Gastro-Oesophageal Reflux Disease

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Gastro

When talking about Gastro-Oesophageal Reflux (GERD) mean reflux of gastric contents into the esophagus.

The regression is mainly due to the presence of acid can cause us serious symptoms-complications and problems in quality of life when you speak of Gastro-Esophageal Reflux Disease (GERD). The esophagus is a straight tube which serves to transport the food from the mouth to the stomach. In the lower part there is an excellent in terms of the anatomical region called the lower esophageal sphincter (LES), which is a valve mechanism which allows the passage of food from the esophagus to the stomach only when swallowed, while at other times hinder the regurgitation of gastric contents into the esophagus.

Key role in the treatment of GERD plays a lifestyle change, then conservative treatment (medication) and for difficult cases there is surgery.

The GERD occurs when transient relaxation of (CEC) or when the LES is not sufficiently close. When acid reflux occurs we feel the food or liquid to the back of the oral cavity. When the acid contents of the stomach is in contact with the mucosa of the esophagus have heartburn (heartburn-burning behind the breastbone). It must be said that transient reflux episodes during the 24 hours are normal and are not necessarily GERD, but when it is often possible to cause many problems.

WITH WHAT APPEARS SYMPTOMS The GERD?

The most frequent symptom in adults is heartburn, often referred to a cardiologist, and it would in all cases to exclude any heart problem.

In other cases we have symptoms of other systems such as dry cough, asthma symptoms, laryngitis or neglected situations problems with swallowing or food impaction episodes.

HOW CAUSED The GERD?

It is not clear the causes of GERD. It seems that the primary role played by the relaxation of the LES while the remaining esophagus is normal. The CEC is under the constant influence of substances, hormones that cause either contraction or relaxation and the balance between them that determines the circumstances.

Also important factor is the presence of hernia, an anatomical abnormality in which the SOC and the upper part of the stomach within the chest. Other factors contributing to creation of GERD are obesity, pregnancy, smoking, and occasionally have been implicated in many substances and foods that exacerbate GERD, as the acidic fruit, chocolate, coffee, alcohol, fat, peppermint spices.

HOW treat or GERD?

The primary role played by lifestyle change, then conservative treatment (medication) and for difficult cases there is surgery. Analytical recommended stopping smoking, reducing weight, small and frequent meals, avoid foods and substances that cause relaxation of the LES, avoid bedtime 2-3 hours after meals, the elevation of the bed head. With regard to medication are many highly reactive pharmaceutical formulations without significant side effects, such as antacids, H2 blockers, proton pump inhibitors, prokinetics.

What if symptoms persist?

If symptoms persist despite initial recommendations should undergo further testing, such as: 1) the esophagus-stomach radiography swallowed barium (barium meal) which receive more information with regard to esophageal motility and the anatomy of the region. 2) Oesophagus-Gastroscopy wherein we direct overview of the esophagus and stomach, and our further the possibility of taking biopsies given. 3) pH- moderate esophagus where through a thin catheter measure the acidity of the esophagus and have an objective view of the patient’s symptoms.

NEVER THINK SURGICAL TREATMENT?

When conservative measures do not work and poor quality of life of the patient or when the patient is negative long-term medication can then be put on the surgical intervention.

The aim of surgery is to create sufficient antipalindromikou mechanism which is accomplished by stitching the upper stomach around the world in order to increase the pressure around the world. The surgery (Nissen fundoplication) may be done laparoscopically with rapid return of the patient to normal activities. Today there is the possibility of endoscopic intervention wherein using gastroskopiou and a special apparatus becomes reinforcing the area around the CEC. The method relates to mild cases and is in progress.

LONG-TERM COMPLICATIONS GERD

If GERD is left untreated there is a case to cause serious complications. The most common is to create inflammation in the lower esophagus due to the chronic acid reflux (reflux). It can be created esophageal stricture by growth of fibrous connective tissue. However, the most serious complication is the development of Barrett esophagus is a precancerous condition, and can lead to esophageal cancer. Patients with GERD should be carefully monitored to avoid complications but be aware that changing lifestyle is the cornerstone to address this situation.

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