Reflux, heartburn, burning, acid reflux are not always the result of our greed or hard-to-digest diet. They are usually a symptom of gastroesophageal reflux, which worsens over time and makes life difficult.

Regurgitation, orreflux , of gastric contents into the esophagus is prevented by the lower esophageal sphincter - a muscular valve located between the abdominal section of the esophagus and the stomach. The muscle fold opens only during swallowing to allow food to pass, and then closes to prevent the digested food from returning to theesophagus . Gastroesophageal reflux is when the sphincter is weakened or dilates inappropriately at the wrong time and allows acid reflux in the stomach. The causes of reflux are not fully understood. It is known, however, that some are born with this condition, and others "work on it" with an inappropriate lifestyle. A poor diet contributes to reflux: fried and fatty foods, coffee, alcohol, chocolate, and the abuse of mint in the form of tea and candies. The development of the disease is influenced by a hiatal hernia, gastric cardia insufficiency, obesity, diabetes, pregnancy, older age, taking certain medications or smoking.

Symptoms of reflux

The symptoms of reflux may be burning, acid regurgitation, pouring food, choking, coughing, retrosternal pain radiating to the neck and throat (imitating heart attack). Sometimes the stomach contents rise so high that you can choke on it - this is often the case when someone is sleeping on a flat pillow. Of course, not all of these ailments are present. We should be encouraged to visit a gastroenterologistheartburnor food "sticking" to the throat, occurring twice a week.

Reflux diagnosis

First, a gastroscopy is performed, and then a radiological examination of the upper esophagus using contrast. This allows the doctor to see if the patient has a hiatal hernia. Then comes the turn of manometry and pH-metry. The patient is locally anesthetized and a multichannel probe is inserted into the esophagus for 10-15 minutes. The computer produces graphs that show whether the sphincter is working, how long it is, and whether the pressure of the lower sphincter is normal. Later, another probe, which is connected to the patient, is inserted through the nose for 24 hoursa walkman-like device. It records, for example, how often gastric contents are thrown into the esophagus, how long these episodes last and when they appear: during the day, at night or around the clock. After performing these tests, it is known whether pharmacological treatment is sufficient or whether an operation is necessary.

Gastroesophageal reflux

When the sphincter is not working properly, the acidic content in the stomach flows back into the esophagus, sometimes even reaching the throat. It irritates the esophagus, larynx, and sometimes - after aspiration - the bronchi and lungs. It can even lead to inflammation of these organs. The gastric mucosa is used to digestive enzymes and hydrochloric acid, and the lining of the esophagus is not. The stomach contents can eat away erosions, which can turn into ulcers over time. Healing ulcers, in turn, lead to a narrowing of the esophagus, which can even make eating impossible. Sometimes in the lower esophagus, a cylindrical epithelium grows (it normally lines the stomach) - forming the so-called Barrett's esophagus. It is dangerous because 40 percent. cases constitute a prelude to neoplastic disease.

Important

If the reflux is not so troublesome and dangerous that it requires surgery, you can help yourself temporarily:

  • do not overeat
  • follow an easily digestible diet
  • give up stimulants
  • Lose weight
  • put a tall pillow under your head to sleep.

Conservative treatment of acid reflux

Most patients qualify for the so-called conservative treatment. Additionally, antacids should be used (eg Alugastrn, Maalox, Gealcid, Rennie). Unfortunately, taking medications (e.g. antacids, improving sphincter motility, shielding the esophagus and stomach walls, and the so-called proton pump blockers) does not always bring good results.

Surgical treatment, i.e. laparoscopy

Doctors are of the opinion that if two treatments carried out within six months do not improve the patient's condition, the symptoms return quickly, the patient is young, the reflux is accompanied by a hernia or the disease is complicated by hemorrhages, dangerous esophageal strictures or Barrett's esophagus - there is no need delay surgery on the esophagus.
The operation is performed using a laparoscope. The sick person falls asleep and five incisions are made on his abdomen. One just above the navel and two on its sides. The laparoscope, camera and surgical instruments are inserted through these 1- and 2-cm openings. The doctor can see the entire operating field on the monitor under high magnification, which makes it easier for him to reach the hidden deep sphincter. The task of the operation is to restore the sphincterefficiency and strength so that it can tighten at the right moments and with the right force. It is repaired using the fundus (it is the part adjacent to the esophagus) - a piece of bottom is wrapped around the lower part of the esophagus, which is used to make a sealing muff. It may wrap around the entire esophagus (360 degrees) or just a part of it (e.g. 300 degrees, 270 degrees). Always so that the patient could swallow freely after the operation. It will be impossible - if the sphincter tightens too much. And if it is too weak, the improvement will be meager. Six months after the surgery, you have to undergo gastroscopy, manometry and pH-measurement. In 90 percent. cases of ailments do not come back. A cured person should keep an easily digestible diet for some time (the harsh regime does not apply for long). He also does not have to take expensive medications.

You must do it

Visit the gastroenterologist if:

  • heartburn occurs at least twice a week
  • you can't do without alkalizing drugs
  • for some unknown reason you suddenly start losing weight
  • you have anemia of unknown origin
  • you have low fever
  • your food rains, especially at night when you sleep flat
  • you get hoarse a lot, especially in the morning
  • in addition to heartburn, there are retrosternal pains
  • swallowing is difficult and painful
  • when such symptoms occur suddenly, especially after the age of 45.

100 he alth questions - stomach, liver & Co.

Category:

Gastrology