General Practice 2022

Gastroesophageal reflux: what é, symptoms, causes and treatment

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Gastroesophageal reflux: what é, symptoms, causes and treatment
Gastroesophageal reflux: what é, symptoms, causes and treatment

Gastroesophageal reflux is the return of stomach contents into the esophagus and towards the mouth, causing pain and constant inflammation of the esophageal wall, and this happens when the muscle and sphincters that are supposed to prevent stomach acid get out of its interior do not function properly.

The degree of inflammation caused in the esophagus by reflux depends on the acidity of the stomach contents and the amount of acid that comes into contact with the lining of the esophagus, which can cause a condition called esophagitis, because the stomach lining protects it against the effects of its own acids, but the esophagus does not have these characteristics, suffering an uncomfortable burning sensation called heartburn.

The symptoms of reflux are quite uncomfortable and, therefore, it is important that the gastroenterologist is consulted so that an evaluation can be carried out and the most appropriate treatment can be indicated, which usually involves the use of drugs that decrease the production of stomach acid and help relieve symptoms.

Reflow symptoms

The symptoms of reflux may appear minutes or a few hours after eating, being mainly noticed by the burning sensation in the stomach and the feeling of heaviness in the stomach. Other common reflux symptoms are:

  • Burning sensation that can reach the throat and chest, in addition to the stomach;
  • Burp;
  • Heartburn;
  • Indigestion;
  • Frequent dry cough after eating;
  • Food regurgitation
  • Difficulty swallowing food;
  • Laryngitis;
  • Recurrent asthma attacks or upper airway infections.

Symptoms tend to get worse when the body bends down to pick something up off the floor, for example, or when the person remains in a horizontal position after a meal, such as at bedtime. Constant reflux can cause intense inflammation in the wall of the esophagus, called esophagitis, which, if not treated correctly, can even lead to cancer. See more about esophagitis.

Symptoms of reflux in babies

Reflux in babies also causes food content to return from the stomach towards the mouth, so some of the signs and symptoms that may indicate this situation are constant vomiting, restless sleep, difficulty breastfeeding and gaining weight and hoarseness due to inflammation of the larynx.

In addition, the baby can develop recurrent otitis due to frequent inflammation of the airways or even aspiration pneumonia, due to food entering the lungs. Know how to recognize the signs and symptoms of reflux in babies.

Causes of gastroesophageal reflux

Gastroesophageal reflux usually arises due to anatomical changes or in the functioning of the sphincter that is present between the esophagus and the stomach and whose function is to allow food to enter the stomach and prevent its return. However, when functional alterations are present, for example, it is possible for gastric contents to return to the esophagus, resulting in symptoms.

Although it is mainly related to changes in the sphincter, which may also be due to the use of some drugs that can interfere with its functioning, such as some antihistamines, antidepressants and calcium channel blockers, for example, it is possible that gastroesophageal reflux is a result of the presence of hiatus hernia or weakness of the muscles in the region.

Furthermore, some factors may favor the occurrence of reflux, such as obesity, diet rich in fatty foods, large meals, especially before bed, consumption of alcohol and caffeinated and carbonated drinks and smoking.

How the diagnosis is made

The diagnosis of gastroesophageal reflux should be made by the gastroenterologist, pediatrician or general practitioner based on the evaluation of the signs and symptoms presented by the person. In addition, some tests are recommended to confirm the diagnosis and check the severity of reflux.

Thus, an esophagusmanometry and a 24-hour pH measurement may be indicated by the doctor, which relates the symptoms presented with changes in the acidity of the gastric juice to determine the number of times reflux occurs.

In addition, digestive endoscopy may also be indicated to observe the walls of the esophagus, stomach and beginning of the intestine and identify the possible cause of reflux. Learn how endoscopy is performed.

How is the treatment for reflux

Treatment for reflux can be done with simple measures, such as eating properly or using drugs such as domperidone, which accelerate gastric emptying, omeprazole or esomeprazole, which reduce the amount of acid in the stomach, or antacids, which neutralize the acidity already present in the stomach.See the most used remedies to treat gastroesophageal reflux.

Dietary changes in gastroesophageal reflux disease are necessary, but must be adapted to drug treatment and also personalized. Generally, the person with reflux should eliminate or reduce the consumption of alcoholic beverages, foods rich in fat, such as fried foods and industrialized products and chocolate, in addition to avoiding cigarettes and soft drinks. In addition, the last meal of the day should be eaten at least 3 hours before bedtime, to prevent stomach contents from returning to the mouth.

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