Stating that in a healthy person, the esophagus protects from stomach acid, through the valve mechanisms between the stomach and the body’s own special fluids, Öziş said, “If there is a looseness in the valve between the stomach and the esophagus, a disorder in the anti-reflux barrier between the stomach and the esophagus as a result of sliding type gastric hernia. If there is a decrease in the acid cleansing of the tube, a delay in gastric emptying, an increase in gastric acid secretion, the esophagus will not be able to protect itself sufficiently from this stomach acid. used the expressions.
Emphasizing that reflux disease is quite common in the society and its frequency has increased over the years, Öziş said:
“A week at least more than once in the chest, burning and / or when defined as not watering mouth, incidence of 20 percent in Turkey. Refluxing we consider as Geographical disease incidence in Eastern Anatolia, Central Anatolia, Mediterranean and compared to other regions of the Black Sea region it is common. Women are increasing in incidence in elderly patients. the incidence of reflux similar to that in western countries, in Turkey.
If we talk about reflux symptoms, we can divide them into 2 groups as typical and non-typical symptoms. Typical symptoms are: heartburn, burning in the mouth, bitter water in the mouth, burning in the chest, burping, gas, bloating, less frequently increased saliva secretion, vomiting of undigested food, difficulty swallowing, pain when swallowing. Reflux disease, depending on the severity and duration of the damage in the esophagus, may cause complications such as tissue change in the lower end of the esophagus for the purpose of protection from stomach acid, which may have cancer potential in the future, which may predispose to esophageal cancer, stenosis and bleeding in the esophagus. Atypical symptoms are non-cardiac chest pain, chronic cough, pharyngitis, frequent throat clearing habits, pneumonia, asthma, hoarseness, ear infection, sinusitis, tooth enamel loss, bad breath, aphthae. “
“Do not go to bed immediately after eating”
Ayşegül Öziş stated that the pH meter, which is used for upper gastrointestinal system endoscopy and measuring the ph of the esophagus, is one of the most sensitive methods in diagnosis.
Öziş said, “By performing upper gastrointestinal system endoscopy, differential diagnosis of diseases that may cause similar complaints such as stomach ulcer, stomach cancer, gastritis can be made, at the same time, it is evaluated whether there is damage in the esophagus, valve laxity between the stomach and esophagus, gastric hernia. The diagnosis of complications such as Barret esophagus, esophagus tumor, esophageal stricture, bleeding can also be made during endoscopy. If deemed necessary during endoscopy, biopsy (piece) is taken from the esophagus and opportunity is provided for tissue diagnosis. used the expressions.
Classifying reflux treatment as “diet”, “lifestyle changes”, “drug therapy”, “surgical and endoscopic treatments” Öziş said:
“Considering that reflux disease is a chronic and recurrent disease, education and suggestions about the changes that patients will make in their lifestyle and eating habits are very important. We recommend eating small and frequent meals, not going to bed immediately after eating, staying in a standing or sitting position for 2-3 hours, not smoking, not gaining excess weight, avoiding tight clothes.As excessive fatty foods cause more acid release from the stomach, avoiding fatty meals. We recommend avoiding carbonated beverages such as chocolate, coffee, alcohol, cola, pickles and very spicy dishes.
Drugs that prevent gastric acid secretion, drugs that neutralize the existing stomach acid, drugs that prevent acid contact with the mucosa by forming a gel layer in the acidic environment of the stomach, drugs that increase gastric motility are used as drug therapy. Surgical indications for GERD include patients who are young and cannot stop using acid-suppressing drugs due to their symptoms and therefore have to use drugs for a long time, patients who cannot use drugs used in reflux treatment due to side effects, patients who do not want to take drugs for a long time, recurrent pneumonia, asthma, Surgical treatment is performed in patients with atypical symptoms such as the escaping of the contents into the trachea and in patients with complications due to reflux disease. In surgical treatment, the valve between the stomach and esophagus is strengthened by the upper part of the stomach. If the patient has an accompanying gastric hernia, this is corrected during the operation. “
Öziş stated that reflux operation is not recommended in patients who are overweight and have reflux due to the possibility of a significant recurrence after surgery, and that obesity surgery is recommended for these patients.