营养与消化道疾病.ppt

营养与消化道疾病 第一节 反流性食管炎 一、概述 反流性食管炎（reflux esophagitis）是胃食管反流性疾病(gastroesophageal reflux disease，GERD)的一种常见形式，它是指由于胃、十二指肠内容物反流入食管引起的一组临床症状和食管的组织损害。 ?Reflux esophagitis falls into the category of reflux gastroesophagopathy. It is characterized by inflammation, erosion, ulcer formation and fibrosis of the esophageal mucous membrane due to reflux of the content of the stomach and duodenum into the esophagus. 二、发生发展与营养的关系 影响LES的食物，如辣椒、酸果、油腻食物、浓茶、酒等 目前认为该类食物引起或加重溃疡病情的原因有：①有高的张力，收敛性大，或是酸性强；②引起胃强有力的分泌；③通过释放胃肠道激素，或是刺激神经反射。 三、疾病与营养预防 1．减少进食量 2. 改变生活方式 3. 情绪平稳，忌烟、酒、咖啡 4. 避免增加腹压 Reflux is very common and practise of simple measures may bring enough relief. The more the stomach is stretched by food, the higher the tendency to reflux. Eating fatty meals as fat delays gastric emptying also increases the tendency to reflux. Try to 1. Eat small meals 2. Eat regularly, this helps in reducing the pressure on the upper part of the stomach caused by large meals. 3. Avoid large rich meals, particularly in the evening this reduces the tendency to reflux. 4. Avoid eating late at night so as to keep the stomach relatively empty at bedtime. 5. Avoid alcohol, if it is being taken, it should be in moderation with meals.6. Smoking should be avoided. Tobacco prevents the esophageal sphincter from working properly, reduces the rate at which the stomach empties and increases stomach acid production.7. Bending should be kept to a minimum, especially after meals. 四、营养治疗 采用低脂肪饮食 1. 控制总能量 2. 减少脂肪摄入 3. 适当增加蛋白质摄入 4. 食物选择： （1）饮食中应吃些易消化、细软的食品 （2）少用刺激性食品 （3）戒烟酒 5. 其他治疗：晚餐不宜多，睡前不加餐， 避免餐后即平卧；避免使用减弱食管下括约肌张力的药物。 The lower esophageal muscle can be weakened by factors other than food. The following recommendations may be helpful in reducing symptoms: Stop using tobacco in all forms. Nicotine weakens the lower esophageal muscle. Avoid chewing gum and hard candy. They increase the amount of swallowed air which, in turn, leads to belching and reflux. Do not lie down immediately after eating. Avoi