Gastrointestinal reflux - causes, symptoms and treatment methods

Gastroesophageal reflux is a ailment that affects an increasing number of people around the world. This disease can significantly reduce the comfort of life, leading to numerous symptoms, which are often a source of pain and discomfort. Understanding the causes and mechanisms behind reflux is crucial for effective treatment and prevention of recurrence. In the article below we will look closer to this widespread ailment.

What is reflux?

Gastroesophageal reflux, also known as GERD (Gastroesophageal Reflux Disease), is a chronic disease, characterized by reversing stomach content to the esophagus. This causes esophagus irritation and can lead to numerous health complications. Under normal conditions, the lower esophageal sphincter (Les - Lower Esophageal Sphincter) acts as a barrier, preventing the inversion of acidic stomach content. When this mechanism fails, reflux occurs. Gerd is a common health problem that affects millions of people around the world. It is estimated that every fourth person in developed countries experience reflux symptoms at least once a month. Untreated reflux can lead to serious complications, such as esophagitis, ulceration and even esophageal cancer. Therefore, it is extremely important to understand the causes, symptoms and available treatment methods.

Gastroesophageal reflux - causes

The causes of gastrointestinal reflux are complex and multi-faceted. They can include both internal and external factors. Here are the most important of them:

Lower esophageal sphincter dysfunction (Les)

Les is a muscle that controls the passage between the esophagus and the stomach. Dysfunctions of this muscle can lead to abnormal opening of Les, which allows acidic stomach content to the esophagus.

Delayed gastric emptying

When gastric emptying is slowed down, excess stomach content occurs, which increases the risk of reflux. Factors such as diabetic neuropathies or mechanical obstacles can contribute to this phenomenon.

Incorrect production of gastric acid

Excessive production of gastric acid is one of the main risk factors for reflux. It can be the result of a diet rich in fats, caffeine, alcohol or spicy dishes.

Pregnancy

Hormonal changes and increased abdominal pressure during pregnancy can lead to weakening Les and increase the risk of reflux.

Obesity

Excessive body weight increases stomach and les pressure, which promotes gastric acid to the esophagus.

Smoking

Smoking affects the relaxation of LES, which increases the risk of gastric content to the esophagus.

Some medications

Drugs such as non -steroidal anti -inflammatory drugs (NLPZ), calcium canal blockers or antidepressants can affect the LES function and gastric emptying, which promotes reflux.

Genetic conditions

Family cases of reflux may suggest genetic predisposition to this disease.

Stress

Chronic stress can affect digestion and increase the production of gastric acid, which increases the risk of reflux.

Gastroesophageal reflux - symptoms

Symptoms of gastroesophageal reflux can be varied and include both typical and unusual symptoms. The most common symptoms are heartburn, i.e. burning pain felt behind the bridge, which intensifies after eating, in a lying position or when leaning, which is the result of irritation of the esophagus mucosa through acidic gastric content. Regurgitation is the back of gastric content to the esophagus and mouth, which causes acidic or bitter aftertaste. Dysfagia, or difficulty in swallowing, results from swelling and damage to the esophagus. Chest pain, often confused with heart pain, is usually smoking and is associated with esophagus irritation. Hunger and sore throat are the result of acid overlapping to the vocal cords. Reflux can also lead to irritation of the respiratory tract, manifested by chronic cough and wheezing, especially at night. Nausea may accompany the feeling of discomfort in the upper abdomen and are associated with excess gastric acid. Abdominal pain and bloating result from irritation of the gastric mucosa and esophagus and excess gases in the digestive tract.

How to treat reflux?

Treatment of gastroesophageal reflux may be on several levels, depending on the severity of the symptoms and individual needs of the patient. This includes lifestyle modification, pharmacological therapy and, in necessary cases, surgical treatment.

Lifestyle modification

Diet: Avoiding foods that intensify the symptoms of reflux (fatty foods, caffeine, alcohol, spicy food). Avoiding food late at night: The last meal should be eaten at least 3 hours before bedtime. Weight reduction: In overweight people, weight reduction significantly reduces reflux symptoms. Lifting the head on the bed: Sleeping with a head raised by 15-20 cm can reduce the risk of riming acid. Avoiding smoking: Quitting smoking can significantly reduce reflux symptoms.

Pharmacological therapy

Proton pump inhibitors (PPI): Drugs such as omeprazole, pantoprazole, esomeprazole work by inhibiting the production of gastric acid. H2 receptor antagonist: Drugs such as ranitidine or famotidine reduce gastric acid secretion. Neutralizing drugs: Used for ad hoc relief of heartburn symptoms, they neutralize gastric acid. Prokinetics: Drugs like metoclopramide help accelerate the gastric emptying.

Surgical treatment:

Nissen foundation: A treatment consisting in the wrapping of the upper part of the stomach around the lower esophagus, to increase the pressure in Les. Endoscopic procedures: Modern techniques such as endoscopy of anti -reflux barriers can be less invasive than traditional operations.

Dietary recommendations with reflux

The diet plays an important role in preventing and alleviating the symptoms of gastrointestinal reflux. Appropriate eating habits and avoiding certain foods can significantly improve patients' comfort. It is recommended to avoid fatty dishes because fats delay the gastric emptying and increase the risk of reflux; That is why it is worth limiting the consumption of fried dishes, fast food and products rich in saturated fat. Gastric pods increase the pressure in the stomach, while alcohol relaxes the lower esophageal sphincter (Les), which promotes reflux, so they should be avoided. Caffeine, present in coffee and tea, increases the secretion of gastric acid, which can support the reversing of stomach content, so its consumption should be limited. Spicy food can irritate the esophagus mucosa and intensify the symptoms of reflux, so it's also worth avoiding. Eating smaller, more frequent meals instead of large ones reduces the pressure in the stomach and the risk of reflux. Protein, which can increase the tension of the lower esophageal sphincter, should come from lean meats, fish and legumes. It is also recommended to eat vegetables and fruits with low acidity, such as bananas, melons, broccoli and carrots, while avoiding sour fruits such as lemons, oranges and tomatoes.

Ways to alleviate the symptoms of reflux

In addition to modifying lifestyle and diet, there are many other ways to alleviate the symptoms of gastrointestinal reflux. Here are some of them:

Avoiding lying immediately after eating

After a meal, it is recommended to stay in a sitting or standing position for at least 2-3 hours.

Lift the head while sleeping

Raising the head of the bed by about 15-20 cm can help reduce the risk of riding acid at night.

Wearing looser clothes

Clothes that do not oppress the abdomen can help reduce stomach pressure.

The use of natural soothing agents

• Ginger: Helps to alleviate digestive problems.
• Peppermint and chamomile: The infusions of these herbs can help relieve reflux symptoms.

Relaxation techniques

Stress can increase the symptoms of reflux, which is why relaxing techniques such as yoga, meditation or deep breathing can be helpful.

Factors increasing the risk of reflux

Knowing the risk factors of reflux, you can take appropriate steps to reduce the likelihood of its occurrence. Here are the most important factors that increase the risk of reflux:

1. A diet rich in fats and caffeine - Eating a large amount of fats, caffeine and alcohol increases the risk of reflux.
2. Obesity and overweight - Excessive body weight exerts additional pressure on the stomach and les, which promotes the retreat of acid.
3. Sedentary lifestyle - Lack of physical activity can lead to muscle weakening, including les, which increases the risk of reflux.
4. Smoking - Nicotine relaxes Les, which promotes the occurrence of reflux.
5. Stress and tension - Emotional and physical stress may increase the secretion of gastric acid and affect digestion, which increases the risk of reflux symptoms.
6. Genetic predisposition - In people where families have reflux, the risk of its development is greater.

Summary

Gastroesophageal reflux is a common and often chronic disease that can lead to numerous health complications if it is not properly treated. Understanding the causes, symptoms and available treatment methods is crucial in managing this disease. Thanks to the appropriate modifications of diet and lifestyle and proper pharmacological treatment, you can effectively control the symptoms of reflux and improve the quality of life.

Sources

Kahrilas, P. J. (2008). Gastroesophageal Reflux Disease. New England Journal of Medicine, 359 (16), 1700-1707. Hunt, R., & Armstrong, D. (2012). The management of Gerd Douring the Remission Phase. World Journal of Gastroenterology, 18 (11), 1584-1592. Spechler, S. J. (2014). Barrett’s Esophagus and Esophageal Adenocarcinoma: Pathogenesis, Diagnosis, and Therapy. Current Opinion in Gastroenterology, 30 (2), 142-148. Fock, K. M., Talley, N., Fass, R., Goh, K. L., Katelaris, P., Hunt, R., ... & Parikh, S. (2008). Report of the Asia-Pacific Conszensus on the Management of Gastroesophageal Reflux Disease. Journal of Gastroenterology and Hepatology, 23 (5), 735-749. Zanten, S. V., Shi, G., & Joseph, R. (2016). Frequent Heartburn: The Importance of Diet and Lifestyle Modifications. Canadian Journal of Gastroenterology, 30 (4), 212-217.