Gastroesophageal Reflux refers to the return of some of the contents of the stomach into the esophagus (the duct connecting the mouth to the stomach). The stomach produces gastric juices, very acid substances that help digest food. The wall of the esophagus is not designed to resist the acidity of the contents of the stomach. Reflux, therefore, causes inflammation of the esophagus, which results in sensations of burning and irritation. Over time, there’s a lesion to the esophagus. Note that a low-level of reflux is normal and inconsequential and referred to as physiological (normal) reflux.
In most patients, reflux is due to a malfunction of the lower esophageal sphincter. This sphincter is a muscular ring located at the junction of the esophagus and the stomach. Typically it is tight, preventing the contents of the stomach from ascending to the esophagus, opening only to let ingested food pass and thus acting as a protective valve. In the event of reflux, the sphincter opens at bad times and lets up the gastric juices of the stomach. People who suffer from reflux often have acid regurgitation after a meal or at night. This phenomenon of regurgitation is quite common in infants because its sphincter is immature.
Gastroesophageal reflux may also be linked to a hiatal hernia. In this case, the upper part of the stomach (situated at the junction of the esophagus) “ascends” with the esophagus into the rib cage through the orifice of the diaphragm (the Hiatal orifice). However, hiatal hernia and gastroesophageal reflux are not synonymous, and the hiatal hernia is not always associated with reflux.
Prolonged exposure of the esophagus to acidic gastric substances can cause:
It is not accompanied by any particular symptoms but detected by endoscopy because the normal gray-pink color of the esophagus tissues takes on a flaming pink-salmon color. Barrett’s esophagus exposes him to the risk of ulcer and, above all, esophageal cancer.
Gastroesophageal Reflux can also cause complications at a distance:
The main symptoms of Gastroesophageal Reflux appear especially after meals or in lengthened position:
Reflux can also result in less frequent and more general symptoms:
In infants, the symptoms of reflux are as follows:
Alarming symptoms lead to seeing a doctor immediately, as they may indicate a complication or other illness:
Smoking (cigarette, cigar, pipe) increases the risk of gastroesophageal reflux. Smoking cessation, with the adoption of other lifestyle measures, can help alleviate the symptoms.
Whether you are taking a medication for gastroesophageal reflux or not, it is essential to put in place the measures of prevention of the recurrences listed above and to modify certain habits of life. If this is not enough, people with regular reflux can get a simple and effective treatment to relieve their symptoms. However, as reflux is a chronic disease, it is sometimes necessary to continue taking medication over the long-term.
Several drugs administered to decrease gastric acidity:
These are the most effective medications to treat reflux, but they can cause side effects if not taken properly. It is therefore essential to follow the recommendations of your doctor. Depending on the age of the disorders, an endoscopy, prescribed. In addition, as a supplement to medication, the doctor sometimes recommends that certain foods be excluded or restricted.
30% to 40% of people with gastroesophageal reflux disease continue to have signs of reflux or feel embarrassed despite proper treatment. The majority of reflux symptoms resistant to PPIs are secondary to “no pathological reflux.”
Good to know: Some specialists sometimes recommend a vitamin supplement to people who are under anti-reflux medication to avoid certain deficiencies. According to some, a deficiency of vitamin B12, vitamin C, magnesium, possibly iron, can occur. Indeed, anti-reflux drugs can decrease the absorption of nutrients and certain medications. If you are taking any other medicines, consult your doctor or pharmacist.
If medications fail, surgery to treat gastroesophageal reflux is possible. However, it is reserved for people with severe complications such as severe nonresponsive oesophagitis associated with a large Hiatal Hernia. It is rarely practiced.
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