The disease, commonly referred to as reflux (gastroesophageal reflux), develops as a result of the deterioration of the valve system between the stomach and the esophagus. The high pressure in the abdomen pushes the stomach contents towards the esophagus, which is located in the lower-pressure chest cavity. Normally, this lid system prevents overflow. However, fast and excessive eating in the modern age over-inflates the stomach until a feeling of satiety occurs and strains the valve system. Additionally, excessive fatty foods, chocolate, cigarettes and alcohol also loosen this valve system. As a result, the number and duration of intermittent reflux increases in almost everyone. The feeling of discomfort such as burning in the chest, bitter water in the mouth, and even food coming into the mouth causes the person to need to clean the esophagus. This allows the irritating content in the esophagus to be pushed back into the stomach by drinking water, swallowing or even taking food. However, the air and saliva taken by swallowing and the water consumed further swell the stomach and put more strain on the valve system. In case of reflux that continues for a long time, the valve system loses its function permanently.
Bitter water and food coming into the mouth due to reflux, burning behind the chest that can become permanent, chronic cough, and hoarseness disrupt the comfort of life in the short term. The person may now become afraid to eat. In the long term, the damage caused by the acidic contents of the stomach to the esophagus deepens; First, the burning decreases or even disappears. However, this does not mean that the reflux is cured. Particularly, bitter water coming into the mouth and continuing cough are indicators of this. Damage to the esophagus is the beginning of changes that can even lead to cancer in the long term.
The most important examination in the diagnosis of the disease is endoscopy. Detection of damage to the esophagus (esophagitis) along with typical complaints is diagnostic. If no damage to the esophagus is detected by endoscopy; In a patient with typical complaints, the exposure of the esophagus to stomach acid for 24 hours is measured using special devices. If it is determined that the acidic stomach content is high according to certain measurements, the diagnosis of reflux is confirmed even if the endoscopy is normal.
The first treatment in the patient diagnosed with reflux is to eliminate the caustic properties of the stomach acid content with medications. Of course, it is also necessary to correct the eating style and habits. I must. With these precautions, 90% of the patients are relieved. After 2 months of drug treatment, the drug is stopped and the patient's complaints are evaluated. Surgery options should be considered in patients who are unresponsive to drug treatment or whose symptoms recur after stopping the drug. In patients whose symptoms recur after stopping the medication, continuous (lifelong) medication may be required. For this reason, surgery is a permanent and good option for younger patients who may use medication for more than 10 years and have few comorbidities.
Surgery is currently performed by a closed (laparoscopic) method. Simply put, during surgery, the top of the stomach is wrapped around the esophagus and a new valve system is created. Although this surgery, like every surgery, has its own risks and complications, the success rate is around 90% in the right patients and correctly performed surgeries.
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