THE FACTS BEHIND GASTRO ESOPHAGEAL REPUX DISEASE
The Gastro intestinal system is responsible for the essential bodily functions that gives nutrients to the body, these includes mechanical and chemical digestion of food, ingestion and propulsion of food, the absorption of nutrients like vitamins and minerals into the bloodstreams and the storage as well as the elimination of waste products from the body through feces. Once these systems have certain disruptions, then disorders will develop that will affect the gastro intestinal functions. And one of these diseases can affect the overall health of the individual. To know what is, and then let us all disorder the facts behind gastroesophageal reflux disease.
DEFINITIONA AND SYMPTOMS:
When we say GERD it means that gastric contents will flow back into the esophagus due to incompetent lower esophageal sphincter, an opening between the stomach and the esophagus. Normal, the lower esophageal sphincter will automatically close once the bolus of food when enter into the stomach, but if the lower esophageal sphincter is incompetent it does not close because of dysfunction, then the tendency is bolus of food together with the gastric acid will flow upward. This reflux usually results to esophagus or inflammation of the esophageal mucosa because of acidity brought about by gastric contents.
That is why, the most common symptoms of gastro esophageal reflux disease is pyrosis or heartburn, often occur 30-60 minutes after meals once the patient is in reclining position. Usually the patient will verbalized of regurgitations of sour or bitter gastric contents in the mouth. Another symptom is dysphagia, atypical chest pain, chronic cough, hoarseness of voice, odynophagia or sharp sterna pain upon swallowing and bronchospasm. These symptoms are all contribute to gastroesophageal reflux disease because of gastric contents back flow.
CAUSES AND RISK FACTORS:
The disease is caused by incompetent lower esophageal sphincter that is why gastric contents flow backward from the sphincter and into the esophagus. Also, it can be a result of impaired gastric emptying from partial gastric obstructions. There are many risk factors that contribute to gastroesophageal reflux disease. It includes obesity, weight gain, chewing tobacco, pregnancy, smoking, eating high fat foods, caffeine, chocolates and levels of estrogens and progesterone. Once gastroesophageal reflux disease is develop, a health restoration is prescribed and certain test will be conducted to assess further the diagnosis.
TEST AND DIAGNOSTICS:
Furthermore, there are diagnostics procedures that help the physician view the system anatomically and assess the degree of damage. First, the doctor ordered to do Berstein test. This test is important in order to differentiate between cardiac and non- cardiac chest pains. Second, is endoscopy procedure, the procedure can visualize any inflammation, lesions or erosions inside the esophagus. These can also help confirming the diagnosis. Third is the use of esophageal manometry test.
These measure the lower esophageal pressure and it also determines if esophageal peristalsis is adequate inside. Fourth, is barium esophagography, this procedure uses barium with radiographic studies in order to diagnose mechanical and any motility disorders. And lastly, there is ambulatory 24-hour pH monitoring, for it determines the amounts of gastroesophageal reflux. Once these tests and diagnostic procedures are completed and the degree of damage has been confirmed then treatment regimen follows.
TREATMENTS:
The management of gastroesophageal reflux disease has been classified into pharmacologic treatments, lifestyle modifications as well as diet modifications. When we say lifestyle changes and diet modifications, this is only applicable if the patient has a mild gastroesophageal reflux disease. These maybe sufficient to relieve symptoms suffer by gastric reflux. In order to avoid reflux of gastric contents, instruct patients to restrict the diet to small frequent feedings either it can be a 4-6 feedings per day. These will decrease the amounts of food in the stomach. Then, always drink adequate fluids at meals in order to assist food passage. Eating slowly and chewing the food thoroughly can be a big help to patient suffering from gastric reflux.
Also, avoid intake of extremely hot or cold foods, spices, fats, alcohol, coffee, chocolates and citrus juices, these will decrease acid secretions. If you are obese or overweight, losing weight is essential in order to decrease the gastroesophageal pressure gradient. Avoidance of tobacco and alcoholic beverages will also be helpful because this can exacerbate esophagitis. Also, after eating, have the head of the bed elevated up to 6-8 inches in order to prevent nocturnal reflux. If these management cannot alleviate the symptoms, them antacid therapy is commonly prescribe to neutralize gastric acid.
If esophagitis is present, H2 receptor antagonist like cimitidine and ranitidine will be helpful. This treatment will require lifelong therapy. Additionally, the use of prokinetic agents and metoclopramide (reglan) can help promote gastric emptying. Also, proton pump inhibitor like omeprazole and lanzoprazole can be helpful to block gastric secretions. However, if these treatments are not successful to relieve the symptoms that brought about by gastroesophageal reflux disease, then surgery is recommended. And one of these surgeries is Nissen fundoplication. This surgery procedure can contribute to relieve the manifestations or gastroesophageal reflux disease.
COMPLICATIONS:
On the other hand, these are the complications that develop once the gastroesophageal reflux disease cannot be controlled. One of these is esophageal stricture formation. Also, ulceration of esophagus will develop with or without fistula formation. This is commonly the result of frequent gastric reflux because of hydrochloric acid contents which can create damage to the esophageal mucosa. Another would be aspirations. Yes, aspirations are very dangerous, because this can progress to pneumonia.
And lastly, the development of Barrette’s esophagus, this means that there is a presence of columnar epithelium just above the esophageal junction which is associated with adenocarcinoma of the esophagus. These complications are very harmful to patients suffering from gastroesophageal reflux disease. Because of this, the prognosis of this condition will be very negative. Eventually, if not properly controlled, death follows. That is why, before reaching this end stage of the condition, it is important to manage carefully the degree of damage and prevent further complications to happens and most of all, help the patients relieve the manifestations of gastroesophageal reflux disease they suffer.
PREVENTIONS:
If the development of gastroesophageal reflux disease is not prevented, then it is important to prevent the symptoms to reoccur. To prevent reflux to reoccur, do not lie down for 3 hours after eating because this is the greatest time frame of reflux. Emphasize to the family of the patient to avoid foods and activities that will aggravate and exacerbate the symptoms such as fatty foods, alcohol, garlic, onions, coffee and chocolate. For activities also, avoid straining activities, tight fitting clothes, bending over and smoking. Additionally, encourage the patient to sleep with head of the bed elevated to 6-8 inches, remember do not elevate their head through pillow because this cannot be effective for reflux.
Next is to advice the patient to have weight reduction program, because this will decrease the intra-abdominal pressure, which can result to incompetent lower esophageal reflux. Most of all, always teach the patient to have smoking cessation because this can bring harm to their overall health. Also, stop or moderately drink alcohol should be follow. Because of this, the acid secretions will be minimized and can prevent gastric reflux in the long run. Patient with gastroesophageal reflux disease should have self-discipline to control things that will aggravate the symptoms brought by the disease, because this way, they can prevent the exacerbation and reoccurrence of the disease itself.
HEARTBURN TREATMENT:
Heartburn or also known as indigestions or dyspepsia is a common symptom of esophageal disease or otherwise gastroesophageal reflux disease. It is a painful sensation of burning and warmth in the lower retrosternal midline. Usually, it radiates like waves upward to the neck which result to the abnormalities of the lower esophageal sphincter. Since it is very painful to the patients, it is very important to relieve this heartburn manifestation. In order to relieve this, instruct the patient that after eating, they should remain upright by standing or sitting. Also to prevent increase of esophageal reflux and regurgitations, restrict wearing of tight fitting clothes.
On the other hand, while sleeping, always elevate the head of bed to prevent nocturnal reflux of food. Just like the management of gastroesophageal reflux disease, in heartburn, have a diet modification to ease pressure and reflux of food. Have small frequent meals for it ease the passage of foods. Instruct the patients that intake of warm and semisoft foods are encouraged that clod and hot foods. Like GERD, antacids are helpful in managing pain. Also, H2 receptor antagonists and proton pump inhibitor can be helpful in alleviating the heartburn. Bear in mind that, patient should obey this treatment regimen for them to be relieve and stop the reoccurrence of heartburn.
CONCLUSION:
GERD can be control if and only if you have self-discipline on your own. The key management for controlling and alleviating the manifestations of this condition are always lifestyle changes, diet modifications and pharmacologic treatment. The success of these treatments lies in how you manage carefully the condition. Always remember that patient who obey to their physician advices always come up to a positive result. Bear in mind that, prevention is better than cure, so, it is a big advantage if you concentrate on how to prevent the symptoms to reoccur or progress than investing on treatments that does not have possibilities to cure. It is better be safe than never.
Many people cannot really understand what is gastro esophageal reflux disease and its signs and symptoms due to the fact that this is not usually a common disease that is happening to an individual. The real meaning of the disease is a chronic symptom or damage to the mucosa that was created by an abnormal reflux of the acid in the stomach into the esophagus. Millions of people around the world experience Gastroesophageal Reflux Disease every waking day of their lives.
GERD brings Bitter mouth taste, severe coughing and painful sore throat and fatigue, which is one of the most annoying feelings you can have when you wake up. This disease can cause severe nighttime heartburn which can really give you a disturbing sleep and stress, thus resulting to inability to function well the next day. The way you live your day can also trigger the things that cause gastroesophageal reflux disease.
Thus, lifestyle plays a big role in your health. Knowing the things that causes you GERD can be very helpful to minimize the occurrence and severity of attacks. Avoid the need for drastic surgical treatments by adopting a healthier lifestyle and using a few of the natural remedies outlined in this category. Gastroesophageal reflux disease need not mean the end of your life!
