胃食管反流病 - 胃回流

Gastroesophageal Reflux Disease - Stomach Flow back

                               
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Gastroesophageal Reflux Disease

What's Gastroesophageal Reflux Disease (GERD)?

Gastroesophageal reflux takes place when contents within the stomach flow back to the esophagus. This happens once the valve between the stomach and the esophagus, the lower esophageal sphincter, does not close properly.

What causes Gastroesophageal Reflux Disease?

When there is an imbalance between the regular disease fighting capability of the esophagus and offensive factors such as acid along with other digestive juices and enzymes within the stomach Gastroesophageal reflux disease (GERD) takes place. Often, the barrier between your stomach and also the esophagus is damaged by weakening from the muscle or even the presence of the hernia, where the main stomach is out of place to the chest. Hiatal hernias, however, are common and never everybody with a hiatal hernia has reflux. A significant cause of reflux is obesity whereby increased pressure within the abdomen overcomes the barrier between patient stomach and also the esophagus. Obesity, pregnancy, smoking, excess alcohol use and use of a variety of foods such as coffee, citrus drinks, tomato based items, chocolate, peppermint and fatty foods could also bring about reflux symptoms.

Do you know the signs of Gastroesophageal Reflux Disease?

Heartburn and/or acid regurgitation are the common symptoms of gastroesophageal reflux disease. Heartburn is really a burning experience felt behind the breast bone that happens when stomach contents irritate the normal lining from the esophagus. Acid regurgitation may be the sensation of stomach fluid coming up through the chest which might get to the mouth. Less frequent symptoms that may also be related to gastroesophageal reflux include unusual heart problems, wheezing, sore throat and cough, amongst others.

How's Gastroesophageal Reflux Disease treated?

Reflux symptoms sometimes go away if dietary or lifestyle excesses that create the symptoms are decreased or wiped out. Avoiding these items may reduce patient’s discomfort:

Excess drinking of alcohol
Coffee
Fatty or spicy foods
Citrus drinks
Tomato-based products
Carbonated beverages
Smoking
Chocolate
Peppermint
Eating within three hours of bedtime
Excess weight gain

Propping in the head of the bed through the night may be helpful. Should symptoms continue over-the-counter antacids may lower discomfort. Antacids, however, only work for a few days and for this reason; they have a restricted role for reflux disease. Histamine H2 receptor antagonists they are cimetidine, ranitidine and famotidine which lower acid generation in the stomach. These medicines work nicely for treating mild reflux symptoms and therefore are quite safe, with few side effects. They are offered over-the-counter in a lowered dose or at a higher dose when distributed by prescription by your physician. Proton pump inhibitors for example omeprazole, lansoprazole, pantoprazole, esomeprazole, and rabeprazole are all highly effective for reflux symptoms. These medications act by blocking the final step of acid production within the stomach and therefore are usually taken once or twice daily prior to meals. For reflux symptoms that take place frequently, proton pump inhibitors are the best medical treatment. Prokinetics, or medicines that stimulate muscle activity in the stomach and esophagus, are occasionally supplied for that treating reflux disease. The only real available drug in the market is metoclopramide, which has little advantage in the treating reflux disease and has several side effects, most of which could be serious.

The surgery for treating reflux disease is called fundoplication. Surgery should be considered in patients with well-documented reflux disease who cannot withstand medicines or keep having regurgitation as a primary symptom. If symptoms continue despite medical treatment, an extensive examination should be completed prior to considering surgery. In this procedure, a hiatal hernia, if present, is removed and the main stomach is covered around the budget of the esophagus to strengthen the obstacle between the esophagus and the stomach. The operation is usually done using a laparoscope, a guitar that avoids a full incision from the stomach. Because of the complexity of this surgery, you should look for a skilled surgeon who has experience in performing this procedure and may discuss the risks and benefits of the process.

How is Gastroesophageal Reflux Disease diagnosed?

When a patient experiences common signs of gastroesophageal reflux disease, namely heartburn and/or acid regurgitation, additional tests prior to starting treatment are typically unnecessary. If symptoms don't respond to treatment, or if other symptoms for example weight loss, trouble swallowing or internal bleeding are present, additional testing may be required. Upper endoscopy is really a test in which a small tube having a light at the conclusion can be used to examine the esophagus, stomach and duodenum. Before this test, patient will receive medications to help him/her relax and lessen any pain he or she might feel. A maximum endoscopy allows patient’s physician to see the liner of the esophagus and detect any evidence of ruin due to GERD. A biopsy of tissue might be done using an instrument similar to tweezers. Receiving a biopsy doesn't hurt or discomfort. Another test, known as pH testing, measures acid within the esophagus and can be done by either attaching a little sensor to the esophagus at the time of endoscopy or by placing a thin, bendable probe into the esophagus that will stay there for 24 hours while acid content is being measured. This post is carried to some small recorder that patient wear on his or her belt. X-ray testing doesn't have role in the initial assessment of people with symptoms of reflux disease.

When should patient visit his/her physician?

Patient should visit doctor immediately for those who have symptoms such as unexplained weight loss, trouble swallowing or internal bleeding in addition to heartburn and/or acid regurgitation. Symptoms that persist once patient has made simple change in lifestyle also warrant a visit to his or her physician. In addition, if patient use over-the-counter medications regularly to reduce symptoms such as heartburn or acid regurgitation, he or she needs to consult a physician to look for the best course of treatment for him/her.