Gastroesophageal reflux is a disease of the esophagus caused by malnutrition. In the stomach there are many reactions aimed at digesting food. And without an acidic environment in the stomach cavity, a person could not live. But if acid enters the esophagus, the walls begin to break down, ulcers form. And, of course, this is not very good for the body, as it can end in cancer without appropriate treatment.
Reflux is a simplified name for a disease. In medicine, it has the full name - gastroesophageal reflux disease or GERD. It is one of the most common gastrointestinal problems in the world.
Symptoms
What are the symptoms of gastroesophageal reflux in an adult? GERD is most often manifested by severe heartburn. It intensifies when performing exercises in a prone position, or when a person is busy with physical activity.
There are other non-specific symptoms. This is dysphagia (painful swallowing), frequent laryngitis, bronchospasm, nausea and belching after eating. Due to the fact that acid enters the oral cavity and destroys tooth enamel, such a patient will have frequent problems with his teeth. There are still otolaryngological symptoms. Frequent inflammation of the middle ear may also indicate this disease.
Concomitant symptoms of gastroesophageal reflux are belching with a sour taste in the mouth, frequent hiccups, pain when swallowing food. With serious complications, esophageal vomiting develops, that is, vomiting by the still undigested contents of the stomach after a relatively short period of time after eating.
Reasons for the development of reflux
The main reason for gastroesophageal reflux is poor nutrition, smoking and eating at a fast pace. When a person takes air in his mouth, the pressure in the stomach rises.
What else could be the reason?
- Violation of the muscular sphincter.
- Increased body weight.
- Alcohol consumption.
- Wrong diet.
- Diaphragmatic hernia.
Among the substances that complicate the course of the disease include the frequent use of coffee, smoking. According to some reports, chocolate is also harmful. A stomach problem such as gastroesophageal reflux often accompanies pregnant women.
Damage to the digestive tract can take medications. We are talking about nitrates, anticholinergics, beta-blockers.
Why does the sphincter work?
The sphincter or cardia itself is a muscle ring that closes immediately after food intake. This ensures its one-way movement in the digestive tract. When this gastric valve does not close completely, hydrochloric acid immediately opens "access" to the esophagus. The valve stops performing its functions for one or several reasons:
- problems with the thyroid and, therefore, with hormones;
- binge eating;
- psychological stress;
- ingestion of such aggressive substances for the mucous membranes as alcohol, hot pepper, coffee;
- some medicines with side effects;
- prolonged severe cough.
Still, the most important factor is overeating, and it is the consumption of fat. When the stomach cavity is greatly stretched, the angle between the esophagus and the stomach itself changes, and food can accidentally enter the lining of the esophagus. Over time, the process gets worse.
One of the most unpleasant consequences of stretching muscle cardia is achalasia. Such a person cannot eat normally. Therefore, you need to understand that gastroesophageal reflux is not just an unpleasant disease. It can lead to very serious consequences.
Types of GERD
As a disease, gastroesophageal reflux, the degrees of which are given below, has some features. Firstly, the first degree - non-erosive reflux - occurs in almost every inhabitant of the Earth from time to time. And at night, due to the horizontal position of the body, acid reflux is absolutely normal. And secondly, the disease is very treatable.
According to the medical classification, there are 3 types of disease:
- Non-erosive reflux. The easiest type, without esophagitis complication. It occurs most often.
- Erosive-ulcerative form - reflux is complicated by ulcers or stricula.
- Barrett's esophagus.
As for the stages of development, then everything is simple. Non-erosive reflux is the easiest disease. The ulcer form is moderate in severity, and the most severe end - the precancerous stage - this is the 3rd item on our list.
What is Barrett's esophagus?
A long course of the disease with an increase in the intensity of acid reflux outside the stomach invariably leads the patient to a doctor. Sometimes, along with acids, pancreatic and bile enzymes also enter the esophagus. These substances injure the mucosa even more. Due to the action of bile on the walls of the esophagus, cyclooxygenase-2 is activated. The presence of this substance is already a harbinger of Barrett's esophagus.
When the distal esophagus is covered with new connective cells after the manifestations, this means that stage 3 of a disease such as gastroesophageal reflux has begun.
During examination with an endoscope, a cylindrical epithelium with special goblet cells is found instead of a stratified squamous epithelium. This is the last stage of GERD development and is, in fact, a precancerous condition. The diagnosis is confirmed only after histological examination.
Cell changes occur in the body as an adaptive reaction to strong irritants, that is, acids and alkalis. After all, the cylindrical epithelium is much "stronger", it is harder to burn through. But when protective cells develop too rapidly, this is a harbinger of cancer.
The likelihood of adenocarcinoma is very high, even after a course of treatment with proton pump blockers, and this medicine is very powerful.
Forecasts
In the first stage, the disease is not at all dangerous. However, do not allow reflux to become more frequent and painful. Approximately 10-15% of people already suffering from reflux develop serious complications. This can be a narrowing of the esophagus, the development of ulcers, esophageal bleeding and adenocarcinomas.
What else to notice about the dangers of gastroesophageal reflux? Treatment of the disease is effective if it is started on time.
Disease in children
Not only adults, but also children are also susceptible to GERD. There are several features of gastroesophageal reflux in children. The treatment, in fact, is the same as in adults.
Why do children get sick? If one of the parents has chronic problems with the stomach, and there were others in his family who also suffer from refluxes of various origins, then the child will probably also have problems.
There may also be other reasons:
- autonomic dysfunction;
- helminthic invasion;
- gastritis, gastroduodenitis;
- beginning hernia of the esophagus;
- the use of medicines containing barbiturates or nitrates;
- excessive consumption of chips, crackers, energy drinks.
An equally important reason for the development of gastroesophageal disease in a child is the lifestyle of the mother during pregnancy. If during the period of carrying the fetus, and then during feeding, the woman did not get rid of the smoking habit, most likely the child will have deviations. For example, deformity of the stomach, diaphragmatic hernia from birth, and more.
Since childhood, GERD has been provoked by the following diseases:
- asthma, bronchitis;
- constipation
- cystic fibrosis;
- high load in sports sections.
According to statistics, boys suffer from GERD more often than girls. Perhaps because they are more involved in sports fields. And if both parents have chronic gastritis, it is possible to conclude with high probability that the boy will begin to experience the first symptoms of reflux already before his youth.
Diagnosis of GERD
With often recurring heartburn, it is recommended that you still take the time and go through several important procedures. For a comprehensive diagnosis is used:
- round-the-clock monitoring of intraesophageal acidity;
- egophagoscopy;
- X-ray examination using barium;
- pH meter to change acidity;
- general blood analysis.
An X-ray with contrast is used to see if there is a hernia of the diaphragm. If it is, the treatment already involves surgery, since conventional antacids will not help.
Gastroesophageal reflux. Treatment
If an adult is diagnosed with either a weak non-erosive form, or an already ulcerous one, then this is a signal of an immediate change in diet and all lifestyle. The basic rule is to eat moderately and clockwise, so as not to overstrain the stomach with a plentiful meal. Pain, belching and heartburn are relieved with some medications. This, for example, Fosfalugel, Almagel, Maaloks. This is a group of antacid drugs. However, their use brings only temporary relief.
Most often, treatment comes down to a simple lifelong intake of pills that help with acute pain. Now there is such a series of drugs as proton pump inhibitors. These include Rabeprazole. This medicine is a good alternative to conventional painkillers, as it helps prevent more serious complications.
How do these drugs work? Such a medicine in this series as Omeprazole simply reduces the production of stomach acid, and the disease stops progressing. However, this does not mean that you can continue to smoke. Smoke from cigarettes not only enters the lungs, but also harms the entire body.
Surgery
If the problems in the body are more serious, a simple diet does not stop there. Surgery may be needed to improve the condition.
During the operation, doctors correct a hiatal hernia . No drugs can cure this pathology. The operation also helps to accelerate the passage of food from the stomach to the intestines due to an increase in the tone of the muscular sphincters.
Disease prevention
So, we know how to treat gastroesophageal reflux. But how to prevent the development of GERD? You need to eat 4 times a day a little. If erosive manifestations occur in the stomach, then 6 times. After eating, no physical exercise should be performed. Dinner must be three hours before going to bed. By following these well-known elementary rules, you protect yourself from the risk of cancer of the esophagus.
One more rule. You need to sleep on a bed with a slightly raised headboard. When the head is raised about 15–20 °, the esophagus is less affected by the relaxation of the sphincter and acid reflux.
What rules are important to observe if reflux disease increasingly makes itself felt in the form of unpleasant belching, pain and heartburn? The very first thing is to stop eating too spicy, fatty foods. Remove coffee and chocolate from the diet. For health, you have to eat cereals, vegetables and fruits.
Output
What can be summed up? Gastroesophageal reflux, the symptoms and treatment of which we have examined in this material, is not dangerous until it kills the epithelial cells of the esophagus wall and does not lead to a clear deterioration in well-being. Fast poor-quality nutrition and stresses in many respects provoke diseases, especially when there is a hereditary predisposition. And this means that you need to follow the diet even more carefully.
Gastritis, ulcers and duodenitis are the most common causes of gastroesophageal reflux. Treatment must be selected, taking into account the real situation. So, you need to go through all the examinations, be sure to do an egophagoscopy and pH-metry.