Gastroesophageal reflux is the passage of gastric or duodenal contents into the esophagus through the cardia. Although it is a physiological phenomenon that occurs after eating, it becomes pathological when episodes become more frequent and prolonged, leading to clinical symptoms or esophageal mucosa lesions. When gastroesophageal reflux is pathological we believe that this is a disease (GERD).
Causes and consequences of gastroesophageal reflux
The mechanism is complex reflux, occurs by excessive relaxation and late LES (Lower Esophageal Sphincter). Engine malfunction esophageal and gastric distention slow stomach emptying favor that constant reflux episodes occur.
The greater or lesser severity of reflux is given by the number of episodes for the duration thereof and the characteristics of the material flows, which can be acidic, if coming from the stomach, or alkaline, if the material is mainly of origin duodenal.
In normal esophagus it has mechanisms to neutralize these materials flow back through the cardia, but reflux disease these mechanisms also fail. The most common cause of GERD is the sliding hiatal hernia.
The direct consequence of GERD is esophagitis, an inflammation of the lining of the esophagus. Also it produces healing ulcerations, increased thickness of the esophageal wall and appearance of what we call Barrett's esophagus, an abnormal change of cells of the esophagus.
Treatment of gastroesophageal reflux
The main goals of treatment will be to eliminate symptoms and prevent future complications. Initially be conservative treatment, since most cases are controlled by medication. Surgery is reserved for cases refractory to medical treatment or in case of complications.
The treatment will be based on two pillars:
• On the one hand, there are medicines that block the production of acid, with drugs, help the stomach emptying.
• On the other, there are the changes in habits and dietary measures: raising the head of the bed, avoid increased abdominal pressure, avoid overweight, constipation, the use of belts and suppress consumption of snuff and alcohol. It is also advisable not to sleep immediately after dinner, and avoid fatty foods, chocolate, coffee, citrus, etc.
What can happen if GERD is left untreated?
Check if gastroesophageal reflux is not treated by a specialist in surgery can produce a substantial decrease in the quality of life for the inconvenience reflux. Eventually it can lead to scar stricture of the esophagus, which may involve swallowing difficulties, the emergence of so-called Barrett's esophagus, which is potentially a pre-malignant lesion.