Gastroesophageal reflux disease
(abbreviated to GERD) a chronic recurring disease, which is directly related to the fact that the contents of the stomach coming back up into the esophagus and irritating its walls. The reason for this is that the contents of the stomach acidic. And on the walls of the esophagus, which show neutral indicators, it acts aggressive, irritating them and causing the development of the disease.
Differentiates between two forms of the disease
- GERD with ezofagitom inflammation of the esophagus. You may notice drastic changes in the wall of the esophagus that are associated with their injury. There are also erosions, ulcers and other serious problems until the cancer of the esophagus
- GERD without esophagitis. Changes in the walls of the esophagus are not observed. Revealed this form somewhere in half of the cases.
Also there are several degrees of the disease that are determined by how and as the affected wall of the esophagus.
- 0 degree no signs of esophagitis
- 1 degree arise a single manifestation of the erosion of the wall (up to 10% of total space)
- 2 multiple degree of erosion, up to 50% of the wall
- 3 degree of multiple erosions, which occupy almost the entire territory
- 4 in addition to the strong degree of inflammation manifested various kinds of complications.
For forms that are erosive in nature, has developed a separate classification called Los Angeles
- degree And there is one or more of the defect in the mucosa of the esophagus, which does not apply
- degree In defects do not apply more than 2 folds of mucous
- the degree of the defects is more than two folds and is less than 75% of the circles
- the degree D all the defects occupy more than 75% of the space of the esophagus and develop very quickly.
The main reasons for the development of such problems as reflux esophagitis, are the following factors
- the imbalance activity of the stomach and esophagus
- weak cardiac sphincter
- reducing the protective properties of the stomach and high acidity of its contents.
In addition to this, there are certain risk factors
- hernia hiatal
- an unbalanced diet
- certain drugs, which adversely affect the stomach.
GERD have these symptoms
- severe heartburn, which is exacerbated in a lying position, in the process of bending, after eating, and active load
- dysphagia or swallowing disorder
- nausea and vomiting (usually after eating)
- the abdomen swells, and the saturation of food is fast
- belch bitter and sour.
These are the main features of which are evident gastroesophageal disease, and more rarely may occur following
- pain over rib cage, which becomes especially strong at swallowing. This is due to the fact that the wall of the esophagus is regularly injured
- in the chest there is a foreign body, a kind of lump
- a cough and sore throat
- high salivation
- bad breath
- appears osiplosti.
In addition, also marked wapisiana symptoms indicating acid reflux
- problems with teeth in the form of cavities and very high sensitivity of the enamel
- reflux laryngitis laryngeal inflammation or reflux pharyngitis inflammation of the pharynx
- inflammation of the nasal sinuses (sinusitis).
Also reflux disease can be similar to ischemic heart disease. In this case the pain appear left of the sternum and is similar to cardiac pain, but is used in the case of heart disease drugs have no effect.
An indicator of the presence of GERD and that the pain had nothing to do with stress and heavy physical activity. Perhaps the occurrence of the disease type of bronchial asthma.
If there is such gastroesophageal reflux disease, symptoms usually this kind
- dyspnea, especially when lying down or during physical activity
- suffocation, a feeling of lack of oxygen.
- analysis of complaints of patient and anamnesis of disease
- analysis of lifestyle and life history (whether someone in the family problems of a similar nature)
- physical examination
- laboratory methods (biochemical analysis of blood, feces analysis, fibroesophagogastroduodenoscopy, the study of gastric material, ultrasound, x-ray, determination of acidity, consultation with a physician).
Gastroesophageal reflux disease requires a comprehensive treatment. Disease GERD treatment can undergo non-pharmacological, surgical and conservative ways.
- avoiding harmful habits, healthy lifestyle
- weight loss, obesity prevention
- control diet, development of correct balanced menu
- proper clothing (do not wear narrow)
- the exception of heavy load on the body, certain exercises and physical work.
Sometimes these methods can greatly improve the condition of the patient, eliminating the unpleasant symptoms and ozdorovit his body. Therapy medical or medicinal nature aimed at combating the negative symptoms of the disease and reducing the acidity content. There may be appointed such drugs
- drugs that block the proton bomb. They decrease the production of stomach acid. Can be assigned for a longer period. After the deadline may require supportive therapy
- medications-antacids, which lower the acidity of gastric contents. This kind of treatment is symptomatic. Use drugs only when one hundred percent accurately identified the causes of the disease
- drugs-prokinetics, which help to activate the motor activity of the digestive system and accelerate the promotion of gastric contents further along the highway.
If long-term ongoing therapy with drugs has no effect and thus develop typical complications of the disease, surgical methods are used, which is reflux esophagitis treatment. The most effective among them are the following
- endoscopic plication sutures on the stomach, which makes it possible to reduce its volume
- radiofrequency ablation of the esophagus. This action relative to the esophageal sphincter thermal radiofrequency energy, which causes decrease in the sensitivity of the sphincter relative to the stretching of the stomach, thereby reducing the probability of emission of the contents of the stomach next to the esophagus PI
- fundoplication by Nissen. This operation, whose essence is to create a special cuff around the esophagus. Thus, the likelihood of development of reflux decreases.
- narrowing of the esophagus
- ulcers of the esophagus, which is deep and captures all its walls
- development of Barret’s esophagus. This is a condition in which the abnormal changes seen in the walls of the esophagus is considered a precancerous disease. Cells mucosa this closes the epithelium which lines the intestines and stomach. For the formation of this problem you need a long history of GERD and regular manifestations of esophageal acidification
- esophageal cancer it is a malignant tumor
- esophageal bleeding
- anemia (anemia), which is a result of regular loss of blood, lowering the level of red blood cells and the protein hemoglobin
- manifestations of certain infectious diseases fungi, herpes and so on.
Prevention of gastroesophageal reflux disease includes
- the fight against excess weight
- quitting Smoking and alcohol
- don’t overeat
- do not snack, do not eat dry
- to eliminate exercises on the slopes and lower abs
- do not drink carbonated drinks, eat at least 34 hours before bedtime
- the rejection of foods that relax the lower sphincter. Is a fatty food, meat, coffee, chocolate and so on
- the elimination of the intense physical load of work that is associated with the slopes
- the use of drugs as prevention short courses. This should be done only as directed by physician and in accordance with all his recommendations.