What is Reflux? What are the Symptoms?

What is Reflux? What are the Symptoms?

Reflux is the movement of stomach contents into the esophagus. In reflux, the upward movement of stomach contents causes acid damage to the esophageal tissues. The most important symptom of reflux is heartburn. In order to treat reflux, the underlying cause must be found. Reflux is caused by factors such as obesity, pregnancy, hiatal hernia, medications and smoking. Depending on the underlying cause of reflux disease symptoms, lifestyle changes, medication and surgical treatment can be applied. If you are experiencing reflux symptoms, you should consult a specialist doctor for symptom relief.

What is Reflux?

Reflux is the movement of stomach acid into the esophagus. The direction of movement of food in the stomach should always be downward. However, if this situation is reversed, that is, if the acid in the stomach moves towards the esophagus, reflux occurs. Reflux can occur occasionally throughout a person’s life. However, if a person experiences reflux attack symptoms twice a week, reflux is no longer a disorder. When reflux becomes chronic, it is called gastro-esophageal reflux disease (GERD).

What are the Symptoms of Reflux?

The movement of stomach acid into the esophagus irritates the tissues. People who experience reflux due to this may feel the following symptoms:
  • Painful burning in the chest
  • Vomiting
  • Difficulty swallowing (dysphagia)
  • Regurgitation (stomach contents coming into the mouth)
  • Heartburn
  • Bad breath
  • Tooth decay
  • Sore throat
  • Asthma symptoms such as chronic cough and shortness of breath
Symptoms in young children and infants can be from different systems, such as the respiratory system or the ear, nose and throat. As a result of affecting these systems, allergic reflux symptoms such as cow’s milk allergy may occur. But these allergies may not be caused by reflux. Therefore, allergy and reflux should be differentiated well.

What Causes Reflux?

The muscles at the entrance and exit of the stomach, which control the direction of movement of the stomach contents, are called sphincters. The most important of these is the lower esophageal sphincter between the stomach and the esophagus. The lower esophageal sphincter opens when food arrives and allows food to pass into the stomach. It closes after the food reaches the stomach. However, in reflux, the lower esophageal sphincter does not close completely and is loose. This can cause stomach acid to leak into the esophagus. The factors that cause this situation are:
  • Pregnancy can cause temporary reflux. The pressure and volume in the abdomen during pregnancy can weaken the lower esophageal sphincter muscles. In addition, during this period, high levels of estrogen and progesterone hormones can constantly stimulate relaxation of the lower esophageal sphincter.
  • Obesity can cause reflux due to increased abdominal pressure and volume. Muscles can be permanently damaged in obesity compared to pregnancy. Therefore, it causes permanent reflux. In addition, adipose tissue may cause relaxation of the lower esophageal sphincter due to elevated estrogen hormone levels.
  • Cigarette smoke causes relaxation of the lower esophageal sphincter, leading to reflux.
  • Drugs such as antidepressant medications, asthma medications, blood pressure medications can cause relaxation of the lower esophageal sphincter, leading to reflux.
  • Hiatal hernia is a stomach hernia that occurs as we age. Gastric hernia causes the lower esophageal sphincter muscle to lose its ability to close.
  • Birth defects, connective tissue diseases and surgeries in the upper abdomen can cause reflux.
  • The lower esophageal sphincter relaxes due to excessive consumption of foods such as chocolate, alcohol, mint, garlic and onions.
  • The high fat and sugar content of evening meals and their large volume make digestion difficult. In addition, foods high in fat increase stomach acid and take longer to digest. This increases the likelihood of stomach acid escaping into the esophagus.
  • In infants, temporary reflux can occur because the lower esophagus between the esophagus and stomach is not fully developed.

What is Reflux Treatment and How Does It Go Away?

In reflux treatment, the doctor prepares a treatment plan by determining the underlying cause. In the treatment of reflux, three different treatments are applied: lifestyle changes, medication and surgical treatment.

Lifestyle Changes

Making lifestyle changes in the treatment of reflux can alleviate symptoms in some mild reflux patients without the need for medical treatment. In fact, at this stage, patients apply the answer to the question “What is good for reflux?” to their lives. Lifestyle changes that are good for reflux include the following:
  • In people who are mildly overweight or obese, weight loss significantly reduces symptoms.
  • If there are foods that trigger reflux symptoms in the individual, those foods should be removed from the diet. Foods that often cause symptoms in reflux patients; coffee, alcohol, fatty and spicy foods, orange, lemon, chocolate and mint consumption can be limited.
  • Meals should be smaller and more frequent.
  • Meals should be consumed slowly and chewed well.
  • Wearing clothes that are too tight should be avoided.
  • Do not lie down after a meal.
  • Dinner should be eaten 2-3 hours before bedtime.
  • Smoking should be stopped.
  • Raising the head of the bed relieves symptoms at night.

Medication Therapy

If lifestyle changes are insufficient to alleviate reflux symptoms or if the patient does not respond to treatment, drug therapy is initiated. The basic principle of drug treatment is to minimize the harmful effects of reflux by controlling the acid produced in the stomach. Drug treatment in reflux consists of the following:
  • Histamine receptor antagonists (H2 blockers): Inhibit stimulation of stomach acid production. This ensures that less stomach acid is produced.
  • Antacids: Neutralize stomach acid. In this way, stomach acid irritates the tissues less.
  • Proton pump inhibitors (PPIs): Significantly reduce stomach acid production.
  • Alginates: Prevents acid from escaping into the esophagus.
Long-term use of these medicines may cause side effects. The doctor decides which medication to use in drug treatment. Therefore, if you suffer from reflux symptoms, consult a specialist physician.

Surgical Treatment

Surgical treatment for reflux is offered to certain people. Surgical treatment is resorted to if the person experiences severe symptoms, has a hiatal hernia, or is non-compliant with treatment or does not respond to drug treatment or experiences side effects due to drug treatment. Surgical treatment includes laparoscopic Nissen fundoplication and bariatric surgery in obese patients. Laparoscopic Nissen fundoplication is a surgical procedure commonly used in the treatment of reflux and hiatal hernia. This method compresses the ligaments between the esophagus and stomach. Reflux can also occur frequently in infants. However, most babies do not need treatment. Reflux will disappear with the development of the baby. Only dietary changes can be made during this process to minimize damage. A baby reflux bed can also be used to help relieve symptoms in babies.

How to Prevent Reflux?

The best way to prevent reflux is to avoid consuming foods that cause heartburn. Obesity is also the most important cause of reflux. Therefore, maintaining a healthy weight according to one’s height and age contributes to the prevention of reflux. In addition, behavioral changes recommended in lifestyle changes in reflux treatment can be applied to prevent reflux attacks.
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