The esophageal sphincter does not close, treatment. The esophageal sphincter: what functions it performs, its functional disorders and their treatment. Treatment of reactive gastritis

A malfunction of the esophagus can provoke severe pathologies.

Structural features

The fibers form the sphincter. When the muscles contract, the opening in the sphincter area closes (reduces in diameter). The organ has two sphincters:

Cardiac or lower esophageal sphincter. This sphincter is located at the border of the esophagus and the stomach. As food moves into the stomach, the cardiac sphincter opens slightly. Before this, it is closed due to muscle tone. This prevents stomach contents from entering the esophagus.
Pyloric sphincter or pylorus (superior). Separates the pyloric region of the stomach from the duodenum. Its functions include regulating the flow of stomach contents into the duodenum.

Job

The cardia of the stomach is a valve that separates the abdominal cavity from the tissues of the esophagus (it is located between them). In other words, this is the vestibule of the stomach. The cardia has the main function of blocking the reflux of food. The contents of the organ include acid, and in the esophagus the reaction can be neutral or alkaline. The pressure in the stomach is higher than inside the esophagus, so it is important that when the lower sphincter opens, the contents do not end up on the esophageal mucosa.

Types of disorders and diseases

If the functioning of the cardia rosette is disrupted (insufficient), the esophageal sphincter does not completely close (does not close). During non-closure, gastric secretions, gastric enzymes, and food particles enter the esophagus, causing irritation, erosions, and ulcers. In medicine, the following main types of sphincter disorders are distinguished:

Increased tone. With this disorder, it does not open completely when food particles pass through. The patient has impaired swallowing function. This pathology develops when exposed to ANS impulses. It is customary to distinguish between two types of this condition (the classification depends on where the pathology is located). Thus, improper functioning of the pharyngeal esophageal sphincter provokes disturbances during swallowing food. In this case, painful sensations arise, the patient may choke, and sometimes a cough appears when food enters the larynx area. If the esophageal sphincter, located between the abdominal cavity and the esophagus, begins to function incorrectly, then food can accumulate in the esophageal sections, which leads to expansion of the organ.
Decreased tone. This pathology is characterized by the reflux of food particles or stomach contents into the upper esophageal region, sometimes into the pharynx. The socket begins to close insufficiently. Such disturbances in the functioning of the cardia can affect the lower esophageal sphincter or both sphincters simultaneously. Sometimes non-closure (when the sphincter does not close completely) and pressure provoke vomiting and nausea.
With the 3rd degree of insufficiency, a gaping sphincter is formed.

Causes

Insufficiency of the cardia rosette can be caused by changes in the structure or structure of various esophageal sections. Scar formation can lead to a narrowing of the sphincter, which persists if the muscles are relaxed. The diameter of the sphincters may increase with diverticulum. In addition, expansion sometimes provokes stretching of the tissues of the lower region of the organ due to disruption of the functioning of one of the sphincters (cardiac). In such cases, it is weakened and cannot work properly.

Symptoms

Changes in the functioning of the sphincters affect the functioning of the organ, which causes the appearance various symptoms- odor from the mouth, pain in the esophagus, dysphagia.

Odor from the mouth. Changes in the diameter of the esophageal sphincters provoke the appearance of such a symptom. This is due to a number of pathogenetic reasons, including the accumulation of food particles and gastric contents in the esophagus. If the upper and lower esophageal sphincter do not function properly, the ingress of gastric contents can cause inflammation of the membranes, the formation of erosions, and various infections.
Painful sensations. Pain can appear due to various disorders of the sphincters. Sometimes pain develops when swallowing; at rest, such sensations may be absent. The development of the symptom is triggered by irritation and damage to the membrane due to the regular ingestion of gastric contents.
Swallowing dysfunction. Dysphagia is considered the most common symptom of cardia failure. In most cases, it occurs when swallowing solid food particles. Drinks and dishes that have a liquid consistency do not cause discomfort when swallowed.

Diagnostics

If suspicious signs appear, the patient should consult a doctor as soon as possible. If necessary, the specialist will refer the patient for further examination. To examine patients suffering from this pathology, it is customary to use the following diagnostic methods:

X-rays help detect reflux esophagitis;
gastrofibroscopy is considered the most informative type of research, as it allows for visualization of pathologies;
study of the work of the cardia, esophagotonokymography, determination of the pH level in the esophagus, etc.

Treatment and strengthening

Cardia insufficiency can be cured using several methods:

Diet. Proper nutrition will strengthen your immune system. In addition to strengthening immune system, you should eat 4-5 times a day, and the portions should be small and equal. Patients should not overeat. You should have dinner two hours before bedtime. It is important to eat dietary boiled and lightly salted foods. It is beneficial to eat steamed food. Products that reduce acidity and relieve irritation caused by it will help improve the patient’s health. Kissels and porridges, which envelop the mucous membrane, are added to the diet. Citrus fruits, pickles, pickled vegetables, canned food, alcohol, and chocolate are excluded from the list. Doctors recommend giving up smoking. This bad habit stimulates the production of enzymes, which negatively affects the functioning of the digestive system.

Restoring the esophageal sphincter is impossible without following a diet.

Drug therapy. There are a number of areas of such treatment. Strengthening the body is achieved with the help of antacid medications (for example, Almagel) - they help relieve heartburn and eliminate pain. Treatment with such agents helps protect the mucous membranes of organs from harmful effects acids. The therapy includes medications that are intended to restore the mucous membrane (for example, Omeprazole). Medications that improve motility overcome poor closure and prevent food retention. A doctor should prescribe antiemetic medications, since vomiting in such cases can be stopped at a reflex level. Painkillers can only be taken after the recommendation of a specialist, since pain can be specific and cause damage to the membranes and tissues. In such cases, analgesics may be ineffective. Sometimes treatment is supplemented with antibiotics and antiprotozoal drugs, which is sometimes associated with infection of erosions and other complications.
Good results can be achieved by treating pathology with natural remedies. For example, inflammatory processes in the mucous membranes are relieved using a decoction of fennel and anise. Pain and heartburn can be eliminated by drinking potato juice, chewing dried raspberry leaves, teas made from peppermint, chamomile, raspberries, cabbage juice, and a solution of crushed activated carbon. In addition, plantain infusions and infusions are effective, flaxseeds, motherwort, oregano, licorice roots, shepherd's purse, calamus root. It is important to remember that the preparations and dosage of herbs and other folk therapeutic remedies should be prescribed by a specialist. The doctor will take into account all the characteristics of the patient’s body and select an individual therapy method. When choosing remedies, it is necessary to take into account how damaged the mucous membranes of the organs are.
If the therapy does not produce a positive effect, the gastroenterologist refers the patient to a surgeon, since severe cases of the disease require surgery. The patient may be prescribed pyloroplasty or other types of surgery.

Forecast

Food must move forward through the gastrointestinal tract. When casting, irritation of the membranes and inflammatory processes are possible, which can lead to complications and other unpleasant consequences. Advanced inflammation can provoke the development of malignant tumors, ulcers and erosions.

Prevention of the esophageal sphincter

To prevent illness, you should eat food often, but in small portions, and do not overeat. It is important to reduce the amount of coffee, garlic, and onions in the diet, not to eat fatty, overcooked foods, and to keep alcohol and carbonated drinks to a minimum. In addition, you need to limit your consumption of citrus fruits, mint tea, chocolate. The patient should perform abdominal exercises and at the same time avoid exertion after meals and do not eat before bed. Smoking cessation is necessary. You should not wear tight clothing (belts, tight pants, etc.). In addition, it is important to undergo a timely examination and contact a specialist if any suspicious symptoms appear.

The esophageal sphincter: what functions it performs, its functional disorders and their treatment

The esophageal sphincter (valve) is an anatomical structure formed by transverse, longitudinal, circular, and spiral smooth muscle fibers. There is an upper esophageal sphincter and a low valve - they ensure the passage of food through the digestive tract in one direction.

Muscular contraction of the organ contributes to the closure and expansion of the lumen of the alimentary canal. During the closure of a functional organ, food does not move back into the esophageal canal, pharynx, or mouth.

Esophageal sphincter: functions

Along the esophageal tube, a bolus of food moves from the mouth into the stomach cavity. The movement of the lump is facilitated by peristalsis of the esophageal tube.

In response to swallowing a bolus, the pharyngeal valve relaxes, the bolus of food freely passes into the cavity of the esophagus, then enters the open cardiac valve, and from there into the gastric region.

The upper esophageal sphincter (UPS or pharyngeal valve) is the pharyngeal cavity from the esophageal cavity, located at the height of the seventh cervical vertebra. It does not allow food to flow back and creates a barrier to reflux into the pharynx and respiratory tract.
Low esophageal sphincter (LES or cardiac valve) - is located at the transition of the cardiac part of the esophageal tube into the stomach cavity, in the place where the epithelial cells of the esophageal tube pass into the gastric mucosa. Normally, the valve opens when the food mass passes through. Other times it is clamped so that the contents of the stomach do not flow back into the esophageal canal.

Swallowing peristalsis works in such a way that the previous swallow is suppressed by the wave of peristalsis of the next swallow. If the first sip does not have time to travel the entire area, the process is disrupted, esophageal peristalsis is inhibited, and the lower cardiac valve relaxes.

The autonomic system regulates the functioning of the sphincters. The nerve system activates and relaxes the tone of the cardiac region. If there is no food mass in the lumen of the esophageal tube, the lower esophageal sphincter contracts. Conversely, the valve opens to allow food masses to pass into the stomach cavity.

Functional disorders

Malfunction of the sphincters occurs separately in one of them or develops in two at once. There are 2 types of esophageal valve disorder:

increased tone - when bolus masses pass, the functional organ does not open completely, during which dysphagia develops, that is, swallowing is impaired;
decreased valve tone - food and gastric mass are refluxed in the opposite direction: into the lower and upper parts of the esophageal canal, pharynx, and oral cavity.

Increased valve vigor

Increased valve tone develops as a result of high impulses of sympathetic nerves. Based on localization, there are two forms of this condition:

Increased activity of the pharyngeal valve causes disruption of the initial moment of swallowing. This condition leads to the development of cough, sore throat, sometimes pain and heartburn occur when undigested pieces of food fall back into the throat.
Increased tone of the lower valve of the esophageal canal leads to the accumulation of food lumps in the cardiac part of the esophagus, which causes its expansion. A person feels nauseous, full after eating, and may vomit.

An increase in valve activity subsequently leads to the development of structural changes in the mucous membrane of the esophageal tract.

Decreased sphincter activity

A decrease in smooth muscle tone directly leads to the fact that the esophageal valve does not close (we will find out the treatment later). In this case, the food bolus moves back to the upper parts of the digestive canal. This condition has manifestations of different nature and depends on where the reduced tone is localized - in the lower or upper part.

Decreased activity of the upper sphincter causes food particles to be thrown into the reverse direction, undigested food remains enter the pharynx, larynx, and upper respiratory tract, which causes a sore throat in the patient, and a cough torments the person during or after eating. If a piece of food gets into the larynx or trachea, suffocation may develop. The patient constantly regurgitates eaten food or empty air.
A deficiency of the lower alimentary sphincter leads to such serious consequences as erosive esophagitis. Regular reflux of gastric mass into the lower parts of the canal and reduced cardiac valve tone play a major role in the pathogenesis of reflux disease (GERD). This leads to ulcerative and erosive lesions of the mucous membrane of the digestive tube.

The decreased tone is directly affected by the parasympathetic system, as well as a decrease in impulses from the nerve fibers of the sympathetic part.

Organic disorders of the sphincters

Structural changes or disturbances in the anatomical composition of different parts of the digestive tube lead to disruption of the functioning of the food valves. Scars, strictures, and tumors of the esophagus disrupt the functioning of the sphincter, since the functional organ narrows and cannot expand even if the smooth muscles relax.

Expansion of the sphincter lumen develops with diverticula, when a bulging of the esophageal wall is formed. An organic increase in diameter is also caused by stretching of the walls of the lower section, which initially forms with increased tone of the cardiac valve.

As a result, the patient develops the following symptoms:

bad breath – putrefactive reactions develop in the cavity of the esophagus;
soreness – pain appears with both decreased and increased valve tone;
impaired swallowing (dysphagia) - has the following manifestations: cough while swallowing food, belching of eaten food or air, discomfort after swallowing a bolus of food.

Esophageal sphincter: how to treat

The goal of therapeutic treatment measures is to restore the normal process of food passing through the esophageal canal. To treat the esophageal valve, medications and manipulations are used. The doctor selects therapy, taking into account the type and nature of the valve dysfunction.

antispasmodics – reduce the tone of smooth valve muscles;
prokinetic agents - increase the tone of smooth muscles, strengthen the sphincter between the stomach and the esophagus (as you know, there are often cases when the valve between the esophagus and the stomach does not close), as well as the upper pharyngeal valve.

Surgical treatment of the esophageal sphincter

If conservative therapy is unsuccessful, or surgical intervention is used to achieve a permanent result.

Bougienage is an expansion of the lumen of the stenotic esophageal canal. For the procedure, a special probe equipped with light and optics is used. The narrowed areas expand with gradual insertion of the probe. Bougies are selected in different sizes and flexibility, depending on the nature of the stenosis.

Esophageal plasty is a surgical procedure that reduces the lumen of the sphincter by suturing the smooth muscle. This procedure is done for erosive esophagitis.

Useful video

In conditions such as lower esophageal sphincter insufficiency, the esophageal sphincter does not close, treatment should be comprehensive. Useful information from experts is provided in this video.

How to strengthen the esophageal sphincter?

In addition to surgical methods, the functioning of a low esophageal valve can be restored using physiotherapeutic procedures. Physiologists have approached this problem in a comprehensive manner: they act on the esophageal canal and nearby organs with currents of various frequencies. The following have shown themselves to be effective:

These procedures can be performed in conjunction with the insertion of an internal probe. Thus, microcirculation of the organ increases, healing proceeds better, and a mild analgesic effect is noted. This way, without intervention, the integrity of the esophageal organ is restored and the tone of the cardiac valve is strengthened.

Exercises to strengthen the esophageal sphincter

Strengthening muscles through therapeutic exercises is considered an alternative treatment method. The difficulty is that there is no direct access to the muscles of the digestive system in this segment: the esophageal canal and all its sections are located inside the chest. But breathing exercises can be very effective.

take turns taking a deep breath and exhaling using chest and abdominal breathing;
Inhale and exhale at different rates, speeding up or slowing down.

Such exercises help well in the early stages of pathology. It is enough to exercise regularly, do gymnastics for three minutes a day. In difficult situations, breathing exercises are unlikely to help. Your doctor will tell you which method to choose and how to strengthen the esophageal valve.

Upper esophageal sphincter

Upper esophageal sphincter (UPS; synonyms: pharyngoesophageal sphincter, pharyngoesophageal sphincter, pharyngoesophageal sphincter; English. Upper esophageal sphincter) - sphincter located on the border between the pharynx and esophagus.

Functionally, it is a valve that allows lumps of food and liquid to pass from the pharynx into the esophagus, preventing them from moving back and protecting the esophagus from air entering during breathing and the trachea from food entering.

Formed by the inferior pharyngeal constrictor (lat. musculus constrictor pharyngis inferior), its cricopharyngeal part. It is a thickening of the circular layer of striated muscles, the fibers of which have a thickness of 2.3 - 3 mm and which are located at an angle of 33-45° relative to the longitudinal axis of the esophagus. The length of the thickening on the front side is 25-30 mm, on the back side 20-25 mm. Sphincter dimensions: about 23 mm in diameter and 17 mm in the anteroposterior direction. The upper border of the sphincter is located at a distance of 16 cm in men or 14 cm in women from the incisors.

The muscles of the upper esophageal sphincter are normally constantly contracted outside the act of swallowing. This is ensured by continuous nerve stimulation by somatic fibers, the motor neurons of which are located in the nucleus ambiguus. The sphincter remains closed due to the elasticity of the esophageal wall and the tonic contraction of the sphincter muscles. Inhibition of the motor neurons of these muscles causes a decrease in muscle tone by 90%, resulting in the opening of the sphincter. The upper esophageal sphincter mainly contracts in the anteroposterior direction, and its lumen takes on a slit-like shape.

During sleep, sphincter tone decreases. Its closed state is maintained only by basal muscle tone. However, the sphincter instantly responds to breathing, head position, stretching, stimulation and tension and thereby protects the esophagus.

The pressure that is created in the upper esophageal sphincter outside the swallowing phase reaches approximately 80-120 mmHg. Art..

Functional disorders of the upper esophageal sphincter can cause a variety of diseases. The most specific ones are listed below.

Dysphagia

The causes of dysphagia (impaired swallowing) can be pathologies of the upper esophageal sphincter caused by various diseases: bulbar poliomyelitis, cerebrovascular disorders, multiple sclerosis, muscular dystrophy, myasthenia gravis, dermatomyositis, pharyngoesophageal diverticulosis. In this case, coordination between the contraction of the pharynx and the contraction and relaxation of the upper esophageal sphincter is lost. The contraction of the latter occurs before the contraction of the pharynx is completed and, as a result, difficulties arise with swallowing.

Extraesophageal manifestations of gastroesophageal reflux disease

If the obturator ability of the upper esophageal sphincter is impaired, penetration of the acidic contents of the stomach, and in some cases even bile from the duodenum, into the pharynx, larynx or respiratory tract can occur. As a result of the impact of aggressive components of refluxate on the mucous membrane or these organs, various existing respiratory and bronchopulmonary diseases may arise or develop: apnea, laryngitis, otitis media, bronchial obstruction syndrome, bronchial asthma. The reflux of refluxate through the upper esophageal sphincter into the pharynx and larynx, as well as the pathological condition caused by the effect of refluxate on the pharynx or larynx, is called pharyngolaryngeal reflux.

Sphincter of the stomach: functional features, significance and methods of strengthening

The gastric sphincter (otherwise known as the cardia) is the boundary between the organs of the peritoneum and the esophagus, preventing food from being thrown back into the esophagus. Normally, the sphincter is closed and opens only after swallowing food. The sphincter of the lower esophagus closes during the digestion of food. With cardiac failure, serious diseases develop that can lead the patient to peptic ulcer or erosive disease. Timely treatment and prevention of sphinctral insufficiency of the stomach in the presence of predisposing factors will avoid many unpleasant complications from the epigastric organs.

Anatomical aspects

Anatomically, the stomach is located immediately below the diaphragm, it borders the pancreas, spleen, left upper edge of the liver, and one of the sections of the duodenum. The left kidney and adrenal gland border the stomach. The stomach seems to be an important organ involved in all digestive processes; the walls of the cavity have a three-layer structure (muscular, serous, mucous). In the stomach cavity, food is crushed, its particles are broken down and mixed. The crushed food in the stomach is disinfected and then enters the intestinal tract. There, processed food goes through the second stage of processing: all useful vitamins, microelements, and other compounds important for normal metabolism are absorbed into the blood through the intestinal walls. The residual mass is sent to the lower intestine, forming into feces.

Important! Structurally, the stomach has a narrow oblong shape, top part, body (cavity), bottom, sphincters. All parts of the stomach make up the lesser and greater curvature.

Structural features

The esophageal sphincter (another name for the cardia) plays a differentiating role, separating the stomach cavity from the esophagus. The structure of the sphincter repeats the structure of the gastric cavity, except for the structure of the muscle layer. The sphincter musculature is better developed due to its physiological purpose, which is expressed in the opening and closing of the sphinctral valve. After food enters the stomach, after some processes it enters the stomach for further movement into the intestines. The sphincter does not allow the food bolus to move back into the esophagus. When food is thrown back, cardiac failure occurs. When the pathology is formed, gastric juice literally burns through the delicate mucous membrane of the esophagus, contributing to the formation of ulcerative or erosive lesions. In cardiac failure, the valve does not close and the contents of the stomach flow back into the esophagus.

Important! In other words, the sphincter is a powerfully muscled valve that closes after food passes from the esophagus to the stomach. The muscular layer of the sphincter is formed after the birth of the child and is completed after he reaches 6-9 months. This is the reason why pediatricians recommend holding the baby upright after each feeding to prevent frequent regurgitation.

Types of gastric sphincters

The stomach consists of two sphincters located at the closing parts of the cavity. Structurally, the sphincters of the stomach consist of muscle fibers of a ring arrangement, which, when contracted, form mucous folds. The sphincter rings have developed muscle muscles that open the upper valve after food enters the stomach and close the lower one when the digested bolus of food enters the intestine.

Cardiac sphincter

The cardiac sphincter is localized in the upper part of the gastric cavity, has ring-shaped muscles with a diameter of up to 1 cm. Folded structures of mucous tissue act as a kind of barrier. The sphinctral upper ring prevents the reflux of food from the stomach with hydrochloric acid, which is part of the gastric juice, into the lumen of the esophagus. Unilateral movement of food is ensured by the depression between the esophagus and stomach at an acute angle. When the stomach is full, the angle of the cavity decreases, which leads to increased sphinctral tone. The muscle tone of the cardiac sphincter can decrease for a number of reasons:

pressure inside the abdomen;
aggressive foods (sour, spicy, salty, flour products and alcohol);
degree of distension of the gastric cavity;
endocrine disorders;
long-term drug treatment;
chronic cough, straining.

Cardiac valve insufficiency often leads to esophageal achalasia. The disease is expressed in the inability of food to pass through the sphincter. This is due to the gap being too narrow during contraction due to increased tone. Other diseases include heartburn or gastroesophageal reflux disease, inflammation of the esophagus. Specific pathologies associated with reflux may include bronchial asthma and laryngitis.

Pyloric (lower) valve

The pyloric sphincter is a small location located between the small intestine and the organ cavity. Pyloric cardium - The final stage the passage of food from the stomach cavity is the lower esophageal sphincter. The main functions include:

separation of intestinal and gastric space;
control of stomach acid and the volume of its intake for digestive processes;
stimulation of intestinal peristaltic rhythms.

The opening and closing of the pyloric sphincter occurs according to nerve impulses and receptors of the stomach. The main diseases with an increase or decrease in the tone of the sphinctral opening include pylorospasm, pyloric stenosis, the development of gastroduodenal reflux, and metaplasia. Metaplastic changes in organ tissues are a precancerous stage.

Predisposing factors

The etiological factors in the formation of cardial insufficiency are disorders of muscle contractions and the state of muscle structures of any origin. Functional and organic disorders are caused by a number of factors that provoke motor disorders and spasm of the pyloric valve. Another important reason for the development of pathology is excess weight patient or complicated gastroenterological history. Other factors for the development of deficiency include:

systematic bloating;
sedentary lifestyle;
diseases of the gastrointestinal tract (for example, ulcerative colitis, erosions, gastritis):
overeating, heavy dinner;
hernia of the diaphragmatic region in the area of the lower valve;
increased pressure inside the peritoneum.

Pathological disorders of the contractility of the lower esophageal sphincter are not always associated with serious functional disorders of the body.

Important! The risk group includes patients over 35 years of age, which is due to the natural aging processes of the body, a decrease in the level of collagen and hyaluronic acid in connective tissue. All these processes lead to a decrease in the elasticity of muscle structures, excessive contraction or relaxation of muscles. The older a person is, the higher the risk of developing reflux disease.

Clinical manifestations and stages of development

The esophageal sphincter gives an immediate reaction in case of any violations and manifests itself instantly in the form of various manifestations. Signs of pathology are proportional to the degree of development of the disease. To identify the symptomatic complex, there are others, general signs for reflux disease:

general weakness and malaise;
dizziness during physical activity;
regular heartburn regardless of food intake;
rolling nausea;
impurities of bile in vomit.

Another characteristic symptom of the development of the disease is pain. Often the pain is localized behind the sternum, in the epigastric space, accompanied by rumbling in the intestines. Symptoms worsen while eating.

Degrees of formation

Lower esophageal sphincter insufficiency is conventionally classified into three main stages:

Stage I (the sphincter does not close completely, frequent belching of air appears);
Stage II (the space of the ring is half of the esophagus, frequent belching of air, discomfort in the epigastric region, prolapse of the mucous membrane);
Stage III (full opening of the valve, inflammation of the esophageal mucosa).

It should be noted that at all stages of the disease the functioning of the large intestine and duodenum is not impaired. Some symptoms of deficiency may resemble the development of other gastroenterological pathologies. Differential diagnostic methods are used to make an accurate diagnosis.

Diagnostic methods

Diagnostic measures consist of conducting research methods aimed at differentiating other diseases of organs or systems with similar manifestations. The main measures include:

study of clinical history;
examination and palpation of the epigastric space;
scintigraphy of the esophagus with contrast agent;
performing FEGDS (fibroesophagogastroduodenoscopy);
daily measurement of stomach acidity;
X-ray.

Constant belching of air is a characteristic symptom of problems in the stomach. Belching can also occur in healthy people, but is often episodic and associated with large meals.

Treatment and strengthening

Treatment of gastric reflux is traditionally divided into medication and surgery. For cardiac reflux, a number of drugs are used to reduce acidity in the stomach cavity. The main groups of medications are foaming and antacid drugs, but they should be taken only when heartburn or sour belching occurs. Proton pump inhibitors are taken every day. A course of drug therapy is carried out only on the recommendation of a doctor. If there is a burdened clinical history, treatment of other diseases is carried out according to the optimal regimen.

Surgical treatment is indicated for organic failure, decreased functionality of the gastrointestinal tract, or severe deterioration of the patient’s condition. The decision about surgery is made collectively with other specialists in various fields.

Strengthening methods

How to strengthen the esophageal sphincter and reduce the risks of developing insufficiency? Strengthening the muscular structures of the sphincter comes down to following a number of preventive measures against reflux disease:

frequent consumption of food in small portions;
lack of overeating;
exclusion of aggressive foods and alcohol from the diet;
quitting tobacco;
weight control;
wearing comfortable clothes without being too tight.

To improve muscle trophism, it is recommended to lead an active lifestyle, do exercises to strengthen muscles, and not abuse alcohol, tobacco and other toxic drugs. The ideal option would be to follow a special therapeutic diet, which is usually prescribed by a doctor. If you follow all the recommendations, you can reduce the risk of reflux, stop the development of sphinctral insufficiency and improve the quality of life.

But perhaps it would be more correct to treat not the effect, but the cause?

The gastrointestinal tract is a complex system that provides the body with necessary compounds and removes metabolic products. For this reason, there is a lot of pressure on it, due to which diseases of the gastric sphincter can develop, namely, weakness of the gastric valve.

Valve operation

Before entering the stomach, food passes through several stages:

oral cavity;
larynx;
esophagus.

Each of them has its own environment. The lower esophageal sphincter, otherwise called the gastric valve or gastric cardia, works as a barrier to the exit of food. This valve prevents acid from escaping into the esophagus. Normally, until a person consumes food, the sphincter closes, opening only when food passes into the stomach. Thus, neither the resulting nutrient mass nor the acid reaches the higher level. Due to some factors of poor nutrition, this process is disrupted, resulting in the development of chalazia, a condition.

Causes of deficiency

Obesity can cause illness.

There are two groups of reasons, which are defined as organic and functional. The former are not associated with anatomical defects of the body and occur due to hiatal hernias or postoperative complications. Due to functional disorders, the cardiac sphincter does not close tightly and works in the opposite direction. He is hampered by pressure in the stomach cavity or intra-abdominal pressure, pyloric spasm. The valve muscles themselves lose tone, become weak and unclench. These ailments are preceded by the following regime violations:

binge eating;
eating food immediately before bedtime;
obesity;
passive lifestyle;
constipation;
excessive physical activity.

The causes of weak valve muscles include previous surgeries, pregnancy and chronic diseases stomach. Some foods and habits are harmful to the normal tone of the sphincter muscles:

tomatoes;
chocolate;
coffee;
fatty foods;
smoking;
alcohol.

Symptoms

Heartburn is one of the first clearly visible symptoms of the disease.

The most striking symptom of cardiac failure is heartburn, which makes itself felt regardless of food intake. In addition to this, the violation is accompanied by the following problems:

belching of air with a bitter or sour taste;
aching or burning pain in the sternum;
pain in the epigastric region;
rumbling sounds in the intestines;
obsessive nausea, sudden vomiting;
increased fatigue, dizziness, weakness.

These conditions may be accompanied by dizziness, rumbling in the stomach and the appearance of white plaque on the tongue, which indicates inflammation of the walls of the esophagus.

Why is it dangerous?

Digestive diseases account for up to half of the pathologies of the adult population in developed countries. At the same time, the number of diseases of this type is constantly growing, since the first symptoms are not noticed and treatment is decided upon when the disease has already reached a critical stage.

Cardiac failure indicates a violation of the diet, poor lifestyle, and heavy stress while you are working. She is a manifestation various diseases, such as gastritis, tumors, ulcers, etc. Because of it, adjacent organs begin to malfunction, creating a danger of serious complications:

bleeding;
scarring of the esophagus (reduce elasticity, reduce lumen);
peptic ulcers

Another negative factor in advanced cardia failure is unpleasant ways examinations. At the same time, long courses of treatment negatively affect other human organs.

Diagnostics

Some of the previously listed symptoms accompany other diseases (stomach ulcer, gastritis, etc.), and various factors act as catalysts for reducing the tone of the valve muscles. Therefore, it is important to correctly determine the nature and causes of the ailment. The following types of research are used for this:

X-ray;
gastrofibroscopy;
pH-metry of the esophagus, esophagoscopy, methylene blue tests.

X-ray using barium sulfate contrast determines the parameters of reflux, the presence of esophagitis or esophageal ulcers. If the results of fluoroscopy are unclear, it is followed by esophagoscopy, which makes it possible to examine the esophageal mucosa and the density of muscle closure.

Therapy

Therapeutic instructions

Before starting treatment, consult a specialist

The following points must be followed so that the cardia of the stomach works normally and begins to close tightly:

Correct diagnosis of the causes by a doctor and their subsequent elimination (this applies to pathologies leading to sphincter dysfunction).
Eat food standing or sitting, keeping your back straight.
Maintain a gap of 2-3 hours between your last meal and bedtime.
Elevate your head while you sleep.
Eliminate from your diet too spicy, fatty, cold or hot, pickled foods.
Consume daily a large number of fiber and include daily first courses in your diet.
Switch to smaller meals, do not overeat, especially be careful not to overeat before bed.
Try to reduce intra-abdominal pressure by reducing the volume of fatty tissue if you are overweight.
Reduce your consumption of foods that are dangerous to the gastric valve (strong coffee, tomatoes, chocolate, etc.).
Quit smoking and limit your consumption of alcoholic beverages.
Try to bend over less.
Do not lie down after eating so as not to provoke heartburn and aggravate the condition of the esophagus.
Wear comfortable clothes that are not tight on your body.
Adjust your physical activity, try to work without significant effort. Walking in the fresh air is especially beneficial.
Undergo periodic examinations with a gastroenterologist and complete the course of treatment prescribed by him.
Do not experiment with medications to avoid complications.

Drug treatment

Prokinetics are used as effective treatment, for example: Cerucal, Metoclopramide, Reglan, Domperidone. They increase the activity of the cardiac sphincter, taken before meals up to 4 times a day. Along with prokinetics, medications are prescribed that suppress reflux (propulsid) and antacids that suppress heartburn (“Gaviscon”, “Almagel”, “Smecta”, “Maalox”, “Gastal”, “Phosphalugel”).

Treatment is supported by omeprazole to restore the walls of the esophagus, antiemetics and painkillers. Sometimes it is necessary to use antiprotozoal drugs and antibiotics.

Why is this happening? - it's all about insufficiency of the lower esophageal sphincter. How to strengthen this muscle, and is it even possible? Let's figure it out.

Methods to strengthen the lower esophageal sphincter

In our country, traditional medicine actively uses for these purposes:

surgical methods to strengthen the lower esophageal sphincter;
stimulating its work through physiotherapy.

Other methods are not common among us. But if we consider the experience of all world practice, then an alternative technique already exists.

How to strengthen the esophageal sphincter? - There are several methods that will be discussed now.

Breathing exercises

Non-traditional methods of treating the lower esophageal sphincter include therapeutic exercises. Complexity this method lies in the lack of direct access to the muscles of the digestive system at this level. The esophagus, and therefore all its sections, are located inside the chest. This is not an area of the back or thigh muscles that can be easily toned. Even the stomach and intestines are easier to influence by contracting the abdominal muscles, or massage through passive movements.

The situation is more difficult with the esophagus; stimulating it requires great effort. But regular breathing exercises can help a little.

The entire procedure must be carried out on an empty stomach (after all, any active movements on a full stomach lead to weakening of the lower esophageal sphincter).
Almost the only organ in the chest area that can be controlled is the lungs. Therefore, we begin quite familiar and simple breathing movements. We inhale and exhale alternately.
There is one small feature - the exercises are done not only with chest, but also with abdominal breathing. This is when, in the process of inhalation and exhalation, not only the chest rises and falls, but also the shoulders, plus the abdominal muscles are involved.
This is the only way to increase the tone of the esophageal sphincter. Many people participate in the training process internal organs: digestive and cardiovascular system, respiratory organs, nearby muscles and blood vessels.
It is necessary to inhale and exhale at different speeds: quickly, slowly, very slowly, gradually accelerating.

In the final stages of sphincter weakening, exercise will not help. But in the initial stages of loss of the sphincter’s ability to perform full contractions, it can be restored with the help of breathing exercises. It is enough to perform such active breathing movements every day for a minute. And don’t be lazy to do them 2-3 times at least 3 times a day.

Physiotherapy

One of the attempts to strengthen the sphincter comes from our physiologists. It was they who tried to approach the treatment of insufficiency of this muscle in a comprehensive manner - in the process of conventional conservative treatment (this also applies to the acute period of development of the disease), the esophagus and nearby organs are exposed to currents. Effectively used:

DDT (diadynamic currents);
electrophoresis with drugs;
through a probe inserted inside.

How to strengthen the gastric sphincter using these effects? These methods also do not directly affect the affected area of the esophagus, since it is difficult to reach. They stimulate the phrenic nerve, which also innervates the esophagus. The electrodes through which the current is supplied are applied to the area of the cervicothoracic spine at the back, and the second one is placed slightly behind the angle of the lower jaw. This is done from 7 to 10 procedures daily or every other day.

Electrophoresis with drugs is carried out in a similar way, but medicinal substances are additionally applied to the cuff with the electrode, which can inhibit excessive stimulation of hydrochloric acid production, which will directly lead to quiet functioning of the esophagus. What happens?

Blood supply to tissues and organs improves.
Healing processes occur much faster.
The person notes a slight analgesic effect.

This way, without interfering with the integrity of the digestive organs, you can strengthen the tone of the lower esophageal sphincter.

Surgical assistance

The following method can be called an extreme case. It is used when everyone else is powerless, drug treatment does not help, and following a diet and rest regime is already pointless.

Other criteria under which surgeons will take on you are deterioration in the functioning of other organs and systems, suppression of the nervous system and the appearance of complications associated with sphincter insufficiency.

The essence of this operation is to strengthen the lower esophageal sphincter. This is done thanks to the walls of the stomach, which line the bottom part esophagus, creating a cuff. This creates additional pressure on the lower esophageal sphincter, which causes it to work better.

Having unsuccessfully tried all possible medicinal methods to get rid of heartburn, if you have problems with the esophagus, you should think about alternative methods of dealing with it. How to increase the tone of the esophageal sphincter yourself? Do some breathing exercises, even if such treatment raises some doubts, but this is another chance for a calm life.

Can esophageal reflux be cured with exercise?

Typically, esophageal reflux, or gastroesophageal reflux, is detected late, when inflammation of the inner wall of the esophagus - esophagitis - has already developed. This is due to the fact that before the appearance inflammatory process, which can be seen during fibrogastroduodenoscopy, it is quite difficult to detect reflux. Available Methods: X-ray diagnostics with contrast agents, chromendoscopy, histological examination - are not accurate enough at the early stage of the disease. Of course, there are reliable diagnostic methods: many hours of measuring the acidity of gastric juice, measuring pressure in the esophagus, impendanmetry of the esophagus - but not every hospital has the opportunity to carry them out, and not every patient agrees to a many-hour study using a nasal probe.

The main symptoms of esophageal reflux: - heartburn;

Belching of air or food eaten;

A burning sensation behind the sternum; a feeling of discomfort in the upper abdomen.

When these symptoms appear on FGDS, areas of inflammation, erosion and ulcers can already be detected.

Since the disease does not go away on its own, it must be treated. But often patients are afraid to take medications, because the esophagus and stomach are a sore subject for them. And they're trying to limit their chemical exposure. In this case, they are interested in treatment with exercise therapy, as well as traditional methods treatment with wormwood, dandelion and celery. So can reflux be cured by exercise?

Reflux itself cannot be cured with exercise alone. This is because the causes of reflux are completely different. These include:

Anatomical features of the upper stomach; - hiatal hernia; - increased acidity of gastric juice; - weakness of the lower esophageal sphincter; - neuroses; - stress; - diet disorders (fatty, spicy foods, foods that promote gas formation);

Gastroduodenal reflux, when bile and pepsin, which is produced by the pancreas, enter the stomach and then the esophagus;

Other diseases of the gastrointestinal tract. It is impossible to eliminate these causes with exercise. Therefore, drug treatment is often aimed at treating the disease that provoked reflux. And if neuroses and stress are cured by conservative methods, then a hernia can only be cured surgically. But this does not mean that exercise therapy is not necessary. Therapeutic exercises help strengthen the diaphragm, which has a beneficial effect on the lower esophageal sphincter and helps retain gastric contents in the stomach.

Since the exercises are designed to reduce the frequency of reflux, you need to do them correctly and make sure that the process does not cause heartburn, belching or noticeable discomfort.

The main thing in the exercises is proper breathing, which helps strengthen the diaphragm. Therefore, you need to learn chest breathing, in which the diaphragm is actively involved. In the first couple of weeks, breathing exercises are performed lying down, for 5-7 minutes, as many approaches as possible. Then, isometric tension exercises are added to them.

The exercises should be selected by a specialist in physical therapy. But in no case should they occur with an increase in intra-abdominal pressure. Therefore, if you feel that during exercise therapy your abdominal muscles are very tense, then this exercise is not for you.

Exercise alone cannot cure reflux. But exercise therapy is a great help that will help strengthen the diaphragm and reduce the incidence of reflux.

Rules for playing sports with reflux esophagitis

In the process of treating many diseases of the gastrointestinal tract, patients are often interested in whether exercise is indicated for them, and if so, what kind of sports and with what intensity. Physical exercise– an important part of therapy for reflux esophagitis.

Of course, on their own they will not cure a diseased organ, but in tandem with a therapeutic diet and medication support, they can greatly speed up recovery and contribute to the overall strengthening of the body.

Nuances of training for GERD

Gastroesophageal reflux disease forces you to draw up a special training plan that takes into account the severity of the disease and the general physical fitness of the patient.

It is a scientifically proven fact that people who regularly exercised suffered much less from the specific symptoms of reflux disease than physically inactive people with a sedentary lifestyle, and especially those who were overweight.

Excess weight greatly increases your chances of developing GERD. People with a body mass index over 30 are more than 2 times more likely to become patients of a gastroenterologist than people with a normal BMI in the range of 18.5–25.

Moderate exercise, especially regular therapeutic and preventive gymnastics, significantly facilitates the course of the disease, softens the symptoms, and sometimes completely eliminates them.

At the same time, the patient should not forget that excessive load is contraindicated for him. In addition, in order not to worsen your condition, you need to follow the recommendations of your doctor and trainer, and also do not forget about the following rules:

Digestion takes some time. In itself, a stomach filled with food is a load on the esophageal sphincter, and when shaking and physical stress are added to this, deterioration is inevitable. To prevent this, you need to train only on an empty stomach.
When planning your diet, you need to focus on your training schedule. Certain foods, especially fatty foods and legumes (by the way, the diet for reflux esophagitis prohibits such foods) take an extremely long time to digest. If the workout should take place 2-3 hours after eating, preference should be given to easily digestible carbohydrate foods, with a minimum content of fat and protein. Before training, you need to avoid consuming foods that cause heartburn and belching.
You should avoid overly intense exercises such as fast running, CrossFit, aerobics. With such a load, the contents of the stomach shake, resulting in discomfort. It is worth giving preference to exercises that keep the body in an “even” position: yoga, moderate jogging, skating, cycling (you can use an exercise bike or a stepper).
There is no need to get carried away with exercises in a lying position (bench press, Pilates), which provokes the reflux of stomach contents into the esophagus.
Throughout the training session, it is worth monitoring the fluid balance in the body. In addition to quenching thirst, water stimulates digestion and stabilizes the functional state of all organs.

Benefits of Exercise for GERD

The advantages of exercise therapy for reflux esophagitis include:

strengthening the lower esophageal sphincter;
reducing the intensity of reflux of stomach contents into the esophagus and mitigating the occurrence of night reflux;
increasing the body's immune defense;
stimulation of metabolic processes.

Breathing exercises for GERD

The key to effective training for reflux esophagitis is correct, even breathing. Before giving yourself an active load, you need to take a comfortable position (most importantly, without lying down). After this, the patient will have to perform the following tasks one by one:

Take a deep breath and slowly release the air. Repeat the exercise at least 5 times. When exhaling, you need to involve the abdominal organs as much as possible, strongly straining and “blowing out” your stomach.
Slowly inhale air and release it in several short exhalations.
Next task: take a slow, deep breath and a sharp, rapid exhalation, actively engaging the peritoneum. Repeat the exercise 8–12 times.
Take a deep breath and hold your breath for 5–7 seconds. Slowly release the air, tensing your abdominal muscles as much as possible. Do several approaches, gradually increasing the period of holding your breath to 17 seconds.
We must not forget about good rest between approaches. Such breathing exercises can cause dizziness, and an unprepared, physically weak person can even faint.

Breathing exercises for reflux esophagitis reduce the pain of symptoms, reduce intra-abdominal pressure and stimulate the functioning of the stomach. Any exercise should be done with maximum tension. abdominal muscles and as if exhaling with your stomach.

Exercises prohibited for GERD:

any abdominal exercises, especially those related to raising legs while lying down;
bending the torso forward and all similar exercises;
lifting sports equipment weighing over 10–12 kilograms.

The treatment plan for GERD excludes exercises in horizontal position, since they intensify the reflux of stomach contents into the esophagus and increase discomfort: heartburn, burning, pain.

It is better to perform any exercise in a sitting or standing position. Moderate-intensity exercise is great for stimulating digestive function, and drinking enough water will further aid this.

In addition to moderate-intensity aerobics, if you have reflux esophagitis, you can do exercises to strengthen your legs, arms and core muscles:

swing your legs and arms;
any training combinations in the knee-elbow position;
various lifts of dumbbells (total weight should not exceed 15 kilograms) and bodybar in a sitting and standing position.

By following all of the above recommendations, gaining endurance and patience, and also enlisting the support of a trainer specializing in exercise therapy, you can not only reduce the unpleasant symptoms of GERD, but also strengthen and improve the health of the body. In tandem with proper nutrition and medication support (exclusively on the recommendation of the attending physician), recovery is progressing by leaps and bounds.

Sports and GERD

Sports will help on the path to curing GERD. Physical exercise will not only speed up recovery, but will also have a beneficial effect on the body. When taking on one or another physical complex, you need to understand that you should not expect therapeutic effect, they are not able to eliminate heartburn - the main symptom of the disease. But they may well speed up the time of recovery. But gymnastic exercises will not bring any effect if you do not follow a diet and take medications.

Physical exercise can strengthen the condition of the entire digestive system.

Be careful with exercise for GERD

Physical activity with functional abnormalities of the digestive organs is often prohibited. There are no strict restrictions for reflux, but you need to remember the basic rules that will help make the sport completely safe for your health and bring maximum benefits.

It is forbidden to exercise immediately after eating. This is because the lower esophageal sphincter is weak, which means activity after eating will cause stomach contents to regurgitate up into the esophagus. This will lead to severe heartburn. In view of these circumstances, you need to wait at least an hour after eating and start sports activities. You should not eat for an hour after activity. There is no need to talk about prohibiting snacking during exercise.

While eating food, you should not bend or twist forward, and you should not lift heavy objects. This will cause the same reaction as exercising after eating. In addition, bending over compresses the stomach, which increases the load on the gastrointestinal tract.

You need to carefully monitor the breaks between food and exercise, and then it will not cause harm. In addition, you need to adhere to a healthy lifestyle.

What loads are contraindicated?

There are certain prohibitions on playing sports with reflux esophagitis. Some doctors recommend avoiding abdominal exercises only, as they increase the pressure inside the abdominal cavity, which can aggravate the disease.

It is recommended to limit the weight you use during training. This rule is suitable for those who have previously worked with heavy weights. Those patients with GERD who have not exercised with weights should not do so.

In general, no sports are prohibited. You need to follow the recommendations of your doctor and not put too much strain on yourself. Then there will be no harm to health. Sport will only be beneficial, as it allows you to free up negative energy, which will reduce the likelihood of relapse of reflux esophagitis due to stress.

Yoga classes: benefit or harm?

Yoga, like any sport, can bring both benefits and harm. Doctors do not recommend asanas that place pressure or stress on the abdominal muscles, as this will cause an increase in internal pressure. Therefore, yoga asanas such as bhujansana, salabhasana and others are prohibited. Yoga exercises that do not load the abs (for example, nauli, udiyana), on the contrary, are indicated for patients with GERD.

Yoga is rich in breathing asanas, which are useful for patients.

Is it possible to cure exercise therapy disease?

It is impossible to cure reflux esophagitis with exercise alone, since no sport will affect the root of the problem. In order to relieve symptoms and get rid of causes, treatment with pharmaceutical drugs is necessary. Sometimes therapy for reflux cannot be done without surgery.

Physical therapy will benefit the patient, as it helps strengthen the diaphragm. Thanks to this, the esophageal sphincter better retains the contents of the stomach in it, without passing upward.

Gymnastics and exercise therapy

Benefits of physical therapy

Exercise therapy should be prescribed by a doctor, since such activity is differentiated depending on the degree of the disease and the physical capabilities of each individual patient. If a patient has complicated or advanced reflux esophagitis, physical activity is completely contraindicated for him. The advantages of physical therapy are the following factors:

such exercises improve muscle tone, which improves metabolic processes and promotes tissue regeneration;
Exercise therapy improves the functioning of the human immune system;
proper activity helps strengthen the diaphragm, which improves the functioning of the esophageal sphincter;
Exercise therapy is used as a preventive measure against GERD;
The right exercises can help get rid of night pain and burning.

Exercise therapy refers to physiotherapeutic treatment, so the complex is different for each patient. It is aimed at achieving specific goals:

strengthen the immune system;
develop the muscle layer, which will improve metabolic processes;
heartburn prevention;
improved absorption of medications.

Breathing exercises

In order for physical therapy for reflux esophagitis to bring maximum benefit, you need to learn how to breathe correctly. To do this you need to do breathing exercises. Before class, you need to find the most comfortable body position, it is best to stand or sit. You need to inhale deeply and exhale slowly. Repeat 4 times. You need to train on an empty stomach. If the patient has a severe degree of illness, he should refuse the procedures.

Such training should be done with breaks for rest, as physical exercise can cause fainting or weakness. You need to train for preventive purposes three times a week. In addition, you need to engage in other activities. Swimming and cardio exercises are useful for reflux esophagitis.

Breathing exercises

At the beginning of the course, everything should be done lying on your back or on your right side on a plane slightly raised to your head. First you need to inhale, sticking your stomach forward and hold it for a few seconds. As you exhale, the abdominal wall relaxes; there is no need to pull in your stomach. The duration of the workout is 10 minutes with breaks of 20 seconds every minute.

Then, after a couple of workouts, you can begin to draw in your stomach as you exhale. After a few more sessions, leg movement is added to breathing. After which you can move on to exercises in a sitting or standing position. A course of physical therapy, which is used to treat GERD, takes approximately 3 months.

Prohibitions and warnings

Each sport has certain caveats, especially if the person playing it is sick. Exercise therapy and breathing exercises are no exception. With esophagitis, you need to remember the following requirements:

You can’t exercise after eating, even if it’s a snack (you can’t exercise after taking a sip of water);
It is better not to do gymnastics during exacerbation of GERD;
everything needs to be done calmly, at a moderate pace, without putting too much strain on the body.

Esophagitis usually recurs 2 times every 12 months, so courses of physical therapy and gymnastics are aimed at prevention. The minimum number of workouts per week is 2 times. Exercises should be selected by the attending physician who is competent in such matters.

Gymnastics is not the only treatment. The patient needs a course of drug therapy. In addition, the patient needs to engage in other sports and lead a healthy lifestyle.

It is important not only to exercise, but to change your lifestyle to one that will have a beneficial effect on the body. This will help prevent relapses of the disease and improve well-being, because sports, proper nutrition and the absence of destructive habits are the basis of health.

Sphincter of the stomach: functional features, significance and methods of strengthening

Anatomical aspects

Important! Structurally, the stomach has a narrow oblong shape, an upper part, a body (cavity), a bottom, and sphincters. All parts of the stomach make up the lesser and greater curvature.

Structural features

Types of gastric sphincters

Cardiac sphincter

The cardiac sphincter is localized in the upper part of the gastric cavity, has ring-shaped muscles with a diameter of up to 1 cm. Folded structures of mucous tissue act as a kind of barrier. The sphinctral upper ring prevents the reflux of food from the stomach with hydrochloric acid, which is part of the gastric juice, into the lumen of the esophagus. Unilateral movement of food is ensured by the depression between the esophagus and stomach at an acute angle. When the stomach is full, the angle of the cavity decreases, which leads to increased sphinctral tone. The muscle tone of the cardiac sphincter can decrease for a number of reasons:

pressure inside the abdomen;
aggressive foods (sour, spicy, salty, flour products and alcohol);
degree of distension of the gastric cavity;
endocrine disorders;
long-term drug treatment;
chronic cough, straining.

Pyloric (lower) valve

The pyloric sphincter is a small location located between the small intestine and the organ cavity. The pyloric cardium is the final stage of passage of food from the stomach cavity and is a lower esophageal sphincter. The main functions include:

separation of intestinal and gastric space;
control of stomach acid and the volume of its intake for digestive processes;
stimulation of intestinal peristaltic rhythms.

Predisposing factors

The etiological factors in the formation of cardial insufficiency are disorders of muscle contractions and the state of muscle structures of any origin. Functional and organic disorders are caused by a number of factors that provoke motor disorders and spasm of the pyloric valve. Another important reason for the development of pathology is the patient’s excess weight or a complicated gastroenterological history. Other factors for the development of deficiency include:

systematic bloating;
sedentary lifestyle;
diseases of the gastrointestinal tract (for example, ulcerative colitis, erosions, gastritis):
overeating, heavy dinner;
hernia of the diaphragmatic region in the area of the lower valve;
increased pressure inside the peritoneum.

Pathological disorders of the contractility of the lower esophageal sphincter are not always associated with serious functional disorders of the body.

Clinical manifestations and stages of development

general weakness and malaise;
dizziness during physical activity;
regular heartburn regardless of food intake;
rolling nausea;
impurities of bile in vomit.

Degrees of formation

Lower esophageal sphincter insufficiency is conventionally classified into three main stages:

Stage I (the sphincter does not close completely, frequent belching of air appears);
Stage II (the space of the ring is half of the esophagus, frequent belching of air, discomfort in the epigastric region, prolapse of the mucous membrane);
Stage III (full opening of the valve, inflammation of the esophageal mucosa).

Diagnostic methods

Diagnostic measures consist of conducting research methods aimed at differentiating other diseases of organs or systems with similar manifestations. The main measures include:

study of clinical history;
examination and palpation of the epigastric space;
scintigraphy of the esophagus with contrast agent;
performing FEGDS (fibroesophagogastroduodenoscopy);
daily measurement of stomach acidity;
X-ray.

Constant belching of air is a characteristic symptom of problems in the stomach. Belching can also occur in healthy people, but is often episodic and associated with large meals.

Treatment and strengthening

Strengthening methods

frequent consumption of food in small portions;
lack of overeating;
exclusion of aggressive foods and alcohol from the diet;
quitting tobacco;
weight control;
wearing comfortable clothes without being too tight.

But perhaps it would be more correct to treat not the effect, but the cause?

Upper esophageal sphincter- an anatomical valve structure located on the border between the pharynx and esophagus.

The main function of the upper esophageal sphincter is to pass lumps of food and liquid from the pharynx into the esophagus, while preventing them from moving back and protecting the esophagus from air entry during breathing and the trachea from food entry.

The upper esophageal sphincter is formed by the cricopharyngeal portion of the inferior pharyngeal constrictor. It is a thickening of the circular layer of striated muscles, the fibers of which have a thickness of 2.3-3 mm and which are located at an angle of 33-45° relative to the longitudinal axis of the esophagus. The length of the thickening on the front side is 25-30 mm, on the back side 20-25 mm. Dimensions of the upper esophageal sphincter: about 23 mm in diameter and 17 mm in the anteroposterior direction. The distance from the incisors to the upper border of the upper esophageal sphincter is 16 cm in men and 14 cm in women. The length of the upper esophageal sphincter, measured using esophageal manometry, is 37.5 ± 7 mm.

The figure below schematically shows the esophagus, upper (UPS) and lower esophageal sphincters (LES). On the graph, the arrow shows a peristaltic wave propagating with a gradient in the distal direction from sensors 1 to 4 (Storonova O.A., Trukhmanov A.S.).

Normal indicators of motility of the upper esophageal sphincter

(Storonova O.A., Trukhmanov A.S.)

The main function of the digestive system is to provide food for the body nutrients and minerals to support life. The oral cavity is initial stage food processing. To ensure that food passes further and does not come back, sphincters are present in the structure of the esophagus.

Structural features

The esophageal valve is formed by smooth muscle. It has features in its anatomical structure. Transverse, longitudinal, circular and spiral muscle fibers form this organ. There is an upper esophageal sphincter and a lower one. The main goal is to ensure that a bolus of food passes through the tract in one direction and prevents it from returning to the upper parts of the digestive system.

By contracting, the muscles at the right moment help close the lumen of the alimentary canal or open it. When the sphincter is closed, food is not able to move in the opposite direction.

When it enters the oral cavity and after initial processing, food enters the esophageal tube. The bolus moves to the stomach. Peristalsis of the organ contributes to the process. In response to swallowing, the pharyngeal valve comes into a relaxed state. Thus, food enters the esophagus. Then it passes into the open cardiac valve, subsequently into the stomach area.

The upper esophageal sphincter is the pharyngeal cavity from the esophageal cavity. Located at the height of the seventh cervical vertebra. The fundamental function is to prevent mechanically processed food from getting back into the pharynx and respiratory tract.

The low esophageal valve is located in the area. The boundary is the change of epithelial cells into the mucous membrane. When the food mass passes this path, the valve opens. The condition is normal. The rest of the time the specified valve is closed. This prevents stomach contents from refluxing into the esophagus.

The peculiarity of peristalsis is that the previous sip of food is extinguished by the wave of the next sip. Provided that the first sip could not, for some reason, travel the entire intended path, then disturbances occur in the process. The lower cardiac valve comes into a relaxed state. Therefore, rapid food consumption leads to dysfunction of the digestive system.

Control of sphincter activity is located in the autonomic nervous system. The nerve plexuses relax or tone the cardiac area. When there is a signal that there is no bolus of food, the lower esophageal sphincter is compressed. It opens to allow food masses to pass into the stomach area.

Irregularities at work

Dysfunction can occur in one of the sphincters or both at once. Such violations include:

Increased tone. A swallowing disorder in which the valve does not open completely. This makes it difficult for food to pass through. Dysphagia occurs.
Decreased valve tone. In case of dysfunction, reverse flow of mechanically processed products occurs. The contents exit into the pharynx and oral cavity.

An unpleasant pathology is a disruption of the activity of the entire gastrointestinal tract as a result of insufficiency. Treatment of the disease is carried out strictly under the supervision of a specialist. The cause is a malfunction of the pharyngeal sphincter.

Spastic nerves with increased impulsiveness lead to the development of increased tone. Pathology can be localized in two forms:

Increased activity. The swallowing process is disrupted from the first stage. There is a cough, sore throat, pain, and a burning sensation. Pieces of food that are not processed to their final state are thrown back into the throat.
Increased tone of the lower valve. In this case, lumps of food accumulate in the cardiac region of the esophagus. Under their pressure, the organ expands. Nausea, a feeling of heaviness and fullness, and in some cases vomiting occur.

With valve dysfunction, pathological disorders occur in the mucous membranes. A valve that has low tone cannot function properly. Lumps of food return back into the digestive canal.

When the tone of the upper valve is reduced, food particles fall back into the pharynx. Food processed by gastric juice may move in the opposite direction. It causes unpleasant sensations to a person in the form of a burning sensation. When processing food in the mouth, a cough or soreness occurs. If a large piece of product gets into the trachea, suffocation occurs. Belching of air or small particles of digested food appears.

Erosive becomes the result of weak activity of the lower sphincter. With the constant reflux of undigested food, reflux disease develops. With chronic exposure to stomach acid, ulcers or erosions develop.

The parasympathetic nervous system regulates the activity of the valves, reducing the impulse supplied by the nerve fibers of the sympathetic system.

Signs

Dysfunction in the functioning of the food valves is caused by pathological changes in the anatomy of the digestive tube. Scar growths and neoplasms of various types lead to malfunction of the sphincters.

The presence of additional growths leads to. There is not enough space for pieces of food to pass unhindered.

The opposite phenomenon leads to protrusion of the walls of the esophagus. Stretching is facilitated by the constant tone of the cardiac valve. The lower esophagus loses its elasticity. You can suspect problems in the digestive system if you note:

Unpleasant odor from the mouth. Indicates the beginning of the process of decay in the esophagus. A person is capable of trying to hide discomfort for a long time, but the smell is an alarming symptom. Its presence becomes a sign of problems in one of the sections of the digestive system.
Pain syndromes. Present with dysfunction of the lower and upper sphincters. The pain is spastic in nature. A person who does not eat food may not feel it. Painful sensations can be the result of irritation and damage to the cells of the organ mucosa.
Dysfunction when swallowing (dysphagia). During a meal, a person begins to cough and feels a sore throat. After swallowing, discomfort remains. Strong belching of air or small pieces of food appears. It occurs when trying to swallow solid pieces of food. With a puree-like consistency or liquid, problems arise less frequently.

Treatment

The goal of treatment of the digestive tract is to normalize the process of food entering the stomach. Treatment consists of the use of special medications and the use of medical procedures. Prescriptions are based on patient complaints and diagnostic data, depending on the severity of sphincter dysfunction. The use of antispasmodics will reduce the tone of the smooth muscles of the valve. Prokinetic drugs help increase muscle activity and help keep the valve flaps closed at the right time. It mainly affects the sphincter between the esophagus and the stomach, as well as the pharyngeal valve.

Surgical intervention is advisable if conservative therapy is ineffective and there is a desire to achieve a permanent result.

Consists of increasing the lumen of the stenotic esophageal canal. Use a probe that has lighting and magnification. Pathologically narrow areas become wider as the probe passes through the channel. This feature allows you to choose the correct bougie size, taking into account its flexibility.

Esophageal plastic surgery is used to suturing smooth muscles. So, the gap becomes smaller size. Used in the diagnosis of erosive esophagitis. Treatment is complex. The use of medications helps prevent the development of complications.

Surgery is a last resort. To make the muscles of the esophagus stronger, it is possible to use physiotherapeutic procedures. Currents of varying frequencies have an effect on nearby organs and the esophageal canal itself. The effectiveness of diadynamic currents and electrophoresis with the use of drugs has been proven.

The presence of a probe inside the esophagus is not a contraindication when prescribing these procedures. When exposed to current, blood circulation increases. The result is an increase in the metabolic rate in the organ and cell regeneration. The tone of the cardiac valve becomes higher. The organ is placed intact after surgery without additional interventions. Carrying out physiotherapy courses helps improve the general condition of the body.

An alternative is therapeutic exercises. The inaccessibility of the organs of the digestive system lies in their location. The chest acts as a reliable shield; breathing exercises are used to strengthen the muscles; alternating chest and abdominal breathing when inhaling and exhaling trains smooth muscles. Changing the speed of breathing increases the supply of oxygen. Blood moves faster.

It is advisable to use gymnastics at an early stage of the disease. Exercising three times a day for 20 minutes can bring results. If the disease was detected late or advanced, then there will be no results from breathing exercises. The doctor will select the required resolution method. If the patient comes in on time and the correct manipulations are carried out, then breathing exercises can be prescribed in combination with the main therapy. In the future, it will not allow the muscles to stretch.

Self-treatment folk remedies may not bring the desired result. In some cases, complications may develop. A gastroenterologist can prescribe decoctions of various herbs, but as an additional treatment. It is not recommended to violate the dosage schedule and dosage yourself. The absence of symptoms cannot indicate complete relief from the disease. If the disease is not fully treated, it progresses to a latent stage and leads to the emergence of a chronic condition.

The information on our website is provided by qualified doctors and is for informational purposes only. Don't self-medicate! Be sure to consult a specialist!

Gastroenterologist, professor, doctor of medical sciences. Prescribes diagnostics and carries out treatment. Expert of the group for the study of inflammatory diseases. Author of more than 300 scientific papers.