Pathological reflux of stomach contents (acid) from the stomach to the esophagus is gastroesophageal reflux. Patients may complain of burning sensation behind the rib cage. Sometimes it is the burning at the back of the esophagus as well as the passage of food and bitter water into the mouth. Esophageal reflux often occurs after meals. Gastroesophageal reflux disease is common in our country as well as all over the world. In a study conducted in our country, gastroesophageal reflux disease was found in 20% of the population.
The origin of gastroesophageal reflux disease symptoms lies in the contact of the esophagus with excessive amounts of stomach acidic content for a long time. Prolonged contact of the acidic contents of the stomach with the esophagus causes damage to the esophagus, which causes a burning sensation. Normally, there is a valve-like structure consisting of muscle at the lower end of the esophagus, which we call the lower esophageal sphincter. This structure prevents acid from flowing back into the esophagus and keeps it inside the stomach. In reflux disease, this sphincter relaxes at frequent intervals and the acidic contents of the stomach leak back into the esophagus. When diagnosing reflux, some tests may be needed to understand whether the findings are actually caused by reflux and whether complications develop. Tests used for this purpose: Barium esophageal gastric duodenum radiography, gastroscopy, esophageal manometer and PH meter. If reflux is not treated, it may progress with serious complications. For example, it may cause stenosis in the esophagus, bleeding, and some pre-cancerous changes in the mucosa. Symptoms that should alert you and your doctor include: Complaints include difficulty swallowing (dysphagia), bleeding, feeling of choking, cough, hoarseness and weight loss. In many patients, the flow of acid up the esophagus and into the mouth can be controlled with lifestyle changes and medications.
Lifestyle changes should be quit smoking, stay away from carbonated and acidic drinks, avoid alcohol, chocolate, caffeine, coffee, tea, fatty, spicy foods and Foods that increase acid, such as tomatoes, should be avoided and are recommendations for weight loss. In addition, eating should be stopped at least 3 hours before bedtime, and raising only the head of the bed will prevent acid reflux throughout the night. Medical treatment has a very important place in gastroesophageal reflux disease, which cannot be prevented by lifestyle changes alone. Anti-acid drugs included in medical treatment help the treatment by protecting the esophagus and suppressing stomach acidity. Medicines called H2 blockers and proton pump inhibitors, which suppress stomach acid, should be used in doses prescribed by your doctor, as with all medicines. With medical treatment, symptoms of gastroesophageal reflux disease can be prevented in most patients. In addition to these drugs, prokinetic drugs that facilitate the downward passage of acid from the esophagus to the stomach are also included in the treatment. If the patients' complaints do not go away with medical treatment or if there are complications such as bleeding or stenosis, surgical techniques can be used. Surgical techniques correct the natural barriers between the esophagus and stomach that prevent acid reflux.
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