Reflux

Gastroesophageal Reflux Disease (GERD) is a picture that develops as a result of the reflux of stomach contents (gastric juice and/or food residues) into the esophagus (esophagus), and is characterized by burning behind the breastbone and bitter water coming into the mouth, especially after meals. Physiological reflux can be observed in normal people, provided that it is less frequent. Responsible for 75% of esophageal diseases, reflux manifests itself with very different clinical presentations. These can range from simple burning to ulcerative esophagitis (wound-crack in the lower part of the esophagus), esophageal stricture, and Barrett's metaplasia, which carries a cancer risk. Although reflux disease can heal on its own, it is an issue that often forces and disrupts people's living conditions. Reflux is observed in approximately 20% of adults. Possible factors in this disease whose cause is not fully understood are:

• Disruption of the lower esophageal valve integrity

• Gastric hernia

• Disruption in esophageal clearance capacity

• Reflux from the small intestine to the stomach

• Increase in gastric volume and acidity

• Delayed gastric emptying

• Increased intra-abdominal pressure (obesity)

• Presence of excess acid in the stomach

• Damage to the esophageal tissue barrier

• Increased reflux at night

    The stomach contents are markedly acidic due to the hydrogen ion secreted by the stomach . If there is reflux of bile from the duodenum to the stomach, the ascending contents from the stomach contain both acid and bile. Bile, which is alkaline, also causes irritation of the esophagus, like stomach acid. At the lower end of the esophagus, there is a valve mechanism that prevents the passage of stomach contents into the esophagus. The most common feature in reflux patients is the laxity of this mechanism. This condition is often experienced with gastric hernia. Gastric emptying disorder or impaired esophageal movement are other causes that trigger this disease.

The symptoms of gastroesophageal reflux disease spread over a wide spectrum. This is specified It is possible to classify the findings as typical and atypical findings in general. The clinical presentation of reflux disease is in the form of bitter and sour liquid in the mouth, belching, bloating, food residues in the mouth, difficulty in swallowing, and a feeling of being stuck in the pharynx. Atypical manifestations include hoarseness, stinging cough, bad breath, palpitations, feeling of pressure on the heart, shortness of breath, feeling of shortness of breath, asthma, dental caries, persistent pharyngitis (chronic pharyngitis), resistant hiccups, chronic sinusitis. In our outpatient practice, we see that reflux disease is responsible for some of the symptoms such as unexplained dry cough, bad breath and hiccups. In this sense, it is a disease that is difficult to diagnose when it is not thought of. Many factors can provoke this disease. These may include alcohol, cigarettes, some drugs, chocolate, coffee, mints, spicy foods, onions, garlic, tomatoes, citrus fruits, conditions where gastric emptying slows down (diabetes), presence of excess acid in the stomach, hernia, pregnancy and excess weight. .

Diagnosis of reflux disease is a complex issue. The most important diagnostic tool is the nature of the patient's complaint. The presence of more than two reflux attacks per week is valuable for diagnosis. In this disease, the definitive diagnosis of which is confirmed by pHmetry, this test is not needed except in very special cases. Although endoscopic procedure is not obligatory for patients with reflux, they should be evaluated for the integrity of the lower end of the esophagus, the degree of damage to the lower end of the esophagus, the presence of Barrett's esophagus, and hernia ground by performing an endoscopy even once in their lifetime.

GASTROESOPHAGEAL REFLUX TREATMENT

 LIFE-TYPE CHANGES RECOMMENDED IN REFLUX

• Chew your food well, avoid eating fast.

• Avoid high-fat foods.

• Avoid additional foods that you find bothersome.

• Avoid all products containing caffeine.

• Do not smoke or drink alcohol .

• Never lie on your back for 2-3 hours after meals don't assume. Maintain an upright position, walk lightly if possible. Do not eat any solid-liquid food within 2-3 hours before going to sleep at night.

• Avoid strenuous exercise immediately after meals.

• If you are overweight, try to lose weight in a controlled way.

• Avoid wearing tight clothes.

• If necessary, raise the head of your bed 10-15 centimeters.

• Do not overeat at once, eat small amounts frequently, and acquire the ability to get up from the table without feeling full.

• Recommended for you Do not use pain relievers. If it is necessary, consume stomach medicine on an empty stomach, and a pain reliever with a low probability of side effects on a full stomach.

   I would like to remind you how important it is. The duration of drug use is specific to the individual. You can learn the details about the practice of drug use from your physician.

Painkillers recommended for other reasons should not be used as much as possible.

Surgical treatment may be required in some of the reflux disease. The surgical decision is possible with a logical patient-physician communication.

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