Gastroesophageal Reflux Disease
Gastroesophageal reflux disease (GERD) is the spontaneous passage of gastric contents into the esophagus. Physiological gastric reflux is mainly due to the transient and spontaneous relaxation of the lower esophageal sphincter following distension of the stomach.
It is a disorder that affects the quality of life. However, to be considered a pathology, the symptoms must be severe in terms of intensity and recurrence.
GERD is typically chronic in nature, but with a good prognosis. Symptoms are of variable intensity and with intermittent periods of remission.
Gastroesophageal reflux disease: what are the causes?
The onset of GERD can be caused by a number of factors. The main cause is a malfunction of the lower esophageal sphincter. Other factors that favor gastric reflux are:
- Esophageal motility.
- Upper esophageal sphincter.
- Mechanisms of clearance (cleaning) of the esophagus and stomach contents.
In many cases it is associated with a hiatal hernia.
Symptoms
Gastroesophageal reflux disease presents a wide range of symptoms ; they range from the simple presence of symptoms to the coexistence of an esophagitis with different severity levels. In addition, complications such as stricture, ulcer of the esophagus or Barrett’s esophagus may be present less frequently .
The variability of symptoms depends on factors such as the duration of the episodes, the volume and the aggressiveness of the reflux material. The contact time between the reflux material and the esophageal mucosa should also be taken into account.
The most frequent symptoms are:
- Heartburn : is the typical symptom. It appears as a burning sensation rising from the epigastrium.
- Acid regurgitation : this is the second most frequent symptom. It consists in the spontaneous passage of the gastric contents to the oral cavity. This can be favored by certain postures or by an increase in abdominal pressure.
- Pain in the center of the chest : appears sharply or suddenly and is produced by spasms of the esophagus. The source of pain is suspected to be related to food intake and not exertion.
- Dysphagia : Difficult swallowing.
- Odinophagy : painful swallowing. It is not a frequent symptom, however, if it appears, it can indicate the presence of esophagitis.
Typical symptoms of gastroesophageal reflux disease have a high diagnostic confidence. With their presence, a diagnosis can be almost certainly established and treatment indicated without the need for complementary diagnostic tests such as endoscopy.
When the patient, however, exhibits alarming symptoms or does not respond adequately to conventional treatment, an upper digestive endoscopy should be performed.
Treatment
It is aimed at calming symptoms and treating esophagitis. In addition, it serves to prevent any complications. It includes sanitation, lifestyle improvement, medication, and, in some cases, surgery.
Dietary hygiene measures for gastroesophageal reflux disease
Lifestyle advice and sanitation should be tailored to the patient’s risk factors. It will also be necessary to take into account how the body responds to the changes introduced.
It is recommended to stop smoking and reduce alcohol consumption as well as weight loss in obese or overweight patients. Another useful measure is to raise the head of the bed in case the symptoms are more intense at night. It is also recommended to:
- Avoid large meals. It is better to eat less, but more often.
- Identify and avoid foods that trigger symptoms.
- Manage stress better.
- Do not perform physical activities that are too heavy.
- Spend more time chewing with meals.
Medicines
Drug treatment is based on the inhibition or neutralization of the production of gastric juice. Among the drug groups commonly used for the treatment of GERD are proton pump inhibitors. These drugs cause complete inhibition of gastric secretion; they relieve symptoms, cure esophagitis and control relapses.
Antacids are also used that quickly and effectively calm heartburn. Prokinetics, on the other hand, are useful when regurgitation prevails. Finally, H2 blockers produce a partial inhibition of gastric juice production. Their indication is the treatment of GERD in the absence of esophagitis.
Do you suffer from this disease? As you can see, there are various factors that can cause or worsen it. However, there are just as many alternatives available for treating and controlling symptoms.
