Reflux

Reflux

Symptoms thought to be indicative of reflux such as reflux, heartburn (heartburn) and gastric acid regurgitation are very common in the population.

In humans, there is a high pressure zone at the junction of the esophagus and stomach. It normally acts as a cover. In this region, there is a specialized thickening consisting of annular suspensory musculature and anchor fibers.

These muscles relax during the swallowing process, allowing the passage of the food pipe to the stomach, in addition, when the stomach wall is stretched with gas and liquid, it opens, allowing the gas to come out (burping). Failure of this system to function causes reflux (GERD). The resistance against the reverse flow of gastric juice towards the esophagus (esophagus) disappears, reflux occurs.

What are the Symptoms of Reflux?

In the study on the nighttime symptoms of reflux disease;

About one fifth of the population suffers from heartburn and heartburn at least once a week at night.
80% of those with heartburn have complaints at night, and 65% of them both day and night.
63% report that their ability to fall asleep and work the next day is affected. 72% use prescription drugs.
About half (45%) report that current treatments do not relieve all symptoms.
When the symptoms are not taken into account;

Achalasia (stenosis of the esophagus),
diffuse,
esophageal spasm,
esophageal carcinoma,
gastric outlet stricture,
gallstones,
 gastritis,
duodenal ulcer,
It can also be seen in other diseases such as coronary heart disease.
Therefore, when these symptoms and complaints are seen, examination and examination are necessary.

The reason for the complications of reflux (GERD); It is due to the direct injuring effect of gastric juice on the epithelium of the esophagus, throat and trachea.

Complications of recurrent reflux are esophagitis, stricture, and barret esophagus. Combined exposure of gastric juice and duodenal fluid causes extensive damage.

Experimental animal studies have shown that reflux of duodenal contents into the esophagus results in inflammation, increasing Barrett's esophagus, and formation of esophageal adenocarcinoma.

How Is Reflux Treated?

The cause of reflux (GERD) should be fully investigated and the cause-oriented treatment should be performed. Anti-secretory drugs, antacids are useful in mild cases without complications. Control and follow-up are very important.

Reflux (GERD) is now considered the cause of the majority of esophageal diseases. It is a chronic disease. When medical treatment is required, this treatment lasts for life. Recent efforts to develop a variety of endoscopic antireflux interventions, although groundbreaking, have not shown lasting success in controlling reflux (GERD). Anti-reflux surgery is an effective and long-term treatment and the only approach that can repair the gastroesophageal valve.

How Can We Protect Against Reflux?

Protective measures to avoid reflux;

Raising the head of the bed
Avoiding wearing tight-fitting clothes
Eating little and often
Avoiding eating shortly before bedtime
Avoid foods that reduce pressure in the lower esophageal sphincter, such as alcohol, coffee, chocolate, and peppermint.
NOTE: We should not fill our stomachs in the evening!!

It is believed that reflux (GERD) originates from the stomach. Delayed gastric emptying secondary to overeating and high-fat eating habits causes stretching of the stomach walls. This stretching, enlarged stomach, causes the valve (sphincter) not to be closed by the stomach walls. It results in the victimization of the esophagus to the gastric juice. Repeated exposure causes inflammation and changes in the structure of the stomach entrance. Esophagitis and carditis are seen. The patient tries to balance this situation by increasing swallowing, neutralizing the gastric juice escaping from the saliva and relieving the discomfort caused by reflux. Increased swallowing results in air swallowing, bloating, and belching. This situation creates a vicious circle by increasing gastric distension, increasing the exposure of the esophagus and its repetitive damage.