Gastroesophageal reflux disease (abbreviated as GRED) is a clinical syndrome characterized by heartburn and acid reflux caused by the reflux of stomach and duodenal contents into the esophagus. It can be simply described as the feeling of acid reflux into the throat, as if there is a fire burning in the chest cavity, which is aggravated after meals and when lying down.
The survey found that 8.16% of people in Shanghai have reflux symptoms, similar to the findings in Beijing and Xi’an. Due to the late recognition of GERD, the majority of people have not yet included GERD in the concept of the disease, so many people are suffering from it and do not know how to solve it.
What are the symptoms of GERD?
Common symptoms are acid reflux, heartburn, regurgitation, belching, and angina-like retrosternal pain episodes, aggravated after meals and when lying down, which are characteristic symptoms of this disease. GERD also has a number of atypical symptoms that are more difficult to detect, such as hoarseness, foreign body sensation in the throat, throat congestion, chronic cough, asthma, etc., which often lead to misdiagnosis. When these symptoms occur, you need to go to a regular hospital for consultation or treatment.
Prevalent groups
Gastroesophageal reflux disease usually increases slowly after the age of 30, and is often related to changes in lifestyle habits, high-fat and high-calorie diets, and obesity, which increases the prevalence of the disease after weight gain.
Bad habits mainly include overeating, excessive alcohol consumption, eating very full every time, especially in the evening before going to bed 2 hours to eat, when the food in the stomach has not been completely emptied, when lying down to rest is easy to cause reflux.
In addition, the accelerated pace of life now, in fact, with less sleep, obesity are related; obesity and reflux disease, and less sleep is a “triangular relationship”, and promote each other. If the pressure can be less, the usual life can be a little easier, rest a little better, not too fat, reflux disease will also be less.
The current treatment methods for GERD include: general lifestyle improvement, medication, which can control most GERD symptoms through medication and lifestyle adjustment, and finally, gastroscopic treatment and surgical fundoplication, through which the majority of patients’ symptoms can be significantly relieved and controlled after control and intervention.
Drug treatment
Drugs to inhibit acid secretion: proton pump inhibitors and H2 receptor antagonists
The more commonly used proton pump inhibitors include esomeprazole, omeprazole, pantoprazole, etc. H2 receptor antagonists such as cimetidine, ranitidine, famotidine, etc. are particularly suitable for patients with severe symptoms and esophagitis. It can reduce 24-hour gastric acid secretion by 50%-70%, but cannot effectively inhibit gastric acid secretion stimulated by feeding, so it is suitable for patients with mild and moderate symptoms.
Gastric stimulants: such as cisapride, the effect of these drugs is to increase the pressure of the lower esophageal sphincter, improve the peristaltic function and promote gastric emptying, so as to reduce the esophageal reflux of gastric contents, and reduce its exposure time in the esophagus.
For a patient with GERD who is first diagnosed, we require 4-8 weeks of treatment, which on the one hand can significantly control the patient’s symptoms and on the other hand can heal the patient’s esophagitis. GERD is a chronic disease and it can actually recur, except for the initial treatment. Our current treatment is to control gastric acid, once the acid secretion is restored, the symptoms will soon return and the inflammation of the esophagus will also return. Therefore, after the initial treatment, a maintenance therapy is often needed.
In maintenance therapy, if there is no clear-cut esophagitis, we emphasize on-demand therapy. This can significantly improve the patient’s quality of life and also significantly reduce the dosage of proton pump inhibitors. In the case of patients with very pronounced esophagitis, it is often necessary to take the medication daily, but long-term maintenance with a dose that was halved at the start of treatment can be considered.
”Self-treatment”
Although most people’s symptoms of acid reflux and heartburn can be relieved or disappear completely with the help of a doctor, objective facts tell us that GERD is a chronic recurrent disease, and there is no method at home or abroad that can achieve a complete cure for the disease – so that it does not recur again. We should look at the disease rationally and change the idea of “once and for all”. Therefore, it is very important to make adjustments to your lifestyle and diet.
1, avoid alcohol and quit smoking. Because tobacco contains nicotine, can reduce the lower esophageal sphincter pressure, so that it is in a relaxed state, plus reflux; wine is the main component of ethanol, not only can stimulate gastric acid secretion, but also can make the lower esophageal sphincter relaxation, is one of the causes of gastroesophageal reflux.
2, pay attention to a small number of meals, eat a low-fat diet, can reduce the frequency of reflux symptoms after eating. On the contrary, a high-fat diet can promote the release of cholecystokinin from the small intestinal mucosa, which can easily lead to reflux of gastrointestinal contents.
3, dinner should not be eaten too much, avoid lying down immediately after the meal.
4, obese people should reduce weight. Because excessive obesity increased abdominal pressure, can promote gastric reflux, especially lying position more serious, should actively reduce weight to improve reflux symptoms.
5, the head of the bed at bedtime should be raised 10 cm -15 cm overall, to reduce the night reflux is a proven way.
6.Minimize activities that increase intra-abdominal pressure, such as excessive bending, wearing tight-fitting clothes and pants, tightening the belt, etc.
7, In short, all habits that can make acid reflux should be avoided.
People’s awareness of this disease is not high, and only a few people can actively seek medical attention. We just need to remember that acid reflux is the main cause, acid suppressants are the main treatment medication available, and lifestyle changes are an important way to prevent acid reflux.