Reflux is a disease that develops as a result of stomach contents escaping into the esophagus. So what are the symptoms of reflux? What causes reflux? Prof. Dr. Gülbanu Canbaloğlu talked about reflux.
Reflux, which is one of the most common diseases in the society in recent years, can invite many ailments that manifest itself in other parts of the body. prof. Dr. Gülbanu Canbaloğlu talked about reflux. It means that it causes a complaint (for example, burning in the esophagus tracing, pain, bitter water in the mouth, etc.) and/or damage to the inner surface of the esophagus. To qualify as a disease, it must cause a complaint and/or damage.
What findings are seen in reflux patients? What are the typical and atypical reflux findings?
Reflux disease can present with different findings. These findings are divided into two as typical and atypical reflux findings.
Typical reflux findings; It is a feeling of getting stuck in the esophagus if there is souring, burning, bitter water in the mouth, painful swallowing or stenosis due to reflux in the esophagus trace. Although it is less common, sometimes reflux patients may present with burping or hiccups.
Atypical reflux findings are; dry cough, bad breath, recurrent sinusitis, hoarseness, chest pain (sometimes mimicking a heart attack), sleep apnea (temporary cessation of breathing during sleep), asthma.
If a patient resembles a heart attack If there is severe chest pain, if the patient's electrocardiography, blood tests related to heart attack and angiography are normal, reflux disease should also be considered in the differential diagnosis. or especially if asthma attacks occur at night, reflux disease should be considered in the differential diagnosis.
What are the causes of reflux?
One of the most important reasons for the occurrence of reflux disease is the insufficiency of a valve at the lower end of the esophagus. Essentially, the main task of this valve is to carry the stomach contents into the esophagus. is to prevent it from falling. When this valve is insufficient or loose, the stomach contents escape into the esophagus, causing some complaints in the patient and damage to the inner layer of the esophagus. Sometimes the drugs used cause reflux by loosening the lid at the lower end of the esophagus.
One of the most important reasons for reflux is diet. Oily, very tomato paste, very spicy foods, heavy meals, consuming too much tea and coffee, eating too much food, carbonated drinks can also trigger reflux. Smoking and alcoholic beverages facilitate reflux. Diseases that delay gastric emptying, esophageal muscle diseases, hiatus hernia, popularly known as gastric hernia (the displacement of the stomach, which should actually be in the abdominal cavity to the chest cavity due to some anatomical disorders), also facilitates the development of reflux.
How to diagnose reflux.
Methods used in diagnosis; A good anamnesis (listening to the patient's story carefully by the physician) is the endoscopy and measurement of the pH value in the esophagus after the physical examination. In some patients, a test that measures the contractile function of the esophagus, called the motility test, should also be performed.
In fact, the diagnosis is easy in a patient with typical complaints. However, if the patient presents with atypical findings (chest pain, recurrent sinusitis, asthma, etc.), if there are alarm findings (anorexia, weight loss, stuck in the esophagus), if there is little or no response to medical treatment, if an evaluation is required in terms of endoscopic or surgical treatment, additional examinations are required. must. Endoscopy; Barrett's esophagus (the cells at the lower end of the esophagus are differentiated from normal and is a condition that increases the risk of esophageal cancer), ulcers, stenosis, mass, gastric hernia. In addition, during the endoscopy, it is also seen whether the gastric valve is sufficient or not. However, it should be kept in mind that only 1/3 of reflux patients have damage to the lower end of the esophagus in endoscopy, and the esophagus can be seen as normal in 2/3 of the patients. The gold standard method in the diagnosis of reflux disease is the measurement of the pH value in the esophagus. The pH value in the esophagus can be adjusted with a thin catheter (wired pH meter) inserted through the nose or, more comfortably, the pH value in the esophagus, which is placed at the lower end of the esophagus without the need for any catheter. It can be recorded with a small capsule (wireless, capsule pHmeter). While the standard pHmeter detects only acid reflux, the so-called impedance pHmeter; acid, weak acid, non-acid, air and fluid reflux and the method that determines the level of this reflux can be obtained in more detail and the treatment can be planned accordingly.
If the patient is a candidate for reflux surgery or there is a disease related to the esophagus muscles. esophageal contraction function should also be evaluated with motility test.
How is reflux disease treated?
Treatment; lifestyle changes, medical treatments, endoscopic treatments and surgical treatment. The most important element in treatment is lifestyle changes. Complaints can often be brought under control when drug therapy is given along with lifestyle changes. As drugs, proton pump inhibitor group (reducing the amount of stomach acid) drugs and syrups are used. Endoscopic treatments and surgical treatment options can be used in cases where there is no response to lifestyle changes and drug treatment. With the developments in endoscopic treatments, extremely good results can be obtained in reflux disease.
What should be considered to prevent reflux?
Lifestyle changes are important to prevent reflux. Individuals with reflux disease should eat regularly and healthily, should not skip meals, should not be late for evening meals and should be a little light. It is important not to go to bed for 3 hours after eating, not to snack late, to avoid drugs and foods that will trigger reflux, to avoid alcohol and cigarettes, not to wear tight clothes, and to lose weight if we are overweight. Raising the head of the bed is also a measure that can be taken to prevent reflux.
Which foods should reflux patients stay away from?
Reflux patients; should stay away from very hot, spicy, sauced foods, fried foods, pastries and leavened foods, fatty heavy meals, pickles, ready-made products and fast-food type diets. Acidic carbonated drinks, chocolate, caffeinated products, citrus fruits, onions, garlic, tomatoes also facilitate reflux. Drinking very hot beverages also triggers reflux.
What complications does reflux disease cause?
Reflux disease� It is often a benign disease. However, in severe cases or in patients who cannot be controlled with treatment, bleeding, perforation (perforation), stricture, Barrett's esophagus (a condition that increases the risk of esophageal cancer) and esophageal cancer may develop. However, these complications are not seen in every reflux patient, and the frequency of these complications is decreasing due to current effective treatment methods.
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