Do you run red lights when there are no cars?
In one’s life, one encounters many things, big or small, that drift around and around with time or disappear into the stars. After living for so many years, you will always feel the presence of stomach acid, more or less reflux. And about half of the patients who visit the hospital’s gastroenterology department confide in the feeling of stomach acidity.
Aunt Jia mainly described her symptoms, emphasizing belching and hiccups and an uncomfortable appetite, until I asked about it and realized that Jia had had acid reflux for several years. There was also once a sore throat discomfort.
I asked, “How come you didn’t mention this symptom?
Hey, who doesn’t have acid reflux?
It has become a habit to tolerate this state and forget what health is like. We often hear a story about a brother who always takes care of his younger brother and gives him half of everything he gets. One day, the brother no longer give him that half, the brother became very angry, feel that the brotherhood is weak, and in fact, originally is the brother’s things, why should be gratuitous constantly to the brother?
I often stand at the traffic lights, looking at the rush of people, obviously a red light, but dodging left and right to rush forward, in China has become a habit, but often people look at me with a strange look, obviously no car, you are still here waiting for what? Once this kind of thinking and habit is developed, it goes beyond the definition of quality and adds the cultural brand to the deviation from the convention. The tolerance of reflux often makes us feel: a line from the sky, acid reflux is not a problem. The key is how often we tolerate it, and whether it masks the true nature of GERD.
This is GERD
Aunt Jia’s disease is actually a condition called gastroesophageal reflux. When the stomach acid in the stomach doesn’t stay well and refluxes into the esophagus, it can cause some corrosive damage to the esophagus. Stomach acid itself is a good thing, with good bactericidal properties that kill bacteria in food and ensure the safety of the stomach and intestines, as well as increasing the activity of pepsin, which helps digestion. However, if stomach acid runs into the esophagus, its strong acidity can irritate the esophageal wall and cause inflammation of the esophageal wall.
How acidic is stomach acid?
Stomach acid is actually the acid of gastric juice, the acid of stomach is a colorless transparent acidic liquid, its PH value is 0.9～1.5. What is this concept? PH value is the international standard for measuring acidity and alkalinity, from 0～14 marks the most acidic to the most alkaline, the old Shanxi vinegar we often eat is acidic enough, the PH value is about 2.5～3, but the acidity of stomach acid is more than 2 times of that of aged vinegar. The main component of stomach acid is hydrochloric acid, and hydrochloric acid is one of the three strong acids, which is very corrosive, once it refluxes into the esophagus, it will erode the mucous membrane of the esophagus, leading to congestion, swelling and even ulcers. Patients will feel like a fire in the chest, also seems to be drinking a spoonful of vinegar in the esophagus. Some people may ask, if the acidity of stomach acid is so high and corrosive, why the stomach which is wrapped with stomach acid is not corroded?
The stomach wall secretes a mucus that forms a protective film (i.e., gastric mucosa) to protect the stomach wall. The gastric mucosa is composed of “mucus gel layer” and “mucosal epithelium” from the inside to the outside, and the total thickness of these two layers is about 1 mm, and the pH value is about 2.3 to 7.
Under normal conditions, the cells of the gastric mucosa layer are frequently renewed, and old cells are constantly shed from the surface and replaced by new cells within the tissue. According to a survey, the human stomach sheds about 500,000 cells every minute, and the gastric mucosa layer is renewed once every 3 days. It can be seen that the lining of the stomach can be completely repaired within a few days or hours after a certain degree of aggression. So it is not that the human stomach does not digest itself, but that it renews itself immediately after being digested to a certain extent.
However, acid reflux and heartburn can be caused by excessive alcohol consumption, eating too much, too salty, too sweet, or taking medication (aspirin) for a long time, etc., because, at once, these things may destroy this barrier and allow the irritation of stomach acid to reach the stomach lining. At the same time, the gastrointestinal tract receives mainly parasympathetic and sympathetic innervation, which is the main mode of communication between the brain command and the gastrointestinal connection. The parasympathetic nerve is mainly the vagus nerve, which is the positive energy of gastrointestinal power, releasing acetylcholine-like neurotransmitters that excite the movement of the gastrointestinal tract and promote the secretion of digestive juices. The sympathetic nerve, on the other hand, is the black face, and its role is to inhibit gastrointestinal motility. But sympathetic nerves act in the opposite way in the heart, so sympathetic excitement, which brings about heart excitement, inhibits the gastrointestinal. So, emotional tension and anxiety is often sympathetic excitement, which constantly inhibits the physical movement and chemical secretion of the gastrointestinal tract, and when mental stress is too much, it is also sympathetic excitement, which inhibits the secretion of the gastrointestinal tract, the mucus can not function, they begin to digest their own stomach with their own gastric juices, and to a certain extent, they will gradually corrode themselves, and develop into “gastric ulcers This will gradually erode itself and develop into a “gastric ulcer”. This can also lead to reflux, which causes acid to flow back into the esophagus.
When the stomach acid runs into the esophagus, we will experience acid reflux, heartburn, which is most likely, and may also belching, just like Aunt Jia, who thought her problem was just burping, not knowing that it was a matter of acid reflux and heartburn slightly with feet. The problem is that we usually always think of belching as hiccups. Belching and hiccups are actually quite distinguishable
Are you belching or hiccups?
We often have conversations like this in the clinic.
What other symptoms do you have?
I also have hiccups from time to time. Hiccup~~, listen, it’s exactly one.
The loud ones are hiccups and the small ones are belching.
I can’t control the hiccups, but I can sometimes control the belching.
I said, “Aunt Jia, this is not hiccups, this is belching. There is a difference between the two.
Hiccups are spasms of the diaphragm after a sudden cold, which cannot be controlled artificially, and the sound of hiccups.
Oh, it dawned on Auntie Jia that this method is common knowledge that everyone knows, and as soon as we talk about this method, that real hiccup will come to the forefront of everyone’s mind.
And as for the belching you mentioned, it is indeed a symptom of GERD. This is something that can be controlled artificially, and some of it is loud and some of it may not be. Belching occurs in normal people and is important, like “burping” in infants and children, as a way to promote digestion. However, belching should be occasional, not indiscriminate, and should be moderate.
As you said, continuous belching at regular times every night should be beyond normal and should be a symptom of gastroesophageal reflux.
Chronic cough is also one of the symptoms of GERD
Just after I sent Aunt Jia away, my cell phone rang, and it turned out to be WB’s sister from the respiratory department.
I’ve been coughing for a long time, and today I did a gastroscopy on her, and it turns out to be caused by reflux esophagitis.
Okay, I’ll be there after the room check, around 10:30.
I called my WB sister, took the chart and went to see the patient.
At the bedside, Wang Yu was coughing hard, his face was red, and his tongue was exposed because of coughing.
According to the auscultatory examination and the medical record, the cause of Wang Yu’s cough was locked in the reflux of the gastroesophagus.
She was wondering, “Doctor, I obviously have a cough and I am in the respiratory department, how can it be a digestive problem?
I asked: Do you have phlegm in your cough?
She looked back and indeed there was very little sputum.
This is a hint that it may not be an infection in the lungs, but something else. We cannot say that a dry cough with little sputum is always caused by GERD, but it is a hint.
About 20% of chronic coughs are gastroesophageal reflux, which is a reality that can be very easily misdiagnosed. The reason for this is the complexity of the disease and the difficulty we have in seeking the essence from the local. The gradual realization of the truth leads us to this line of thinking, but you should think about it when you have a cough but no lung infection, a digestive problem.
I told WB, if there is nothing wrong with breathing, transfer to our gastroenterology department.
WB nodded his head.
Why does stomach acid run into the esophagus
Whether it’s acid reflux, heartburn, or coughing, it’s all caused by stomach acid running into the esophagus. So why does stomach acid reflux into the esophagus? It’s mainly because of cardia relaxation and cardia inflammation.
Cardia and pylorus: the two barriers that cause reflux
The human body is very powerful, and various functions are in perfect coordination. For digestion, the main thing is the balance of the various tubes that move matter and energy in and out of the body.
Some people say that gastroenterologists are the plumbers of the human body, and this is true, it is important to keep this pipeline open. From the mouth to the anus, there are many valves in this digestive tract, and these valves should be opened when they should be opened, and closed when they should be closed. Only to ensure the body’s metabolism. And once the valve screw of the tube is loose, with the movement of the body, a part of the pressure will allow the formation of reflux of the contents.
The lumen of the body has the esophagus, stomach, duodenum, small intestine, and large intestine, and the valves between them are, the cardia between the esophagus and stomach, the pylorus between the stomach and duodenum, and the appendix between the large and small intestine.
The gastroenterologist is the one who has to refurbish the valves between these tubes, and the switches are at the right time. Reflux is the most important digestive disease. The most important disease of the digestive tract is that the qi is not in order. Qi reversal leads to reflux, and reflux leads to the formation of digestive disorders.
Every time I walk on the road and see people walking while eating breakfast, I worry for them, such habits are both unhygienic and healthy, and this unstable state of eating is also an important trigger for gastroesophageal reflux. Especially when eating on the bus, the feeling of being upside down, how are swallowing whole. Growing up, I encountered many times the emergency brake, the back of the people all of a sudden rushed to the front car, until one day I became a gastroenterology doctor, I realized that many times, the digestive system is a train in a hurry.
Gastroesophageal reflux and bile reflux
Anatomical location: in the order of esophagus, cardia, stomach, pylorus, duodenum
Differences in reflux: one is gastric acid and the other is bile.
The symptoms will also be different: the former is mainly acid reflux and heartburn, the latter is mainly bitterness in the mouth
Seven-line poem. Three carriages with two gates, esophageal cardia and gastric pylorus 12, the brake cardia and pylorus off is not enough, the back of the car allows things into the front compartment.
In other words, the digestive tract is like a train, in which the middle three carriages are esophagus – (cardia) – stomach – (pylorus) – duodenum. Between the esophagus and the stomach is the cardia, while between the stomach and the duodenum is the pylorus. The esophagus generally does not have passengers, and food passing through the cardia usually sits in the stomach for half an hour before passing through the pylorus into the next compartment, and usually these two doors do not turn back and close automatically. After passing through the pylorus automatically closed, there are new passengers in the duodenum on board, is secreted from the liver, temporarily in the gallbladder waiting for the bile, they will accompany a portion of food passengers greasy fat leaders to go the whole way. Some trains are fast, some trains are slow, but in any case, trains sometimes drive fast, there are brakes, when the carriages between the passages in disrepair, or attacked by rain, or leaking oil, is infected with Helicobacter pylori and other reasons, can not be closed in time, in the emergency brake, the passengers inside the stomach was thrown to the esophagus, hit hard on the esophageal wall, there was no stomach acid esophagus, it felt The invasion of stomach acid, produce acid reflux heartburn, is gastroesophageal reflux disease, due to this situation stimulates the cardia to close more, more passengers back to the esophagus, is reflux esophagitis.
And if the pylorus is not closed in time, accompanied by passengers from the third car back to the second section is bile, is bile reflux gastritis, if the brakes brake more violently, or even intestinal obstruction, then, there is also completely thrown out of the mouth bile, such as alcoholism after a drunken, mouth spitting yellow-green bile scenario.
There are many ways to avoid emergency braking. The most common symptom of emergency braking is acid reflux heartburn, and the most important western medical treatment is to inhibit the production of stomach acid and reduce the number of passengers, which will make the order of the ride then well.
Why is the cardia flaccid and why is it inflamed
From this train travel, gastroesophageal reflux is due to frequent emergency braking, age, the main reason is the relaxation of the cardia sphincter, why is it relaxed here. The main reason is aging or inflammatory irritation and physical stress. The sphincter of the cardia is a ring-shaped muscle, a circle hooped there, for the elderly, the decline in the function of the esophagus, the sphincter of relaxation, will lead to incomplete closure of the valve, should be closed when not closed, gastric acid reflux to the esophagus, and even the pharynx, oral cavity, there will be this symptom.
Eating too much can make the cardia “lose its guard”
This morning, after the checkup, we returned to the hot doctor’s office, Lao Song and Director Tang were also there, Director Tang called me and Dr. Zhao, how is the task assigned to you last week, how is the status of the general lecture done, how to speak to the patients in the whole department?
Basically, it’s done, let’s do it in the afternoon.
The talk on living with GERD was held as scheduled. Xiao Zhao and I gave illustrated explanations on the causes, diagnosis and treatment of GERD, especially life regimen.
First of all, you can’t eat too much, I drew a big stomach on the slide, a cartoon man with burping, is frowning in pain, next to the drawing of three carriages, the middle one is exaggeratedly up and full of passengers, while two passengers are squeezed to the front and back of the carriage.
I said, this is squeezed to the front and rear carriage of passengers, is the stomach acid, because there is no place to la. So when you eat too much, the pancreatic door has been closed, but the stomach peristalsis is like a train running into bumps, there is no place to go to the passenger is likely to be squeezed into the previous car. The door is also squeezed, so there are always passengers (stomach acid) in the bump forced to return to the first carriage – the esophagus, so we should not usually eat too much.
Second, reduce coffee, strong tea, and smoking. These things are like the oil between the stomach and esophagus, the cardia, which destroys the mucosal layer of the stomach and makes the cardia lose its self-opening. This slide shows a survey by the World Health Organization that smoking not only directly harms the mucous membrane of the digestive tract, but also reduces the pressure of the lower esophageal sphincter by 50%, causing inflammatory irritation. The rising smoke forms a gruesome image of a skeleton, staring malevolently at the stomach while tearing open the gate between the stomach and esophagus with a drifting hand ……
How to treat gastroesophageal reflux
We are most concerned about having this disease, how to get rid of the root cause?
Treatment is a rigorous process, but to make the treatment clear, you need to have the talent of a director and learn to tell a story. From the specific process, to understand the main points of treatment.
In the end, GERD treatment, especially in the case of long-term recurrent episodes, is a process that helps patients get off the bench.
David Zhang came to me because he was referred by a friend. He was 40 years old, and his sad face at the clinic made people feel like shedding tears. He started to have stomach pain and acid reflux and heartburn symptoms 2 years ago, and was clearly diagnosed with GERD and chronic non-atrophic gastritis after gastroscopy, and his treatment plan was to take the strongest oral acid suppressant PPI (proton pump inhibitor, lazoloid, such as omeprazole) to suppress stomach acid. Until now is still taking PPI acid suppressants, can not get rid of, so that now, emotional sensitivity and impatience, general diet, poor appetite, poor sleep, good urine and stool, worry about abdominal distension, have a history of smoking for many years, 20 cigarettes / day, have not quit.
I looked at his tongue and pulse: dark red tongue, yellowish-white coating, and stringy pulse. Based on his narrative, I considered that this patient had been troubled by stomach acid for more than two years and had used the strongest stomach acid inhibiting drug PPI (proton pump inhibitor) for more than two years, forming a dependence, and due to the inhibition of stomach acid, the digestive function was also affected to the extent that abdominal distension occurred for a long time, with recurrent illness and mental distress. I wrote two diagnoses in the medical record book.
Traditional Chinese medicine diagnosis: stomach pain (liver and stomach stagnation and heat, cold and heat misalignment)
Western medicine diagnosis: gastroesophageal reflux disease, chronic non-atrophic gastritis
Seeing this history of taking medication, considering that after 2 years of taking PPI, we can’t stop immediately, it is necessary for us to take a step-down treatment, so that the slightly weaker tidings, instead of the lazos, to relieve the stomach acidity, and not to drop too low at once. So that the step down can be steadier, so that our stomach can more easily adapt to this change, and also facilitate the body to restore its own function, produce normal stomach acid and restore normal digestive function.
Lao Zhang, there are a total of three kinds of drugs to inhibit stomach acid: according to the power of acid inhibition,: the weakest is the aluminum hydroxide component of the neutralizing gastric acid preparations, the stronger is the H2 receptor antagonists, such as a variety of titin, and the strongest is the PPI proton pump inhibitors, is our common variety of lazol. It is the drug that has been taken for 2 years.
Ah, then what to do? I’ve been taking it for two years and still not well.
Don’t worry, the three have different strengths of action, but each has its own characteristics and advantages and different mechanisms of action. We hope to gradually restore your own function, using a cooperative approach of Chinese and Western medicine.
From the TCM point of view, this stomach acidity comes from the “fire stagnation in the liver meridian”, caused by the heat stagnation in the liver and stomach, from a bad mood, sensitive and anxious personality. The liver fire offends the stomach and the stomach Qi reverts upward, resulting in acid reflux, which in turn leads to weakness of the spleen qi, resulting in lack of gastrointestinal power and abdominal distension, with some signs of blood stasis over a longer period of time.
So my prescription and treatment plan for you is as follows.
Treatment: Drain the liver and clear the fire, calm the cold and heat, and strengthen the spleen and regulate the qi
Prescription: Lian Zhu Liu Yi Wan and Han Xia Di Xie Xin Tang plus reduction (unit: g)
Huang Lian 6 Wu Zhu 3 Citrus aurantium 15 Fried white atractylodes 15 each
Radix Bupleurum 12 Radix Scutellariae Sinensis 12 Radix Macrocephalae 10 Radix Eucommiae 10
Sour date palm 20 Qing Hanxia 10 Xia Ku Cao 10 Calcined corrugated corrugated flower 20 (first decoction)
Inner gold 10 raw licorice 8
Self-prepared 3 slices of ginger 4 jujubes (broken open)
At the same time, H2 receptor antagonist-complex ranitidine 0.1*12*1 box/0.1 was given twice a day, half an hour before meals, and no more rabeprazole was used. At first he nodded half-heartedly.
Again, it is an acid suppressant, and although the mechanism of action shows that it is not as powerful as your previous drug, yet there is also multiple clinical evidence of good efficacy in patients who have not been able to suppress stomach acid with PPIs for a long time.
Chinese medicine has a different perspective than Western medicine. In GERD, Chinese medicine considers it to be a “liver” problem, with the liver fire being the initiator, igniting the side branch of the stomach fire by means of wood over earth, plus your years of smoking, which depletes the body’s spleen and stomach yin. We use Huang Lian Wu Zhu Yu to clear the Stomach Fire and promote the balance of Yin and Yang to treat the symptom of the disease. We use Chai Hu Scutellaria to combine into a liver-unblocking pair to inhibit the development of Liver Fire at its source. As important gastrointestinal dynamics drugs, Atractylodes macrocephala and Citrus aurantium can strengthen the spleen and regulate qi, balance from the perspective of tonification and drainage, and promote the metabolism of the stomach and intestines.
Chinese and Western medicines are used together, and there is a particularly important prerequisite: relaxation, and limiting smoking to 10 cigarettes/day and getting more involved in outdoor exercise. Of course it’s best to quit smoking, but in your case, I’m worried that the withdrawal symptoms of not smoking will be too much to bear all at once.
David Zhang was particularly happy when he came back, his symptoms were about one-third better, and after three follow-up visits, the symptoms gradually reduced heartburn and acid reflux did not occur, and the 5th treatment, the compound ranitidine was reduced to once a day.
This process of drug reduction was equivalent to helping Zhang gradually get off the bench. Treating with the cooperation of Chinese and Western medicine to restore his own function. Establishing a step for patients trapped on high ground, from PPI to H2 receptor antagonist, while giving them a crutch or handrail with TCM.
Gastroesophageal reflux disease can develop into esophageal cancer
After 2 days, Wang Yu has been transferred to our gastroenterology ward. The pathology report of the gastroscopy was delivered to the doctor’s office yesterday, and according to the pathology results, I gave a new account of Wang Yu’s condition during the room visit today.
Wang Yu, have you ever heard of GERD before?
No, I’ve always looked at it as breathing. Fortunately, Dr. Wang talked about it, and she said you would discuss some cases often, precisely for the sake of the patient.
Many diseases are not one-sided, and it is a gradual process for us doctors to recognize the disease and make a diagnosis for the patient, so we can’t be too anxious when we are sick.
Today your pathology report came out, and from the results of the pathology, we are one step closer to your diagnosis.
It should be Barrett’s esophagus in GERD reflux esophagitis.
Doc I didn’t understand what this means.
The most general diagnosis of your disease should be gastroesophageal reflux disease, which is inferred by the symptoms, and further based on the gastroscopy, see the inflammatory infiltration of the esophagus, you can diagnose reflux esophagitis, by doing the gastroscopy to take down the body’s tissue, sent to the electron microscope for magnification of 1 million times, you can see the squamous epithelium is replaced by columnar epithelium, you can further diagnose it as Barrett’s esophagus.
Barrett’s esophagus is a precancerous esophageal lesion, which is the intermediate process of transformation of esophagitis to esophageal cancer. However, this process is very long, and it is likely that it will not arrive in this lifetime.
Wang Yu immediately nervous, that is to say, my GERD will develop into esophageal cancer.
It’s possible, but don’t worry, I smiled at her, there are three major stages from GERD to esophageal cancer, from GERD to esophagitis there are about 30 steps; from esophagitis to esophageal precancerous lesions there are 30 steps; from esophageal precancerous lesions to esophageal cancer there are 100 steps, from this progressively deeper diagnosis it can be seen that you have gone more than 60 steps. There is no way to go backwards, but we will have a way to make you stop and not go, or go slower.
Okay, I understand, I will listen to you and treat well.
How to do self-care in life while treating
The disease comes from life, we must go to life.
After treatment, Wang Yu was discharged from the hospital and his cough had basically disappeared. I have emphasized in the discharge instructions that we need to review the gastroscopy regularly, after the first 6 months, and if there is no change, we can review the gastroscopy in a year or two years.
So what kind of porridge do you think I should drink after discharge to nourish my stomach? Wang Yu seems to be very knowledgeable about dietary health and nutrition.
Different porridge has different nutrition. So what do you eat normally? Drinking porridge is always good for the stomach, is it also good for reflux esophagitis?
Drinking porridge feels comfortable, but the effect on GERD is negative, although the porridge containing grains and cereals can indeed strengthen the spleen and stomach, but it is harmful to GERD.
If it is indigestion and other patients with insufficient gastric acid secretion, drinking porridge can be appetizing, stimulate gastric acid secretion and supplement nutrition, while GERD is too much gastric acid, drinking porridge may stimulate more gastric acid, and, fluid food is more likely to reflux back.
We should choose alkaline food is appropriate in order to neutralize stomach acid, such as hairy buns, especially the big alkali, and soda crackers, can be used as a snack to keep around.
Then can I drink coffee, I love coffee. — Wang Yu seems to have sensed that the form is not good
As for coffee and desserts, you should not eat them, both of which will also stimulate the stomach and produce more stomach acid.
For the treatment of diseases, we should not only learn how to take the right medication, but also know how to prevent and develop healthy habits.
After gastroesophageal reflux, irritation symptoms tend to lead to chest discomfort, especially when lying down, the effect of gravity, so that more and easier flow of stomach acid to the esophagus, it will aggravate the burning sensation, and even affect sleep.
This is a problem, but there are symptoms, there are countermeasures, disease from life, we must go to life. We need 3 life hacks to first solve the sleep disorder caused by GERD.
First, choose a 15-20 cm high pillow, a little higher than normal, resulting in a high head position, forming a high esophagus and low stomach, which can prevent partial reflux of gastric juice. Let gravity work for us. Second, do not eat 3 hours before bedtime, eating will bring the secretion of gastric acid, reduce dinner, and avoid snack stimulation, etc., can avoid excessive secretion of gastric acid; third, reflux esophagitis attacks are frequent, you should choose to sleep on the left side, because the stomach is in the left side of the body, the position of the stomach will be lower in this position, or the use of gravity, to reduce acid reflux.
From life, to life, to make reflux no longer have, more specifically, the disease from the mouth, but also and from the mouth to eliminate: eat high-quality but low-fat, easily digestible food is the main. Eating in moderation, do not overeat, to seven or eight minutes full is appropriate. Excessive diet increases the burden on the stomach, causing digestive dysfunction of the stomach, so that the gastric emptying slowed down. Food stays in the stomach, the pressure in the stomach increases, and food is more likely to reflux into the esophagus, causing heartburn, acid reflux, burping, bloating and other discomforts. Eating time should be sometimes zoo, three meals at regular intervals, the choice of dinner time is particularly important. Dinner should be arranged three hours before bedtime. Modern people due to work, dinner is relatively abundant, and the amount of food eaten is relatively large. Stomach emptying time is about 3 to 4 hours, dinner time is too late, sleep when the stomach contents can not be completely emptied, once lying down, the food retained in the stomach is easy to flow back into the esophagus. Before going to bed should not eat. You should also avoid eating too sweet, too salty food, minimize the intake of coffee, strong tea, chocolate, high-fat diet. Due to the existence of individual differences, different patients have different reactivity to the same food. Most patients with GERD have heartburn when they eat foods that are too sweet, but some patients have heartburn that is relieved by eating desserts. Therefore, we should make individualized records of the foods that tend to cause heartburn ourselves to avoid taking the same foods again and causing a recurrence of the disease. The belt should also be loosened to influence the reflux of acid by reducing abdominal pressure.
Regular review is important.
GERD is a digestive disease that is very prone to recurrence. Studies have shown that 20% to 80% of patients who take western medication for this disease will relapse after stopping the medication if they do not adhere to the treatment, and even in patients who use the medication for long-term maintenance treatment, 2% to 10% relapse. Many GERD patients have this experience, heartburn and other uncomfortable symptoms are quickly controlled after taking medication, once the medication is discontinued, a little carelessness in life, such as eating food that can easily cause reflux sweet potatoes, staying up late drinking strong tea and coffee, work is not smooth angry, may lead to the relapse of the disease, so that heartburn, acid reflux and other uncomfortable symptoms occur again.
Therefore, depending on the situation, you should choose six months, a year to review.
All these contents are very lifelike, remember these contents, you can be discharged, put this doctor’s instructions into your life.