Encrypted as K21 in ICD 10, GERD is a pathological condition in which substances in the stomach enter the esophagus. The condition is fixed quite often, is regularly repeated, occurs spontaneously. Pathology is chronic.
general information
Known as K21 in the ICD, GERD is an abbreviation with a rather long official name: gastroesophageal reflux disease. A pathological condition is characterized by a regular alternation of remissions, exacerbations. Pathogenesis is due to reflux - this is the term that refers to the ingestion of gastric contents into the esophagus.
Frequent repetition of reflux provokes a violation of the integrity and functionality of the mucous membranes of the esophagus. This is due to the chemical activity of the duodenal contents. If the patient’s card contains the code K21 according to the ICD (GERD), it is highly likely that the pathological condition most affects the lower parts of the esophagus. Chronic violation of the integrity of the mucous membranes is accompanied by problems of motility, failure of evacuation gastric functionality. These phenomena are accompanied by fairly characteristic symptoms that are unpleasant enough to see a doctor without delaying an appointment.
Nuances and features
The GERD code in ICD 10 is K21. It is he who is indicated on the patient’s chart if the diagnosis is confirmed. GERD can be suspected by specific symptoms that appear in the digestive system. Symptoms of this pathological condition do not always indicate a transformation in the structure of organic tissues that form the esophagus. A number of symptoms are characteristic of GERD, regardless of the stage, form, nuances of the course of the disease. Moreover, the severity of the manifestations of the disease varies from case to case. Often, the strength of the symptoms makes it possible to fairly accurately predict how much histologically degenerated the tissues of the mucosa covering the esophagus.
Types and Forms
In medicine, a classification system has been developed for varieties of reflux. GERD is a general concept within which individual categories are distinguished based on the specific features of a case. The most convenient system for dividing all patients into groups is based on the assessment of the level of transformation of the tissues covering the esophagus.
The first type is non-erosive. At the appointment, the doctor will definitely explain what kind of disease it is - GERD of a non-erosive type. It will be recorded on the patient’s card as NERB. This is a pathological condition, accompanied by specific symptoms, while violations of the integrity of the mucous membranes cannot be detected. An endoscopic examination is prescribed to confirm the diagnosis.
Another type is erosive. With this pathology, symptoms are observed against the background of esophageal erosion, ulceration, severe changes in the structure of the mucous membranes.
Finally, there is a form of the disease called Barrett's esophagus. She is considered the most severe.
Symptom classification
Finding out the features of GERD, what kind of disease it is, what are its manifestations, consequences, how to deal with it, specialists in the field of gastroenterology have done a lot of research and practical work. As part of the synthesis of experience, a world congress was organized. The location of the event was Montreal. It was there that it was proposed to divide all the symptoms of the disease into three types. Groups of esophageal and extraesophageal symptoms were identified: those clearly associated with reflux and presumably caused by it. The proposed option turned out to be the most convenient of all existing, as it helped to distribute the totality of manifestations of pathology based on the level, strength, type of course, shape and nuances of the case.
Explaining to the patient what GERD is, what the diagnosis is, what manifestations in a particular case helped to suspect pathology, the doctor will definitely pay attention to the presence of heartburn and narrowing of the esophagus among the patient's complaints. It has been established that a runny nose, inflammatory processes in the throat, and larynx can indicate GERD. Sometimes the pathology manifests itself as cough, asthma, fluid belching and soreness in the sternum, behind it. Among the symptoms of the disease are a tendency to caries, frequent relapses of otitis media. In some cases, GERD is associated with cancer processes in the digestive tract.
Relevance of the issue
Doctors have long been engaged in clarifying what it is - GERD. Symptoms, treatment, consequences, dangers, causes of the pathological condition - an urgent problem of modern medicine. Such a pathology is most characteristic for people living in developed countries - the frequency of occurrence is several times higher than that characteristic of lower-level societies.
Some time ago, at the world congresses of gastroenterologists held as part of a reflection of the current situation, doctors agreed that the most common disease of the last century was a stomach ulcer. For this century, the most pressing problem is GERD. This forces us to pay special attention to the study of the causes and mechanisms of the development of a pathological condition. Since it is known that GERD can provoke malignant degeneration of cells, it is important to develop new methods to combat pathology, ways to prevent it, timely detection and correction.
Where did the trouble come from?
Doctors study in detail the nuances of the disease, its causes, symptoms and treatment of GERD. What it is, where it comes from, how it is formed, what are the triggering factors - all these aspects are still being clarified, although even today scientists have a considerable amount of knowledge about pathology. It has been revealed that a decreased tone of the esophagus sphincter and weakening of the ability of this organ to independently clear food elements can provoke GERD. The gastrointestinal contents that enter the esophagus during reflux have a categorically negative effect.
In a number of cases, they learn from their experience what GERD is, people whose mucous membrane of the esophagus weakens lose their ability to neutralize the negative effects of substances that accidentally enter the organ from the stomach. The formation of a pathological condition is possible, if the ability of the stomach to empty is disrupted, the pressure in the abdominal cavity rises.
Factors and Hazards
You’re more likely to find out what GERD is, what it manifests itself and what troubles it brings if a person regularly encounters stress factors. The negative aspect is the forced position of the body for many hours every day, if you have to constantly lean forward.
Studies have shown that GERD is more often diagnosed in people who are overweight, as well as in people who are addicted to smoking. Certain dangers are associated with the period of bearing a child. GERD is characteristic of those whose menu is dominated by food that is dangerous for the gastric mucous membranes. These are a variety of products, from chocolate and spirits to spicy dishes, roasted, strong coffee. On their own, they can find out what GERD is, people who are forced to take medications that affect the concentration of dopamine in the circulatory system. Phenylethylamine transformation products, Pervitin, Phenamine preparations can provoke a pathological condition.
And if more?
The weakening of the esophagus sphincter, which closes the organ from below, is one of the common causes of GERD. The main task of this element is to delimit the esophagus, stomach. Muscle tissue should close tightly immediately behind the food lump, which has moved from the esophagus to the gastric cavity. For various reasons, a loose closure of this ring is possible. Just with such a phenomenon, a person will know by himself what GERD is. Food from the gastric cavity gets the opportunity to penetrate back into the esophagus, the integrity and health of the mucous membranes are violated, the inflammatory process starts. If studies confirm the preliminary diagnosis, the patient is prescribed treatment for esophagitis.
The development of insufficient functionality of the esophagus sphincter, located in the lower part of the organ, causes an increase in pressure in the abdominal cavity. This is especially common in overweight patients, as well as in women expecting a baby. The GERD menu is another important hazard. If the diet is wrong, unbalanced, the person does not observe the regimen of food intake, conditions suitable for the pathological condition are formed, and the body's defenses are weakening, resources are depleted.
Manifestations and their nuances
As can be seen from the reviews, GERD for patients with pathology becomes a real test. Most often, people turn to a doctor because of heartburn - this complaint is most typical. An unpleasant burning sensation is localized behind the sternum, especially strongly soon after eating or during a night's rest. Heartburn is worse if you drink sparkling water, go in for sports, and lean forward. With this position of the body, as when in a horizontal position, geometric conditions are formed that cause the contents of the gastric cavity to enter the esophagus.
GERD can be suspected by impaired ability to swallow. This is due to spasms of the esophagus. At first, difficulties are observed with the absorption of solid food, gradually spreading to soft. With the progression of the condition, dysphagia creates problems with the use of fluids. In some cases, symptoms indicate the development of complications, neoplasm.
Cases and Predictions
If manifestations of GERD are observed for several months with a frequency of more than two times a week, you should visit a gastroenterologist to clarify the condition. In the framework of studies, it is established how great damage to the esophagus mucosa is. For this, an endoscope is used. It is customary to divide all cases into positive and negative. The first involves esophagitis, in which ulceration, erosion can be seen in the lower half of the organ. The negative form is not accompanied by esophagitis, visible damage cannot be detected.
A prolonged course of the disease can cause the formation of Barrett's esophagus. The term refers to the state of metaplasia of epithelial cell structures. Pathology is considered a precancerous condition. Its identification requires a particularly responsible attitude to the issue of treatment, proper nutrition, lifestyle changes, since there is a high probability of malignant neoplasms in the esophagus.
Establishing diagnosis
Clarification of the condition requires determining the type and type of GERD, the severity of the pathology. If there are complications, they need to be clarified and evaluated. A preliminary diagnosis is formulated based on the patient's complaints and medical history. Diagnosis of GERD involves analysis and instrumental examinations. The first and main measure is gastroscopy. Using an endoscope, the condition of the esophageal mucosa is examined, narrowed areas are revealed. To confirm the diagnosis, tissue samples may be taken for histological laboratory examination.
In order to formulate clinical recommendations that are adequate for the identified form of GERD, it is necessary to do manometry. The term refers to such a study, during which the pressure indicators of the esophageal sphincter of the lower zone of the organ are determined. As part of the analysis, they confirm inadequate work or adequate functioning.
Continuing to study
Suspecting GERD, the doctor will direct the patient to an X-ray. Such a picture is especially important if there are manifestations of dysphagia. As part of the study, tumor processes and strictures are determined. If there is a hernia, you can clarify its features and position.
Daily acidity control is another study that is necessarily carried out in cases of suspected GERD. Analysis is needed to evaluate acidity and reflux over 24 hours. Even if the acidity is within an adequate framework, such a daily analysis helps to clarify GERD.
What to do?
After confirming the diagnosis, the doctor will explain how to treat GERD. The therapeutic course will drag on for a long time, consisting of several consecutive steps. It is important to practice a comprehensive adjustment of the condition. The first step is the relief of the most pronounced manifestations, then an optimal program for suppressing inflammatory processes is prescribed. In parallel, the doctor is working on a course of preventing complications of the condition.
With GERD, clinical recommendations include the use of medications. Antacids and drugs are primarily prescribed to control secretory function. Useful substances that stimulate the kinetics of food in the digestive tract. If the reflux is acidic, prescribing compounds that inhibit the proton pump are prescribed. If a conservative approach does not have the desired effect, surgery may be prescribed.
Aspects of therapy
If the disease is just beginning to develop, positive results can be obtained without even resorting to the drug course: it is enough to adhere to the diet recommended for GERD, abandon bad habits and reconsider the way and rhythm of life. We will have to restructure our daily routine in such a way as to create optimal conditions for the normal functioning of the digestive tract.
The main health-prescription recipe for GERD is a complete rejection of alcohol and tobacco. Smoking, alcohol are strictly prohibited for life. If you are overweight, you must also consider a figure correction program. It is important to rationalize nutrition, normalize the regime, eat food often and in small quantities. They completely refuse nutrition that negatively affects the mucous membrane or muscle tissue of the sphincter.
Everyday life as a guarantee of health
If the diagnosis of GERD is confirmed, you will have to think about changing the berth. Persons suffering from such a pathology are recommended to sleep on an inclined bed - the head should be slightly higher than the foot. Before going to bed is strictly prohibited. Do not lie down immediately after eating.
Physical activity or exercise immediately after eating is contraindicated. You can’t lift weights, bend over. Doctors recommend giving up tight clothes, not using belts and bandages.
After passing the therapeutic course, you will have to regularly undergo an examination to prevent complications and relapses. Often, the doctor sends the patient to a sanatorium or spa treatment to consolidate the primary results of the therapeutic program. Do not neglect such recommendations.
Therapy: different approaches
As medical practice shows, with GERD, physiotherapy gives a good result. In particular, electrophoresis is prescribed using Cerucal. Well-proven electric sleep and decimeter procedures.
Drink should be weak mineral alkaline water. Before drinking, if there is gas, it should be removed. The liquid is heated, consumed in small portions 30 minutes before a meal. The course is at least a month. After drinking mineral water, you can lie down a little, so that the chemically active liquid is in longer contact with the mucous membranes of the diseased organ. Maximum efficiency can be achieved if mineral water is consumed in a supine position, sipping through straws.
Herbs vs GERD
To treat the disease, you can take a couple of glasses of daily infusion prepared on mixed in equal proportions of chamomile inflorescences, yarrow, St. John's wort, celandine. Another option: calendula inflorescences and leaves of coltsfoot are taken in a tablespoon, chamomile inflorescences - a quarter of the tea, mix everything and pour boiling water. Ready infusion is used as food for a tablespoon four times a day for a quarter of an hour before a meal.
You can try the recipe with plantain and St. John's wort, taken in equal proportions. Chamomile inflorescences are mixed with them (4 times less than any other component), brewed with boiling water and allowed to infuse. The finished drink is used four times a day for a tablespoon half an hour before the meal.