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gastroesophageal reflux disease

What happens if you have gastroesophageal reflux disease?

What happens if you have gastroesophageal reflux disease?

A burning sensation in your chest (heartburn), usually after eating, which might be worse at night. Chest pain. Difficulty swallowing. Regurgitation of food or sour liquid.

gastroesophageal reflux disease

Disease reflux gastric reflux is very common worldwide and affects about 15% of the adult population in the United States. Reflux gastric reflux leads to a significant decline in the quality of life and to the continuing need for medical services and an economic burden on health budgets.

Usually, a distinction is made between mild illness (complaints appearing twice a week), moderate illness (more than twice a week) and severe illness (when symptoms appear every day).

If alarming signs appear, such as swallowing disorders (dysphagia), weight loss, bleeding or anemia, it is necessary to go to the doctor immediately.

Symptoms of gastroesophageal reflux disease

Characteristic symptoms of reflux gastric reflux include heartburn (Heartburn) after eating meals and raise food (regurgitation – Regurgitation).

It can also show  atypical signs when other body systems are affected. For example, asthma, chronic cough, chest pain, throat pain, excessive phlegm and the like.

gastroesophageal reflux disease (GERD) diagnosis

To diagnose gastroesophageal reflux disease, an x-ray is not needed, but an endoscopy is needed, preferably within a few months of the complaint. In this examination, the severity of the disease can be determined, which ranges between A and D, and in special cases, a biopsy examination can be performed.

Recently, a therapeutic test was included in which the patient receives large doses of a drug for gastroesophageal reflux disease, for two weeks, and then the extent of the clinical response is examined.

About 15% of patients with gastroesophageal reflux disease undergo more advanced tests, during which the motility of the esophagus is examined – esophageal manometry, in which the pressure of the esophageal sphincter and the functional performance of the esophageal body are checked.

By monitoring the pH of the esophagus, the amount of reflux is determined, the relationship between the patient’s complaints and the appearance of reflux cases in the recording.

gastroesophageal reflux disease (GERD) treatment

In the first stage of the treatment of reflux gastric reflux it is advised to make changes in lifestyle, stop smoking, reduce weight and not eating fatty foods, fried, citrus, chocolate, spicy foods, drinking coffee and tea center. You must abstain from eating and drinking (except for water) approximately four hours before bedtime. It is preferable to sleep so that the upper part of the body is at an angle of about 30 degrees.

For some patients, just a change in lifestyle is not enough, they need to be given medication. These medicines stop acid production in the stomach. Today it is practiced to give treatment gradually – with a large dose at first, then the dose is reduced after 4-8 weeks. The effective drugs are from the group of Proton Pump Inhibitors (PPIs) and include: Omeprazole, Lansoprazole, Pantoprazole. These medicines cause acid production in the stomach to stop during 60% – 70% of the hours of the day. Thereafter, the dose may be reduced depending on the clinical response.

A small number of GERD patients, especially those who initially developed acute esophagitis, require continued treatment and follow-up for varying lengths of time. The purpose of this treatment is to reach the minimum dose of medication that will allow the GERD patient to have a good quality of life. The treatment may be given once, twice a day, or once every other day.

Recently, a method has spread in which the patient himself determines the drug dose according to his clinical sense. In this way, two thirds of the patient’s drug dose can be reduced.

Other medications for the treatment of GERD include: Histamine receptor blockers (such as: Zantac, Famotidine, Cimetag). Those whose acid secretion is high at night and who benefit from the addition of these drugs.

Currently, there are no medications available to improve esophageal motility, except for Motilium, which has a small effect.

Another group of GERD patients, which has received a great deal of attention in the medical literature in recent years, is the group of patients with GERD but whose disease cannot be diagnosed by non-defective endoscopy (NERD). These patients present with symptoms of gastroesophageal reflux disease without endoscopic evidence of esophageal mucosal injury. They, too, sometimes need to be treated with medication, even in a large dose.

There is a possibility to perform surgery (fundoplication) that is performed laparoscopically (Laparoscopic surgery).

In a small percentage of patients, complications may occur, such as narrowing of the esophagus or the appearance of special changes (Barrett’s sesophagus), in the esophageal mucosa, which require close monitoring by a gastroenterologist. The appearance of Barrett’s mucosa is associated with prolonged exposure of the esophageal mucosa to gastric content containing acid, bile and upper gastrointestinal enzymes. These patients require close medical follow-up with frequent biopsies.

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