Search
Language
Esophagitis caused by gastroesophageal reflux
Table of Contents
1. What are the impacts of reflux disease on the body
Reflux disease, also known as gastroesophageal reflux disease, is a chronic condition in which the contents of the stomach return to the esophagus due to weakening of the lower esophageal sphincter (LES). The pressure in the stomach is higher than in the esophagus, so in case of excessive relaxation of the LES, the stomach contents move back into the esophagus, causing a range of unwanted symptoms.2. What is the set of symptoms associated with gastroesophageal reflux disease (GERD)?
The symptoms associated with gastroesophageal reflux disease (GERD) can be divided into esophageal symptoms such as acid reflux, regurgitation of food into the esophagus, difficulty swallowing, stomach upset, and chest pain, often burning; and extraesophageal symptoms such as cough, hoarseness, and throat irritation. These symptoms are often confused with other disorders, such as cough with respiratory diseases and stomach upset with normal overeating. Similarly, chest pain is often attributed to a cardiological disorder rather than an identification with GERD. Therefore, it is important to conduct a thorough medical history, order appropriate tests, and practice self-observation.3. Recognition of the disease
Should any of the above-mentioned symptoms be experienced, it is recommended to seek medical advice to determine their cause. Based on the consultation, the doctor may suggest the following procedures: gastroscopy, pH measurement in the esophagus (assessment of pH in the esophagus), esophageal pressure measurement (assessment of esophageal pressure), swallowing impedance measurement (evaluation of swallowing motor function and type of reflux: acidic/non-acidic). Based on these assessments, the doctor can rule out or confirm the presence of a reflux disease and choose the most suitable form of treatment.4. Therapeutic interventions
Therapeutic interventions are multidimensional in nature, and in order to be effective and reduce the symptoms of reflux, they must encompass: the use of medications to decrease gastric secretion, modifications to the patient's lifestyle, including dietary changes, and in particularly severe cases, the undertaking of a surgical procedure.5. What modifications in lifestyle and diet are indispensable
Lifestyle and dietary habits play a crucial role in the management and prevention of reflux-related disorders. The medical and nutritional recommendations include:6. Body mass diminution
Provides substantial aid to individuals battling excess weight and obesity, particularly those with the so-called abdominal type, also referred to as the apple type. In this situation, body mass amplifies the disease's symptoms. A surplus of adipose tissue instigates a rise in intraabdominal pressure, consequently aggravating reflux symptoms. Research has demonstrated that those suffering from reflux who have decreased their body mass have encountered a substantial relief in symptom severity.7. Abandonment of nicotine addiction
The habit of cigarette smoking reduces the level of tension in the lower esophageal sphincter (LES) due to its calming effect. Consequently, smoking can lead to an excessive reflux of gastric content into the esophagus, thereby exacerbating the symptoms.8. Limitation of alcohol consumption
Alcohol, similar to cigarettes, reduces the pressure of the lower esophageal sphincter (LES) and contributes to the intensification of reflux symptoms. Furthermore, it increases the quantity of salty acid released in the stomach, which, in excess and in the absence of concomitant food consumption, results in irritation of the gastric mucosa and an intensification of discomfort, and can even be the cause of ulcer formation and, in the future, stomach cancers.9. I alter my positioning during periods of rest and sleep
Throughout periods of rest and sleep, it is significant to ensure a minor elevation so that your head and body are located above your stomach. This enables gravity to hinder the regurgitation of stomach contents, facilitating easier esophageal cleansing and reduced symptoms.10. Scope of modifications in diet
– Consuming small meals regularly. It is recommended to consume 5-6 meals per day at regular intervals of 3-4 hours; – in case of reflux disease in highly athletic individuals, it is possible to consume more meals in order to provide adequate calorie intake; – slow eating, thorough chewing to facilitate gastric digestion; – large amounts of fluid should not be consumed during meals to avoid diluting stomach acids and thus impairing digestion; – after eating, it is recommended to avoid lying down for at least 2 hours. The last meal should be consumed approximately 3-3.5 hours before going to bed, as the cleaning of the esophagus in the lying position is less effective; – adequate fluid intake – it is recommended to consume at least 1.5 liters of still, low-mineralized mineral water; – it is not recommended to drink citrus juices, as they can exacerbate the occurrence of reflux symptoms. It is also worth avoiding strong coffee and tea drinks and carbonated beverages, as they can act irritatingly on the gastric mucosa. Some recommend consuming milk to reduce the symptoms of reflux. Unfortunately, excessive intake of milk has the opposite effect, increases the production of stomach acids, and thus exacerbates the symptoms; – proper selection of meals and their preparation – it is recommended to consume steamed, cooked, fried, or stewed meals without added fat. Reducing the intake of fat in the diet allows for reducing the number of self-initiated LES relaxations and thus reducing the symptoms of reflux.11. Detailed list of products that intensify reflux symptoms:
– Beverages: coffee, tea, alcohol, carbonated drinks, citrus juices, tomato juice, meat gravy, hot cocoa drink; Cereal products: coarse-grained cereals such as grits; Dairy - full-fat milk, melted cheese, feta, blue cheese, sour cream, cream, scrambled eggs fried in fat; Meat - canned meats, pâté, fatty pork, duck, goose, bacon; Fats - lard; Vegetables - onion-like, legume-like, leek, artichokes, garlic, asparagus; Fruits - citrus fruits such as orange, tangerine, kumquat, lime; Spices - chili, horseradish, black pepper, curry, ginger, mustard; Sauces - mayonnaise, mustard, or based on full-fat cream; Sweets - chocolate and high-fat baked goods. In cases of individuals with pronounced reflux symptoms or those engaged in competitive sports, a visit to a qualified dietitian is necessary to establish the most optimal diet plan based on the collected data, the sport practiced, and the degree of disease progression.12. How to combine physical activity with reflux disease
Reflux disease is particularly burdensome for physically active individuals. Very intense physical exertion exacerbates the symptoms of reflux and hinders the execution of training. Exertion of low and moderate intensity is highly recommended to strengthen the abdominal muscles, especially the diaphragm, which may reduce the symptoms associated with the disease. For individuals who were previously physically inactive, but now diagnosed with reflux disease, it is important to engage in physical activity: walking, cycling, swimming, nordic walking, rollerblading, jogging with low intensity, preferably 3-4 times a week for at least 30 minutes. Only after the body has become accustomed to physical activity can more intense exercises be performed. In order to reduce the symptoms of reflux, in addition to the aforementioned recommendations, it is important to follow certain rules: – wait at least 2.5-3 hours after eating before starting the training; – for fluid replacement, choose still water, low mineralization, and in cases where the physical effort lasts longer than 60 minutes – isotonic isoosmotic drinks; – avoid exercises that involve sudden leaning of the body and exercises in which pressure is exerted on the stomach. Both leaning and exercises in which pressure is exerted on the abdominal cavity increase the pressure in the abdominal cavity and increase the frequency of regurgitation; – exercises that exacerbate the symptoms of reflux are, for example, sit-ups, bends, weightlifting, exercises with the head below the stomach, exercises that exert pressure on the abdominal cavity, e.g. on a sloping bench.
