What is gastroesophageal reflux?
We are facing gastroesophageal reflux disease. This disease is one of the most frequent in the 21st century. We must differentiate reflux disease, reflux is sometimes physiological, as we can clearly understand in an eructation, or vomit. That's physiological, that's what we all have. The pathological is when that happens too much, that is, many times and in great quantity and number.
What causes gastroesophageal reflux?
The cause of gastroesophageal reflux, let's say gastroesophageal reflux disease, is a malfunction of a sphincter that is found separating the esophagus from the stomach, the lower esophageal sphincter. That lower esophageal sphincter is going to cause many medications to work badly, also alcohol, and those causes that produce pressure in the abdomen will cause the gastric content to tend to ascend into the esophagus. If the esophageal sphincter inside is malfunctioning, symptoms of gastroesophageal reflux will occur. As everyone will understand, what are those symptoms. The typical symptom is the retrosternal burn, behind the sternum, even if the acids come to your mouth. There are even patients who tell us that they vomit without them wanting. All that entails? An important retrosternal pain, which is also fixed in the mouth of the stomach, and sometimes, in a percentage of 20% or 30% of patients tell us they have pharyngitis. It is logical to understand: the acidity of the gastric juice can rise up to the throat, which causes burning behind the sternum and in the throat.
Is it possible to prevent gastroesophageal reflux?
Literally it can not be prevented, but it can be minimized. It is clear, when the lower esophageal sphincter, which is the control that does not raise the juice or food to the esophagus, the stomach when that sphincter is under a lot of pressure will work worse. what do I want to say with that? That all the measures that are thinning, clothes that do not compress, will improve what is gastroesophageal reflux. All those things that do not compress the abdomen. Also certain medications or the same alcohol affect the functioning of the lower esophageal sphincter. There are medicines that alter it, the alcohol also alters it. What is happening? That the sphincter does not work well, if it does not work well we will have a pathological gastroesophageal reflux and as a result, gastroesophageal reflux disease.
What treatment requires gastroesophageal reflux?
The treatment of reflux or gastroesophageal reflux disease will be divided into two parts. Medical treatment is always indicated at the beginning, or surgical treatment. The medical treatment apart from the measures that I have already said above, which are to avoid meals, avoid drugs, avoid tight clothing, as well as raise the head of the bed, medical treatment consists mainly of Omeprazole. It is a gastric proton pump inhibitor. Omeprazole has many derivatives, many people take different components, but Omeprazole is basic and is the best. If the medical treatment fails between three and six months, surgery is indicated. What is the surgery? In creating a new esophageal sphincter. Imagine that the esophagus is a neck, and the stomach is a tie. What we are going to do is knot that tie knot around the esophagus so that when the stomach pressure increases, close and there is no rise of the juices towards the esophagus with all the consequent damage to said epithelium.