Encoded as K21 in ICD 10, GERD is a pathological condition in which substances in the stomach enter the esophagus. The condition is fixed quite often, regularly repeats, occurs spontaneously. The pathology is chronic.
General information
Known as K21 in the ICD, GERD is the acronym for the rather long official name: gastroesophageal reflux disease. The pathological condition is characterized by a regular alternation of remissions, exacerbations. The pathogenesis is due to reflux - it is this term that refers to the entry of gastric contents into the esophagus.
Frequent repetition of reflux provokes a violation of the integrity and functionality of the mucous membranes of the esophagus. This is due to the chemical activity of the duodenal contents. If the ICD code K21 (GERD) is indicated in the patient's card, it is highly likely that the pathological condition most strongly affects the lower esophagus. Chronic violation of the integrity of the mucous membranes is accompanied by problems of motility, failure of gastric evacuation functionality. These phenomena are accompaniedquite characteristic symptoms, unpleasant enough to see a doctor without delaying an appointment.
Nuances and features
GERD code in ICD 10 - K21. It is he who is indicated in the patient's card, if the diagnosis is confirmed. You can suspect GERD by specific symptoms that appear in the digestive system. The symptomatology of this pathological condition does not always indicate the transformation of the structure of the organic tissues that form the esophagus. A number of symptoms are characteristic of GERD, regardless of the stage, form, and nuances of the course of the disease. In this case, the level of severity of the manifestations of the disease varies from case to case. Often, the strength of the symptoms allows you to fairly accurately assume how strongly the tissues of the mucous membrane covering the esophagus have been histologically degenerated.
Types and forms
In medicine, a classification system for reflux varieties has been developed. GERD is a general concept, within which separate categories are distinguished based on the specific features of the case. The most convenient system for dividing all patients into groups is based on an assessment of the presence of the level of transformation of the tissues covering the esophagus.
The first type is non-erosive. At the appointment, the doctor will definitely explain what kind of disease it is - GERD of a non-erosive type. It will be recorded on the patient's chart as NERD. This is a pathological condition, accompanied by specific symptoms, while violations of the integrity of the mucous membranes cannot be detected. An endoscopic examination is prescribed to confirm the diagnosis.
Another type is erosive. Atsuch a pathology, the symptoms are observed against the background of erosion of the esophagus, ulceration, pronounced changes in the structure of the mucous membranes.
Finally, there is a form of the disease called Barrett's esophagus. It is considered the most difficult.
Classification of symptoms
Finding out the features of GERD, what kind of disease it is, what are its manifestations, consequences, how to deal with it, experts in the field of gastroenterology have done a lot of research and practical work. As part of the generalization of experience, a world congress was organized. Montreal was chosen as the venue for the event. It was there that it was proposed to divide all the symptoms of the disease into three types. Groups of esophageal and extraesophageal symptoms were identified: clearly associated with reflux and presumably caused by it. The proposed option turned out to be the most convenient of all existing ones, as it helped to distribute the totality of manifestations of pathology based on the level, strength, type of flow, form and nuances of the case.
Explaining to the patient what GERD is, what kind of diagnosis it is, what manifestations in a particular case helped to suspect a pathology, the doctor will definitely pay attention to the presence of heartburn and narrowing of the esophagus among the patient's complaints. It has been established that GERD can be indicated by a runny nose, inflammation in the throat, larynx. Sometimes the pathology manifests itself as a cough, asthma, liquid belching and soreness in the sternum, behind it. Among the symptoms of the disease are a tendency to caries, frequent relapses of otitis media. In some cases, GERD is associated with cancerous processes in the gastrointestinal tract.
Relevance of the issue
Doctors have long been engaged in clarifying what it is - GERD. Symptoms, treatment, consequences, dangers, causes of a pathological condition are an urgent problem of modern medicine. This pathology is most typical for people living in developed countries - the frequency of occurrence is many times higher than that characteristic of lower-level societies.
Some time ago, at the world congresses of gastroenterologists, as part of the reflection of the current situation, doctors agreed that the most common disease of the last century was a stomach ulcer. For the current century, the most urgent problem is GERD. This forces us to pay special attention to the study of the causes and mechanisms of the development of the pathological condition. Since it is known that GERD can provoke malignant degeneration of cells, it is important to develop new methods to combat pathology, ways to prevent it, detect and correct it in a timely manner.
Where did the trouble come from?
Doctors study in detail the nuances of the disease, its causes, symptoms and treatment of GERD. What it is, where it comes from, how it is formed, what are the triggering factors - all these aspects are still being clarified, although even today scientists have a considerable amount of knowledge about pathology. It was found that GERD can be provoked by a decreased tone of the esophageal sphincter and a weakening of the ability of this organ to independently cleanse itself of food elements. Gastric and intestinal contents entering the esophagus during reflux have a categorically negative effect.
In some casesthey learn from their own experience what GERD is, people whose esophageal mucosa weakens, loses the ability to neutralize the negative effects of substances that accidentally enter the organ from the stomach. The formation of a pathological condition is possible, if the ability of the stomach to empty is disturbed, the pressure in the abdominal cavity increases.
Factors and dangers
You are more likely to find out for yourself what GERD is, how it manifests itself and what troubles it brings if a person regularly encounters stress factors. The negative aspect is the forced position of the body for many hours every day if you have to constantly lean forward.
Research has shown that GERD is more commonly diagnosed in people who are overweight, as well as in people who tend to be addicted to smoking. Certain dangers are associated with the period of bearing a child. GERD is characteristic of those whose menu is dominated by food that is dangerous for the gastric mucosa. These are a variety of products, from chocolate and spirits to spicy dishes, roasted, strong coffee. By themselves, people who are forced to take medications that affect the concentration of dopamine in the circulatory system can find out what GERD is. The transformation products of phenylethylamine, the preparations "Pervitin", "Phenamine" can provoke a pathological condition.
And more details?
Weakening of the esophageal sphincter, which closes the organ from below, is one of the common causes of GERD. The main task of this element is to distinguish between the esophagus and stomach. Muscle tissue should close tightly immediately behind the food bolus,moved from the esophagus into the gastric cavity. Due to various reasons, loose closure of this ring is possible. It is with such a phenomenon that a person learns by himself what GERD is. Food from the gastric cavity gets the opportunity to penetrate back into the esophagus, the integrity and he alth of the mucous membranes are disturbed, and the inflammatory process starts. If the studies confirm the preliminary diagnosis, the patient is prescribed treatment for esophagitis.
The development of insufficient functionality of the esophageal sphincter, located in the lower part of the organ, causes an increase in pressure in the abdominal cavity. This is especially common in patients who are overweight, as well as in women who are expecting a child. The menu for GERD is another important risk factor. If the diet is wrong, unbalanced, a person does not follow the diet, conditions suitable for the pathological condition are formed, and the body's defenses weaken, resources are depleted.
Manifestations and their nuances
As can be seen from the reviews, GERD for patients suffering from pathology becomes a real test. Most often, people turn to the doctor because of heartburn - this complaint is the most typical. An unpleasant burning sensation is localized behind the sternum, especially strongly soon after a meal or during a night's rest. Heartburn is aggravated if you drink sparkling water, play sports, lean forward. With this position of the body, as well as when in a horizontal position, geometric conditions are formed that cause the contents of the gastriccavity in the esophagus.
GERD can be suspected by a violation of the ability to swallow. This is due to spasms of the esophagus. At first, difficulties are observed with the absorption of solid food, gradually spreading to soft food. As the condition progresses, dysphagia creates problems with fluid intake. In some cases, symptoms indicate the development of complications, a neoplasm.
Cases and Predictions
If the manifestations of GERD are observed for several months with a frequency of more than twice a week, you should visit a gastroenterologist to clarify the condition. As part of the research, it is established how large the damage to the esophageal mucosa is. For this, an endoscope is used. It is customary to divide all cases into positive and negative. The first suggests esophagitis, in which ulceration and erosion can be seen in the lower half of the organ. The negative form is not accompanied by esophagitis, visible damage cannot be detected.
Prolonged course of the disease can cause the formation of Barrett's esophagus. The term refers to the state of metaplasia of epithelial cell structures. Pathology is considered a precancerous condition. Its detection requires a particularly responsible approach to the issue of treatment, proper nutrition, lifestyle changes, since there is a high probability of a malignant neoplasm in the esophagus.
Diagnosis
Clarification of the state requires determining the type and type of GERD, the level of severity of the pathology. If there are complications, they need to be clarified and evaluated. The preliminary diagnosis is formulated based on the patient's complaints and medical history. DiagnosticsGERD involves tests and instrumental examinations. The first and main measure is gastroscopy. Through the endoscope, the condition of the esophageal mucosa is examined, narrowed areas are revealed. To confirm the diagnosis, tissue samples may be taken for histological laboratory testing.
In order to formulate adequate clinical recommendations for the identified form of GERD, it is necessary to do manometry. The term refers to such a study, during which the pressure indicators of the esophageal sphincter of the lower zone of the organ are determined. As part of the analysis, confirm the lack of work or adequate functioning.
Continuing learning
If you suspect GERD, the doctor will refer the patient for an x-ray. Such a picture is especially important if there are manifestations of dysphagia. As part of the study, tumor processes, strictures are determined. If there is a hernia, you can clarify its features and position.
24-hour acidity control is another study that is mandatory if GERD is suspected. The analysis is needed to assess the level of acidity and the number of refluxes in 24 hours. Even if the acidity is within adequate limits, such a daily analysis helps to clarify GERD.
What to do?
After confirming the diagnosis, the doctor will explain how to treat GERD. The therapeutic course will be delayed for a long time, it will consist of several successive steps. It is important to practice complex adjustment of the condition. The first step is the relief of the most pronounced manifestations, then an optimal program for suppressing inflammatory processes is prescribed. In parallel, the doctor is workingcourse of prevention of complications of the condition.
For GERD, clinical guidelines include the use of medications. First of all, antacids and drugs to control secretory function are prescribed. Useful substances that stimulate the kinetics of food in the digestive tract. If the reflux is acidic, proton pump inhibitors are prescribed. If a conservative approach does not have the desired effect, surgery may be prescribed.
Aspects of therapy
If the disease is just beginning to develop, positive results can be obtained even without resorting to a medication course: it is enough to adhere to the diet recommended for GERD, give up bad habits and reconsider the lifestyle and rhythm of life. You will have to rebuild your daily routine in such a way as to create optimal conditions for the normal functioning of the digestive tract.
The main he alth prescription for GERD is a complete rejection of alcohol and tobacco. Smoking and alcohol are strictly prohibited for life. If you are overweight, you should also consider a body shaping program. It is important to rationalize nutrition, normalize the regime, eat food often and in small quantities. Completely refuse food that negatively affects the mucous or muscle tissue of the sphincter.
Daily as a guarantee of he alth
If the diagnosis of GERD is confirmed, you will have to think about changing the bed. Persons suffering from such a pathology are recommended to sleep on an inclined bed - the head should be slightly higher than the foot. Eating before bed is strictly prohibited. Do not lie down immediately after eating.
Physical activity or exercise immediately after a meal is contraindicated. You can not lift weights, bend over. Doctors recommend giving up tight clothing, not using belts and bandages.
After completing the therapeutic course, you will have to undergo regular examinations to prevent complications and relapses. Often, the doctor sends the patient to a sanatorium or spa treatment to consolidate the primary results of the therapeutic program. Do not neglect such recommendations.
Therapy: different approaches
As medical practice shows, with GERD, physiotherapy gives a good result. In particular, electrophoresis is prescribed using Cerucal. Electrosleep and decimeter procedures have proven themselves well.
Drink should be weak mineral alkaline water. If gas is present, it should be removed before drinking. The liquid is heated, consumed in small portions 30 minutes before the meal. The course is at least a month. After drinking mineral water, you can lie down a bit so that the chemically active liquid contacts the mucous membranes of the diseased organ longer. Maximum effectiveness can be achieved if mineral water is consumed in a supine position, sipping through a straw.
Herbs for GERD
For the treatment of a disease, you can take a couple of glasses daily of an infusion prepared on chamomile inflorescences mixed in equal proportions, yarrow, St. John's wort, celandine. Moreone option: calendula inflorescences and coltsfoot leaves are taken in a tablespoon, chamomile inflorescences - a quarter of a teaspoon, everything is mixed and poured with boiling water. Ready infusion is used for food in a tablespoon four times a day a quarter of an hour before a meal.
You can try the recipe with plantain and St. John's wort, taken in equal proportions. They are mixed with chamomile inflorescences (4 times less than any other component), brewed with boiling water and allowed to brew. The finished drink is used four times a day for a tablespoon half an hour before a meal.
