Gastroesophageal reflux disease (GERD) is the most common disease of the digestive system. Gastroesophageal reflux is the reflux of stomach contents into the esophagus. In fact, gastroesophageal reflux is a normal event that can occur 10-50 times a day after eating. Since this condition lasts for a short time, it may not be noticed or may cause very mild symptoms. Gastroesophageal reflux disease (GERD) occurs when the frequency and number of gastroesophageal reflux increases and the symptoms begin to disturb the person or if damage develops in the inner wall of the esophagus without symptoms. It becomes a disease when it causes damage to the tube (esophagitis). The most important factor that causes reflux disease is acid. Acid causes gastroesophageal reflux disease to occur by remaining at a higher rate, staying longer and reaching higher levels in the esophagus. It is thought to constitute 10-15%. Since the sensitivity of the esophagus to acid is different in each person, the severity of the findings also varies. The most common symptoms of GERD are described as a burning sensation behind the breastbone and bitter water coming into the mouth. GERD occurs equally frequently in men and women, but Barrett's metaplasia, an undesirable consequence of this disease, is more common in men. Barrett's metaplasia occurs as a result of prolonged GERD. It is a cellular change in the lower end of the esophagus due to reflux. There is a risk that this condition may turn into a type of cancer of the lower end of the esophagus.
GER disease does not only affect the digestive system but also the respiratory system. Chronic cough, asthma, throat and pharynx inflammation, hoarseness, deepening of the voice can occur. Reflux disease may underlie such problems.
Endoscopy is mandatory in the diagnosis and treatment of reflux disease and is generally the first choice method. The degree of damage and the problems it causes are evaluated. At the same time, the stomach and the upper part of the duodenum are evaluated, and biopsies are taken when necessary.
The gold standard method in the diagnosis of gastroesophageal reflux disease is the esophageal acid test, i.e. PH METER. It is a diagnostic method that uses 24-hour measurement and recording to detect occult reflux in patients with normal endoscopy. It is not mandatory to perform a Ph meter for those with obvious esophagitis.
VIEW Disease is classified as non-erosive reflux disease, erosive reflux disease and Barrett's esophagus. Barrett's esophagus occurs in 10-15% of patients with GER. Changes at the cell level, which we call dysplasia, develop in 5% of patients with Barrett's. There is a close relationship between these changes and cancer of the lower end of the esophagus. , timing can be significantly affected by sleeping patterns. Keeping weight within normal limits, avoiding smoking, not wearing tight clothes, avoiding overeating at one meal, not going to bed immediately after eating, keeping the head of the bed elevated, and staying away from foods that cause complaints (such as coffee, chocolate, fatty and fried foods) are just a few of them.
REFLUX PATIENTS FOR WHICH SURGERY IS RECOMMENDED:
1-Those with severe reflux
2-Those who have to use reflux medications continuously
3-Medication while using Those who are comfortable but whose symptoms reappear when they stop taking medication
4-Those who have a wound in the esophagus that does not heal despite using medication
5-Those who have Barrett-type lesions in the esophagus or those who have bleeding reflux disease
6-Patients with serious respiratory problems due to reflux and whose cough and hoarseness do not improve despite drug treatment
7-Young and middle-aged patients
8-Having difficulty swallowing, hiatal hernia (patients with hiatal hernia, that is, the esophagus-stomach junction or the upper part of the stomach slipping over the diaphragm)