Gastroesophageal reflux disease (GERD) ,In this condition a physiological valve (lower oesophageal sphincter-LES)in the lower part of the esophagus junction with the stomach is loose or lax allowing the gastric contents to reflux or regurgitate into the stomach. This is called GERD-Gastroesophageal Reflux Disease And commonly many people refer to this as ACID REFLUX. Many times this is referred to as LAX LES in endoscopy.
Many factors may cause GERD,
1) When there is excessive intra abdominal pressure like pregnancy, accumulation of fluid in the abdomen, or mass in the abdomen This increased pressure causes reflux and heartburn.
2)Certain food groups such as dairy, spicy, caffeine , citric acid, or fried foods and eating patterns.
3)Medications that include painkillers, sedatives, antidepressants, and medications for allergies, high blood pressure, and asthma
4)Hiatus The top portion of the stomach protrudes into the chest through the diaphragmatic opening, obstructing normal meal intake.
Anyone can develop GERD. People are more likely to have GERD if they, are overweight or have obesity, pregnant woman, smoke or frequently come into contact with second-hand smoke
Heartburn(retrosternal burning), Regurgitation, The feeling of food caught in the throat, Coughing on lying down, Chest pain, Problem swallowing, Vomiting, Sore throat and hoarseness, Belching
Endoscopy, Barium swallow, Ambulatory acid (pH) probe test, Oesophageal manometry.
Usually, this is treated with lifestyle modifications and medicines like,
Avoid spicy food items, and beverages. Avoid smoking, Avoid lying down immediately after the food.
1)Antacids are given to provide quick relief by neutralizing stomach acids. 2)H-2 receptor blockers and Proton pump inhibitors are given to decrease acid production.
3)Prokinetic medicines.
If lifestyle modifications and medicines are not effective surgery-LAPAROSCOPIC FUNDOPLICATION is advised.
In this surgery the hiatus or the diaphragmatic opening is tightened and to stop reflux, the surgeon wraps the top of the stomach over the lower oesophageal sphincter. This increases pressure on the lower oesophageal sphincter and typically reduces acid reflux. Fundoplication is usually performed by a minimally invasive (laparoscopic) procedure. In this procedure, upper part of the stomach is wrapped completely or partially (Nissen fundoplication).
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