Gastroesophageal reflux, or reflux as it is commonly known among the people, is a disorder that occurs when stomach acid backs up into the esophagus, which is defined as the esophagus in medicine.
What is Gastroesophageal Reflux?
Gastroesophageal reflux, or reflux as it is commonly known among the people, is a disorder that occurs when stomach acid backs up into the esophagus, which is defined as the esophagus in medicine. Although it cannot be determined exactly, the rate of reflux in the whole society is approximately 20% when considering those who have reflux complaints at some point in their lives. There is no significant difference between men and women in terms of the incidence rate. Gastroesophageal reflux, which is characterized by indigestion, heartburn, burning in the esophagus and stomach acid coming into the mouth after meals, occurs temporarily in some people and goes away on its own after a while. However, in some people, the complaints due to reflux can be frequent, uncomfortable and quite painful. This causes a burning in the back of the chest (Heartburn). Reflux, the cause of which cannot be determined exactly, is often confused with ulcer, but these two disorders are completely different from each other. Complaints begin to appear about half an hour after meals. "What is gastroesophageal reflux?" It is necessary to answer the question. Normally, the acid and bile contained in the stomach contents do not escape into the esophagus. Between the stomach and the esophagus is the lower esophageal sphincter, or in other words, the gastric valve. This valve allows food to enter the stomach, but prevents stomach contents from ascending. Thus, the strong acids used for digestion of food in the stomach do not destroy the esophageal mucosa. Gastroesophageal reflux, on the other hand, is the reflux of stomach contents into the esophagus. Consisting of acid, pepsin and bile salts, this liquid may occasionally contain food particles. il. The person feels a burning (Heartburn) in the posterior region of the rib cage. In addition, food particles and bitter water may come into the mouth. (Regurgitation) Reflux complaints may also occur in the REM phase of sleep. Reflux can occur in two different ways, physiological and pathological. Reflux, which can occur from time to time in healthy individuals, is a physiological event. It can be 10 to 50 times a day. However, physiological reflux usually lasts for a very short time and its symptoms are very mild.
Mostly, the person does not realize this situation. However, gastroesophageal reflux that lasts for a long time, causes severe symptoms, recurs many times during the day, wakes the person from sleep, is considered within the scope of pathological reflux. Since this ailment, which affects approximately 20% of the population, is relieved by simple dietary changes or the use of antacid drugs, physicians are often not consulted for the diagnosis and treatment of the disease. Before moving on to gastroesophageal reflux treatment methods, it is necessary to talk about the symptoms of reflux.
What are the Symptoms of Reflux?
The most common symptom of gastroesophageal reflux is a burning sensation in the chest area known as "Heartburn". Some people may feel the burning sensation in the neck, back and shoulder area. In some cases, this feeling can also be confused with heartache. This situation is so great that approximately 50% of people who undergo coronary angiography do not have any heart-related disease and reflux is diagnosed. The burning sensation in the esophagus usually starts suddenly and continues for hours. It can cause a person to wake up from sleep. Ingestion of stomach contents, difficulty in swallowing, burping, hiccups, nausea and vomiting are among the symptoms seen in the presence of reflux. The condition that the stomach contents come into the mouth, which is defined as regurgitation in medicine, is usually after meals, but sometimes it can also happen during the meal. This condition, which causes burning in the throat and a bad taste in the mouth, is one of the common symptoms of gastroesophageal reflux. Reflux symptoms often occur while lying down.
What are the Causes of Reflux?
The main reason for reflux is the prolonged contact of stomach acid with the esophagus. Gastric acid enters the esophageal mucosa Emesis causes this tissue to be damaged, thus causing the person to feel a burning sensation. In order to avoid this situation, there is a valve-like structure consisting of muscle tissue between the stomach and the esophagus called the lower esophageal sphincter. Reflux occurs as a result of frequent relaxation of the lower esophageal sphincter, which prevents the gastric contents from ascending. The decrease in the resistance of this valve can be temporary or permanent.
Structurally abnormal sphincter causes the stomach contents to contact the esophagus all day long. Reflux recurs frequently if the gastric valve is looser than normal. As a result, the esophagus is constantly exposed to stomach acid and over time, the esophageal tissue is shed. Over time, the severity of reflux increases and can lead to different disorders such as ulcers, bleeding, shortening. In untreated advanced cases, it can also cause Barrett's esophagus disease, which increases the risk of esophageal cancer. In addition to all these, it can also be seen due to Hiatal hernia disease, which is defined as the escape of a part of the stomach through the opening in the diaphragm through which the esophagus passes.
However, the cause of reflux is not yet known exactly. Although current studies show that gastroesophageal reflux can start from the stomach, this information is not yet clear. Causes such as eating too much, eating rich in fried foods, consuming excessive spices can also cause reflux. . If reflux is not treated, it can lead to diseases such as growth retardation, anemia, pneumonia, esophagitis, peptic stenosis, laryngitis, pharyngitis, bronchitis, asthma, Barrett's esophagus and cancer in children.
How to Prevent Reflux?
Reflux is a disease that can be controlled with simple measures. Some of these methods can be listed as follows:
Using a high pillow while lying down, Not eating too much, Eating little but often, Chewing food well, Limiting chocolate consumption, Reducing coffee and tea consumption, Not consuming carbonated drinks, Getting rid of excess weight, Staying away from stress, Stopping alcohol and cigarette consumption, Not wearing tight clothes.
How to Diagnose Reflux ur?
After the person applies to the doctor with reflux symptoms, the physician takes the patient's anamnesis in detail. Medications defined as proton pump inhibitors (PPIs) are given to the patient to relieve symptoms. The patient is called for control after 1-2 weeks. If the complaints are relieved by the use of medication and continue when discontinued, the person is diagnosed with gastroesophageal reflux. Another method used for diagnosis is 24-hour pH monitoring.
A small device left in the stomach entrance from the nose measures the pH level of certain points in the esophagus of the person for 24 hours. As a result of this examination, the person can be diagnosed with gastroesophageal reflux. In barium esophageal stomach duodenum radiography method, the radiologist examines the patient while drinking barium. Another diagnostic method is gastroscopy. Gastroscopy is an endoscopic imaging method. As a result of this procedure, a diagnosis of reflux can be made.
How to Treat Reflux?
Reflux treatment is largely based on lifestyle changes. Many people diagnosed with gastroesophageal reflux can keep reflux under control by changing their lifestyle, even without the need for medication. In addition to lifestyle changes, some patients may require drug therapy, while others may require surgical intervention. The drugs used in the treatment of reflux provide suppression of stomach acid. In the surgical treatment method, the lower esophageal sphincter, or in other words, the muscle in the gastric valve is strengthened.
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