Acid reflux disease.

Acid reflux disease is defined as the presence of gastric juice in the stomach is acidic (including acid or hydrochloric acid in a) reflux to the esophagus and stomach irritation. And neck. Patients with symptoms of epigastric burning. What is chronic gastritis. I have an ulcer drug that relieves it.


The disease is common. Especially in people older than 40 years the author has had the disease for many years. Experience in taking care of themselves, they know how to treat this disease as well. I would like to come again in this review. (This column was presented by this disease, once called "Gerd - gastric reflux disease" in the June issue of Medicine 2547).



¤ English name.
Disease, acid reflux disease, Gerd, gastric reflux disease.



¤ English.
Gastroesophageal reflux disease, GERD.



¤ reason.
Associated with abnormal function of the sphincter at the bottom of the esophagus (lower esophageal sphincter, LES) in normal subjects during swallowing sphincter is similar to the way the food passes into the stomach. When the food passes into the stomach until the sphincter will shrink band to block the enzyme. (As HCl) in the stomach reflux up the esophagus.

However, people with acid reflux. The sphincter at the bottom of the tube. All of this disability. A gastric reflux to the esophagus than usual. (People with gastric reflux after eating it 1-4 times, which causes no symptoms) to cause symptoms. And inflammation of the lining of the food tube.
The cause of the sphincter function remains unclear. Believed to be caused by the decline with age. (The disease usually occurs in people older than 40 years) or the sphincter does not fully develop (in infants) or a congenital anomaly.
The disease is associated with obesity. Health conditions and diseases, diabetes, respiratory diaphragm (hiatal hernia), which flow into the stomach to the diaphragm.



It also found that the catalyst for a major disease progression.
o How much to eat. (Eating a large meal or volume) stimulate the secretion of gastric juice was good. With the expansion of the stomach and the sphincter relaxes.

o lying down (especially within two hours after eating) to sit down low in the curve begins to flow more easily.

o the belt tight. Waist or wear it, it increases the pressure in the stomach and gastric reflux.

o drinking alcohol or caffeine (eg coffee, tonic), and stimulates gastric acid secretion and more. Added to the sphincter relaxes too.

o A diet high in fat and fried food, fried rice with the oil. The gastric slow motion. A greater chance of acid reflux.

o Smoking, drinking alcohol and carbonate (soda), eating spicy food and onions, garlic sauce, tomato juice, tomato juice, grape juice, sour (eg orange juice), fruit tart, chocolate or peppermint for use of certain medications (such as bronchodilators drugs Antigua Colin Energy Logic. Pressure-lowering drugs, beta-blocking and anti-calcium group. Psychoactive drugs. NC State women's profiles, etc.) to strengthen the sphincter relaxes. Or more acid secretion.

o Asthma is believed to be the result of coughing and breathlessness. Increased pressure in the abdomen. Cause acid reflux.

o Epe years and the effect of the opium derivatives. Make food more slowly into the intestine. It has acid reflux.



¤ symptoms.
Patients who have symptoms of epigastric or chest pain at 30-60 minutes after eating or after eating to lie down, sit down, bend down low on the belt tight. Waist or wear it. Often have more than 2 times per week and the symptoms Intermittent chronic pain is often a time for 2 hours.

Some pain is pain from a fracture to the pharynx. (Similar to symptoms of myocardial infarction), or cork with a tight chest. (Similar to indigestion), or may have nausea, frequent burping or a lump in throat, neck.

Some may have the reverse, or mirror the gastric juice, sour (acid regurgitation) up to the throat. Or feel bitter or sour taste of bile acids in the mouth or throat. Or breath odor.

Some may have no symptoms or burning stomach pain, dry cough, but Belching. (Especially after eating. Or you are in the infantry), difficulty swallowing or chest pain when swallowing.

Some may feel bitter, I wake up in the throat, hoarseness, sore throat symptoms Eprigiwpak may bite your tongue or I (as a pillow to sleep at night. The reflux of gastric irritation to the throat, larynx and trachea), which is a chronic disease of months. Patients often seek medical pathology Ear - Nose - Throat. Which will be diagnosed with acid reflux disease.



¤ a separate disease.
Burning epigastric pain tight chest or neck Belching may be caused by other causes such as

o Diseases of Epe. (Wounds or wound stomach small intestine), patients have epigastric burning was hungry. (Before meals), or cork tightly after each meal. There may be associated with nausea or vomiting.

o gastric cancer. Patients have similar symptoms. Diseases of Epe. I will continue to have symptoms of vomiting, weight loss or black stool.

o myocardial infarction. Patients who have symptoms of epigastric cork tightly. I'm up to the neck, jaw or upper arm for hours to be consecutive days. Often feel tired or dizzy shake with the wind.
Sore throat, hoarseness, chronic cough may be separated from other causes such as inflammation of the larynx, throat, larynx, lung inflammation, tuberculosis, lung cancer, etc.



¤ diagnosis.
Doctors often diagnosis of symptoms, including epigastric burning pain in the chest and neck tight Belching after eating at a catalyst. Or have behaviors that cause relapse.
In unclear cases, such as X-ray examination may be performed by a gastrointestinal barium swallow flour. Or endoscopic examination of the esophagus and stomach. They can be separated from acid reflux disease, ulcer Epe. Stomach cancer. And other causes.



¤ Self.
People who have a tight chest or neck epigastric burning Belching. The treatment of drug resistant acid liquid (antacid) 15-30 per ml, 4 times a day and notice that there is a recurrence of any food or behavior. Should be avoided.

See your doctor if any unusual characteristics of any of the following.

o have a pain in the neck, jaw or upper arm.

o symptoms, fatigue, vomiting, fatigue, pale yellow eyes, black stool. Or weight loss.

o More than 40 years of age.

o anti-acid pills a week and a great relief. Or a relapse after treatment.

o they are concerned or unsure of themselves.



When doctors found to be acid reflux disease, it should behave as follows.

o the full continuum of drug on the advice of a doctor.

o If you are overweight or obese. Should find a way to lose weight.

o Note that the consumption of any of the symptoms. I try to avoid such foods, it (the rice with the fried the chicken in oil), spicy food and onions, garlic, alcohol, tobacco, tea, coffee beverages with caffeine, soft drinks, juices, citrus fruits and sour sauce, tomato juice, tomatoes, chocolate, certain drugs.

o Avoid eating large amounts of food. (Real or not) and avoid drinking lots of water. During the meal. I ate dinner in a small interval of time to sleep and leave at least 3 hours.

o after eating should release the belt and pants and a loose hook. Do not lie or sit down in the lower curve should stand or sit up straight and feel the stomach. Avoid heavy lifting and other exercise after a meal.

o Regularly exercising and relaxing. Because stress has contributed to increased acid secretion. Recurrent symptoms.

o If there is a relapse into sleep. Or wake up in the morning. A sore throat, hoarseness, sore tongue, I should support the head 6-10 inches high by supporting the head and legs are high. Or special equipment (bed wedge pillow) under the mattress conforms to the slope angle of the head down to waist level. The hotel has a mechanism to adjust the head high. How many pillows are not recommended for high boost. It may cause abdominal curls. Abdominal pressure increases. The pressure begins to flow.



¤ treatment.
Medical therapy is the introduction of such practices. And drug treatment, which may be parallel or parallel to one of the following.

o The acid liquid drug (antacid) 15-30 per ml, 4 times a day in combination with reduction of the acid group of anti-H -2 (H2 antagonist) as well as native New York (ranitidine) 150 mg per day. 1 tablet, 2 times of some medical drugs may be enhanced by close-ups of the gastrointestinal tract, such as the Methodists to no end. (Metoclo-pramide), 10 mg 1 tablet 3-4 times a day with.

o The reduction of the acid as a drug resistance profile, ie, the pump (proton-pump inhibitors), such as the Grand Old Sol's (omeprazole) 20 mg 1-2 times a day.

The first start of treatment. The same drug for 4-8 weeks in patients who have symptoms or a very long time, it may be 3-6 months after stopping the drug if the patient does not have such a behavior, or eating foods that trigger symptoms. I would also recommend that patients with recurrent drug (Parallel to that used to work) as soon as I have. Do not leave it for several days, may take only 3-5 days is enough, but if the symptoms recur frequently or leave it for several days. It may take long time.


Patients need to follow to prevent disease progression, strictly and continuously. It can be free of symptoms and complications. If you need medical treatment relapses from time to time and so on.
In cases where the drug is ineffective or complications can be treated with surgical repair using endoscopic sphincter into the abdominal cavity. (Laparoscopic fundoplication) or other means. (Which were in many ways).



¤ complications.
If it is a chronic, long time. Some potential complications are common. Inflammation of the esophagus. (Esophagitis), patients with chest pain when swallowing. If not treated. Later it may become ulcerated esophagus (esophageal ulcer) patients may have symptoms such as bleeding, vomiting of blood. Melena may eventually cause esophageal stricture (esophageal stricture), patients have difficulty swallowing, vomiting, and often have to stretch the esophagus using a tool from time to time. You may need surgery.

Some patients may have changes in the cells lining the esophagus to become. Barrett esophagus (Barrett?? S esophagus) which can be diagnosed by endoscopy and biopsy to prove the esophagus. Patients with this condition have an esophagus cancer is about 2-5 percent of the time, swallowing pain, difficulty swallowing, frequent vomiting, weight loss.

In patients with acid reflux to the pharynx and trachea may become inflamed throat, bronchitis (chronic cough, sore throat), larynx, inflammation (swelling, hoarseness an audio cable) frequent asthma exacerbations. The juice flows into the bronchial irritation.

Serious complications, including pneumonia and aspiration of gastric juice into the lungs (aspiration pneumonia), which is common in infants aged 1-4 months, the disease is also a factor in the pathogenesis of chronic sinusitis. Erosion of the teeth and the bite of a protease for a long time.



¤ progression.
If diagnosed and treated early. And continuous. The trial was conducted, it will help to mitigate the disease or recovery. After treatment but may recur from time to time I have to eat from time to time to recurrence of symptoms. (For pregnant women. After birth, symptoms may disappear by itself).
If not abandoned, but not the drug itself, it is often severe. And various complications.



¤ protection.
People with acid reflux disease. I need to prevent disease progression with the rules is a serious and continuous (see the "self").



¤ prevalence.
The disease is common. It is the first. The symptoms of epigastric burning in a private firm that has about 10-15 percent of people with such symptoms is more common in people older than 40 years, but it may be found in children and young people. In men than in women about three times.