Gastroesophageal Reflux
What is GERD?
Gastroesophageal reflux is the passage of gastric contents into the esophagus through the lower esophageal sphincter. The refluxed material can be contained in the stomach or intestine.
Regurgitation is the ascent to the mouth or pharynx of material from the stomach or esophagus.
What are the causes?
* Relaxation of lower esophageal sphincter. Alteration of lower esophageal sphincter motility by altering various mediators (VIP, peptide YY, motilin, cholecystokinin and neurotensin).
Decreased esophageal peristaltic activity.SYMPTOMS
* Heartburn is the most common. It is a burning or stinging sensation behind the sternum to the neck, most frequently with certain foods (fats, chocolate, alcohol, coffee and snuff).
* Dysphagia, or difficulty swallowing food.
* Dry mouth.
* More frequent dental infections.
* Chronic cough or asthma.
* Bleeding ulcers hidden by the esophageal mucosa.
TREATMENT AND RECOMMENDATIONS
Changes in lifestyle, diet and weight reduction if overweight.
* Raise the head of the bed 3 to 8 cm.
* Dinner or any meal 3 to 4 hours before bedtime or lying down.
* Avoid certain foods that relax the lower esophageal sphincter, caffeine, alcohol, snuff, spices. mint chocolate.
Medication
* H2-blockers are used, which reduce the action of histamine on gastric cells and thus reduce gastric acidity. Cimetidine (Tagamet ®), ranitidine (Zantac ®), famotidine.
* Inhibitors of proton pump that dry acid production in the stomach. Omeprazole (Losec ®), lansoprazole.
* Stimulating the motility of the esophageal sphincter. Metaclopramida (Primperam ®) Urecholine (Betancol ®).
* The surgery is performed to uncontrolled symptoms or complications of Barrett’s esophagitis. Mainly aims to correct hernias (sliding) hiatal, restoring the stomach to the abdominal cavity and closing the passage through the diaphragm so that does not happen again.