Gastroesophageal reflux disease (GERD) is a term used to describe problems caused by stomach acid leaking into the esophagus. Symptoms occur when the esophagus is irritated by acid. As an alternaive; The terms reflux, acid reflux, reflux esophagitis, regurgitation are also used.
Reflux symptoms
- Burning in the middle of the chest
- Sour liquid coming to the throat and/or mouth (regurgitation)
- Swallowing is difficult, pain is felt during swallowing (dysphagia)
- Chronic laryngitis, chronic cough
These symptoms can also be seen in other diseases, but they are also among the symptoms of reflux disease. Symptoms usually occur after meals, especially after large amounts of spicy food, increase when lying down, and may decrease with the use of antacid medication. Fatty foods, chocolate, coffee, mint, alcohol, and tobacco products may increase symptoms.
Pregnancy, obesity, and high stomach acidity cause reflux symptoms to increase.
Causes of reflux
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The muscle fibers of the diaphragm surround the area where the esophagus connects to the stomach. If there is looseness in this area, the stomach slides into the chest cavity and the acid in the stomach easily passes into the esophagus due to the pressure difference in the chest cavity. This condition is known as hiatus hernia (stomach hernia) and is one of the most common causes of reflux.
Irregularity or weakness in the movements of the esophagus may cause reflux.
Since salivary secretion decreases in smokers and during sleep. The disappearance of the neutralizing effect of saliva in the esophagus may cause reflux complaints.
Inadequacy of the muscular structure (LES) that prevents the passage between the stomach and the esophagus may lead to reflux.
The empty stomach. Delay in digestion may cause the stomach contents to "overflow" into the esophagus.
Results of reflux
As a result of constant contact with acid, irritation and inflammation in the layer lining the inside of the esophagus. occurs (esophagitis).
This condition causes pain and painful swallowing (dysphagia).
Long-lasting inflammatory condition leads to a disease called Barrett's esophagus, which can turn into cancer in the future. This condition is seen in approximately 10% of reflux patients.
Permanent stenosis may occur in the esophagus for the same reason.
Diagnosis of reflux
The most effective method used today for the diagnosis of reflux is endoscopy. Diagnosis is made by examining the esophagus and stomach with a camera inserted through the mouth, with a light anesthesia or without the need for anesthesia, and by taking a biopsy if necessary.
24-hour acid measurement with the help of a probe placed in the esophagus is also a definitive diagnostic tool. .
In cases where endoscopy cannot be performed, films taken under medication may also be helpful in diagnosis.
When should reflux be treated?
The symptoms of the disease may help the person. Reflux disease should be treated when it begins to occur frequently and affect the quality of life. Since long-term reflux disease can lead to esophageal cancer, esophageal stenosis and bleeding, patients with chronic symptoms should be treated.
Reflux treatment
Patients with mild symptoms can get rid of their symptoms with some precautions, without even needing medication:
- Staying away from foods that cause reflux such as coffee, chocolate, fatty foods
- Before going to bed. Not eating and not getting into a lying position immediately after eating
- Not smoking
- Not drinking alcohol
- Raising the head of the bed i
- Losing weight
Patients whose complaints do not go away with these measures can start antacid treatment that the doctor deems appropriate.
Patients whose complaints do not go away despite drug treatment can be diagnosed with Barrett's esophagus. Patients with esophageal stenosis, patients who develop esophageal stenosis, and patients who cannot use medication may require surgical treatment.
The standard surgical treatment applied is known as fundoplication. This treatment, which was performed with open surgery in previous years, is performed with a closed (laparoscopic) method in recent years and patients return to their normal daily lives within 1-2 days.
There are also endoscopic methods such as Stretta, EndoCinch, Enteryx, Plicator, which are still in the trial phase. Maybe they will be able to take their place in the treatment of GERD in the near future.
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