Gastro-esophageal reflux (Gastro esophangeal reflux disorder)
Gastro-esophageal reflux(Gastro esophangeal reflux disorder)
Gastroesophageal reflux disease, reflux is very common throughout the world and affects about 15% of the adult population in the United States. Gastro-esophageal reflux leads to a significant decline in the quality of life and to the continuing need for medical services and is a heavy economic burden on health budgets.
Discrimination is, usually, from mild disease (complaints appear twice a week), moderate disease (more than twice a week) and acute illness (when symptoms appear every day).
If appeared worrisome signs, such as swallowing disorders (dysphagia - Dysphagia), low weight, bleeding or anemia (anemia - Anemia), it is necessary to go to the doctor immediately.
Symptoms of gastro-oesophageal reflux
Symptoms characteristic of GERD include heartburn gastroesophageal reflux (Heartburn) after eating meals and raise food (regurgitation - Regurgitation).
It can also be shown, too, is typical signs of injury when the other organs of the body. For example, asthma (Asthma), chronic cough, chest pain, sore throat, frequent phlegm and the like.
The diagnosis of gastro-oesophageal reflux
For the diagnosis of gastro-esophageal reflux disease, there is no need for an X-ray (Rntgn - X - ray), but there is a need to examine the Endoscopy (Endoscopy), and preferably within a few months of the appearance of the complaint. In this test, can determine the severity of the disease, which range between A and D, and in special cases can be an examination of biopsy (Biopsy).
Recently, therapeutic test in which the patient receives high doses of medicine for gastro esophageal reflux disease, inclusion, for two weeks, is then examine the clinical response.
About 15% of patients who suffer from gastro-esophageal reflux undergo more sophisticated tests, during which esophageal motility examination - pressure measurement (Manometry) esophagus, as it is compressed examination of the esophagus sphincter and functionality of the body of the esophagus.
By checking monitoring pH in the esophagus is determining the amount of reflux, the relationship between patient complaints and cases of reflux in the registry.
The treatment of gastro-esophageal reflux
In the first phase of the treatment of gastro-esophageal reflux is recommended changes in lifestyle, stop smoking, reduce weight and not eating fatty foods, fried, citrus fruits, chocolate, hot foods, drinking coffee and tea center. Must obligation to refrain from eating and drinking (except water) by almost four hours before going to sleep. Going to sleep so that the upper part of the body at an angle of approximately 30 degrees.
For some patients, it is not enough merely a change in lifestyle, but there is a need to give them medicine. These drugs stop the production of acid in the stomach. From practice today to give the treatment gradually - a large dose at the beginning, then the dose is reduced after 4-8 weeks. Effective drugs are inhibitors of proton pump group (Proton Pump Inhibitors - PPI) include: Humberasul (Omeprazole), to Ançobrazaul (Lansoprazole), pantoprazole (Pantoprazole). These drugs cause to stop the production of acid in the stomach by 60% - 70% of the hours of the day. Then, the dose can be reduced depending on the extent of clinical response.
A small number of patients with gastro-esophageal reflux, especially those who suffered severe inflammation of the esophagus in the beginning, they need to continue and follow-up treatment for varying periods. The purpose of this treatment is to reach the minimum dose that allows for a patient gastro esophageal reflux good quality of life. Treatment may be given once, twice a day, or once every two days.
In recent spread the way in which the patient's own identification dosage according to the clinical sense of. In this way, can be reduced two-thirds of the dose covered by the patient.
Other drugs to treat gastro-esophageal reflux include: blockers histamine receptors (such as Zantac - Zantac, Famotidine - Famotidine, Simitaj - Cimetag), these drugs are not described today for patients with gastroesophageal reflux esophageal in general, but only dealt with a small group of patients with gastroesophageal reflux esophageal who have acid secretion have a high in the night hours they who benefit from the addition of these drugs.
Not available, currently, drugs to improve the kinetics of the esophagus, with the exception of medicine Mutileom (Motilium), a slight influence.
Another group of patients with gastro-esophageal reflux, which enjoys a large degree of attention in the medical literature in recent years, are patients who suffer from gastroesophageal reflux esophageal group but can not diagnose the disease have by endoscopy (Endoscopy), which does not appear defects (NERD). These patients suffer from symptoms of gastro-oesophageal reflux without endoscopic evidence of injury to the mucosa of the esophagus. They, too, need treatment with medicine sometimes, and even a large dose.
There is a possibility of surgery (fundoplication - Fundoplication) are made laparoscopic (Laparoscopic surgery).
With a small percentage of patients, may get complications, such as narrowing of the esophagus or the emergence of a private changes (Barrett's esophagus - Barrett'sesophagus), in the mucosa of the esophagus, which require close monitoring by the gastroenterologist. The emergence of Barrett mucosa linked exposure mucosa of the esophagus, over a long time, into the stomach content that contains acid, bile and enzymes upper gastrointestinal tract. These patients need medical follow-up closely with biopsy (Biopsy) frequent.
