Reflux Disease

REFLUX DISEASE DEFINITION

Gastroesophageal Reflux Disease is defined as the reflux of stomach contents into the esophagus. It is a common disease that can be seen in 1 out of every 5 people in the society. In the human stomach, especially after a meal, a strong acid and enzymes necessary for digestion are produced. While acid and these enzymes do not cause any damage to the stomach, the esophagus is sensitive to these substances. For this reason, reflux of stomach contents into the esophagus can cause damage to this organ.

In fact, every person may have reflux from time to time, that is, reflux of the stomach contents into the esophagus, but in order to be called GERD, these reflux events must have caused symptoms or complications that will impair the quality of life of the individual.

WHAT ARE THE CAUSES OF REFLUX DISEASE?

There is a muscular valve called the lower esophageal sphincter between the stomach and the esophagus. This lid is usually closed, except when swallowing bites. Impairment of the function of this valve or an increase in the number of temporary loosenings experienced during the day may result in GERD. Various factors have been identified that may trigger an increase or dysfunction in these sphincter relaxations. These

  • Excessive post-meal stretching

  • Obesity

  • Pregnancy

  • Some drugs (Trisklic antidepressants, antihypertensives (calcium channel blockers) etc.)

  • Cigaret

  • Chocolate

  • fatty foods

  • Fermented alcohol products

  • carbonated drinks

WHAT ARE THE SYMPTOMS OF REFLUX DISEASE?

  • Burning sensation in the chest (a burning sensation just behind the bone in the anterior chest wall called the sternum (board of faith))

  • Regurgitation (Coming of stomach contents into mouth)

  • Burning in the throat, acid in the throat

  • stomach or chest pain

  • difficulty swallowing

  • Sore throat, thickening of the morning voice

  • unexplained cough

HOW TO DIAGNOSIS REFLUX DISEASE

Those who suffer from long-term reflux disease (for 5 years or more) or those over the age of 40 who have new reflux complaints should definitely undergo endoscopy in order to diagnose the disease and make a differential diagnosis. In addition, those with weight loss (more than 10% of body weight involuntarily in the last 6 months), those who have difficulty in swallowing or describe painful swallowing, men with iron deficiency anemia or women with postmenopausal iron deficiency anemia, and those with a history of gastric bleeding should also undergo endoscopy. . Endoscopy is performed in a very comfortable way for patients with the method called conscious anesthesia today. Apart from this, it would be more appropriate to try medical treatment (medications that block acid pumps in the stomach called proton pump inhibitors) before endoscopy in young adult individuals whose complaints have just started.

There may not always be signs of reflux during endoscopy. In this case, the acid level (pH) at the lower end of your esophagus is measured with a device called a 24-hour pHmeter to confirm the diagnosis, and these pH measurements are stored for 24 hours by a recording device worn on your waist.

TREATMENT OF REFLUX DISEASE

Surgical treatment should be preferred in individuals with well-documented GERD endoscopically or with 24-hour pHmetry, and in individuals who cannot tolerate or do not want to use proton pump inhibitors for a long time.

WHAT ARE GERD COMPLICATIONS?

Majority of GERD patients do not have serious complications, especially those who receive appropriate treatment. Those with untreated and uncontrolled GERD

  • ulcers

  • stenosis in the esophagus

  • Frequent pneumonia, asthma

  • Structural transformation of the layer that covers the esophagus, called Barrett’s esophagus, to the intestinal tissue (observed in the small intestine) can be observed. Although this complication is rare, it carries the risk of developing into cancer. This risk is higher in those with long-term uncontrolled and untreated reflux.

ARE THERE RULES THAT THE PATIENT MUST FOLLOW IN GERD TREATMENT?

Lifestyle changes are of great importance in the treatment of GERD. Let’s list these measures

  • You should not eat late at night.

  • There should be at least 3 hours between dinner and sleep.

  • Being overweight or obese, especially wide abdominal circumference, can trigger reflux, so it is IMPORTANT TO LOSE WEIGHT!!!

  • Smoking must be stopped.

  • Sleeping at night while sleeping on the left side reduces reflux. Raising the head of the bed has also been shown to reduce reflux.

  • Extremely fatty, tomato paste, large-volume meals should be avoided, and carbonated drinks should not be consumed.

  • The person should identify the foods that touch himself and take care not to consume them.

  • While it is known that light exercises such as brisk walking are good for reflux, it should not be forgotten that heavy exercises can trigger reflux.

As a result, individuals with symptoms of reflux disease, whose incidence can reach 20% in the community, should definitely be examined by a gastroenterology specialist. It should not be forgotten that leaving reflux disease, which is a chronic disease, without treatment can lead to life-threatening complications in the long run.

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