> Gastroesophageal reflux: symptoms, causes and treatment

The disease gastroesophageal reflux (or GERD, Gastro-Esophageal Reflux Disease) is a disease of the digestive system. The gastroesophageal reflux occurs when the acids of the stomach, or the contents of the stomach, back (regurgitation, or heartburn) in the alimentary canal that connects the mouth with the stomach (esophagus). This condition gets an irritation of the esophageal wall.

typically, the acid reflux, or heartburn, is a condition quite common in the digestive phase. However, if it is not isolated symptoms, and the episodes should repeat at least two times a week, or may interfere in the life of all the days, è well go to the doctor.

usually, the majority of people suffering from acid reflux is able to control the disorder by changing life-styles, with the feed-the-counter medication. But in some cases, the reduction of the symptoms may require the administration of specific medicines prescribed by the doctor.

Sintomi

The symptoms of gastroesophageal reflux may include:

    the

  • feeling of a lump in my throat;
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  • heartburn that can; reach up to the throat, with a sensation of bitter taste in the mouth;
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  • dry cough
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  • chest pain;
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  • hoarseness, or sore throat;
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  • difficultyà on swallowing (dysphagia);
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  • regurgitation of stomach acids or food (acid reflux).

Complications

The persistence of the condition of chronic inflammation of the esophagus può providing some of the complications:

    the

  • the Barrett’s Esophagus. It is an abnormal change (metaplasia) that occur in the cells of the lower part of the esophagus. The risk of cancer of the esophagus is low, however, these changes are associated with an increased risk. The doctor saprà to seek, through endoscopic examinations regular warning signs of esophageal cancer.
  • the

  • the Ulcer esophageal. It is a wound site by the gastric acid. The ulcer esophageal può bleed, cause pain and make it difficult to swallowing.
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  • the esophageal Stenosis. It means a narrowing of the esophagus procured by the gastric acid, damaging the cells located in the lower part of the esophagus. The damage to the product leads to the formation of scar tissue that, with time, narrows the channel for food, making it difficult to swallow.

it is good to have recourse immediately to the doctor when you experience chest pains or other symptoms, such as, for example, difficulty; of breathing, or pain in the arm. Sometimes, a heart attack can be confused with symptoms from gastroesophageal reflux.

Cause

that in The cases più common causes the disease from gastric reflux is an abnormal functionalityà of the lower esophageal sphincter. It is a circular band of muscles located around the lower part of the esophagus.

Under normal conditions, this valve relaxes when swallowing to allow the passage of food or liquid toward the stomach, then closes again.

If the esophageal sphincter relaxes abnormally or weakens, the acidità of the stomach, può go back into the esophagus causing a burning sensation. This condition, if repeated over time, può irritate the wall of the esophagus to cause inflammation (esophagitis). The persistence of the inflammation può damage to the lining of the esophagus, giving rise to a narrowing of the esophagus, bleeding, or Barrett’s esophagus.

risk Factors

Conditions that can increase the risk of gastroesophageal reflux:

  • the delayed gastric emptying (digestion very slow, the food remains too long in the stomach)
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  • obesityà
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  • pregnancy
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  • hiatal hernia
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  • smoke
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  • diabetes
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  • asthma
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  • connective tissue disorders, such as scleroderma

Diagnosi

In most cases, the diagnosis is performed on the basis of the symptoms manifested by the patient, after excluding other diseases such as hiatal hernia or heart disease. In this case, the doctor can; prescribe medications antacids and/or to provide indications for a regime of appropriate food. If the symptoms disappear, does not usually need further investigation.

on The contrary, if the symptoms persist or gastroesophageal reflux reoccur once the therapy, the doctor può to have further tests:

    the

  • the The pH-metric: it is a test that monitors the amount; (and dwell time) of acid into the esophagus. It is an examination which is running in an outpatient procedure and provides a long-term monitoring for 24 hours. It performs by inserting a catheter (thin flexible tube) into the esophagus (passing through the nose). The tube is connected to a small device that records the parameters relating to when and for how long the acidità of the stomach regurgitates into the esophagus. The examination is painful (apart from the annoying insertion of the nasogastric tube) and the small unit può be fastened around the waist with a belt. Before performing the examination, in general, the doctor has to break the drug therapies.
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  • the esophageal Manometry: this is a test that measures the motilità of the esophagus. As for the previous examination, is provided for the insertion, through the nose, a probe that reaches the esophagus.
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  • the x-ray of the urinary upper digestive: this is a traditional examination made with the x-rays need to drink before the barium, a liquid that coats the inner wall of the digestive tract.
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  • the Gastroscopy (or EGDS: Esophagogastroduodenoscopy): è a examination that uses the gastroscope, a tool that allows you to look inside the esophagus and the stomach. The test is run by inserting a fine probe, flexible, with a light and camera giù to the throat or to the nose. In the course of the examination it is possible to perform a biopsy, that is; collect a sample of tissue to proceed with further testing.

Cure

Farmaci

    the

  • the Antacids that protect the esophageal mucosa from the action of acids. Can give quick relief, however they do not cure a esophagus inflamed which has suffered damage from the action of gastric juices. In the trade if they are different (for example: Maalox, Gaviscon). It should be borne in mind that abuse of these drugs can; cause side effects, such as diarrhea or constipation.
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  • the Medications that reduce the production of acids. Are H2 receptor blockers (also called H2 antagonists). These are drugs that are used to block the action of histamine on the parietal cells of the stomach, getting così a reduction in the production of hydrochloric acid for up to 12 hours after intake. These drugs include cimetidine, famotidine, nizatidine, or ranitidine .
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  • the Drugs that block the production of acids. It is of PPI, proton pump inhibitors (lansoprazole, omeprazole) that reduce the acidità of the gastric secretions. In this way, the esophageal tissue damaged have time to heal. You must keep in mind that these drugs, although generally well tolerated, with the long-term use can be associated with a small increased risk of bone fracture and to a deficiency of vitamin B-12.
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  • the Prokinetic. Are drugs that stimulate the motilità, accelerating così gastric emptying (metoclopramide, domperidone).

Chirurgia

The majority of cases of gastroesophageal reflux can be controlled with the use of medications, lifestyle change, and with a suitable power source. When the use of drugs does not produce the desired effects, or when is necessary to avoid the use of long-term medications, the doctor può to suggest, to second of the cases, some of the surgical procedures.

The surgery has the goal of reinforce the lower esophageal sphincter, this is the valve that opens and closes, regulating the passage of food in the stomach. It intervenes therefore in cases of malfunction of the esophageal sphincter that causes the reflux of secretions.

The method più used takes the name of “Nissen Fundoplication” in the course of which it wraps the upper part of the stomach around the outside of the lower esophagus. In this way, you get a reinforcement of the point concerned.

usually surgery is performed laparoscopy. With this technique the surgeon makes some small incisions in the abdomen, in which it places instruments and, among these, a flexible tube with a microcamera.

After the surgery, usually is required a hospital stay not exceeding three days, within a week the patient is able to return to activitiesà daily. For about a month willà to follow a diet that allows easy passage of food (soft diet).

Remedies

to make a lifestyle Change, diet, stress reduction are all factors that can reduce the frequency of attacks of heartburn. Here’s what is important:

  • No smoking. The smoke affects the functionalityà of the lower esophageal sphincter.
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  • Maintain the right weight. The excess belly fat pushes the stomach upwards and può to cause the regurgitation of the acids into the esophagus.
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  • Meals are moderate in quantity; of food. Avoid filling the stomach.
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  • Avoid foods and beverages that bring about the heartburn. Each person has a sensitivityà especially to certain foods, it is so important to learn to recognize those that trigger an attack of heartburn. They are generally fatty foods or fried foods, alcohol, carbonated drinks, chocolate, tomato sauce, garlic, onion, mint, caffè tè.
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  • Avoid clothing that is too tight in the waist.
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  • do Not lie down after a meal. Wait for the stomach to empty before lying down or going to bed. Even anticipate the time of the dinner.
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  • Sleep with your torso slightly raised. In this case, the force of gravityà, there is help. Sleep slightly raised (10-15 cm.) può to reduce the risk of heartburn. Add pillows under the head is not very useful, it is necessary that the bed is slightly inclined, raising the head of the bed. Si può make “do it yourself” by placing under the foot of the bed (by the head) of the thickness, or you can buy specific products in shops of health.

Cure naturali

there is an alternative medicine that has proven healing of gastroesophageal reflux, however, some complementary and alternative therapies, if combined with the care of a physician, can produce beneficial effects.

Then, after consultation with the doctor, the ability may be the following:

    the

  • the Acupuncture. There is limited evidence to suggest that the effects of the reduction of heartburn. In any case, scientific studies important do not report the benefits.
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  • the herbal Remedies. The use of herbs are among the remedies most used, and include herbal teas, just to name a few, elm, licorice and chamomile. It should be remembered that the use of herbal remedies può provide side effects also important, in addition to interfering with the drugs. So, before starting any herbal treatment, it is important to consult with your doctor to determine the quantityà, and doses.
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  • the relaxation Therapies. The reduction of anxiety and stress, può to reduce the symptoms.

IN ARGOMENTO:

gastric Disorders, acid reflux gastro esophageal. Fucus, or seaweed.

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