Gastroesophageal reflux disease - a pathology in which the contents of the stomach are able to go back into the esophagus. In this case, the mucous membrane is damaged, which is why symptoms occur. Such a pathology does not depend on food intake, occurs systematically, often worries at night in a horizontal position.
Causes of occurrence
Gastroesophageal reflux disease is more often the result of malnutrition, high fat content in the diet, swallowing a significant amount of air. The following reasons can also provoke a disease:
- Incorrect or insufficient functioning of the lower sphincter that separates the esophagus and stomach. This may be due to a congenital malformation of the gastrointestinal tract or an acquired pathology.
- Diaphragmatic hernia.
- Deterioration of esophageal clearance. Foodlingers in the stomach and, accumulating, provokes the reflux of hydrochloric acid back.
- Eating food that irritates mucous membranes.
- Increased abdominal pressure. It often occurs due to damage to the internal organs or the accumulation of a large amount of fluid inside.
- Digestive tract ulcer.
- Repetitive stress.
- Overweight.
- The use of certain groups of medicines. Some drugs help reduce the tone of the esophageal sphincter.
The appearance of gastroesophageal reflux disease is promoted by bad habits: smoking, alcohol abuse. This condition often occurs in pregnant women due to increased stress on the stomach.
Classification of pathology
Classification of gastroesophageal reflux disease is as follows:
- Sour form. Here the acidity level is 4 units. There is a significant amount of hydrochloric acid in the stomach, which exceeds the norm.
- Slightly acidic. Indicators change within 4-7 units.
- Alkaline.
Also, gastroesophageal reflux disease (GERD) is non-erosive (unpleasant symptoms are mild, the inflammatory process does not develop), ulcerative-erosive (wounds, ulcers appear on the gastric mucosa, the risk of bleeding increases). The most complex form of pathology is Barrett's esophagus - this is a precancerous condition.
Symptomatics
Causes and symptomsgastroesophageal reflux disease should be known to those people who have a genetic predisposition to diseases of the digestive tract. This pathology is characterized by such manifestations.
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Often the patient has pain behind the sternum, which spreads to other parts of the body: neck, back, shoulders, arms.
The first symptoms of gastroesophageal reflux disease may not be too intense, but they appear often, so you should not hesitate to visit a doctor. The manifestations become more pronounced after active physical exercises, excessive consumption of sweet foods, heavy food, at night.
Diagnostic features
Gastroesophageal reflux disease (GERD) symptoms are non-specific. Bythe patient's appearance cannot be diagnosed, so he needs to undergo an examination, including:
- Proton pump inhibitor test. Its duration is 14 days.
- Sphincter manometry. It will help you learn their functionality.
- Determination of motor activity of the esophagus.
- Monitoring the pH of gastric juice. It is carried out throughout the day. Thanks to this study, it is possible to establish the frequency of reflux, as well as the rate of deacidification.
- Fibroesophagogastroduodenoscopy. Such a study makes it possible to differentiate GERD from gastric cancer.
- Helicobacter test.
- Chromoendoscopic examination of the esophagus. Such a diagnosis is necessary for patients who have frequent attacks of GERD, and the disease itself has a chronic course.
- Ultrasound of the internal organs of the abdominal cavity and heart.
- Electrocardiogram to differentiate angina pectoris.
- X-ray of the esophagus with contrast medium.
Endoscopic examination is used for treatment and diagnosis. It allows you to determine the degree of damage to the esophagus:
- Zero. There is no tissue damage yet.
- First. Small erosions appear on the mucosa, but they do not merge together.
- Second. At this stage, the wounds affect a large area and begin to merge. However, the lower third of the mucosa is still intact.
- Third. At this stage, erosion covers almost the entire lower part of the esophagus (distaldepartment).
- Fourth. This stage is the most difficult, as it is considered a precancerous condition. Conservative treatment in this case may be useless.
Also, the patient is assigned laboratory tests of blood, feces. To make an accurate diagnosis, you will have to additionally contact a pulmonologist, cardiologist, ENT, and also a surgeon.
GERD in children
Signs of gastroesophageal reflux disease (GERD) in children are:
- Cough at night.
- Frequent and profuse regurgitation.
- Loss of appetite, weight loss.
- Loss of consciousness.
- Increased irritability, frequent crying.
- Sleep problems.
- Headache.
Treatment of gastroesophageal reflux disease in children involves the use of drugs, taking into account the severity of the pathology, the severity of symptoms, and the characteristics of the organism. More often, babies are prescribed drugs that stabilize gastric motility: Domperidone, Metoclopramide.
After taking such funds, the stomach is released faster, and the tone of the esophageal sphincter increases. The duration of therapy is 10-14 days. Any drugs in childhood are prescribed with extreme caution.
Medical and surgical treatment
Drugs for gastroesophageal reflux disease must be selected by a doctor, depending on the general condition of patients, the threat of complications, the type of pathology. GERD should not just be treated, it is necessary to prevent relapses. A person may be prescribed the following medications:
- Antacids: Gaviscon, Maalox. These funds neutralize the effect of hydrochloric acid, stimulate the production of bicarbonates, which produce a cytoprotective effect. The tone of the lower sphincter is increased. They are used only for short-term elimination of unpleasant manifestations. They are used as adjunctive therapy, however, they do not last long. This type of remedy should be used after an hour of eating, as well as before going to bed. It is better to use 3rd generation products.
- Prokinetics: "Motilium". They help to improve the tone of the sphincter. The gastrointestinal tract is quickly released from digested food. Prokinetics can reduce the number of refluxes. At the initial stages of the development of pathology, drugs of this type are allowed to be used in monotherapy. It is important to remember that some drugs in this group cause drowsiness, insomnia, general weakness, so they are prescribed in short courses.
- Proton pump inhibitors: "Omeprazole". They stabilize acidity and maintain it at a normal level for at least 16 hours. The course of therapy with such means is 6-8 weeks. Such drugs are considered the most effective and strong. Their advantage is a small number of possible side effects.
- Antisecretory drugs: "Famotidine". These drugs reduce the production of acid, as well as its negative effects.
- Cytoprotectors: "Preductal". With these drugs, it is possible to reduceacidity of the juice in the stomach, enhancing the production of bicarbonates, increasing the protective function of mucus. The blood flow in the mucosa of the esophagus is activated.
- Reparants: "Dalargin", sea buckthorn oil. These funds accelerate the healing of erosion.
During therapy, it is also necessary to monitor your own weight, to abandon tight clothing. You should also drink 2-2.5 liters of fluid per day.
In the treatment of gastroesophageal reflux disease, drugs are prescribed only by a doctor, and if the patient has taken any drugs before, they will have to be abandoned.
If the medical treatment of the pathology is ineffective, the patient is prescribed surgery. There are several types of procedures:
- Endoscopic surgery.
- Laparoscopy. Thanks to this procedure, the acute angle between the stomach and esophagus can be restored.
- Radiofrequency ablation of the esophagus.
- Argon plasma coagulation.
Depending on the intervention, the recovery period lasts several weeks.
Folk Therapy
If a person is diagnosed with gastroesophageal reflux disease, treatment with folk remedies can also be effective. But it must be used in combination with drugs. Before using any folk prescription, you should consult your doctor. The following tools will be useful:
- Decoction of flax seeds. For cooking, take 4 tbsp. l. raw materials andpour 2 cups of hot boiled water. It takes half an hour to an hour to insist. After cooling, the decoction should be filtered and taken at bedtime, 5 sips. The duration of therapy is 5-6 weeks. The tool helps protect the esophageal mucosa from the damaging effects of hydrochloric acid, increases its resistance.
- Milk. It has an enveloping effect. You can drink it after meals, as well as before a night's rest.
- Raw potatoes. It must first be cleaned and cut into small pieces. Further, they should be chewed slowly. This remedy will help with heartburn. Potato juice is also considered useful. Drink 1/4 cup 3 times a day.
- Birch bark. It must first be ground into a powder. Raw materials are used daily for 1 tsp. The powder should be washed down with plenty of water.
- Decoction of marshmallow root. It will take 6 g of pre-crushed raw materials, as well as a glass of warm liquid. The mixture must be boiled in a water bath. The duration of the process is 30 minutes. After straining, the decoction should be cooled and taken 0.5 cups up to 3 times a day.
- Juice of celery roots. It soothes heartburn, helps to eliminate other symptoms. The patient needs to use 3 tbsp. l. fluids three times a day.
- Pumpkin seed. They also help to soothe pain and heartburn. It is enough just to eat a small handful of the product a day.
- Herbal collection. It is necessary to mix 1 tbsp. l. elecampane root, aloe, add to the composition of 2 tbsp. l. grapes, 4 tbsp. l. hypericum flowers. All raw materialsmust be crushed beforehand. The mixture is poured with freshly boiled water and boiled for 20 minutes over low heat. After the liquid has cooled, it must be filtered and drunk 125 ml up to 5 times a day.
- Decoction of plantain. You need 6 tbsp. l. finely chopped leaves of the plant combined with 1 tbsp. l. chamomile flowers and 4 tbsp. l. St. John's wort, and then pour 1 liter of boiling water. Additionally, you will have to boil the broth over low heat (20 minutes). The liquid should be infused for half an hour. Use a decoction should be 1 tbsp. l. three times a day.
- Gold centaury. Requires 1 tbsp. l. raw materials to steam 0.5 liters of boiling water. It is better to pour the grass in a thermos, as it must be infused for half an hour. You need to take liquid in half a glass in the morning and in the evening.
Folk remedies are not a panacea and can not get rid of all diseases. But the competent use of prescriptions in conjunction with medications will keep the pathology under control and prevent the development of complications. Before using any folk remedy, it is mandatory to consult a gastroenterologist.
Eating Rules
Diet for gastroesophageal reflux disease is the basis of proper treatment. Without it, therapy will be ineffective, and relapses will be frequent. A person will have to follow these rules:
- Food should be taken often, but in fractional portions. You will have to eat up to 6 times a day.
- Food should not be too hot or too cold.
- After eatingdo not immediately lie down, bend over or do physical education.
- It is important to limit the consumption of those foods in which the formation of hydrochloric acid is faster, and the tone of the esophageal sphincter is reduced. It is better to completely abandon alcohol, legumes, spicy and fried foods, foods containing a large amount of fat.
- In the presence of gastroesophageal reflux disease, the menu should contain vegetables and fruits, foods containing vitamins E and A. Thanks to them, the renewal of the gastric mucosa is faster.
- The menu needs to be diversified. After the disease goes into remission, it is allowed to diversify. But here it is important to take into account the individual characteristics of the body.
- It is strictly forbidden to overload the stomach with food. In this case, its motility slows down and its contents are thrown into the lower esophagus.
The patient is strictly forbidden to starve, as this only aggravates the situation. The use of tea and coffee should be limited. S alt and spices are removed from the diet. The last meal occurs a few hours before bedtime.
The basis of the diet is cereals, boiled and stewed vegetables, vegetable oils.
Possible Complications
Since it is imperative to treat gastroesophageal reflux disease, it is necessary to see a doctor even with mild but constant discomfort. In the absence of therapy, the following complications are possible:
- Peptic ulcers or erosions on mucous membranes.
- Appearanceholes in the walls of the esophagus.
- Internal bleeding.
- Stenosis of the esophagus due to scarring.
- Lung abscess.
- Relapse of chronic bronchitis.
- Inflammatory process in the nasopharynx.
The most severe complication is a precancerous condition.
Disease prevention
So, the symptoms, treatment of gastroesophageal reflux disease are already clear. But it is better not to allow the appearance of this disease at all. If the pathology has already developed, then it is necessary to reduce the frequency of relapses. To do this, you will have to follow the following preventive measures:
- Stop carbonated and alcoholic drinks.
- Wear comfortable clothing that won't compress your abdomen.
- Stay he althy.
- Stop smoking. Nicotine negatively affects not only the circulatory system and lungs, but also the digestive organs.
- Sleep on a high pillow.
- Don't be obese. If a person has a lot of weight, then it needs to be normalized. For this purpose, it is required to perform physical exercises, but only 2-3 hours after eating.
- It is forbidden to lift weights over 10 kg.
- All medications are best taken with the permission of a doctor, especially if they cause relaxation of the esophageal sphincter.
Gastroesophageal disease is an unpleasant pathology that can eventually lead to the development of cancer. To prevent this from happening, it is necessary to start treatment when even weak, but permanent symptoms appear.symptoms. Compliance with preventive measures will reduce the risk of illness.
