GERD: Symptoms, Semiotics, Classification and Treatment

Under the abbreviation GERD (gastroesophageal reflux disease) in medicine is meant a specific pathology associated with the transfer of gastric contents to the distal (lower) sections of the esophagus due to the insufficiency of the cardiac sphincter, which in a healthy organism completely ensures the separation of the hollow spaces of these two organs. In this case, the diagnosis can be exhibited in any cases of pathological casting, not associated with nausea and vomiting, as well as anti-peristaltic movements.

GERD: Symptoms, Semiotics, Classification and Treatment

Gastroesophageal reflux disease can occur at any age and is characterized by its frequency. Thus, in adults the incidence is about 50% regardless of sex. In 10 percent of the patients examined by the FGDS method, morphological changes in the mucous membrane of the organ were noted (in fact, these are erosive forms). GERD in children is also manifested relatively often, especially in infants, which is due to the incompetence of the cardia.

Pathogenesis of GERD development

The pathogenetic pattern of GERD development is recognized by pH tests in the esophagus and stomach. The esophageal acidic index of a healthy person is 6 units, which indicates a slightly acidic environment. With GERD, the pH value drops to 4, which approximately doubles the aggressiveness of the thrown contents for the walls of the organ. In the stomach, the normal pH is 1.5-2, but its damage does not occur, since the mucosa is protected by the mucus produced by the covering cells.

Aggressive contents of the stomach are thrown into the esophagus, if cardiac pulp is insufficient to ensure the delimitation of the organs' environments. This condition is called weakness of the esophageal sphincter and manifests itself in the case of an increase in episodes of relaxation, for example, with the frequent swallowing of large pieces of solid food. Also a predisposing factor that is inevitable as a result of a systematic 3-year recurrence will lead to GERD, is the habit of sleeping after eating. In fact, the contents of the filled stomach in the vertical position of the body can not affect the cardia. However, when lying down, this happens with absolute probability.

In the GERD process, the classification of causes includes hernial protrusion in the esophagus of the diaphragm, which provides increased mobility of the esophagus and does not support its partial external compression at the level of the cardial opening.

GERD: symptoms

The main characteristic signs of the pathology are complaints of patients for burning chest pain, which occurs almost immediately after the end of food intake. When you change the position of the body (laying on a horizontal surface, slopes in the lateral or frontal plane) , there is also a burning sensation in the chest. The patient is worried about sour eructations, swallowing, associated with a painful impulse due to damage to the mucous membrane of the organ. The swallowing of solid food is violated even when thoroughly chewed, while the liquid passes freely, but causes discomfort due to the temperature (cold or thermal) irritation of the damaged areas. GERD symptoms are similar to angina pectoris, but their difference is not from exercise, but from eating.

Treatment of GERD: pharmacotherapy and adherence to diet

Under the observance of the dietary regime, the patient should understand the use of food more frequent and smaller doses. It must be crushed or thoroughly chewed. Its temperature should not be more than 40 degrees. Pharmacotherapy consists in receiving blockers of the proton pump, prokinetics and H2 blockers of histamine receptors according to the scheme prescribed by the doctor. If the symptoms go away in the treatment of GERD, then the therapy continues in maintenance doses using the first and third classes of the above drugs.