Reflux refers to the reflux of acidic stomach contents into the esophagus. This causes symptoms such as heartburn and pain behind the breastbone which occur especially after meals and when lying, difficulty in swallowing, sour taste in the throat or mouth, nausea and vomiting, hoarseness and cough.
Reflux occurs when the esophageal sphincter, sealing the esophagus against reflux of gastric contents, is leaking.
Possible complications include strictures (narrowing) of the esophagus and / or Barrett’s mucosa.
The causes of reflux (acid reflux, heartburn)
The most common causes of heartburn are the following states:
diaphragmatic hernia: Due to a large gap diaphragm (hiatal hernia) push part of the stomach into the chest cavity. By reducing the pressure of the lower esophageal lock there is an increased reflux.
Overweight: for obesity increases the pressure in the abdominal cavity. As a result, the esophagus, the stomach contents occasionally be highly compressed.
foods: sweet foods, peppermint, coffee and alcohol weaken the function of the sphincter.
smoking: Smoking inhibits the function of the sphincter
lying position: if you suffer from acid reflux, this condition is worsening due to the Gravity usually lying down. You can mitigate this problem by lifting up or put the headboard of the bed.
How is the diagnosis of esophageal inflammation detected (gastroesophageal reflux disease)?
For the definitive diagnosis is gastroscopy (gastroscopy) is best.
Here, the exact extent of the inflammation is detected and tissue samples taken to exclude chronic inflammatory changes (Barrett’s mucosa) from the feeder tube.
Sometimes additional tests of Speiseröhrenmotilität and sphincter pressure are (manometry ) and acid measurements in the lower part of the esophagus sense (pH-metry).
, the pressure measurement of the esophagus is not painful, lasts 15-20 min and assessed the function of the lower sphincter.
Upon examination, a thin pressure probe through the nose into the esophagus is introduced . In pressure measurement (manometry) and the transport function of the esophagus is examined, which can be affected at reflux with heartburn and acid regurgitation.
, the pH monitoring (acid measurement) evaluate the reflux and whether this is responsible for the symptoms.
, the investigation is not painful and lasts for 24 hours, while a thin probe is inserted through the nose into the esophagus. During the examination, the patient / interior give symptoms (heartburn, stomach pain) to. In the evaluation shows whether the complaints listed are caused by reflux.
What is Barrett’s esophagus?
Barrett’s esophagus is a complication of chronic reflux disease.
This leads to the relocation of specialized mucosa of the stomach into the esophagus, in the gastroscopy as reddish tongue mucosa visible. The diagnosis of Barrett’s mucosa is made ??from tissue samples by pathologists: one distinguishes three forms that contain a different high risk of cancer. Accordingly, the expression of Barrett’s mucosa either control gastroscopy is recommended at appropriate intervals or ablation of Barrett’s mucosa.
Treatment of reflux
Avoid fat and big meals, eat in an upright position; keep the evening meal as small as possible.
reduced weight loss acid reflux. Avoid alcohol and nicotine high coffee consumption. If your symptoms occur at night, you should use an extra pillow or high place the headboard of the bed.
using so-called proton pump inhibitors, most inflammation of the esophagus can be brought to a healing, in mild cases, other drugs sufficient (eg, H2 blockers).
Alternatively, for long-term drug therapy is surgery, called fundoplication available.