Gastroesophageal reflux occurs when stomach acid moves up into the esophagus and causes burning or burning in the throat. The causes can be diverse but early diagnosis is essential to avoid possible future complications.
Gastroesophageal Reflux (GER), as stated by experts in General Surgery, is the disorder caused by the passage of stomach contents into the esophagus. The esophagus is a tube that connects the mouth with the stomach, crossing the thorax from top to bottom, and, therefore, adapted to contain food and saliva, but not the corrosive gastric juices. These acids, as they rise up into the esophagus, can produce a burning or fiery sensation in the chest, can irritate the throat and cause throat clearing and bad breath, and can even pass into the respiratory system and cause coughing or laryngitis. Another serious consequence of GER, when maintained over time, is that it can cause a special type of esophagitis called Barrett’s esophagus, which can lead to esophageal cancer.
Causes of Gastroesophageal Reflux
We all have reflux to a greater or lesser extent, but in some cases it is excessive and starts to cause more or less important problems. The fundamental cause of excessive reflux is the loss of strength in the muscle that acts as a valve to prevent the return of gastric contents into the esophagus. We call this valve the Lower Esophageal Sphincter (LES) and it can be weakened for many reasons: first of all, it is a muscle and, like any other muscle, in some individuals it is stronger than in others. But, in addition, some diseases can further weaken the sphincter, including hiatal hernia. On the other hand, certain beverages and foods such as alcohol, garlic, tomatoes, fats and nuts also favor the opening of this sphincter and, therefore, reflux. Finally, other factors that increase reflux are those that increase pressure on the sphincter: obesity, hypertrophy of the abdominal musculature, large meals, head down or lying down position or the use of tight clothing.
Diagnosis of Gastroesophageal Reflux
The fundamental test for the diagnosis of GER is called phmetry (pronounced pe-achi-metry) and consists of the introduction of small tubes through the nose that allow the acidity at different points of the esophagus to be measured over a 24-hour period. Esophageal manometry is performed in conjunction with phmetry and provides information on the strength of the LES and the motility of the esophagus. Gastroscopy and barium gastroduodenal study allow the diagnosis of esophagitis or Barrett’s esophagus and hiatal hernia, if present.
Treatment of Gastroesophageal Reflux
Depending on the severity of the symptoms or the inflammation of the esophagus, we can use these 3 forms of treatment in isolation or in combination:
1) dietary treatment, which avoids situations that favor reflux.
2) pharmacological treatment: to reduce the acidity of the gastric juice
3) surgical treatment: by means of laparoscopy a valve system is created that replaces the effect of the LES and provides the most definitive solution.
Recommendations for Gastroesophageal Reflux
Therefore, the 7 measures that we can recommend if you suffer from heartburn or cough due to reflux are:
1. Maintain an adequate weight and avoid tight clothing.
2. Elevate the head of the bed (for example, by placing a fat book on the legs of the head of the bed base).
3. Do not go to bed after eating (allow a couple of hours).
4. Do not smoke. Its carcinogenic effect increases the risk of GERD.
5. Avoid alcohol and foods that cause reflux (garlic, tomatoes, nuts, fatty foods), especially at dinner.
6. Avoid large meals. It is better to eat several small meals than one large one.
7. Get in the hands of a specialist. There are effective remedies for this problem and not taking care of it, besides enduring the symptoms of burning, coughing or halitosis for a long time, can have very serious consequences.