Gastroesophageal reflux disease
Gastroesophageal reflux disease or shortened (GERD) is a condition in which gastric acid returns to the esophagus, and even to the throat, irritating their mucous membranes.
GERD is the most common disease that includes the stomach and esophagus, and can be exacerbated by many different factors, including lifestyle, medication, diet, pregnancy, weight gain, stress, and other health conditions …
Normally, the ring muscle at the bottom of the esophagus, referred to as the lower esophageal sphincter, prevents the acid reflux (or return). In the case of GERB, this muscle does not function properly.
Symptoms of reflux disease
Heartburn is the basic symptom of GERB. It is described as a painful burning sensation in the center of the chest, behind the chest bone. Often begins in the upper part of the abdomen and spreads into the neck or throat. Pain can last up to 2 hours and usually worsens after a meal. Lying or bending can also lead to worsening of this pain.
Other symptoms of GERB include:
- Regurgitation of bitter acid into the throat as you sleep or bend
- Bitter taste in the mouth
- Persistent dry cough
- Hoarseness (especially in the morning)
- A feeling of tightening in the throat, as if a piece of food was stuck
- Problem with swallowing
- Sore throat
- Nausea
- Pain in the stomach after meals
If there are serious symptoms such as vomiting blood or blood in the stool, severe abdominal pain and sudden weight loss – there may be a suspicion of stomach cancer.
Causes and risk factors
The following factors contribute to the weakening or relaxation of the lower esophageal sphincter, which exacerbates acid reflux:
Lifestyle: alcohol or cigarette use, obesity, poor body condition.
Drugs: calcium channel blockers, theophylline, nitrates, antihistamines.
Nutrition: fatty and fried food, chocolate, garlic and onion, drink with caffeine, sour food, such as citrus fruits and tomatoes, spicy food, aroma mint.
Eating habits: eating plentiful meals, fast eating or eating immediately before bedtime.
Other medical conditions: hiatal hernia, pregnancy, diabetes, rapid weight gain.
How to diagnose GERD?
A doctor can usually diagnose GERD based on the symptoms you report. First, changes in diet and lifestyle can be recommended, and perhaps the use of an antacid.
If symptoms persist for more than 4 weeks in spite of this therapy, a person can refer to gastroscopy and other studies of the stomach and esophagus. This includes also X-ray of the esophagus, stomach and upper part of the intestine (duodenal ulcer).
X ray is performed by taking a contrast fluid that makes certain characteristics visible on X-rays. This test provides less information than gastroscopy, but may exclude other conditions such as stomach ulcer or esophagus blockage. This includes swallowing barium.
Gastroscopy is performed by obtaining a sedation, and a flexible probe with a small camera at its end is slightly lowered down the throat. The camera allows the doctor to see the damage to the esophagus, the severity of GERD, and to exclude serious complications of GERB, gastric cancer or unexpected illness.
This procedure allows the specialist to diagnose, evaluate the damage, and take a biopsy if necessary, and even treat certain conditions on the spot.
Treatment of reflux disease
Treatment of GERD includes medicines, including antacids and H2 blockers: in difficult cases sometimes it is necessary to perform surgery.
If changes in diet, lifestyle habits and drug use do not work, as in severe cases of GERD and gastric cancer – the next option is surgery of the stomach and esophagus.
GERD surgery
The operation most commonly used for Gastroesophageal Reflux Disease (GERD) is called fundoplication, which functions by the principle of increasing pressure in the lower part of the esophagus to allow natural and healthy retention of acid in the stomach.
In Atlas General Hospital this procedure can now be done laparoscopically. The surgeon makes several very small cuts in the stomach and inserts long narrow instruments and a fiber optic camera (laparoscope) through the cuts. This method leaves small scars, and recovery after surgery is considerably faster than when it comes to surgery in a classic way.
In the case of gastric cancer, an operation called gastrectomy is performed, which can be total or subtotal.
Postoperative course
A few days after the operation of the stomach and esophagus, liquid food can be taken, followed by a diet determined by the doctor, depending on the general health status of each patient individually.
In the case of laparoscopic surgery, the length of stay in the hospital is only a few days, followed by the arrival of the scheduled controls.
Prognosis
Gastroesophageal reflux disease (GERD) can be treated, but recidives are still quite common, especially if you do not change your lifestyle.
If recidive occurs, long-term therapy and / or surgery will be necessary to avoid further complications.
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