Reflux Diseases

What is Reflux?

Gastro-esophageal Reflux disease, known as gastric reflux among the public, is the return of stomach content to the esophagus. Reflux is seen when acidic stomach content comes to the esophagus and esophagus can not protect itself from this acid because of contact with acidic content for a long time.  Reflux is seen in 20% of the adults.

Stomach content is distinctly acidic because of the hydrogen ion secreted by the stomach.  If there is  back flow of bile juice from duodenum to the stomach, the content coming up from the stomach contains both acid and bile juice.  Alkaline bile juice also irritates the esophagus just like the stomach acid.  Reflux develops when acidic or bilious stomach content comes to the esophagus and when esophagus can not protect itself from acid or bilious content because of contact for a long time.

There is a flap mechanism on the lower end of the esophagus that prevents passage of stomach content to the esophagus.  The most common problem observed in patients with reflux is the looseness of this mechanism.  This situation is mostly experienced together with stomach hernia.  Stomach circulatory disorder or impaired esophagus function are other reasons that trigger this disease.

What are the Complaints if Reflux?

Epigastric burning is the most common complaint of our patients.  Also burning in the chest, acidity, bitter taste in the mouth, bad breath, bloating, belching, feeling of drowning especially after meals and when slept on a full stomach, palpitation and pressure on heart together with chest tightness may be experienced.  There may be difficulty in taking a deep breath.  In the advanced stage, chronic pharyngitis, chronic sinusitis, allergic asthma and tooth decay may be encountered.

Complaints Related With Ear Nose And Throat Diseases

• Chronic pharyngitis
• Chronic sinusitis
• Hoarseness
• Chronic irritation cough

Treatment of Reflux Disease

There are different options for the treatment of reflux starting from social measures ranging to surgical intervention.

• Social measures:  Various social measures such as raising the head of the bed, avoiding foods and beverages that trigger reflux (orange juice, pizza, beverages containing cola, etc.), not to prefer to wear too tight clothes can be fairly effective in patients who have mild reflux.
• Second option is medication.  Medication known as proton pump inhibitors (PPI) reduce secretion of acid at a great extent, thus help complaints to disappear.  However, drug therapy usually necessitates continuous usage.  When drugs are not taken, complaints are experienced again and disease acts up.  The reason is that acid secretion is inhibited only when the drugs are taken.
• Intervention models, known as endoscopic treatments, could not establish presence both in Europe and America, because efficiency of these models is not yet satisfactory.
• One of the most important options in the treatment of reflux is surgery.  Of course, laparoscopic method, that is close surgery, is preferred for this intervention.  Upper section of the stomach is surrounded and stitched to the lower end of the esophagus, in this way reflux is avoided.  Patients can be discharged from hospital 1 day after the operation that lasts approximately 45-60 minutes.  There is no requirement of medication after the reflux surgery, however patients should comply to a diet for 1- 1.5 months.  After this diet period is completed, it is possible for these patients to consume the foods and beverages that were avoided in the preoperative period.  There may be gas and bloating complaints in the postoperative lives of the patients.