Do you often feel heartburn in the upper stomach? Have you had mild cough for a couple of months though you did not catch cold? Do you wake up at night because some unpleasant pressure in the upper abdomen does not let you enjoy your rest? If you answer “YES” to the questions, perhaps should visit your gastroenterologist and find out about REFLUX and the ways to prevent it.
What is reflux and GORD
Reflux is uncontrolled return of the content of stomach and duodenum to the oesophagus. The process is a normal and may occur several times a day after meal without causing any adverse sensations or damaging oesophageal mucus. When the amount of reflux content is above normal limit and the reflux is frequent, this is GORD, gastro-oesophageal reflux disease. According to NCIB, 8.8-25.9 % of Europeans suffer from the symptoms of GORD.
Symptoms of GORD
Most of GORD patient report the main symptom of the disease, that is, heartburn. It is the burning and gnawing sensation behind the breastbone and frequent eructation with sour or bitter content after meal. The acid reflux content irritates airway mucus and causes chronic cough that cannot be explained by cold or other upper respiratory disease, morning hoarseness and throat itch, and pains and aches in chest and upper abdomen that resemble the symptoms of myocardium infarction. It is worth remembering that the symptoms in teenagers are usually associated with GORD, while in senior adult they often mean heart diseases. Also, reflux can be one of the causes of insomnia because horizontal position of the body makes it easier for the stomach content to go up the oesophagus. GORD can be suspected, if the symptoms repeat several times a week and last for over a month.
Possible causes of GORD
It is important to know why the stomach content is so bad on the oesophagus in order to understand what causes GORD. The stomach releases gastric juices, basic components of which are hydrochloric acid and ferment pepsin. The substances facilitate digestion of food proteins and act as bactericides (kill food bacteria). They also transform the gastric acids into a sour liquid that erodes oesophageal mucus just like lemon juice drops do with the sensitive skin.
What makes the acids go back to the stomach?
There is a layer of muscles that forms the lower oesophageal sphincter at the point of transition between oesophagus and stomach. When you swallow food, the sphincter releases, allows the food flow to the stomach and then contracts to prevent the stomach content to go back to oesophagus. Peristaltic (waving) oesophageal movements push food towards the stomach as well. GORD usually develops because of the disordered oesophageal sphincter contraction between meals. Sour content reflux irritates the oesophageal mucus and causes oesophagitis, which is inflammation of oesophagus manifesting as oesophageal mucus erosions and bleeding. Remember: if you vomit with oesophageal blood, the vomited content is with bright red blood addition. GORD is also caused by the gastric bottom hernia, which is the condition, when a part of the stomach slides through the diaphragm and impedes reflux prevention by the oesophageal sphincter. The possibility of GORD is much higher, if a person has both of the conditions described above.
There are also several secondary causes of GORD, including weak or poorly coordinated oesophageal movements, slower secretion of saliva to protect oesophageal mucus from the sour content, increased acidity of gastric juices and access of bile into the gastric content. Abnormal oesophageal narrowing, swallowing disorders and oesophageal cancer may develop if the processes above are allowed to continue.
How to relieve the unpleasant symptoms
Since there are many factors that may cause the bothering symptoms, treatment of the symptoms varies as well. The most important thing is to visit your family doctor or gastroenterologist immediately at the first manifestation of the symptoms because most of the GORD cases are healed by selection of proper diet. If diet fails, doctors offer pharmaceutical treatment. Most widely used and known preparations are hydrogen receptor blockers (the so-called H2 receptor blockers). Many popular drugs contain the active substance called proton pump inhibitor. It is the good choice because of the long-term effect and facilitation of regeneration of the damaged oesophageal mucus. Antacids are the drugs to reduce gastric acidity; they do not eliminate causes of the symptoms and frequent use of the drugs may have many side effects, such as diarrhoea or constipation, because they disturb the digestive function of the stomach. The drugs to strengthen weak oesophageal sphincter can also be prescribed. They have fewer side effects but may cause tiredness and confusion. Presumably, the preparation with the least side effects, which is more mechanical than chemical, is magnesium alginate, the natural substance obtained from the brown seaweed; it swells out in the stomach thus making a viscous barrier to prevent the sour content of the stomach from flowing back to the oesophagus. Its effect lasts for a couple of hours and then the substance is eliminated with excrements without an access to blood. Magnesium alginate is safe for extended use.