Gastroesophageal reflux disease (GERD) is detected in an average of twenty percent of patients with gastrointestinal tract problems. However, after the arrival of coronavirus infection in our lives, this number began to increase. What is esophageal dyskinesia related to?
In relaxed mode
GERD is an inflammatory lesion of the lower esophagus due to recurrent reflux of stomach and duodenal contents into it. This is one of the acid-dependent diseases, where the main factor in the development is the hydrochloric acid of the stomach. Each episode of reflux indicates that the lower food sphincter (a muscular valve that regulates the transfer of contents from one organ to another) is in a weakened state. To understand, let’s look at the mechanism of the stomach. When the esophagus passes into the stomach, there is a special sphincter. When one takes a sip, it opens and the food enters the stomach. While the digestion process continues, this clamp must be closed. However, for many people, for various reasons, this modern work is interrupted and the clamp is either open all the time or slightly closed.
– The most common symptoms of GERD are heartburn, belching with air and food, reflux, dysphagia (disturbance of the passage of contents through the esophagus), pain in the epigastric region that occurs after eating and is aggravated by oblique movements, chest pain. Also, often the only sign of the disease can be hiccups, – says Candidate of Medical Sciences, Associate Professor of the 2nd Department of Internal Medicine of the Belarus State Medical University Nikolai Kapralov. – A few decades ago, all these symptoms were mainly attributed to the manifestations of chronic gastritis, however, as it turned out later, these are two diseases of a completely different nature.
In addition, GERD has bronchopulmonary, otolaryngological and even dental manifestations: chronic cough, pneumonia, chronic obstructive pulmonary disease, chronic pharyngitis, chronic otitis media and caries. This is due to the fact that the reflux of gastric contents can occur not only in the upper esophagus, but also in the nasal and oral cavities, larynx, trachea and pharynx, which eventually leads to the development of inflammatory processes. In about 5-6 percent of patients with pulmonary pathology, the underlying cause is reflux of gastric contents into the esophagus and then into the bronchopulmonary system.
Gastroenterologists call the 21st century phenomenon a significant reduction in the number of patients suffering from gastroduodenal ulcers due to the discovery of Helicobacter pylori infection and the development of effective antibiotic treatment methods. At the same time, however, the number of patients with GERD has increased. There can be many reasons for this disease. For example, genetics play a negative role: if your close relatives have GERD, the chances of developing this disease will increase. Being overweight can also lead to reflux problems: intra-abdominal pressure creates a higher position of the stomach (by the way, this is why GERD is not uncommon in pregnant women).
– Passion for strong coffee, alcohol, smoking, fatty foods also affect the wrong flow of stomach contents, as these products relax the esophageal sphincter, Nikolai Kapralov warns. – The stress factor, which was seriously discussed during the coronavirus pandemic, cannot be ruled out. By the way, today many gastroenterologists refer patients with GERD for consultation with a psychotherapist: in order to put the physical element in order, you must first solve the problem of the soul – help the patient get rid of depressive thoughts, overwork, stress.
A number of diagnostic studies are performed to detect the reflux of gastric contents into the esophagus. The main thing is the endoscopic. It allows you to assess the degree of damage to the mucous membrane of the esophagus and the gap of the open valve, as well as to control the healing process during treatment. Daily (24-hour) esophageal pH measurement is also used – a unique method introduced into clinical practice in Belarus in 1999 that makes it possible to determine the frequency, duration and severity of reflux, the effect of body position, food intake and drugs in it. Such a study allows the diagnosis to be made before damage to the esophagus occurs. For a fee, the method of daily intraesophageal pH measurement for adult patients is performed at the State Foundation “Scientific and Practical Center for Surgery, Transplantation and Hematology of Minsk”. To date, more than a thousand people across the country have been examined.
Change your lifestyle
The treatment of GERD is conservative and aims to reduce reflux, improve the esophageal lumen and protect the esophageal mucosa. Patients are advised to refrain from long-term use of drugs that cause reflux (sedatives, sedatives, etc.), to avoid bending forward and horizontal position of the body immediately after eating, not to wear tight clothes and tight belts, corsets , bandages, leading to increased intra-abdominal pressure.
– But first of all, the patient must change his lifestyle: to eliminate smoking, overeating, to normalize body weight, to eat food at least a few hours before going to bed, – advises Nikolai Kapralov. – It is important to exclude from your diet acidic fruit juices, foods that increase gas formation, to eat less chocolate, garlic and onions. Alcohol, strong coffee, carbonated beverages, spicy sauces are prohibited.
The expert suggests another technique that significantly reduces the intensity of regression during sleep: just lift the head of the bed by 20-30 cm.
BY THE WAY
The main risk of GERD is that prolonged reflux threatens serious complications, including Barrett’s esophagus (precancerous changes in the esophagus), upper respiratory tract disease – pharyngitis, laryngitis, chronic bronchitis, tracheitis, tracheitis.