What to do if the esophagus is burned by stomach acid. Treatment of stomach burns. Treatment of esophageal burn

This is a very serious pathological condition that sometimes causes irreversible changes internal organs. It can occur as a result of accidental or intentional consumption of any aggressive liquids whose chemical formula contains alkaline, acidic, alcoholic or acetic compounds.

Such injuries are dangerous not only because they develop burns to all internal organs through which the aggressive liquid has passed, but also because they provoke the development of severe intoxication, and it is not known which is more dangerous. Toxic hepatitis, complex nephrosis, blockage of renal tubules, metabolic alkalosis - this is far from full list possible side complications. As a rule, chemical burns of the stomach are accompanied by pulmonary edema, which significantly worsens the prognosis and clinical picture of the patient’s condition.

Chemical burn of the stomach: characteristic symptoms

The aggressive liquid enters the stomach through the esophagus, so all organs that are in the path of the dangerous chemical are damaged. Everyone has clear symptoms. In these cases the following are observed:

• severe, unremitting pain everywhere: in the mouth, larynx, esophagus and in the stomach itself;
• severe shortness of breath, causing suffocation;
• severe vomiting with blood and pieces of gastric mucosa.

The success of further treatment depends on the amount of assistance provided in the first minutes. Therefore, each of us simply must know how to act in such a situation.

Chemical burn: first aid and subsequent treatment

Damage to the epigastrium with aggressive liquids is very dangerous. To prevent the formation undesirable consequences, you need to respond immediately. First aid for chemical burns of the stomach is to quickly neutralize the drunk reagent. If a person swallows alkaline composition, it is necessary to urgently rinse the stomach with a weak acid solution. You can stir a spoonful of table vinegar in a three-liter jar and force the patient to drink as much of the prepared liquid as possible.

If the patient is poisoned by acid, then gastric lavage is done using a solution of baking soda. Remember: the stomach must be rinsed completely to ensure that all the chemical comes out of the stomach. While you are pumping your stomach, make a call to " ambulance"- a chemical burn to the stomach requires urgent hospitalization.

Treatment of the victim will be long and complex. It will be aimed at gradually removing the patient from a state of shock and burn toxemia. Doctors will do:

• correction of the activity of the cardiovascular and respiratory systems;
• prevention of acute renal failure;
• preventing scarring of the walls of the stomach and esophagus.

Remember: a chemical burn to the stomach is the most dangerous pathological condition that can easily be fatal. Therefore, you cannot hesitate for a minute: timely assistance and beyond complex treatment will help you maintain health and a full life.

Collapse

Alcoholic drinks do not benefit the body. They harm not only when they get into the stomach and intestines, but also on the way to these organs. With systematic abuse, a burn of the esophagus with alcohol is often diagnosed. If treatment is not started, serious complications may develop. You can get a burn from any liquid containing alcohol, but the severity will depend on the amount you drink and the strength of the drink. Next, we will try to find out the symptoms of such a lesion and treatment methods.

After drinking strong alcohol, the symptoms of an esophageal burn appear most clearly

How does an esophageal burn manifest itself?

An alcohol burn to the esophagus, and therefore the stomach, can be observed if a liquid containing ethyl alcohol is ingested. Even a drink within 20 degrees has a negative effect on the mucous membrane, because the absorption process is sharply reduced and ethanol is retained in the stomach and corrodes the walls. Alcohol around 70% ABV causes serious damage. This is not only medical alcohol, but also tinctures, which are sold directly in pharmacies.

The first signs of an alcohol burn are:

• The appearance of dizziness.
• Weakness in the body.
• Loss of taste.
• Pain in the esophagus.
• Pain in the abdomen.
• Feeling nauseous.
• Vomit.

If you examine the mucous membranes of the oral cavity, you can find white coating, swelling and redness.

High-strength alcohol in large quantities can provoke corrosion of the walls of the stomach and esophagus, which can have serious consequences.

When alcoholic drinks enter the body, the first thing that greets it is digestive system, which takes the blow. Ethyl alcohol molecules instantly affect the mucous membrane and provoke the appearance of small ulcers, capillary bleeding and death of blood vessels.

After drinking strong alcohol, the symptoms of an esophageal burn appear most clearly:

• There is swelling of the tongue and lips.
• Swelling of the pharynx and larynx provokes shortness of breath even at rest.
• Hoarseness appears as the vocal cords suffer.
• There are disturbances in the process of swallowing.
• Vomiting.

If vomiting is observed, then an admixture of blood and pieces of mucous membrane can be found in the vomit.

If, when such symptoms appear, measures are not taken and the person is not sent to the hospital, then serious complications will arise.

The severity of damage to the esophagus by alcohol

Depending on the amount drunk, the strength of the drink and the frequency of alcohol abuse, a burn to the esophagus can have varying degrees of severity:

1. 1st degree is the easiest. Ethyl alcohol affected the surface layer of the organ. Slight redness, swelling and tenderness can be diagnosed. If you stop drinking alcohol at this stage, the symptoms disappear after 10-14 days, and no special treatment is even required.
2. The average degree is the 2nd. Destructions affect the mucous membrane and smooth muscle fibers underneath it. Swelling can develop so severe that the lumen of the esophagus is blocked and the passage of food becomes impossible. Upon examination, the doctor discovers ulcers, which after some time are covered with a layer of blood protein - fibrin. If there is no infection, the healing process takes about a month.
3. Grade 3 is considered the most severe. The burn affects all the walls of the esophagus and even spreads to neighboring organs. Not only local phenomena are observed, but also symptoms of intoxication in the form of a state of shock. Even after healing, and this will take at least 3 months, and sometimes a couple of years, scars remain.

The more severe the degree of damage, the longer the healing period and the more complex the treatment.

Help with alcohol burns

If there is a burn to the stomach from alcohol on the face, then the victim urgently needs to receive help. It is as follows:

1. The first step is to wash off traces of alcohol-containing substances. This is done by inducing vomiting by drinking large amounts of water.
2. Take the person to the hospital.

Basic treatment for burns consists of the following procedures:

• Reception medications having an analgesic effect. Suitable: “Promedol”, Analgin.”
• Using medications that can relieve esophageal spasm. Atropine will cope with this effectively.
• Means for normalizing the functioning of the cardiovascular system.
• Prevent exposure of the body to toxic substances.
• Help the patient cope with shock. For this purpose, Prednisolone injections and saline solutions administered intravenously are used.
• To avoid complications and infection, it is recommended to take antibacterial agents, for example, "Ampioks".
• Relanium will help calm the victim.
• Dehydration of the body requires the installation of a drip to restore water-salt metabolism.

For a victim of an alcohol burn for the first time, it is recommended to take any vegetable oil; it will speed up the healing process. Eating is not recommended.

For severe burns, gastroendoscopy is not performed at first to avoid additional injury to the walls of the esophagus.

A common consequence of a burn is narrowing of the esophagus. To avoid this, doctors use the bougienage procedure. It consists of expanding the lumen of the organ using probes made of elastic material. Each time the diameter of the probe increases. The procedure can begin no earlier than 5-7 days after the esophagus burn and continue for several months after healing.

It is important that the patient understands during treatment that only complete exclusion of alcohol from his life can guarantee successful therapy. Even 100 grams of an alcoholic drink will reduce all the efforts of doctors to zero.

Treating burns with folk remedies

Recipes from traditional healers can also help effective assistance in the treatment of the consequences of drinking alcoholic beverages, but before using them you should definitely consult a doctor. The first thing you need to do is remove acute symptoms burn, and then you can add traditional medicine for a speedy recovery.

We can recommend the following effective recipes:

1. Prepare a decoction based on medicinal chamomile and oak bark and use for rinsing several times a day. Chamomile has anti-inflammatory and antiseptic properties, and oak has astringent properties, which will speed up the restoration of damaged mucous membranes.
2. The second recipe is this: take 1 tbsp. l. violets and add 200 ml of boiling water, leave for 2 hours and use for rinsing.
3. Another effective recipe based on milk and honey. Dilute a tablespoon of honey in a glass of warm milk and drink in small sips at a time.
4. Prepare flax seed tincture using 12 tablespoons of seeds and 1 liter of water. Take 50 g three times a day. During the infusion process, the seeds release a viscous substance that will envelop the walls of the stomach and esophagus, promoting their restoration.

Successful treatment of an esophageal burn with alcohol is impossible without following a special diet. Doctors recommend:

• Eliminate baked goods and brown bread from your diet.
• The diet should not include spicy, salty, or sour foods, so as not to injure the mucous membrane.
• Eat food often, but in small portions.
• In the morning after waking up, take a tablespoon of sea buckthorn or olive oil.
• Eliminate carbonated drinks, replacing them with herbal infusions, tea, and milk.

A combination of medications and traditional medicine recipes will give good results, and recovery will take less time.

Consequences of a burn

If you do not take urgent measures after receiving a burn to the esophagus or stomach from alcoholic beverages and do not undergo a course of therapy, complications cannot be avoided. Most often diagnosed:

• Inflammation of the mucous membrane of the esophagus and stomach.
• Due to the formation of scar tissue, obstruction of the esophagus is formed.
• Formation of a through hole in the stomach.
• Fistulas in the trachea and bronchi due to perforation and adhesion of the esophageal tube to the bronchi.
• Pneumonia, which leads to blockage of the airways.
• Oncology.

The prognosis for a patient with a burn from alcoholic beverages depends on the severity of the injury. Grades 1 and 2 respond well to treatment, but grades 3 and 4 can end in failure for a person, even death.

Contents of the article:

A burn to the esophagus can be thermal, chemical or radiation. Most often there is a chemical version. Aggressive liquids that get inside destroy the delicate mucous membrane of the organ. Treatment and rehabilitation are very long. Only timely assistance allows you to avoid complex operations. About 70% of patients subsequently suffer from stenosis or obstruction of the esophagus. Most often, adhesions form in places of physiological narrowing of the esophagus. The risk group includes young children with their natural curiosity, as well as people with suicidal tendencies.

What are the types of esophageal tube burns?

There are two types of esophageal burns: chemical and physical. The latter is divided into thermal and radiation. Under the influence of aggressive factors, all walls of the organ are affected. 70% of all victims are children preschool age. For child's body this is a real disaster. Treatment takes years, and it is not always possible to save the child.

The most common cause of upper gastrointestinal burns in adults is accidental ingestion of chemicals. About 30% of adult patients ingest toxins for the purpose of suicide.

Chemical

In practice, chemical burns are most common. The impact of caustic reagents occurs in two stages:

1. Direct damage.
2. Stage of chemical transformations.

The danger lies in the second stage. Active molecules enter into a cellular reaction, causing tissue necrosis. Destruction penetrates all the walls of the esophagus. Its integrity is disrupted, perforation occurs with the transition of inflammation to the mediastinum.

When chemicals are ingested, the entire upper gastrointestinal tract is affected. In especially severe cases, substances enter the stomach and small intestine.

A life-threatening burn is alkaline. This phenomenon is due to the nature of exothermic transformations. When a burn occurs, proteins are destroyed by alkali and fats are saponified. These reactions lead to the formation of a biological conductor. Aggressive molecules penetrate through it into the deeper layers of the esophagus. Even a small amount of alkali is enough to corrode the organ and develop mediastinitis (inflammation of the mediastinum).

When intoxicated with low-quality alcohol, severe tissue necrosis (death) develops.

Under the influence of low pH, a dense burn crust instantly forms. It prevents caustic molecules from penetrating deeper.

The risk group is young children. The reason for this is their age-related curiosity, as well as the negligence of their parents. Household chemicals are usually replete with colored jars and labels; pleasant flavors attract little researchers. Therefore, any reagents should be stored in places protected from children.

Thermal

This variant of pathology is much less common than the chemical one. However, esophageal tissue can be burned by hot food, hot tea, or coffee. Eating scalding hot foods accounts for the lion's share of all causes of thermal burns of the esophagus.

Factors contributing to this are:

• haste, quick swallowing of food;
• improper serving and serving;
• eating specific foods.

A professional risk group consists of fire show artists. During performances, they put burning objects into their mouths. If the rules are violated, a severe thermal burn develops.

IN Lately Patients from nightclubs and bars are often hospitalized. The reason for this is the consumption of burning alcoholic beverages. When burning alcohol is swallowed, a combined burn is formed. Its course is extremely difficult.

Ray

Most rare view esophagus burn. Develops due to the effect of radionuclides on tissue. This pathology occurs due to accidents nuclear installations, radioactive fallout, and also due to radiation therapy and diagnostics.

Radiation burns progress slowly. Symptoms do not appear immediately, but the consequences are very serious. This is the nature of nuclear energy.

Can the esophagus be burned by gastric juice?

Gastroesophageal reflux is a pathology characterized by failure of the cardiac sphincter of the stomach and the reflux of hydrochloric acid into the lower third of the esophageal tube. Under the influence of caustic gastric contents, an aseptic burn of the esophagus develops.

The tissues swell and are infiltrated with lymphocytes. On endoscopy, swelling, redness and multiple ulcerations of the esophagus are observed. Patients are bothered by heartburn, pain, and a feeling of a “lump” in the throat.

What substances most often cause chemical burns?

The arsenal of aggressive solutions that cause burns to the esophagus is wide and varied. Caustic household chemicals are especially dangerous. Laundry detergents, bathtub cleaners, toilet blocks, and window cleaners are considered chemically active.

Very severe lesions are caused by powders and solutions for cleaning sewer pipes (for example, “Mole”). Even inhalation of fine particles can cause irritation of the mucous membranes. You should work with them carefully: wear rubber gloves, a mask and preferably safety glasses.

Chemical burns can be caused by:

1. Substances with low pH (acids): acetic essence, chloric, carborane, nitric, hydrofluoric, xenonic acids, as well as aqua regia.
2. Alkali: alkali metal hydroxide, sodium hydroxide.
3. Substances with different pH: phenol, alcohol, alcohol, Lysol, iodine, sublimate, hydrogen peroxide, silicate glue, potassium permanganate, acetone.

Severity and course of burn injury

The walls of the esophagus are penetrated by nerves and vessels. Tissue damage causes severe pain syndrome and bleeding. The pain spreads to all parts of the gastrointestinal tract.

Symptoms of esophageal damage are varied:

• nausea and vomiting;
• pronounced swelling of the lips, tongue, cheeks, chin;
• disturbance of consciousness;
• hypersalivation (increased salivation);
• nervous excitement;
• pallor;
• heart rhythm disturbance;
• reflex cough;
• hoarseness of voice;
• odynophagia (pain when swallowing);
• dysphagia (impaired swallowing);
• severe intoxication syndrome (weakness, malaise, confusion, photophobia);
• fever;
• shortness of breath and rapid breathing;
• at severe course a state of shock is possible, as well as the appearance of esophageal-bronchial fistulas.

Symptoms develop not only due to the destruction of esophageal tissue, but also due to the entry of necrosis products into the systemic circulation. Against the background of severe intoxication, liver and kidney failure occurs.

After entering the lumen of the esophageal tube, the aggressive liquid destroys the mucous membrane and moves to the deep layers of the esophageal wall.

Caustic reagents cause tissue necrosis. The complicated course is caused by burns of the physiological areas of narrowing of the organ. The severity of the disease depends on the properties and amount of liquid swallowed.

Degrees of burn damage to the esophagus:

1. Mild degree. Only the epithelium is affected. The mucous membrane is swollen and hyperemic. Contact bleeding. Recovery lasts up to 2 weeks.
2. Moderate weight. The mucous and submucosal membranes are damaged. Patients are worried about pain severe swelling. The mucosa is covered with superficial erosions. Recovery occurs in approximately 30-40 days.
3. Severe degree. All layers of the esophagus and surrounding tissues are affected. Signs of complications are severe pain, impaired consciousness, drop in blood pressure. Rehabilitation lasts several years. In some cases, patients die.

Possible consequences

The most serious complication is post-burn strictures of the esophagus. At the site of cell necrosis, connective tissue cords (adhesions) are formed. The lumen of the esophagus narrows - stenosis occurs.

Patients with stenosis suffer from dysphagia. Some find it difficult to swallow solid food, while others find it difficult to swallow even liquid food. To prevent such complications, burns of the pharynx and esophagus are treated from the moment of diagnosis. Pledge successful therapy– early bougienage.

As a result of the impact of the aggressor on the mucous membrane, reflex swelling of the larynx may develop. A serious complication is asphyxia (suffocation). The condition is especially dangerous for patients in a condition alcohol intoxication. Such patients often die. If a burn is suspected, but in the absence of consciousness, the pharyngeal cavity is examined. If there is erosion, the patient is urgently hospitalized.

A late complication is cancer. According to statistics, patients with post-burn strictures are most susceptible to esophageal tumors.

Burn of the esophagus and stomach in a child

The overwhelming number of children who received gastrointestinal burns belong to the youngest age category. Currently, more and more children are being treated for burns due to the mistaken use of liquid or powder. household chemicals.

With older children the situation is much more complicated. Sometimes they hide for fear of punishment. At that time, the disease progresses, causing severe complications.

Chemical burns of the esophagus in children are treated in a surgical hospital. Since all processes occur very actively in a growing body, adhesions begin to form much earlier. Babies begin bougienage of the esophagus much earlier.

Diagnostic features

Diagnosis is based on medical history, as well as the results of x-rays and endoscopy.

• A study is performed with contrast (barium suspension). X-rays done in two projections: direct and lateral. The picture is taken in a standing position.
• Esophagoscopy is the most informative research. It allows you to determine the degree of organ damage. In real time, the doctor finds burn marks, strictures, pockets and adhesions in the esophagus.
• Be sure to take blood for analysis. A burn blood picture is characterized by an increase in the number of leukocytes, lymphocytes, as well as an increase in the erythrocyte sedimentation rate.

How to treat a burn of the esophagus

Treatment for moderate to severe burns is carried out in a hospital. Such measures are due high risk esophageal perforation, bleeding and sepsis (blood poisoning).

If you suspect ingestion of chemical reagents, immediately call an ambulance. In case of severe damage to the esophagus, the patient is hospitalized in the department intensive care. The patient undergoes further treatment in the surgical department.

Urgent Care

Emergency aid algorithm:

1. Drink plenty of fluids. Drinking plain water room temperature. The volume of liquid is 5 liters per day. You can add an ampoule of lidocaine to your drink. Inducing vomiting is not recommended, as this can cause rupture of the mucous membrane.
2. Anesthesia. Relieving pain is preventing the development of shock. The drugs are administered parenterally.
3. Neutralization. Drink a couple of glasses of cow's milk in small sips.

It is prohibited to treat burns with ethyl alcohol, or to try to neutralize the reagents yourself!

First aid for a burn to the esophagus is provided at home or in an ambulance. The correctness of its implementation determines fast recovery sick.

Further treatment

Treatment of a chemical burn of the esophagus is carried out in surgical departments hospitals, and in especially severe cases - in intensive care.

After hospitalization, the patient is given a nasogastric tube. Before the procedure, the oropharynx is irrigated with lidocaine solution. The contents of the stomach, as well as a chemical reagent, are removed through a tube.

In case of an alkaline burn, the stomach cavity is washed with a slightly acidic solution. Acidic pH is inactivated with a slightly alkaline solution. If there is no information about the nature of the reagent, wash with neutral solutions (water, milk).

1. Pain relief. Morphine derivatives are used, and in less severe cases, combined non-steroidal painkillers (Spazmalgon).
2. Antispasmodic therapy. 0.5-0.6 ml Atropine.
3. To relieve neuropsychic agitation - Diazepam.
4. Infusion medications – NaCl 0.9%, Reopoliglyukin, Hemodez.
5. To relieve inflammation - Prednisol, Methylprednisolone.
6. Antibacterial agents to prevent infection.

The task of the conservative stage is to restore vital functions.

Diet

In case of a burn, mechanical and chemical sparing of the esophagus and stomach is important. For mild injuries, enteral nutrition (through a tube into the stomach or naturally) begin on the 2nd day of illness.

For burns of II and III severity, parenteral nutrition is prescribed in the first days (introduction nutrients directly into the bloodstream). For a burn medium degree severity, enteral feeding through a tube begins on days 7-8. In severe cases - depending on the patient’s condition. In the future, the diet is agreed upon with the surgeon.

Bougienage of the esophagus

Early bougienage gives positive results in more than 90% of cases. Early is called bougienage, which begins in the first two weeks of the disease. If not followed, 75% of patients develop stenosis, requiring late bougienage.

The need for manipulation is due to development and rapid maturation connective tissue. Scar changes appear on the walls of the organ. As a result, the lumen of the esophagus narrows and stenosis develops. Bougienage involves inserting a stent (tube) into the esophagus, which expands its lumen and prevents adhesions from occurring.

Surgery

Surgical treatment is prescribed when preventive measures are ineffective.

Indications for surgery:

• unsuccessful bougienage of esophageal scars;
• complete closure of the esophageal lumen;
• suprastenotic (located above the narrowing) expansion and thinning of the walls;
• fistulas opening into the trachea and bronchi.

Operations are not performed if the patient has cachexia (complete exhaustion).

Treatment with folk remedies

Only minor burns of the esophagus are treated at home. It is prohibited to use folk remedies without first consulting a doctor.

Effective recipes for healing the esophagus:

• 1 chicken protein whisk in 200 ml water. Drink up. This recipe is used as an emergency medicine.
• 2 tsp dry chamomile to 1 cup of boiling water. Leave for 10-15 minutes. Drink 1/3 cup of infusion before each meal.
• 12 tsp Boil flax seeds in 1 liter of water in a water bath for 10-15 minutes. Cool and drink in small sips throughout the day.
• 1 tsp pour a cup of hot water over quince seeds. Leave for 20-30 minutes. Drink 3 tbsp. 4 times a day.
• 1 tbsp. Infuse marshmallow root in a glass of boiling water for half an hour. Leave for half an hour. Filter through cheesecloth. Drink 2-3 tbsp. 3 times a day.
• 1 tbsp. dry raw large-flowered slipper, pour 2 liters of boiling water and leave for 2 hours. Take 1 glass before meals.

Preventive measures

Remember and follow the 5 rules of prevention:

1. Do not change the original reagent containers.
2. Storing household chemicals in protected places.
3. Do not use or keep vinegar essence at home.
4. Do not take or gargle with a solution of potassium permanganate.
5. Talk to children and warn them about the danger.

It is better to prevent burns of the esophagus than to treat them, since rehabilitation lasts from several months to several years. And treatment, in particular bougienage, is an extremely painful and unpleasant procedure. All diseases of the esophagus increase the risk of developing cancer.

In life, many may encounter a burn of the stomach and esophagus, and in this regard, doctors distinguish between thermal and chemical burns. So the first includes a burn when swallowing hot food, and the second when the stomach is damaged by household chemicals, detergents or cleaners, solvents, and so on.

If we talk about a chemical burn, then it is provoked by concentrated acids, such as acetic or sulfuric, hydrochloric, alkalis in the form of caustic soda or sodium hydroxide.

Symptoms

In this case, doctors distinguish between local and general symptoms stomach burn. Thus, a local lesion is characterized by a strong pain attack, radiating to the neck and behind the sternum, in top part belly. If internal organs are damaged, the signs will manifest themselves in the form of tissue swelling, the person cannot swallow, hoarseness of voice is diagnosed due to damage to the esophagus and vocal cords.

With such damage to internal organs, the patient is diagnosed with shortness of breath due to swelling of the tissues, plus there may be vomiting interspersed blood clots due to damage to internal tissues.

The general symptoms are characteristic and similar to general intoxication of the body - this is an increase in body temperature, weakness and attacks of nausea, a disruption in the rhythm of the heart. All this is caused by the negative effect of decay products on the entire body and every organ.

The burn to the stomach and the degree of damage will directly depend on indicators such as the concentration of the product that entered the body, as well as the amount of the toxic substance that entered the stomach.

Degrees

Doctors in practice distinguish three degrees:

1. The first degree is considered the mildest - the damage affected only the superficial tissues, the mucous membrane of the stomach and esophagus. In this case, redness and swelling are diagnosed, but such symptoms disappear after 12-15 days.
2. The second degree is considered moderate severity, when the gastric mucosa is destroyed, affecting the layer of dermis under the mucus, consisting of muscle cells. At this stage it is diagnosed severe swelling, which blocks the lumen into the esophagus, and if there are no complications, then everything goes away in a month.
3. The third degree is considered the most severe, when the entire stomach is affected, spreading to the surrounding tissue and organs located nearby. This degree of poisoning is characterized by general intoxication and painful shock; during the healing of the affected areas, scars may form and the affected organ itself may narrow. If you follow all the doctors’ recommendations, recovery of the affected organ can take from 3 months to 2 years.

More on the topic: Malignant tumor stomach: how long do people with this diagnosis live?

Treatment

If we are talking about the first degree of damage, treatment may be limited to procedures performed at home. At the same time, grades 2 and 3 are treated in a medical facility - this will help avoid negative consequences in the form of sepsis and bleeding, rupture of the walls of the stomach and esophagus, and so on. The main thing in this case is not to hesitate and if you suspect a burn to the stomach, call an ambulance.

First aid to the victim

First aid to the patient will determine in the future how effective the treatment will be and the results of the victim’s recovery. At the very beginning, rinse the patient’s stomach, thus ridding him of the substance that led to the burn. Give as much water as possible to drink, causing vomiting.

Next, it is necessary to neutralize the substance itself that has entered the stomach - in this case, the main thing is to determine what poisoned the patient and what caused the burn. If you cannot do this due to the victim’s state of shock, damaged ligaments and lack of voice, or childhood, smell what the breath smells like and try to find a container containing a possible chemical compound.

If it is possible to find out that the cause of the burn was acid, then it is worth neutralizing it by rinsing the stomach with an alkali solution. As an option for preparing an alkaline solution at home, take ½ tsp. baking soda and dilute it in 1 liter. warm, boiled water, give a drink, provoking a gag reflex.

Alternatively, you can prepare a neutralizing alkaline solution for washing from acetic or citric acid or using vegetable oil. In case of a stomach burn with potassium permanganate, rinse and neutralize its negative effect by rinsing the insides with a 1% strength solution of ascorbic acid or water with the addition of lemon juice.

More on the topic: Getting rid of sludge in the stomach: using different methods of cleansing

If you cannot determine what caused the burn, let the patient drink at least 2 glasses of milk, in small sips, and the liquid should be warm. The main condition for all rinsing procedures is that this should be done in the first 5-6 hours after the liquid gets inside.

Treatment of the consequences of a stomach burn in the hospital.

In a medical institution, gastric lavage is carried out orally, but if laryngeal edema is diagnosed, lavage is carried out through the anus using a probe. The composition for washing in the hospital itself contains analgesics.

Afterwards, doctors prescribe a comprehensive course of treatment to eliminate stomach cramps, eliminate the state of shock and preventive measures aimed at preventing scarring of the affected areas of tissue and mucous membrane. To avoid infection, a course of antibiotics characterized by a wide spectrum of action is used during treatment, as well as drugs that normalize the functioning of the heart muscle and kidneys.

During the first 4-6 days, doctors prescribe the intake of vegetable or vaseline oils, which contribute to the speedy tightening and healing of burn-affected areas of internal organs, but food, even in its liquid state, is excluded for this period.

When especially severe lesions the patient undergoes gastrostomy - this is a procedure in which a tube is inserted into the cavity of the stomach itself through a hole made on the front wall abdominal cavity. This is how the patient is fed in the first weeks of rehabilitation and recovery after a burn. During the examination, X-rays and endoscopy are not performed - this prevents additional injury to the stomach and esophagus.

Stomach burn in children - what to do.

Young children are mostly susceptible to burns of the esophagus and stomach - due to their curiosity and misunderstanding, they can put into their mouths and swallow any household chemicals, detergents or cleaning products, and so on. In this case, you should immediately call an ambulance and this should be done even with the slightest burn of the stomach and esophagus.

Contents [Show]

There are two types: thermal and chemical. Thermal is caused by swallowing hot food. But in most cases, a chemical burn occurs - damage to the walls of the esophagus by aggressive and caustic chemicals. This can happen if these liquids are accidentally ingested, if you lack self-control while intoxicated, or if you attempt suicide.

Most often, a chemical burn of the esophagus is caused by:

• Concentrated acids (acetic essence, hydrochloric sulfuric acid)
• Alkalis (caustic soda, caustic soda, sodium hydroxide)
• Other substances: phenol, lysol, ethanol, iodine tincture, sublimate, ammonia, silicate glue, potassium permanganate solution, acetone, hydrogen peroxide, electrolyte solutions.

Along with a burn of the esophagus, lesions of the mucous membrane of the mouth, pharynx and stomach often occur.

70% of victims are children aged one to ten years. This statistic is due to the natural curiosity of babies and their habit of tasting everything. The rest are adults who accidentally or intentionally drank caustic liquids. Among those who tried to commit suicide using chemicals, the majority were women.

It is believed that a burn to the esophagus with acid is more easily tolerated than with alkali. This is explained by the fact that in the first seconds, when acid enters, a kind of film (scab) forms on the mucous membrane, which prevents further penetration of the substance into deeper layers. In addition, the acid concentration is reduced due to the water that is released from the affected tissues.

Burns caused by alkalis often have more severe consequences. This is caused by the peculiarity of the chemical reaction occurring in the tissues. Proteins are destroyed, fats are saponified, and a gelatinous mass is formed from the cells. Alkali easily passes through it, causing necrosis (necrosis) of the deeper layers of the esophagus. Even if small amounts (20-50 ml) are swallowed, a hole may form in the wall of the esophagus.

Most often, accidental ingestion of liquid is caused by improper storage. Containers are placed in places accessible to children. Bright labels of household chemicals attract children's attention and arouse interest. It happens that chemicals are poured into containers not intended for their storage: glass jars, plastic bottles. Lack of labels and warnings that the liquid is poisonous may lead to its accidental use for other purposes.

Anatomy of the esophagus

The esophagus is part of the gastrointestinal tract. It is a muscular tube 25-30 cm long. Its function is to ensure the passage of chewed food from the pharynx to the stomach.

In cross section, the esophagus has a star-shaped appearance due to folds and grooves. This structure helps the fluid move faster. In the case when it is necessary to swallow a portion of solid food, the folds are smoothed out and the lumen of the esophagus expands.

The wall of the esophagus consists of three membranes:

1. Mucous membrane lines the inside of the esophagus. Its glands produce mucus, which facilitates the passage of food.
2. Muscularis amounts to middle layer esophagus. Has two layers of smooth muscle. Some go along the esophagus, others encircle it with rings. Their task is to ensure the movement of swallowed food from the pharynx to the stomach.
3. Connective tissue membrane (adventitia) limits the esophagus and makes it possible to change the width of its lumen.

The esophagus begins and ends with sphincters. These are muscle rings that look like thickenings of the walls of the esophagus. Their task is to let or not let food into the gastrointestinal tract and prevent it from refluxing from the stomach into the esophagus. The esophagus has three narrowings and two expansions. This feature is associated with the adjacency of other internal organs to it: the aorta, diaphragm.

Symptoms of a burn to the esophagus Local symptoms esophagus burn

The tissues of the esophagus are penetrated by nerve endings. Therefore, their burn causes severe

It is felt in the neck, behind the sternum and in the upper abdomen. Footprints

noticeable on the lips and in the oral cavity.

Tissue swelling quickly occurs. As a result, the lumen of the esophagus is blocked and the swallowing process is disrupted.

Shortness of breath occurs due to swelling of the laryngeal tissue. This is often accompanied by vomiting mixed with mucus, blood and pieces of the affected mucous membrane of the esophagus and stomach. Sometimes spasms of the esophagus occur.

Immediately after ingestion of an aggressive liquid, damage occurs first to the mucous membrane, and then to other membranes of the esophagus. Chemical compounds destroy cells and cause tissue death. The areas where the esophagus has physiological narrowings are most affected. Cauterizing liquids linger there and cause severe burns.

A 3rd degree burn can create a hole in the wall of the esophagus. In severe cases, the bronchial wall is also destroyed and an esophageal-tracheal fistula occurs.

General symptoms of damage to the body

General intoxication of the body develops. It is caused by poisoning, which occurs due to the accumulation

toxins

– tissue breakdown products. Its signs are an increase

temperature

Strong

weaknessnausea

Violation of heart activity.

Kidney-liver failure can result from damage to the body by toxins. The kidneys and liver, which are responsible for clearing the blood of waste products, are unable to cope with their task.

The severity of damage to internal organs depends on the concentration of the chemical and the amount of liquid ingested.

There are three degrees of esophageal burn:

1. I degree, the easiest. The lesion affected only the upper layers of the epithelium, which covers the mucous membrane of the esophagus. There is redness, swelling, and increased vulnerability. All phenomena disappear within 10-14 days.
2. II degree, average. The mucous membrane and submucosal layer of muscle cells are destroyed. In this case, severe swelling occurs, which can completely block the lumen of the esophagus. The lesions have the appearance of ulcerations, which are gradually covered with a layer of fibrin fibers, a blood plasma protein. If no complications arise, the surface of the esophagus heals by the end of 3-4 weeks.
3. III degree – severe. The lesion covers all layers of the esophagus and can spread to the surrounding tissue and nearby organs. In this case, common phenomena arise - intoxication and shock. During the healing process, scar processes develop. Narrowing and shortening of this organ is possible. If emergency care is carried out correctly, healing lasts from three months to two years.

Treatment of a burn of the esophagus Treatment of a burn of the esophagus of II-III degree is carried out in a hospital. This is necessary to prevent serious complications (bleeding, esophageal rupture, sepsis). It is impossible to determine the degree of burn on your own. Therefore, if you swallow cauterizing liquids, call an ambulance as soon as possible.

Depending on the extent of the damage, the patient is hospitalized in the intensive care unit or intensive care unit.

The treatment is carried out by a toxicologist.

First aid to the victim

The first thing to do is gastric lavage. The victim is given a liter of water to drink and vomited to remove the chemical compounds.

The next step is to neutralize the substance. In order to provide correctly first aid it is necessary to determine what caused the burn of the esophagus. It is often impossible to interview the victim: state of shock, childhood. Then you need to try to determine this by the smell of your breath or find the container in which the chemicals were located.

If it is determined that the burn was caused by acid, then to neutralize its effect it is necessary to rinse the stomach with alkali. To do this, use a 2% solution of sodium bicarbonate (2 g per liter of water). At home, you need to dilute half a teaspoon of baking soda in a liter of lukewarm boiled water and drink in small sips. After this, try to induce vomiting.

As first aid for a burn of the esophagus with alkali, gastric lavage is used with a weak solution of acetic, citric acid or vegetable oil.

If the burn is caused by potassium permanganate KMnO4, then wash with a 1% solution of ascorbic acid.

If the cause of the burn cannot be determined, the effect of the chemical compound can be neutralized with milk. Give 2 glasses of milk in small sips, warm but not hot.

It is important to rinse within the first 6 hours after drinking the liquid.

Treatment of a burn of the esophagus in a medical institution

If the patient has a spasm and cannot swallow, then gastric lavage is carried out in the hospital through a tube. Before this, it is generously lubricated with oil. Analgesics are pre-administered to relieve pain during the procedure - promedol 1 ml. 2% solution or atropine sulfate. In addition, local anesthesia of the mouth and pharynx is performed.

Complex treatment of chemical burns of the esophagus:

1. For pain relief, promedol, morphine, and analgin are used.
2. To relieve esophageal spasm, atropine 0.5-0.6 ml is prescribed.
3. Relanium is used as a sedative to relieve agitation.
4. To relieve shock - prednisolone, sodium bicarbonate solution, rheopolyglucin, intravenous saline solutions.
5. To prevent the formation of scars on the walls of the esophagus, adrenal cortex preparations are administered.
6. For warning infectious complications broad-spectrum antibiotics are used - cefamezin, ampiox
7. If necessary, medications are prescribed to normalize the activity of the heart and kidneys

In the first 5-7 days, vegetable or vaseline oil is prescribed - this promotes better healing of burns. Eating food, even liquid food, is excluded during this period.

In severe cases, the patient undergoes gastrostomy. This is an opening into the stomach cavity through the anterior wall. This is necessary for nutrition in the first weeks after a burn.

In the first days, in case of a II-III degree burn, X-rays are not prescribed and endoscopic examination so as not to further injure the esophagus.

To prevent narrowing of the esophagus, bougienage is prescribed. This is a procedure for gradually widening the esophagus using elastic probes of different diameters. Such manipulations begin from 5-7 days and are repeated for several months after the mucous membrane has healed.

The forecast depends on:

• the type of solution that caused the burn and its quantity.
• degree of damage, with degrees 1-2 it is favorable
• pH level of cauterizing liquid – liquids with a pH less than 2 and more than 12 cause severe damage
• correctness and timeliness of first aid and further treatment
• complications that occur after a burn

In the most severe cases - stage 3 - mortality can reach 50-60%. In other cases, the prognosis is favorable. Timely and correct treatment of a burn of the esophagus gives favorable results in 90% of cases.

Prevention of esophageal burns

The main measures to prevent burns of the esophagus include proper storage of household chemicals. Substances that are cauterizing liquids must be stored separately from food products.

Keep household chemicals out of the reach of children. If everyone heeded this warning written on every label, there would be far fewer accidents.

It is especially dangerous to pour chemicals into food containers: cans, bottles. These liquids are mistakenly mistaken for water and drunk, resulting in a burn to the pharynx and esophagus.

About 70% of burns are caused by ingesting vinegar essence. Based on this, you should stop using it and replace it with vinegar.

Caustic soda, which is used to clean pots and pipes, should not be stored in the kitchen. It does not have a pungent specific odor and is mistaken for baking soda.

In previous years, up to 10% of victims received burns after drinking a strong solution of potassium permanganate, which was used as a disinfectant. Therefore, if you still have supplies of this drug, do not dilute it in mugs and do not leave the prepared solution where children or other family members can get it.

Conversations with children on the topic of safety play an important role in the prevention of esophageal burns. It is necessary to promptly tell your child what dangers household chemicals pose and why they should not be used for other purposes.

Answers to frequently asked questions: What causes esophageal burns in children?

The majority of victims - up to 45% - are children under 7 years old. How older child, the less the risk that he will take an unsuitable liquid into his mouth. According to statistics from specialized departments of children's hospitals, the main cause of esophageal burns in children is vinegar essence (about 60%). In second and third place are cleaning products and ammonia.

In recent years, the amount of household chemicals based on concentrated acids and alkalis has increased sharply. Each apartment has a variety of liquids in colorful packaging. “Mr. Muscle”, “Mole”, tile and toilet cleaners and stain removers cause severe consequences and disability.

What are characteristic symptoms esophagus burn?

The first symptoms of a burn to the esophagus occur immediately after the cauterizing liquid enters the body.

Signs of a burn to the esophagus:

• Severe pain and burning behind the sternum.
• Due to swelling of the larynx, there is a lack of air and suffocation.
• Traces of burns and necrosis - tissue death - are visible on the lips and mouth.
• Spasm of the esophagus causes difficulty swallowing.
• Severe salivation occurs.
• Vomiting, often mixed with blood. Thus, the body tries to get rid of the chemical compounds that have entered it.

If these symptoms appear, you must immediately call an ambulance.

How to provide first aid for a burn of the esophagus?

The prognosis of the course of the disease and the speed of recovery depend on whether first aid is provided correctly.

First of all, it is necessary to cleanse the body of the substance that caused the burn. To do this, they give you water or milk to drink, and then induce vomiting.

After the remaining chemicals have been washed away, you can begin to neutralize their effects. You cannot start from this step. Because the reaction of acid and alkali releases a large amount of carbon dioxide. This may cause suffocation.

If the victim drank acid, then you need to give him a weak solution of baking soda (2 grams per liter of water). If the burn was caused by alkali, then neutralize its effect with a weak solution of vinegar in water or citric acid (3-4 grams per liter).

The ambulance team performs gastric lavage through a tube. Before this, the patient is given 100 ml to drink. novocaine solution for anesthesia of the mucous membrane of the pharynx and esophagus. Analgesics are administered subcutaneously to relieve pain shock. About 10 liters of water are used to lavage the stomach.

After cleaning the stomach, the hospital department begins complex treatment appropriate to the patient’s condition. They take medications that improve the functioning of the heart, kidneys and lungs, hormones, painkillers and drugs for intravenous nutrition.

If the victim can swallow, then in the first days a 5% solution of novocaine is prescribed - 100 ml in small sips throughout the day. It is also recommended to drink vegetable oil with the addition of an antibiotic.

What happens when the esophagus is burned by alcohol (alcohol)?

Alcohol burns occur when strong alcoholic beverages are swallowed. This can happen when consuming medical alcohol 70 or 96% and various tinctures based on it. When the esophagus is burned by alcohol, loss of taste, dizziness and weakness, pain in the neck, chest, and stomach occur.

When the esophagus is burned with alcohol, a white coating of fibrin forms on the surface of the mucosa, which resembles the white of a boiled egg. This is tissue that is dead as a result of an alcohol burn.

96% alcohol tans mucosal cells. A thin film is formed, which delays penetration into deeper layers. Therefore, severe burns do not occur when drinking alcohol. If the stomach has not been filled, a burn to the gastric mucosa may occur. But more dangerous is alcohol poisoning, which occurs when taking large doses of alcohol.

What happens when the esophagus is burned with vinegar?

Table vinegar does not cause severe burns to the esophagus. More severe consequences occur when vinegar is absorbed into the blood. Vinegar destroys

red blood cells

and arises

renal failure

Serious acid damage to the esophagus can occur if vinegar essence is ingested. It has a cauterizing effect. Water leaves the cells of the esophagus, and they turn into a dry crust - a scab.

Although acetic acid, unlike alkalis, does not cause perforation (rupture) of the esophagus, it can cause severe painful shock and damage to internal organs: liver, kidneys, heart.

How to treat a burn of the esophagus folk remedies?

First-degree chemical burns of the esophagus, after examination by a doctor, can be treated at home with folk remedies.

As first aid for burns of the esophagus ethnoscience advises drinking a liter of milk or a glass of vegetable oil, or 5 raw egg whites. These products help neutralize the effects of chemicals.

For a speedy recovery, you can use one of the recipes

1. Stir the white of a fresh egg in a glass of water. Protein forms a film on the burned surface and promotes its healing.
2. Chamomile tea prevents the development of complications, soothes and relieves inflammation. Brew tea at the rate of 2 teaspoons of flowers per cup of boiling water. Leave for 15-20 minutes. Drink warm throughout the day.
3. A decoction of flax seed is used as an enveloping agent that promotes healing of the mucous membrane and relieves pain. To do this, take 12 teaspoons of seeds, add a liter of water and boil over low heat for 10 minutes. After this, let it cool and filter. Drink in small sips throughout the day.
4. Pour a teaspoon of quince seeds with a glass of boiling water, leave for 30 minutes, then strain. Take 4-5 times a day, 1 tablespoon before meals.
5. Pour a tablespoon of marshmallow rhizome into 200 ml of boiling water. Leave for 30 minutes, strain. Take a few sips 3-4 times a day.
6. Tricolor violet herb - 1 tablespoon, pour a glass of boiling water. Leave in a warm place for 2 hours. Strain and drink throughout the day.

Treatment of burns of the esophagus is a complex and lengthy process that can last for years. That's why it's so important to prevent this accident from happening. Take precautions when using chemicals and keep them away from children.

What foods can cause a burn to the esophagus? By eating hot food, you can get a thermal burn of the esophagus, which will result in the typical symptoms described above in the article. The optimal food temperature is no more than 40°C. It is dangerous to eat food that has not cooled down, especially for children. In addition, constant consumption of hot food can lead to spasms of the esophagus, inflammatory processes, and cancer.

What are the possible consequences of a burn to the esophagus? The following conditions may develop as a result of a burn to the esophagus::

• Esophagitis– inflammatory process in the mucous membrane of the esophagus.
• Scar narrowing of the esophagus. The narrowing caused by chemical burns is most often located in the lower part of the esophagus. There can be many areas of scar narrowing, sometimes they stretch along the entire length of the organ. Sometimes scar tissue also grows in the surrounding fatty tissue, causing the esophagus to move to the side. Scar narrowing of the esophagus after burns is eliminated using bougienages(gradual expansion of the lumen) or surgical intervention.
• Cicatricial shortening of the esophagus.
• Perforation of the esophagus. A hole forms in the wall of the organ. Most often this occurs due to burns from alkalis. In turn, perforation can lead to other, more severe complications.
• Mediastinitis- inflammation of the space that is located inside the chest between the lungs and is filled with internal organs ( mediastinum). The inflammatory process develops as a result of penetration of the contents of the esophagus into the mediastinum against the background of perforation.
• Esophageal-bronchial and esophageal-tracheal fistulas. With perforation and development inflammatory process Pathological communications may occur between the esophagus and the bronchi and trachea.
• Aspiration pneumonia. Thermal and chemical burns of the esophagus are usually combined with lesions epiglottis– cartilage of the larynx, which covers Airways while swallowing. It ceases to cope with its functions; food and saliva entering the lungs lead to the development of pneumonia.
• Pleurisy. Inflammation of the pleura - a thin film of connective tissue that covers the outside of the lungs and lines the inside of the chest cavity. May occur as a complication aspiration pneumonia or perforation of the esophagus.
• Esophageal carcinoma. After a burn, the risk of cancer increases 10-1000 times. The diagnosis can often be very difficult to establish in the early stages.

Can gastric juice burn the esophagus? Gastric juice is acidic, and if it enters the esophagus, it can damage its mucous membrane. This happens when gastroesophageal reflux disease (GERD). Impact gastric juice on the esophageal mucosa can lead to some complications:

• erosions and ulcers of the esophagus;
• esophageal bleeding;
• narrowing of the esophagus;
• Barrett's esophagus– a precancerous disease in which cells that differ from normal appear in the mucous membrane of the esophagus;
• esophageal carcinoma.

What is a radiation burn of the esophagus? Radiation burns of the esophagus are rare. They are caused by the effect of ionizing radiation on the organ and arise, as a rule, as a complication of radiation therapy in the treatment of tumors of the mediastinum and mammary glands. Typically, such radiation burns of the esophagus manifest themselves in the form of inflammation of its mucous membrane - esophagitis. Swallowing is impaired, pain occurs and discomfort in the chest.
How is a burn of the esophagus coded in the ICD?

Depending on the cause of the burn, it is designated by one of two codes:

• T28.1– thermal burn of the esophagus;
• T28.6– chemical burn of the esophagus.

What happens when the esophagus is burned by soda? In the past, at the end of the 19th century, poisoning and burns of the esophagus with soda were quite common. But this was not food familiar to all modern people ( sodium bicarbonate), A caustic soda – sodium hydroxide. This very aggressive substance, capable of causing severe burns to the skin and mucous membranes, was previously widely used for the manufacture of various hygiene products.

Currently, burns of the esophagus with caustic soda are extremely rare. Burns of the esophagus caused by another alkali are much more common - ammonia. This substance is often thoughtlessly used to sober up during alcohol intoxication.

What substances most often cause chemical burns of the esophagus?

• Acids: acetic, sulfuric, hydrochloric.
• Alkalis: caustic soda, caustic potassium, caustic soda, ammonia.
• Heavy metal salts: copper sulfate, sublimate.
• Strong solution or potassium permanganate crystals.
• Phenol.
• Alcohol.

Damage to the esophagus as a result of exposure to liquids with high temperatures, alkalis and acids, leads to the development of burns of the esophagus. Such conditions occupy an important place in the structure of injuries among the population and lead to severe conditions, the need for long-term treatment and a serious decrease in the quality of life. In this regard, understanding the causes of the disease, knowledge of the main symptoms and methods of treatment is necessary for every person.

This is what a burn to the esophagus looks like during esophagoscopy

Burns of the esophagus occur as a result of exposure to a number of chemicals on the wall of the organ, or elevated temperature. A similar condition may occur in the following cases:

• Damage to the mucous membrane as a result of contact with acids or alkalis. Most often it occurs due to poisoning at work, suicide attempts and the mistaken use of these aggressive liquids. Acids and alkalis damage the wall of the esophagus in a short period of time and lead to damage of varying severity - from an inflammatory reaction to perforation of the wall with the development of mediastinitis and bleeding. Sometimes, similar damage can be caused by hydrogen peroxide. A burn of the esophagus with acid leads to the formation of a dense crust, while a burn with alkali often leads to softening and rupture of the wall. Chemical burns of the esophagus are the most common type of burns of this organ.
• Damage to the lining of the organ can occur as a result of a burn of the esophagus by liquid or food with a high temperature. You can burn your esophagus with excessively hot tea, other drinks, or just boiling water. Thermal burn of the esophagus is less common than the first option and leads to inflammation and necrosis in the upper parts of the esophagus.

Thermal burn of the esophagus can occur when drinking hot drinks

As a rule, damage to the esophagus from aggressive liquids is the result of accidents!

The entry of aggressive chemical liquids or liquids with elevated temperatures into the esophagus leads to the development of the following processes:

• Acute inflammation, which is simple esophagitis. As a rule, such a condition does not require specific treatment and if you follow a gentle diet, it goes away on its own without any complications.
• Ulceration of the wall with formation ulcerative defect of varying depths (from the inner epithelial layer to the outer shell). Superficial ulcers are capable of self-healing without surgery, while deeper defects require hospitalization of the patient and medical treatment. operational assistance due to the possible development of severe complications: bleeding from the esophageal vessels, perforation of the wall with the development of mediastinitis, adhesions between the walls and narrowing of the lumen of the organ up to its complete absence.
• If caustic alkalis enter the esophagus, perforation may quickly develop without the stage of ulceration. In these cases, the patient needs emergency surgical care.

Symptoms for burns of the esophagus can be divided into two large groups: local and general, characterized by the peculiarities of their manifestations.

At the first moment of the burn, severe pain appears

The esophagus contains a lot of nerve fibers, and therefore any damage to its wall leads to severe pain. Most often, it is widespread in nature with the main localization in the retrosternal region with transition to the neck and upper abdomen. In addition, external signs of poisoning include: visible damage and burns on the lips and facial skin.

Some of the aggressive fluid always ends up in the larynx, which leads to damage to the vocal cords. This situation is manifested by hoarseness and changes in the person’s voice. Possible swelling of soft tissues, leading to disruption of the swallowing process and difficulty breathing with symptoms of shortness of breath.

In rare cases, a spasm of the esophageal muscles may occur, which leads to an even greater increase in pain and the appearance of colic behind the sternum.

In addition to local pain and other symptoms, the patient begins to experience developing intoxication of the body associated with the accumulation of toxins and breakdown products of esophageal tissue in the body. The patient experiences a rise in body temperature, general weakness, nausea and headache. With severe intoxication, liver and kidney failure may occur, which directly threaten the patient’s life.

By clinical symptoms There are three degrees of severity of burns:

• Mild severity occurs when the surface epithelium is damaged. The mucous membrane becomes red, swollen and more easily injured. This condition goes away on its own within one to two weeks if you follow a gentle diet.
• Moderate severity is associated with the destruction of the mucous membrane and the muscle layer lying behind it. In addition to direct damage, severe swelling appears that can completely close the lumen of the organ. Ulcers form in the esophagus, healing up to one month with treatment.
• In severe cases, all layers of the wall are affected, and even nearby organs. Intoxication and inflammatory syndromes are clearly expressed, and infection is possible. The esophagus becomes narrowed and scarred, and it may become shorter or completely impassable for solid and liquid food. The process of complete healing extends to several months or even years.

Burns vary in severity

An esophageal burn is a serious condition that requires immediate hospitalization and treatment.

It is not difficult to make a correct diagnosis of a burn of the esophagus. As a rule, the doctor immediately understands what he is dealing with after interviewing the patient or people close to him. The fact of taking an aggressive liquid immediately explains all the symptoms. Additional consultation with the surgeon allows you to identify the type of damaging agent, its quantity and concentration, as well as assess existing damage and determine further tactics.

Intensive therapy and stabilization of the patient's condition allow additional research methods to be carried out. The “gold standard” in diagnosing a burn of the esophagus is an endoscopic examination, which allows the doctor to examine the esophagus, determine the volume and location of damage. In some cases, the risk of complications can also be assessed. Endoscopy also allows you to assess the dynamics of recovery during the treatment process, as it is a simple, cheap and informative examination method.

In addition, in some cases, X-ray examination of the esophagus with a contrast agent is used. In this case, the contours of the esophagus, wall defects, as well as narrowings and perforations in the organ are clearly visualized.

Treatment of esophageal burns is a difficult task, requiring an integrated approach and a combination of both surgical and therapeutic methods. The burned organ regenerates for a long time, replacing the damaged areas.

First aid for a burn of the esophagus should be provided to all patients before hospitalization in the intensive care unit of the hospital. What to do during development this state? First aid consists of thoroughly rinsing the mouth with normal clean water, to remove and neutralize the aggressive agent, as well as taking two glasses of milk, which also do an excellent job of neutralizing. Under no circumstances should you try to induce vomiting in a patient in order to clear the stomach of acids, alkalis or other substances using a large volume of water. As a result of such an attempt, the esophagus may rupture, which will significantly worsen the person’s chances of recovery.

First aid for a chemical burn of the esophagus should be provided quickly, preferably while transporting the patient to the hospital or simultaneously with calling an ambulance. Urgent Care - essential component good luck and effective treatment, especially with a chemical burn.

Treatment of a burn of the esophagus must necessarily be comprehensive and include the following steps:

• Adequate pain relief through the use of narcotic analgesics - Promedol, Morphine, Tramadol and other drugs.
• Antispasmodic therapy with Atropine to relax the muscle wall of the organ.
• Preventing the development of painful shock with the help of Prednisolone, Reopoliglucin and other drugs.
• Prevention of bacterial infection involves the use of antibacterial drugs - Amoxicillin, cephalosporins, Amoxiclav and others.
• When renal or liver failure develops, appropriate groups of drugs are used.

Carrying out infusion therapy

In the first week after a burn, plant oils are used to prevent further ulceration of the mucous membrane. These days they don’t even take liquid food. Parenteral nutrition is used. In severe cases with the development of esophageal stenosis and other complications, a gastrostomy tube is recommended to provide nutrition. As a rule, X-ray and endoscopic methods should not be used in the first days due to the possibility of developing side effects from these procedures and worsening general condition sick.

Which treatment method is the most effective? It is very difficult to give one answer to this question - it is necessary to treat it comprehensively. In order to prevent and treat narrowing of the esophagus, bougienage is used, which consists of a gradual expansion of the esophagus using special elastic bougies of various diameters. This manipulation is carried out by a surgeon starting from the second week after receiving the burn, and continues for several months after the mucosal defects have completely healed.

Do not self-medicate under any circumstances - this will only worsen the results and can lead to serious complications, including death.

Children are much more likely to be affected at an early age. Almost half of all cases of esophageal burns among children occur under the age of seven years. First of all, this is due to poor organization of the baby’s life. Parents may leave dangerous liquids (hydrogen peroxide, acetic acid) within reach of the child, and children rarely pay special attention to what they are trying to put in their mouths. In addition to these products, very often children get burns as a result of taking ammonia or various aggressive cleaning agents.

Burns of the esophagus in children, as a rule, are severe with symptoms of severe intoxication. Children are always subject to hospitalization and monitoring of their condition. Very often, to prevent stenosis, bougienage with elastic dilators is used in childhood, as well as various plastic surgeries on the esophagus. Surgery can cope with even severe defects of the esophageal wall.

Household chemicals should be stored out of the reach of children

The most important cause of esophageal burns, especially in childhood, is drinking inappropriately aggressive liquids and solutions. In this regard, the most important point in preventing such injuries is organizing proper storage and access to such liquids. All household chemicals, vinegar essence, and ammonia must be stored out of the reach of children. It is necessary to check and update the labeling on all containers with solutions, especially aggressive ones.

Alcohol burns to the esophagus can be prevented by limiting its use, or even better, by completely abstaining from alcoholic beverages. It must be remembered that alcoholic drinks are powerful damaging agents that can cause ulceration on the mucous membranes of even an adult. Any product containing alcohol can burn the internal lining of the digestive tract.

For children vital role Conversations about safety rules are played. It is recommended to conduct such conversations in the form of educational games. With this simple measure, most childhood injuries can be prevented.

A burn to the esophagus and stomach occurs as a result of substances of elevated temperature or chemical reagents entering the internal organs of a person. Depending on the irritant, burns are classified as thermal or chemical.

• Thermal injuries develop from swallowing food that is too hot or from inhaling large amounts of steam.
• Chemical damage occurs as a result of damage to the walls of the stomach or esophagus by various chemicals and other harmful substances.

According to medical statistics, most burn injuries occur as a result of chemical exposure.

The most common chemical damages are:

• acid burn (vinegar essence);
• burn from alkali (caustic soda, caustic soda);
• burns with other substances (alcohol-containing liquids, phenol, gasoline, acetone, silicate glue, potassium permanganate solution).

At the first symptoms of a burn or after direct ingestion of irritating substances, the victim must be referred to a medical facility. A person’s life often depends on the timeliness of treatment measures taken, especially if the stomach or esophagus is damaged in children.

Signs of a burn

There are nerve endings on the soft tissues of the esophagus, so after a burn the victim experiences severe pain. Pain in the abdominal area is the first sign traumatic injury. Besides, painful sensations can spread to the neck or back area. After a burn injury to the esophagus, traces of the burn (redness and swelling) are observed in the oral cavity and on the lips.

As a result of exposure to chemical reagents, the victim’s voice changes and hoarseness is observed.

The consequences of a traumatic injury are swelling of the esophageal mucosa, as a result of which the victim is impaired natural process swallowing. Tissue swelling is accompanied by shortness of breath, vomiting, and spasms of the esophagus.

When ingesting chemicals, not only the walls of the esophagus are affected, but also other components of the stomach. The chemical aggressor that gets inside destroys tissue cells, resulting in tissue necrosis.

In case of serious burn injuries, the formation of a hole in the esophagus, destruction of the bronchi and the occurrence of a fistula in the esophagus are observed.

Along with the main symptoms of a burn, the victim experiences chills, his body temperature rises, and his heart rhythm is abnormal.

The severity of a stomach burn depends on the duration of exposure of the aggressor to the internal organs, on the nature of its origin and on the concentration of the irritant substance. Accordingly, with more complex traumatic lesions, the victim experiences more painful symptoms, accompanied by general weakness and other negative symptoms.

Severity of burns

In medical practice, there are 3 degrees of severity of burns of the esophagus or stomach.

• First degree ( easy stage). In case of a burn injury, only the upper layer of the soft epithelium is damaged, while the internal soft tissues are not affected. Symptoms of a 1st degree burn are redness and slight swelling of the mucosal walls, the victim feels slight pain. As a rule, no special medical intervention is required in this case, and all signs of a burn injury disappear within a half-month on their own.
• Second degree (middle stage). During a burn, the mucous membrane and internal muscle esophagus or stomach. As a result of the burn, severe swelling appears on the mucous membrane, and the surface of the mucous membrane itself becomes covered with ulcers. In this case, the victim must receive qualified medical treatment. If no complications arise as a result of the injury, the injury will heal within a month.
• Third degree (severe stage). As a result of a burn injury, all layers of the esophagus and stomach are damaged, and the damage often spreads to nearby internal organs. After the incident, the victim experiences shock and intoxication occurs in the body. Even if the victim receives timely medical care, scars remain at the burn site, and the wound heals in a period of 3 months to 3 years.

Treatment and first aid

A 1st degree burn does not require drug treatment, but the victim still needs to be shown to a doctor to clarify the diagnosis and to carry out preventive procedures for complications after the burn. 2nd and 3rd degree burns require medical intervention, which is provided to the victim after providing primary care.

The further successful recovery of the patient from a burn of the esophagus and stomach depends on the speed and immediacy of primary care.

First aid:

• rinse the stomach. To do this, the victim must promptly drink at least 1 liter of pure warm water, and then provoke vomiting;
• if the lesion is caused chemical compounds, then the reagent is neutralized. This action can be carried out only if the nature of the stimulus is reliably known. If the burn aggressor is not known, then neutralization is carried out only by doctors;
• the victim must be taken to a medical facility or an ambulance team must be called to the scene of the incident.

In a medical institution, the nature of the lesion is determined and the main aggressor of the burn is determined. After determining the necessary basics, the patient's stomach is washed again. If the victim experiences esophageal spasm, rinsing is carried out using a probe. Before using the umbrella, the esophagus is pre-treated with oil and the patient is given an anesthetic.

The main treatment for burns consists of the following procedures:

• taking painkillers;
• use of drugs to relieve esophageal spasm;
• normalization of the cardiac and excretory systems;
• preventing intoxication of the body;
• relieving the victim of shock.

As additional methods For treatment, doctors recommend that the victim take vegetable oil orally. In addition, the victim should follow a strict diet.

Chemical burn of the esophagus and stomach

A dangerous chemical burn to the esophagus occurs as a result of intentional or accidental ingestion of aggressive chemicals. Most often, the aggressor of chemical damage is vinegar essence or alcohol-containing liquids.

Symptoms:

• spasm of the esophageal muscles;
• sharp pain in the stomach area, radiating to the neck or back;
• pain shock;
• intoxication of the body;
• vomit;
• breathing problems;
• hoarseness of voice.

After a chemical burn, the victim must be urgently taken to a medical facility. Further successful treatment, and often the life of the victim, depends on the speed of provision of primary care.

Acid burn

If it is reliably known that traumatic damage to the esophagus occurred due to acid, then the effect of the irritant must be neutralized with an alkaline solution. To prepare an alkaline solution, use baking soda (in the ratio of 1 teaspoon of soda per 1 liter of boiled warm water). The victim is given a prepared alkaline solution to drink and then vomited.

Alkali burn

As a result of a burn of the esophagus and stomach with alkali, gastric lavage is performed with acid solutions. In this case, you can use acetic, tartaric or citric acid. A small amount of water dissolves in a liter of warm and boiled water. required acid, and then the victim drinks the prepared solution. After which vomiting is induced.

Acetic or other acid can be replaced with vegetable or sea buckthorn oil.

Burn with alcohol (alcohol)

The degree of injury from a burn caused by an alcohol-containing substance is influenced by the amount of liquid drunk and its strength. The first signs of alcohol trauma are: dizziness, general weakness, loss taste qualities, pain in the stomach, abdomen, neck and back.

Primary care for burn injuries is gastric lavage. After this, the victim must be taken to a medical facility.

Vinegar burn

The most dangerous burn injury is caused by vinegar. The speed of initial assistance actions directly affects the future life of the victim. After taking vinegar, you must immediately rinse your stomach with an alkaline solution ( soda solution) or plain water.

Even when the victim does not feel pain or changes in general physical condition, he still needs to be taken to a medical facility to provide basic treatment for a vinegar burn.

Thermal burn of the stomach or esophagus

Thermal damage to the stomach or esophagus occurs during the process of swallowing uncooled food or during intense inhalation of hot vapors.

In medical practice, thermal burns are not as common as chemical burns. Grade 1 lesions can be treated by independent methods, and for burn injuries of 2nd and 3rd degrees, the victim must undergo treatment as prescribed by a doctor.

Food burn

When swallowing hot food or liquid, pain occurs in the esophagus. First aid for food burns involves cooling the walls of the esophagus. To do this, the victim needs to drink 1 liter in small sips. cool water.

With severe burns of the esophagus, damage to the walls of the stomach is possible.

Boiling water burn

First aid for a burn with boiling water is similar to first aid for a burn with hot food. After a traumatic injury, the victim needs to drink enough cool water.

After a burn to the esophagus, the victim must follow a diet that excludes salty, spicy and smoked foods.

Burn of the esophagus and stomach in a child

In most cases, children suffer from burns of the esophagus and stomach. Kids drink the liquid they are interested in, but at the same time do not think at all about the possible consequences.

After a traumatic injury, adults urgently need to call an ambulance; this is important to do in a timely manner even in cases where there is a slight burn to the child’s esophagus.

First aid after a burn in a child is to lavage the stomach cavity; for this, the baby needs to drink a large amount of cool water and then induce vomiting.

Further treatment is prescribed only by the doctor after examining the little patient and conducting the necessary laboratory tests.

It is important for parents and adults to take care of the prevention of burn injuries to the child’s esophagus. To do this, you must follow these simple steps:

• Follow the rules for storing household chemicals. It should be kept out of the reach of children;
• Replace vinegar essence with vinegar. It must also be stored in places inaccessible to the baby;
• Conduct timely conversations with your child about the dangers of chemicals and the consequences of burns.

Alternative treatment for burns of the esophagus or stomach

After providing medical assistance as a result of 2nd and 3rd degree damage, as well as after a 1st degree burn, the victim can use traditional therapy. Traditional therapy methods will help normalize physical state the victim and contribute fast healing wounds and restoration of functions of the esophagus and stomach.

• take 1 tbsp daily on an empty stomach. a spoonful of vegetable, sea buckthorn or olive oil;
• drink fresh milk several times a day;
• three times a day, take 1 glass of decoction of medicinal herbs (chamomile grass, quince seeds, marshmallow roots).

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Burns of the esophagus are a violation of the integrity of the tissues of the tract, which is formed as a result of contact with chemicals, thermal objects or radiation.

A thermal burn of the esophagus occurs when hot liquid or food enters the body. Chemical type damage occurs in case of direct contact with chemically active liquids. Most often, these liquids are: acetic or sulfuric acid, sodium hydroxide (caustic), ethyl-containing preparations, tinctures, manganese powder, peroxide (regular peroxide solution), acetone, ammonia, phenol.

In addition to the esophagus itself, the oral cavity, pharynx and stomach are affected. The largest group of victims (about 70%) are children under 11 years of age. Acid burns are less harmful to the body than alkaline burns. Exposure to alkali behind chains chemical reaction, with subsequent destruction of proteins, disruption of the integrity of the epithelium and necrosis of the digestive tract.

The esophagus itself is a tube made of smooth tissues and muscles, the length of the passage part is 27-30 cm. The main functionality is the delivery of food from the oral cavity to the stomach. If you look at the esophageal tract in section, you can see its star-shaped shape. This design is necessary for the body to quickly push food and liquid through.

Basic shells:

• Mucous membrane - located inside, produces a viscous liquid that allows food to pass easily.
• Muscular – located between the mucous membrane and the connective membrane (in the middle). Consists of two types of smooth muscles (some run transversely, others lengthwise). The main function is to push food to the stomach.
• Connective tissue – regulates the diameter of the lumen of the esophagus.
• The esophagus also has peculiar valves (at the beginning and end), which serve to allow or limit the passage of food, and also act as a blockage valve (do not release food from the stomach cavity into the esophageal tract).

Since the entire area of ​​the esophageal trachea is covered with a chain nerve endings, its damage causes acute pain. The pain also touches cervical region, chest area(top and back) and belly. Oral cavity may become red and swollen, resulting in difficulty breathing. Chemical burns of the esophagus lead to tissue swelling, difficulty swallowing, shortness of breath, and vomiting (possibly with blood and epithelial particles). After spasms begin, the internal epithelium gradually dies.

In some cases, aggressive liquids cause through-and-through damage to the walls of the stomach and esophagus. In addition, it is possible to burn through the walls of the bronchus and form a phenomenon called tracheal fistula. A burn to the stomach by hot food can cause sharp cramps in the abdominal area, metabolic disorders, and permanently damage the shape of the smooth walls.

Poisoning of the body caused by the ingestion of toxins leads to increased body temperature, general weakness, nausea, and heart rhythm disturbances.

Depending on the type of damage complexity traditional medicine defines three degrees of food burns:

• The first one is easy. The aggressive liquid affects only the upper layers of the walls and partially the mucous membrane. The maximum manifestation is swelling, dizziness and redness of the damaged areas.
• The second is average. Affects the mucous structure of the stomach lining and tonic fibers. The injuries resemble small ulcers covered with fibrin (a blood protein).
• The third one is hard. The entire alimentary tract and adjacent organs are affected. There is severe intoxication, a state of shock, and the development of scar tissue.

First aid for burns of the esophagus requires immediate rinsing. To do this, the patient is forced to drink a liter of clean water and the gag reflex is specially induced. Afterwards, if possible, it is necessary to establish what exactly the person was poisoned with.

Chemical burns of the esophagus caused by acid can be neutralized with baking soda. 5 grams of soda are dissolved in a liter of water, then the patient drinks the prepared liquid, after which vomiting must be induced again.

If the burn, on the contrary, is caused by an alkaline environment, you need to prepare a weakly concentrated solution of citric acid or olia (no more than two grams per 1 liter of water).

Burns caused by potassium permanganate must be neutralized with a solution of ascorbic acid (concentrate no more than 1%). When the cause of the injury cannot be identified or you are not sure of its origin, it is better to resort to the use of milk (it will absorb toxins). You must drink 400 grams of warm milk and then throw up what you have drunk.

The initial examination of the victim is carried out by several doctors, namely a surgeon, a gastroenterologist and a therapist. When the cause of the burn is established, appropriate treatment is prescribed; if the examination fails to determine the cause, radiography or esophagogastroscopy is prescribed. Hardware examination allows you to determine the area of ​​damage, find out about the presence of scars and other lesions. Diagnosis will also help to identify the type of injury received, whether it is a chemical burn of the stomach or thermal.

In case of excessive narrowing of the esophagus, rinsing is performed through a special probe. To make the procedure less painful, the patient is injected with promidol or atropine. In order to calm the patient, Relanium is administered intravenously. Saline solution or rheopolyglucin will help eliminate shock. Prevention of the growth of scar tissue is ensured by drugs that include hormonal substances (hydrocortisone). Treatment for a chemical burn of the esophagus includes compliance with proper diets and eating easily digestible foods.

Will help prevent infection antibacterial drugs, for example, cefamezine.

Additionally, medications may be prescribed to normalize the functioning of the heart and kidneys. In the first week of rehabilitation, the patient should take vegetable oil. In especially severe cases, food intake is carried out by introducing a food tube or droppers with nutrients. Sometimes a hole is made in the patient's anterior wall of the stomach, through which a nutrient mixture is supplied through a hose.

Alcohol burns of the esophagus occur as a result of oral ingestion of 70 or 90% alcohol, as well as alcohol tinctures. In this case, the patient experiences a white coating on the mucous membranes, swelling and redness. Large volumes of alcohol-containing liquids can cause corrosion of the stomach walls. Poisonings are accompanied general symptoms intoxication (nausea, vomiting, dizziness), in this case the stomach is immediately washed with plenty of water to avoid the appearance of ulcerative wounds caused by alcohol.

Vinegar

The vinegar liquid itself is not a factor in severe injuries that need to be treated in the hospital. Vinegar is dangerous because, when absorbed into the blood, it destroys its components (proteins, red blood cells), which in turn will lead to a decrease in the functioning of the immune system and diseases of the kidney system. Damage to the epithelium of internal organs is possible when acetic essence gets on them. A large dose of vinegar can cause shock and abnormalities in the functioning of the heart and liver.

Characteristic for people suffering from reflux gastroesophageal disease. The peculiarity of the disease is that it provokes the release of gastric juice into the esophagus. The digestive secretion, in turn, gets on the mucous membranes of the esophagus, burns them, all this leads to ulcerative formations, stenosis and even cancer.

Treatment of chemical burns of the esophagus at home is not always effective, and can sometimes lead to serious pathologies. It is best not to self-medicate, but to seek qualified help, this will avoid further complications.

• mix 200 grams of boiled water and one egg white, drink;
• drink green or chamomile tea several times a day;
• make a tincture from flaxseeds(12 spoons per liter of water) and drink 59 grams three times a day;
• take a decoction of quince seeds (one tablespoon per glass of boiling water);
• treat yourself with violet tea.

Forecast

The rehabilitation period directly depends on how severe the degree of burn is, how much active substances entered the body and how aggressive they are. High concentration alkaline solutions cause severe damage to internal organs. First and second degree thermal burns are the safest. Chemical injuries of high severity (3 -4) – can lead to death, in medical practice this is 50% of cases.