The article will discuss the modern treatment of GERD. What is this pathology? How to get rid of it?
Gastroesophageal reflux disease (GERD) is a pathological condition in which there is a reflux of what is contained in the stomach into the lumen of the esophagus. This disease can often develop against the background of insufficiency of the cardia. This kind of disease can manifest itself at any age, regardless of the gender of the person. In order to cure this pathology, not only traditional medicine methods are used, but also folk remedies.
The treatment of GERD with the help of folk remedies is considered today no less effective than therapy involving the use of synthetic medications. But, of course, the only condition immediately before the use of this or that folk medicine or pharmaceutical is the obligatoryconsultation with the attending physician. Next, let's talk about how GERD is treated, and also consider the methods of alternative and drug therapy.
Symptoms of pathology
The main symptoms of this disease are heartburn with belching, which appear at least twice a week for four to eight weeks or longer. Patients may also complain of a feeling of some kind of constriction in the epigastric region, which occurs fifteen to forty minutes after eating. This feeling, as a rule, can be provoked by the use of foods that stimulate the synthesis of hydrochloric acid in the stomach. These include the following foods: fried and spicy foods along with juices, alcohol, dry red wine, carbonated drinks such as Coca-Cola, Fanta, and so on. In addition to them, provocateurs are: coffee with chocolate, cocoa, radish and butter in excessive quantities.
Often, patients with reflux disease may complain of pain in the chest, which is given to the neck, jaw, shoulder or arm, and in addition, under the left shoulder blade. In the event that there is pain in the region of the left shoulder blade, then a differential diagnosis with angina pectoris should be carried out.
The symptoms and treatment of GERD are often linked. Directly in gastroesophageal reflux disease, chest pain is associated with the following factors:
- Eating too much, mostly overeating.
- Low head position during rest and sleep.
Those or other complaints, as a rule, are provoked by physical exertion associated with frequent bendingtrunk, and besides, with the fact that the stomach is full of liquid, sweet or fatty foods and alcohol. Unpleasant symptoms may worsen at night. The entry of contents from the esophagus into the region of the bronchial lumen can lead to bronchial spasms and Mendelssohn's syndrome. In this case, it should be noted that for the onset of a fatal case, it will be enough if about four milliliters of gastric juice gets into the bronchial tree.
How is reflux disease treated?
Drug treatment of GERD is divided into two stages: initial (initial) and secondary.
In the first phase, transit pump inhibitors are prescribed, for example, substances such as lamprazole or pantoprazole. Preparations based on these components are prescribed for the healing of erosive esophagitis. They also help to completely overcome clinical manifestations. Initial therapy should be continued for four weeks. Next, patients are transferred to a dose that maintains remission over the next month. In the erosive form of the disease, the duration of initial therapy should be four to twelve weeks, followed by the use of one of the long-term treatment regimens. The conventional strategy for antisecretory drug therapy is to initially give double doses of inhibitors for two months, followed by a transition to long-term treatment.
Treatment of GERD (second phase) is supposed to be long-term, the goal of which is to achieve remission. There are three types of treatment. First, assignedlong-term daily use of inhibitors. Second, full-dose inhibitor therapy for a short three-day course is given if symptoms worsen. Thirdly, they carry out “day off” therapy, within the framework of which the use of inhibitors in an anti-relapse dosage is prescribed.
If initial therapy fails within two weeks, esophagoscopy with pH monitoring should be performed. In the event that monitoring indicates nocturnal breakthroughs in acidity, then the patient will be prescribed Famotidine or Ranitidine in addition to a double dose of inhibitors. In situations where the reflux is bilious, patients are shown the appointment of ursodeoxycholic acid. To achieve resistance of the esophageal mucosa, a decoction of flax seeds is recommended, as well as such drugs for the treatment of GERD as Maalox, Phosphalugel and Gestal.
Maalox is considered the most effective. Such patients are also prescribed prokinetics in the form of Cisapride or Cerucal, which increase the tone of the esophageal closure and reduce the severity of gastroesophageal reflux. These medicines, among other things, reduce the acidification of the esophagus. A positive result is achieved through the use of sea buckthorn and rosehip oils. The dose is selected individually: from one teaspoon to three times a day. Consider the main methods of treating GERD.
Endoscopic and surgical treatment
Endoscopic, and in addition, surgical treatment of GERD is recommended for patients infollowing cases:
- The body's need for long-term medical treatment.
- Insufficient effect of drug treatment.
- Diaphragmatic hernia of large volume of reflux.
- Complications in the form of bleeding, stricture and development of Barrett's esophagus, as well as the presence of cancer of the esophagus.
- Personal desire of the patient.
But before that, GERD drug treatment is most often performed. We will consider the most effective folk remedies below.
The criteria for the effectiveness of therapy in this case are the following goals:
- Achieve healing of erosive lesion of the esophagus.
- Heartburn relief.
- Improve overall quality of life.
The recurrence rate within the first twelve months after successful completion of therapy is typically between forty and sixty-five percent for the erosive type of pathology.
The treatment regimen for GERD is selected by the doctor individually.
What diseases can this pathology be associated with?
The nature of gastroesophageal reflux disease is due to the fact that the motility of the stomach and esophagus is disturbed. This disease develops with a reduced antireflux barrier, reduced tone of the esophageal closure and clearance. Patients who suffer from a violation of the production of digestive hormones, and in addition, pancreatic enzymes, are at an increased risk of manifestation of the symptoms of this disease, which occurs due to a decrease in the resistance of the esophageal epithelium. Decrease in production also matterssaliva along with a violation of the cholinergic innervations of the esophagus. GERD often develops in patients who are carriers of Helicobacter pylori. For such patients, there is a higher risk of stomach ulcers.
What else is included in effective GERD treatment?
Therapy without leaving home
The most important condition for the treatment of this pathology is a change in habitual lifestyle, which involves the following measures:
- Completely give up bad habits such as smoking and drinking.
- It is extremely important to reduce excess body weight and lose weight.
- It is recommended to avoid lying down immediately after eating. Thus, in no case should you go to bed after eating.
- You should stop wearing corsets, and in addition, various bandages and in general everything that can increase intra-abdominal pressure in the body.
Treatment of GERD with esophagitis should be comprehensive. It is equally important that a person be able to change the regime, as well as the nature of his diet:
- It is required to completely eliminate overeating.
- Don't eat at night.
- It is important to try to minimize in your diet foods that are rich in fats, such as milk, goose, duck, pork, lamb, coffee and Coca-Cola. You should also not lean on citrus fruits, tomatoes, garlic, and in addition, dry red wines.
Dispensary observation is subject to patients,who suffer from prolonged heartburn for ten years or more. Patients with an erosive form of pathology and Barrett's esophagus must also be observed. In cases of development of Barrett's esophagus, inhibitors should be prescribed to patients in a double dose for at least three months, followed by a decrease in the amount of the drug to the standard norm. With regard to endoscopic control with biopsy, it must be carried out annually. In the presence of high-grade dysplasia, an endoscopic examination with multiple biopsies from the affected mucosal areas is required. For patients with Barrett's syndrome and dysplasia, endoscopic mucosal resection or surgical esophagotomy is recommended.
GERD treatment reviews abound.
What drugs are used to treat gastroesophageal reflux disease today?
Today, specialists prescribe the following drugs for the treatment of this pathology:
- The medicine "Pantoprazole" is prescribed 20 milligrams twice a day or 40 times a day at night. The therapeutic course in this case is a month. Maintenance dose is 20 milligrams at night for the next month.
- The drug "Famotidine" is also prescribed at 20 milligrams twice a day: first before breakfast and then before dinner.
- Medication "Ranitidine" take 150 milligrams twice a day. The most effective drugs for the treatment of GERD are sold in any pharmacy.
- Pharmaceutical product "Sucralphate" is taken 500 milligrams an hour and a half after meals beforefour times a day.
- Maalox is used two packets up to three times a day.
- Metoclopramide taken 20 milligrams three times daily.
Next, let's talk about folk methods.
GERD and traditional medicine
It is important to understand that traditional medicine will not help to eliminate the main cause of the disease, which lies in the weakness of the cardiac sphincter. Folk methods only help to reduce the intensity of symptoms. In the people today, there are many tools that help normalize the condition of patients with GERD. We are talking about the use of special decoctions prepared from herbs with the addition of, for example, honey. In addition, you can turn to drinking mineral water or tinctures. It is important to emphasize that before using any folk remedy, it is recommended to consult with your doctor.
What else does the treatment of GERD with folk remedies involve?
Using Potato Juice
In this case, starch, which is contained in potatoes, in which there is a lot of it, has a special healing property. Starch can completely envelop the esophagus, thereby becoming a defense against the negative effects of hydrochloric acid. Of course, the disease will not go away from the use of this remedy, but it will be possible to get rid of the feeling of heartburn for a long time.
Using Chaga Mushroom Tincture
This mushroom grows on birches. It is widely used for the treatment of diseases of the digestive system. The mushroom must first be crushed and brewed with boiling water. The mixture is then infused for one hour. The medicine is taken several times a day. It perfectly helps to eliminate the symptoms of this unpleasant disease. The mushroom has the following beneficial properties:
- The product contains many useful trace elements that have a stimulating effect on the immune system. In addition, they help bind hydrochloric acid, which is secreted by the stomach.
- The composition of the fungus includes anti-inflammatory substances, they perfectly cope with inflammation in the esophagus, which are provoked by the aggressive influence of hydrochloric acid.
The disadvantages of using this tool are as follows:
- The appearance of allergic reactions in the presence of individual intolerance.
- This mushroom is toxic and should only be used as directed.
Plants and herbs
For the effective treatment of GERD with folk remedies, herbs with various plants are widely used. The most effective are the well-known chamomile with nettle, St. John's wort, sea buckthorn and lemon balm. But it is very important to be able to brew them so that they have a healing effect. The most effective remedy is considered to be a decoction made from chamomile with St. John's wort and lemon balm. All these herbs must be taken in equal parts and brewed with boiling water, and then let it brew a little. It is necessary to use the decoction in the form of tea. In order to enhance the beneficial properties, it is recommended to add a little honey. The resulting drink is differentanti-inflammatory, soothing and wound healing effects.
Nettle also has an anti-inflammatory effect, in this regard, it can be brewed or added to various dishes, such as soups. Sea buckthorn oil is famous for its wound-healing effect, but it is allowed to use it in small quantities. It is important to note that only water-based products are allowed to be used for the treatment of this pathology. It is strictly forbidden to use alcohol tinctures due to the fact that ethyl alcohol can irritate the mucous membrane of an already affected esophagus.
Aloe juice is often used in the traditional treatment of GERD.
Using aloe juice
Aloe juice is considered a unique remedy that is rich in a mass of healing properties. This tool is actively used to treat many diseases that occur in the digestive system. To reduce the symptoms of GERD, you need to mix the juice of this plant with honey, and then dilute with some water. The resulting medicine is taken throughout the day. It is important to note that it is not advisable to use pure honey for GERD. Thanks to aloe juice, the following beneficial effects can be achieved:
- Immune activation occurs.
- Reduces inflammation.
- It has a wound healing effect.
- There is an enveloping effect.
Treatment of GERD during pregnancy
Treatment of such an ailment asgastroesophageal reflux disease in pregnant women is carried out under the supervision of specialized specialists. In the event that this disease manifested against the background of pregnancy, then there is a rather high probability that it will turn out to be temporary, and the symptoms will be reduced to zero immediately after childbirth. At the initial stage of this pathology during pregnancy, doctors, as a rule, recommend lifestyle changes along with herbal medicine, and only if there are extremely uncomfortable symptoms, medical treatment is considered appropriate. In general, GERD therapy in pregnant women is symptomatic and improves the quality of life along with the well-being of the expectant mother.
Treatment of GERD in children
The following methods are used to treat this pathology in children:
- non-drug therapy;
- drug therapy;
- surgical correction.
The younger age group is treated non-pharmacologically with postural therapy (changing body position) and dietary modification.
To reduce gastroesophageal reflux and reduce the risk of esophagitis, breastfeed while sitting at a 50-60 degree angle. Overfeeding is not allowed. After feeding, be sure to hold the baby in an upright position. During sleep - a special elevated position of the torso.
In order to correct nutrition, mixtures with anti-reflux properties are selected, which help thicken food and reduce reflux.
Older children should:
- often eat fractionalportions;
- increase protein in the diet, reduce fat;
- eliminate fatty foods, fried foods, spicy foods;
- do not consume carbonated drinks;
- limit sweets;
- be upright after eating for at least half an hour;
- do not exercise after meals;
- eat no later than three hours before bedtime.
As medicines you can use:
- proton pump blockers - Rabeprazole;
- prokinetics - Domperidone, Motilium, Motilac;
- means that normalize gastric motility - "Trimebutin";
- antacids to neutralize hydrochloric acid (Maalox, Phosphalugel, Almagel).
In more severe cases, surgery is indicated.
Which specialists will help with the development of GERD or diagnostic methods
First of all, you need to contact a gastroenterologist. When examining patients suffering from gastroesophageal reflux disease, the following signs are usually detected:
- The appearance of dry mouth, also called xerostomia.
- The appearance of hypertrophic mushroom papillae of the tongue, which is the result of the process of gastric hypersecretion.
- Presence of a positive left or right phrenicus symptom.
- The appearance of signs of laryngitis, which manifests itself in the form of hoarseness.
The diagnosis of reflux disease is confirmed by X-ray, when it becomes apparent that the contrast agent has flowed back from the stomach into the esophagus. Apart fromIn addition, the results of round-the-clock pH monitoring are being studied. But the main standard for diagnosing GERD is the endoscopic research technique.
Today, there is the following classification of esophageal lesions according to esophagoscopy data:
- Zero grade at which the esophageal mucosa is intact.
- At the first degree of severity, doctors observe separate signs of erosion that do not merge with each other.
- At the second degree of severity, erosions are observed that merge with each other, but they do not spread to a large area of the esophageal mucosa.
- At the third degree of severity, erosive lesions occur, which occupy a third of the esophagus. In this case, erosion can merge and spread to the entire area of the esophageal mucosa.
- At the fourth degree of severity, doctors observe erosive and ulcerative changes with complications. In this case, there may be a stricture of the esophagus with bleeding and metaplasia of the mucosa with the formation of Barrett's esophagus.
Specialists are guided by the following diagnostic criteria in case of suspected GERD:
- Presence of typical clinical symptoms in the form of heartburn and sour belching.
- Testing with proton pump inhibitors. The study evaluates the effectiveness of a weekly course of modern inhibitors.
- Perform endoscopic confirmation of esophagitis.
- Positive 24-hour resultsesophageal pH monitoring.
The following techniques are used to diagnose and treat GERD symptoms:
- Submission of a general blood test with its biochemical study.
- Testing for Helicobacter pylori.
- Taking a biopsy. Such an analysis is indicated if endoscopy suspects the presence of intestinal metaplasia. Also, this analysis is necessary for patients suffering from ulcerative lesions of the esophagus, stenosis, and in addition, with suspected non-reflux origin of esophagitis.
In conclusion, it should be said that today such a disease as GERD is a very common occurrence. Its treatment can be effective if targeted therapy is carried out using modern drugs. As for folk methods, they also have the right to use in this case and are applicable as an additional stimulating treatment.
Reviews on the treatment of GERD and the most effective ways are presented below.
Reviews
Reviews on the treatment of this pathology are mostly positive. She responds well to therapy. Especially if you take an integrated approach. A very effective diet. If you also adhere to the correct body position after eating, then you can get rid of the disease in a short time.
We looked at how GERD is treated with medicines and folk remedies.
