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Gastro-esophageal reflux disease – treatment and prevention

Gastro-esophageal reflux disease is the occurrence of the characteristic symptoms or the presence of erosions in the esophagus caused by the reflux of gastric acid from the stomach. Gastric reflux is caused by a pathology of the lower esophageal sphincter function.

Reasons and risk factors

Disruption of the natural barrier between the esophagus and the stomach is usually not caused by a single apparent cause. However, there are risk factors that increase the likelihood of developing the disease.

Chorobą refluksową przełyku: Pani bierze biało-czerwoną tabletkę, która leży na stole

Reflux disease may appear secondary to: diabetes mellitus, hormonal disorders, rheumatic diseases, taking certain medications, alcohol consumption, obesity and pregnancy.

Symptoms and sequelae

Symptoms of gastro-oesophageal reflux disease may be aggravated when lying down, bending over, and after a fatty, heavy meal.

The most common symptoms of regurgitation in the stomach include burning behind the breastbone (heartburn), hoarseness (especially in the morning), dry cough and chest pain.

Reflux disease is not only associated with severe symptoms. The consequence of untreated disease is the appearance of a precancerous condition which is the so-called Barrett’s esophagus. It is a condition of cell replacement in the esophagus caused by chronic damage to the epithelium from alleged acidic food. The abnormal esophagus can become neoplastic. Barrett’s esophagus does not cause pain or any other subjective symptoms, and diagnosis requires endoscopic examination performed in a hospital setting.

Due to the risk of malignant neoplastic disease, there are specific alarm symptoms that may indicate the presence of neoplasm. These symptoms include dysphagia, pain upon swallowing, sudden weight loss and gastrointestinal bleeding. The presence of at least one of these symptoms requires rapid, accurate diagnosis.

Treatment of acid reflux disease

Reflux disease is a chronic disease. In order to treat ailments, it is necessary to follow the recommendations constantly, even for the rest of your life.

The general recommendations are: A diet with a limited amount of fat, coffee and alcohol, weight loss (only for obese patients), refraining from eating immediately before going to bed, raising the head of the bed.

Drug treatment is based on an attempt to reduce the acidity of the stomach contents. The most commonly used drugs reduce the secretion of hydrochloric acid in the stomach (proton pump inhibitors – PPIs), e.g. omeprazole, pantoprazole, esomeprazole, lansoprazole, dexlansoprazole, rabeprazole. They are one of the most commonly prescribed drugs in primary health care (POZ).

Surgical treatment in gastro-esophageal reflux disease is sometimes used to reduce the doses of drugs or when other treatments are ineffective. The method requires a careful analysis of all the positive and negative effects of the operation.

The appearance of GERD symptoms often requires, in addition to taking medications, extended diagnostics such as endoscopy, X-ray contrast or a 24-hour pH measurement. Adherence to medical recommendations and thorough diagnostics minimize the risk of dangerous complications of the disease.

Literature:

Szczeklik, P. Gajewski, Interna Szczeklik.

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