Gastroesophageal reflux disease: symptoms, causes and treatment features

Gastroesophageal reflux disease is a pathology in which the contents of the stomach can go back into the esophagus. In this case, the mucous membrane is damaged, which is why symptoms occur. Such a pathology does not depend on food intake, occurs systematically, often worries at night in a horizontal position.

Causes of occurrence

Gastroesophageal reflux disease is often a consequence of malnutrition, the content of a large amount of fat in the diet, and ingestion of a significant amount of air. Such reasons can also provoke the disease:

• Abnormal or insufficient functioning of the lower sphincter separating the esophagus and stomach. This may be due to congenital malformation of the gastrointestinal tract or acquired pathology.
• Diaphragmatic hernia.
• The deterioration of the clearance of the esophagus. Food lingers in the stomach and, accumulating, provokes the reflux of hydrochloric acid.
• Eating food that irritates the mucous membranes.
• Increased pressure in the abdominal cavity. It often occurs due to damage to internal organs or the accumulation of a large amount of fluid inside.
• Digestive tract ulcer.
• Often recurring stresses.
• Excessive body weight.
• The use of certain groups of medicines. Some drugs help reduce the tone of the esophageal sphincter.

The appearance of gastroesophageal reflux disease is promoted by bad habits: smoking, alcohol abuse. This condition often occurs in pregnant women due to increased stress on the stomach.

Pathology classification

The classification of gastroesophageal reflux disease is as follows:

1. Sour form. Here the acidity level is 4 units. In the stomach there is a significant amount of hydrochloric acid in excess of the norm.
2. Slightly acidic. Indicators vary within 4-7 units.
3. Alkaline

Also, gastroesophageal reflux disease (GERD) is non-erosive (unpleasant symptoms are weak, the inflammatory process does not develop), ulcerative-erosive (wounds, ulcers appear on the gastric mucosa, and the risk of bleeding increases). The most complex form of pathology is Barrett's esophagus - a precancerous condition.

Symptomatology

The causes and symptoms of gastroesophageal reflux disease should be known to those people who have a genetic predisposition to diseases of the digestive tract. The specified pathology is characterized by such manifestations.

Often the patient develops pain behind the sternum, which extends to other parts of the body: neck, back, shoulders, arms.

The first symptoms of gastroesophageal reflux disease may not be too intense, but often occur, so you should not hesitate to visit a doctor. The manifestations become more pronounced after active exercise, excessive consumption of sweet foods, heavy foods, at night.

Diagnostic Features

Symptoms of gastroesophageal reflux disease (GERD) are nonspecific. In terms of the patient’s appearance, the diagnosis cannot be made, so he needs to undergo an examination, including:

1. Test using a proton pump inhibitor. Its duration is 14 days.
2. Sphincter manometry. She will help to learn their functionality.
3. Determination of motor activity of the esophagus.
4. Monitoring pH of gastric juice. It is carried out throughout the day. Thanks to this study, you can establish the frequency of refluxes, as well as the rate of decrease in acidity.
5. Fibroesophagogastroduodenoscopy. This study allows us to differentiate GERD from cancer of the stomach.
6. Helicobacter test.
7. Chromoendoscopic examination of the esophagus. Such a diagnosis is necessary for patients in whom GERD attacks often appear, and the disease itself has a chronic course.
8. Ultrasound of the internal organs of the abdominal cavity and heart.
9. Electrocardiogram for the differentiation of angina pectoris.
10. X-ray of the esophagus using a contrast agent.

Endoscopic examination is used for treatment and diagnosis. It allows you to determine the degree of damage to the esophagus:

• Zero There is no tissue damage yet.
• First one. Small erosions appear on the mucosa, but they do not merge together.
• The second one. At this stage, the wounds infect a large area and begin to merge. However, the lower third of the mucosa is not yet damaged.
• The third. At this stage, erosion covers almost the entire lower part of the esophagus (distal section).
• Fourth. This stage is the most difficult, as it is considered a precancerous condition. Conservative treatment in this case may be useless.

Also, the patient is prescribed laboratory blood tests, feces. To make an accurate diagnosis, you will additionally have to consult a pulmonologist, cardiologist, ENT specialist, and also a surgeon.

GERD in children

The signs of gastroesophageal reflux disease (GERD) in children are as follows:

• Coughing at night.
• Frequent and profuse regurgitation.
• Loss of appetite, weight loss.
• Loss of consciousness.
• Increased irritability, frequent crying.
• Trouble sleeping.
• Headache.

Treatment of gastroesophageal reflux disease in children involves the use of drugs taking into account the severity of the pathology, the severity of symptoms, and the characteristics of the body. More often babies are prescribed medications that stabilize gastric motility: Domperidone, Metoclopramide.

After taking such funds, the stomach is released faster, and the tone of the esophageal sphincter rises. The duration of therapy is 10-14 days. Any drugs in childhood are prescribed with extreme caution.

Drug and surgical treatment

Medicines for gastroesophageal reflux disease must be selected by the doctor, depending on the general condition of the patients, the threat of complications, such as pathology. GERD should not only be treated; relapse must be prevented. Such drugs may be prescribed to a person:

1. Antacids: Gaviscon, Maalox. These funds neutralize the effect of hydrochloric acid, stimulate the production of bicarbonates, which produce a cytoprotective effect. The tone of the lower sphincter is increased. They are used only for a short-term elimination of unpleasant manifestations. They are used as adjunctive therapy, however, do not last long. Use this type of remedy after an hour of eating, as well as before going to bed. It is better to use 3rd generation products.
2. Prokinetics: Motilium. They help improve sphincter tone. The digestive tract is freed from digested food faster. Prokinetics can reduce the number of refluxes. At the initial stages of the development of pathology, drugs of this type are allowed to be used in monotherapy. It is important to remember that some drugs in this group cause drowsiness, insomnia, general weakness, so they are prescribed in short courses.
3. Proton Pump Inhibitors: Omeprazole. They stabilize acidity and maintain it at a normal level for at least 16 hours. The course of therapy with such agents is 6-8 weeks. Such drugs are considered the most effective and powerful. Their advantage is a small number of possible side effects.
4. Antisecretory drugs: Famotidine. These drugs reduce the production of acid, as well as its negative impact.
5. Cytoprotectors: "Preductal." Thanks to these drugs, it is possible to reduce the acidity of juice in the stomach, enhance the production of bicarbonates, increase the protective function of mucus. The blood stream in the mucous membrane of the esophagus is activated.
6. Reporters: "Dalargin", sea buckthorn oil. These funds accelerate the healing of erosion.

During therapy, it is also necessary to monitor your own weight, abandon tight clothes. You should also drink 2-2.5 liters of fluid per day.

In the treatment of gastroesophageal reflux disease, drugs are prescribed only by a doctor, and if before that the patient took some drugs, then they will have to refuse.

With the ineffectiveness of medical treatment of pathology, the patient is prescribed surgery. There are several types of procedures:

• Endoscopic surgery.
• Laparoscopy. Thanks to this procedure, you can restore the acute angle between the stomach and esophagus.
• Radiofrequency ablation of the esophagus.
• Coagulation with argon plasma.

Depending on what the intervention will be, the recovery period lasts several weeks.

Folk therapy

If a person is diagnosed with gastroesophageal reflux disease, treatment with folk remedies can also be effective. But it should be used in combination with medications. Before using any alternative prescription, you should consult your doctor. Such tools will be useful:

1. A decoction of flax seeds. For cooking, take 4 tbsp. l raw materials and poured 2 cups of hot boiled water. For insisting, it takes half an hour or an hour. After cooling, the broth should be filtered and taken before bedtime in 5 sips. The duration of therapy is 5-6 weeks. The tool helps to protect the mucous membrane of the esophagus from the destructive effect of hydrochloric acid, increases its stability.
2. Milk. It has an enveloping effect. You can drink it after a meal, as well as before a night's rest.
3. Raw potatoes. It must first be cleaned and cut into small pieces. Next, they should be chewed slowly. Such a remedy will help with heartburn. Potato juice is also considered useful. You should drink 1/4 cup 3 times a day.
4. Birch bark. It must first be crushed into powder. Raw materials are consumed daily for 1 tsp. The powder must be washed down with plenty of water.
5. Broth from the root of the marshmallow. It will take 6 g of pre-ground raw materials, as well as a glass of warm liquid. The mixture must be boiled in a water bath. The duration of the process is 30 minutes. After filtering, the broth should be cooled and taken in 0.5 cups up to 3 times a day.
6. Juice of celery roots. It soothes heartburn, helps eliminate other symptoms. The patient must use 3 tbsp. l liquid three times a day.
7. Pumpkin seed. They also contribute to soothing pain and heartburn. Simply eat a small handful of the product per day.
8. Herbal harvest. It is necessary to mix 1 tbsp. l elecampane root, aloe, add to the composition of 2 tbsp. l grapes, 4 tbsp. l Hypericum flowers. All raw materials must be pre-crushed. The mixture is poured with freshly boiled water and boiled for 20 minutes over low heat. After the liquid has cooled, it must be filtered and drunk 125 ml up to 5 times a day.
9. Plantain broth. Need 6 tbsp. l finely chopped leaves of the plant combine with 1 tbsp. l chamomile flowers and 4 tbsp. l St. John's wort, and then pour 1 liter of boiling water. In addition, you have to boil the broth over low heat (20 minutes). The liquid should be infused for half an hour. Use the broth should be 1 tbsp. l three times a day.
10. Centaury. Requires 1 tbsp. l raw materials steam 0.5 liters of boiling water. It is better to fill the grass in a thermos, as it should be infused for half an hour. You need to take the liquid in half a glass in the morning and in the evening.

Folk remedies are not a panacea and can not get rid of all diseases. But the competent use of prescriptions in combination with medications will help keep the pathology under control and prevent the development of complications. Before using any folk remedy, it is mandatory to consult a gastroenterologist.

Nutrition rules

Diet for gastroesophageal reflux disease is the basis for proper treatment. Without compliance, therapy will be ineffective, and relapse frequent. A person will have to follow these rules:

1. Food should be taken often, but in fractional portions. Have to eat up to 6 times a day.
2. Food should not be excessively heated or cooled.
3. After eating, you can not immediately go to bed, bend over or exercise.
4. It is important to limit the consumption of those products in which the formation of hydrochloric acid occurs faster, and the tone of the sphincter of the esophagus decreases. It is better to completely abandon alcohol, legumes, spicy and fried foods, foods containing a large amount of fat.
5. In the presence of gastroesophageal reflux disease, the menu should contain vegetables and fruits, products containing vitamins E and A. Thanks to them, the renewal of the gastric mucosa occurs faster.
6. The menu needs to be diversified. After the disease goes into remission, it is allowed to diversify. But here it is important to consider the individual characteristics of the body.
7. It is strictly forbidden to overload the stomach with food. In this case, its motility slows down and its contents are thrown into the lower esophagus.

The patient is strictly forbidden to starve, as this only exacerbates the situation. Tea and coffee should be limited. Salt and spices are removed from the diet. The last meal occurs a few hours before going to bed.

The basis of the diet is cereals, boiled and stewed vegetables, vegetable oils.

Possible complications

Since it is necessary to treat gastroesophageal reflux disease, it is necessary to consult a doctor even with mild, but constant discomfort. In the absence of therapy, such complications are possible:

• Peptic ulcers or erosion on the mucous membranes.
• The appearance of holes on the walls of the esophagus.
• Internal bleeding.
• Esophageal stenosis due to scar formation.
• Abscess of the lung.
• Relapse of chronic bronchitis.
• Inflammation in the nasopharynx.

The most serious complication is a precancerous condition.

Disease prevention

So, the symptoms, treatment of gastroesophageal reflux disease are already understood. But it is better to prevent the onset of this disease altogether. If the pathology has already developed, then the frequency of relapses must be reduced. To do this, you must follow these preventive measures:

1. Refuse the use of carbonated and alcoholic drinks.
2. Wear comfortable clothing that will not crush in the abdomen.
3. Stick to a healthy diet.
4. Stop smoking. Nicotine negatively affects not only the circulatory system and lungs, but also the digestive organs.
5. Sleep on a high pillow.
6. Avoid obesity. If a person has a lot of weight, then it needs to be normalized. To this end, you need to perform physical exercises, but only 2-3 hours after eating.
7. It is forbidden to lift weights above 10 kg.
8. Any medications are best used with the permission of a doctor, especially if they lead to relaxation of the esophageal sphincter.

Gastroesophageal disease is an unpleasant pathology, which over time can lead to the development of cancer. To prevent this from happening, it is necessary to start treatment with the appearance of even mild, but persistent symptoms. Compliance with preventive measures will reduce the risk of disease.