguish between the concepts of gastritis and gastropathy. The first diagnosis is made by confirming morphological changes in the gastric mucosa characteristic of inflammation. Therefore, in addition to assessing symptoms and objective research data, to confirm chronic gastritis, it is necessary to conduct a histological examination of the biopsy obtained during fibrogastroduodenoscopy. The second variant of damage to the gastric mucosa is gastropathy, which occurs as a result of exposure to various damaging factors and is manifested by disorders of the epithelial layer and vascular changes. Gastropathy is characterized by the absence of an inflammatory process or its insignificant severity.

Types of superficial gastropathy

Gastropathy can be diffuse or local, limited in nature. When a probe is inserted after examining the esophagus, the mucous membrane of the cardia is examined, then the body of the stomach and, finally, the antrum and pylorus. If hyperemia is detected in all gastric sections, then the diffuse nature of the pathology is indicated in the conclusion, this most often happens with the erythematous variant of gastropathy. If the process is focal in nature, then a localized form of gastropathy is diagnosed.

With continued exposure to infectious, damaging or provoking factors on the gastric mucosa, as well as with inadequate therapy, the acute process can turn into a chronic form of gastropathy or gastritis.

Symptoms of erythematous gastroduodenitis and its treatment options

Erythematous gastroduodenitis is a disease of the gastrointestinal tract, characterized by damage to the gastric mucosa by hydrochloric acid, which begins to corrode it, causing inflammation. To prevent the development of the inflammatory process, it is important to know what it is and begin timely treatment of the disease.

Medicines

Drug therapy is mandatory for this disease. The treatment regimen usually includes antibiotics. They are prescribed to eliminate the bacteria H. Pylori. But therapy is also impossible without taking the following groups of drugs:

• antacid medications;
• bismuth preparations;
• proton pump inhibitors;
• enzyme agents;
• antispasmodics;
• sedatives;
• prebiotics;
• vitamins.

Advice! Drug therapy is selected exclusively by the attending physician. It is not recommended to take medications without his consultation.

Surgical treatment

Indications for surgery are the failure of long-term drug treatment, as well as the appearance of esophageal strictures. Surgical intervention is necessary for the development of Barrett's esophagus, when there is a risk of malignancy. Indications for surgery include regular esophageal bleeding, a combination of reflux esophagitis with bronchial asthma that cannot be adequately treated, and frequent aspiration pneumonia.

The operation is performed by Nissen fundoplication. The goal of surgery is to restore normal functioning of the cardinal sphincter.