Reflux disease: how to treat it. Gastroesophageal reflux disease: causes, symptoms, treatment

Antipyretics for children are prescribed by a pediatrician. But there are emergency situations for fever when the child needs to be given medicine immediately. Then the parents take responsibility and use antipyretic drugs. What is allowed to give to infants? How can you lower the temperature in older children? What medications are the safest?

GERD (gastroesophageal reflux disease) is one of the most common chronic diseases of the upper digestive system, resulting from gastroesophageal reflux. Reflux is the retrograde reflux of stomach and duodenal contents into the esophagus. Gastric juice and enzymes damage its mucous membrane, and sometimes the overlying organs (trachea, bronchi, pharynx, larynx).

The causes of reflux can be very diverse. The most common causes of GERD are:

decreased tone of the lower esophageal sphincter;
increased pressure in the abdominal cavity (during pregnancy, obesity, ascites);
diaphragmatic hernia;
overeating or hasty consumption of food, as a result of which a large volume of air is swallowed;
eating foods that require more time to digest and, as a result, linger in the stomach.

Symptoms of GERD

People suffering from GERD are regularly bothered by heartburn - a burning sensation in the chest that occurs after eating certain foods, overeating, or physical activity.

– a burning sensation behind the sternum, appearing 1-1.5 hours after eating or at night. The burning sensation can rise to the epigastric region, radiate to the neck and interscapular area. Discomfort may increase after physical activity, overeating, drinking carbonated drinks, or strong coffee.
Belching is a phenomenon caused by the flow of stomach contents through the lower esophageal sphincter directly into the esophagus and then into the oral cavity. Belching causes a sour taste in the mouth. Belching most often appears in a horizontal position or bending of the body.
Pain and difficulty swallowing food. These symptoms more often appear with the development of complications of the disease (narrowing or tumor of the esophagus) and are caused by the presence of constant inflammation in the damaged mucous membrane of the esophagus.
Esophageal vomiting is a sign of GERD, which also appears with the development of complications. Vomit is undigested food eaten shortly before the onset of vomiting.
Hiccups are a sign of a disease, the development of which is caused by irritation of the phrenic nerve, causing frequent contraction of the diaphragm.

GERD is characterized by an increase in the above-described esophageal symptoms in a horizontal position of the body, bending forward and physical activity. These manifestations may be reduced by taking alkaline mineral waters or milk.

Some patients also experience extraesophageal symptoms of the disease. Patients may experience chest pain, which may be interpreted as signs of heart disease (acute coronary syndrome). When stomach contents enter the larynx, especially at night, patients begin to experience dry cough, sore throat, and hoarseness. Rejection of gastric contents into the trachea and bronchi may occur, resulting in the development of obstructive bronchitis and aspiration pneumonia.

Signs of gastroesophageal reflux can also be observed in absolutely healthy people; in this case, reflux does not cause the development of pathological changes in the mucous membrane of the esophagus and other organs. However, if the above symptoms occur more than 2 times a week for 2 months, you should consult a doctor for examination.

Diagnosis of GERD

The doctor makes a preliminary diagnosis of GERD based on the patient’s complaints. To clarify the diagnosis, the following studies are carried out:

Daily intraesophageal pH monitoring is the main research method that confirms GERD in a patient. This test determines the number and duration of reflux during the day, as well as the length of time during which the pH level drops below 4.
Proton pump inhibitor test. The patient is prescribed a drug from the group of proton pump inhibitors (Omez, Nexium) in a standard dose for 2 weeks. The effectiveness of therapy is confirmation of the disease.

In addition to these diagnostic methods, the patient may be prescribed other studies. They are usually necessary to assess the condition of the esophagus and other organs of the digestive system, identify concomitant diseases, and also to exclude diseases with a similar clinical picture:

FEGDS (fibroesophagogastroduodenoscopy) with urease test;
chromendoscopy of the esophagus;
X-ray examinations of the esophagus and stomach using contrast;
ECG and daily ECG monitoring;
Ultrasound examination of the abdominal organs.

Treatment of GERD

Nacotine and alcohol contribute to the occurrence of reflux. Giving up these bad habits is an important step towards getting rid of GERD.

First of all, the patient needs to change his lifestyle, namely, give up such bad habits as smoking and drinking alcoholic beverages. These factors contribute to the occurrence of reflux. People who are obese need to normalize their body weight with the help of a specially selected diet and a set of physical exercises.
Compliance with diet and nutrition. Food should be taken in small portions 5-6 times a day, avoid overeating. After eating, it is recommended to avoid physical activity and horizontal body position for several hours. Strong coffee and tea, carbonated drinks, chocolate, citrus fruits, spicy foods and spices, as well as foods that promote gas formation (legumes, cabbage, fresh black bread) should be excluded from the diet.
Drug therapy is aimed at relieving symptoms of the disease and preventing complications. Patients are prescribed proton pump inhibitors (omez, Nexium), H2-histamine receptor blockers (ranitidine, famotidine). For bile reflux, drugs ursodeoxycholic acid (ursofalk) and prokinetics (trimedat) are prescribed. Occasionally, antacids (Almagel, Phosphalugel, Gaviscon) can be used to get rid of heartburn.

The prescription of therapy must be entrusted to a doctor; self-medication should not be done, as this can lead to the development of complications.

Which doctor to contact

If heartburn and other signs of GERD appear, you should consult a gastroenterologist. The role of the endoscopist is important in diagnosis. A nutritionist is involved in the treatment of the disease. In addition, consultation with a cardiologist is required to exclude coronary pathology.

Gastroesophageal reflux disease (GERD) a disease characterized by the development of specific symptoms and/or inflammatory lesions of the distal part of the esophagus due to repeated, retrograde entry of gastric and/or duodenal contents into the esophagus.

The pathogenesis is based on insufficiency of the lower esophageal sphincter (circular smooth muscle, which is in a state of tonic contraction in a healthy person and separates the esophagus and stomach), which contributes to the reflux of stomach contents into the esophagus (reflux).

Long-term reflux leads to esophagitis and sometimes to tumors of the esophagus. Typical (heartburn, belching, dysphagia) and atypical (cough, chest pain, wheezing) manifestations of the disease occur.

Pathological changes in the respiratory system (pneumonia, bronchospasm, idiopathic pulmonary fibrosis), vocal cords (hoarseness, laryngitis, laryngeal cancer), hearing organ (otitis media), teeth (enamel defects), may be additional signs indicating reflux .

The diagnosis is made based on a clinical assessment of the symptoms of the disease, the results of endoscopic studies, and pH-metry data (monitoring pH in the esophagus).

Treatment consists of lifestyle changes and taking medications that reduce gastric acidity (proton pump inhibitors). In some cases, surgical treatment methods may be used.

Classification of GERD
First of all, the classification divides gastroesophageal reflux disease into 2 categories: GERD with esophagitis and GERD without esophagitis.
- GERD with esophagitis (endoscopically positive reflux disease)
  Reflux esophagitis is damage to the mucous membrane of the esophagus, visible during endoscopy, an inflammatory process in the distal (lower) part of the esophagus caused by the action of gastric juice, bile, pancreatic and intestinal secretions on the mucous membrane of the esophagus. It is observed in 30-45% of patients with GERD.
  
  Complications of reflux esophagitis are:
  - Esophageal strictures.
  - Erosion and ulcers of the esophagus, accompanied by bleeding.
  - Barrett's esophagus.
  - Adenocarcinoma of the esophagus.
  The condition of the esophageal mucosa is assessed endoscopically according to the M.Savary-J.Miller classification, or according to the Los Angeles (1994) classification.
  - Classification by M.Savary-J.Miller as modified by Carrison et al.
    - Grade 0 – there are no signs of reflux esophagitis.
    - I degree – non-confluent erosions against the background of mucosal hyperemia, occupying less than 10% of the circumference of the distal esophagus.
    - Grade II - confluent erosive lesions occupying 10-50% of the circumference of the distal esophagus.
    - III degree – multiple, circular erosive and ulcerative lesions of the esophagus, occupying the entire circumference of the distal esophagus.
    - IV degree – complications: deep ulcers, strictures, Barrett’s esophagus.
  - The Los Angeles classification is used only for erosive forms of GERD.
    - Grade A - one or more defects of the esophageal mucosa no more than 5 mm long, none of which extends to more than 2 folds of the mucous membrane.
    - Grade B – one or more mucosal defects more than 5 mm in length, none of which extends to more than 2 folds of the mucous membrane.
    - Grade C – defects of the esophageal mucosa that extend to 2 or more folds of the mucosa, which together occupy less than 75% of the circumference of the esophagus.
    - Grade D – defects of the esophageal mucosa, occupying at least 75% of the circumference of the esophagus.
- GERD without esophagitis (endoscopically negative reflux disease, or non-erosive reflux disease)
  GERD without esophagitis (endoscopically negative reflux disease, or non-erosive reflux disease) is damage to the esophageal mucosa that is not detected by endoscopic examination. Occurs in more than 50% of cases.
  
  The severity of subjective symptoms and duration of the disease do not correlate with the endoscopic picture. With endoscopically negative GERD, quality of life suffers in the same way as with reflux esophagitis, and pH measurements characteristic of the disease are observed.

Epidemiology of GERD
The incidence of GERD is often underestimated, since only 25% of patients consult a doctor. Many people do not complain because they manage the symptoms of the disease with over-the-counter medications. The occurrence of the disease is promoted by a diet containing excess amounts of fat.

If we evaluate the prevalence of GERD by the frequency of heartburn, then 21-40% of residents of Western Europe, up to 20-45% of residents of the USA and about 15% of residents of Russia complain about it. The likelihood of having GERD is high if you experience heartburn at least twice a week. In 7-10% of patients it occurs daily. However, even with more rare heartburn, the presence of GERD cannot be excluded.

The incidence of GERD in men and women of any age is (2-3):1. Incidence rates of GERD increase in people over 40 years of age. However, Barrett's esophagitis and adenocarcinoma are approximately 10 times more common in men.

ICD 10 code K21.

For bronchospasms, the differential diagnosis is between GERD and bronchial asthma, chronic bronchitis. Such patients undergo pulmonary function testing, radiography and CT scan of the chest. In some cases, there is a combination of GERD and bronchial asthma. This is due, on the one hand, to the esophagobronchial reflex, which causes bronchospasm. On the other hand, the use of beta-agonists, aminophylline, reduces the pressure of the lower esophageal sphincter, promoting reflux. The combination of these diseases causes their more severe course.

In 5-10% of cases of GERD, drug therapy is ineffective.

Indications for surgical treatment methods:

For complications of GERD.
If conservative treatment is ineffective.
When treating patients under 60 years of age with a hiatal hernia of 3-4 degrees.
With grade V reflux esophagitis.

Before starting treatment, it is necessary to assess the patient's risk of complications. Patients who are at high risk of developing complications should undergo surgical treatment instead of prescribing medications.

The effectiveness of antireflux surgery and maintenance therapy with proton pump inhibitors is the same. However, surgical treatment has disadvantages. Its results depend on the experience of the surgeon, and there is a risk of death. In some cases, after surgery there remains a need for drug therapy.

Options for surgical treatment of the esophagus are: endoscopic plication, radiofrequency ablation of the esophagus, laparoscopic Nissen fundoplication.

Radiofrequency ablation of the esophagus (Stretta procedure) involves applying thermal radiofrequency energy to the muscle of the lower esophageal sphincter and cardia.

Stages of radiofrequency ablation of the esophagus.

The balloon is inflated and needles are inserted into the muscle under endoscopic guidance.

The installation is confirmed by measuring the tissue impedance and then a high-frequency current is applied to the ends of the needles while cooling the mucosa by applying water.

The tool is rotated to create additional “damage spots” at different levels and usually 12-15 groups of such spots are applied.

The antireflux effect of the Stretta procedure is associated with two mechanisms. One mechanism is to "tighten" the treated area, which becomes less sensitive to the effects of gastric distension after eating, in addition to creating a mechanical barrier to reflux. Another mechanism is disruption of the afferent vagal pathways from the cardia, involved in the mechanism of transient relaxation of the lower esophageal sphincter.

After laparoscopic Nissen fundoplication, 92% of patients experience complete disappearance of symptoms of the disease.

Treatment of complications of GERD
- Strictures (narrowings) of the esophagus.
  Endoscopic dilatation is used in the treatment of patients with esophageal strictures. If, after a successful procedure, symptoms recur within the first 4 weeks, carcinoma must be excluded.
- Esophageal ulcers.
  For treatment, you can use antisecretory drugs, in particular, rabeprazole (Pariet) - 20 mg 2 times a day for 6 weeks or more. During the course of treatment, control endoscopic examinations with biopsy, cytology and histology are carried out every 2 weeks. If a histological examination reveals high-grade dysplasia, or, despite 6-week treatment with omeprazole, the ulcerative defect remains the same size, then consultation with a surgeon is necessary.
  The criteria for the effectiveness of treatment for endoscopically negative GERD (GERD without esophagitis) is the disappearance of symptoms. Pain often resolves on the first day of taking proton pump inhibitors.

Gastroesophageal reflux disease is a pathological process that results from deterioration of the motor function of the upper gastrointestinal tract. If the disease lasts for a very long time, then this is fraught with the development of an inflammatory process in the esophagus. This pathology is called eophaginitis.

Reasons for the development of the disease

There are the following reasons for the development of gastroesophageal reflux disease:

Increase in intra-abdominal pressure. Its increase is associated with excess weight, the presence of ascites, flatulence, and pregnancy.
Diaphragmatic hernia. Here all the conditions are created for the development of the disease presented. There is a decrease in pressure on the lower part of the esophagus in the sternum area. A hiatal hernia is diagnosed in old age in 50% of people.
Decreased tone of the lower esophageal sphincter. This process is facilitated by the consumption of drinks that contain caffeine (tea, coffee); medications (Verapamil, Papaverine); the toxic effect of nicotine on muscle tone, the use of strong drinks that damage the mucous membrane of the esophagus; pregnancy.
Eating food in a hurry and in large quantities. In such a situation, a large amount of air is swallowed, and this is fraught with an increase in intragastric pressure.
Duodenal ulcer.
Eating large quantities of food containing animal fats, peppermint, fried foods, spicy seasonings, carbonated drinks. The entire list of products presented contributes to prolonged retention of food masses in the stomach and an increase in intragastric pressure.

How does the disease manifest itself?

The main symptoms of gastroesophageal reflux are as follows:

heartburn;
belching acid and gas;
acute sore throat;
discomfort in the pit of the stomach;
pressure that occurs after eating, which increases after eating food that promotes the production of bile and acid. Therefore, you should give up alcoholic drinks, fruit juices, carbonated water, and radishes.

Often, the symptoms of gastroesophageal reflux disease manifest themselves in the form of belching of semi-digested food masses with bile. In rare cases, patients suffering from esophagitis experience the following symptoms:

vomiting or urge to vomit;
profuse salivation;
dysphagia;
feeling of pressure behind the sternum.

Often, patients suffering from esophagitis experience retrosternal pain, radiating to the shoulder, neck, arm and back. If the presented symptoms occur, then you need to go to the clinic for a heart examination. The reason is that these symptoms can occur in people suffering from angina. Pain syndrome behind the sternum with reflux disease can be triggered by eating large amounts of food or sleeping on a very low pillow. These symptoms can be eliminated with the help of alkaline mineral waters and antacids.

Gastroesophageal reflux disease and its symptoms are more pronounced under the following conditions:

upper body tilt;

the use of sweets in large quantities;

heavy food abuse;

the use of alcoholic beverages;

during a night's rest.

Gastroesophageal reflux disease can provoke the formation of cardiac, dental, bronchopulmonary and otolaryngological syndromes. At night, a patient suffering from esophagitis experiences unpleasant symptoms from the following diseases:

Chronical bronchitis;
pneumonia;
asthma;
painful sensations in the chest;
heart rhythm disturbance;
development of pharyngitis and laryngitis.

During the collection of chyme into the bronchi, there is a possibility of bronchospasm. According to statistics, 80% of people suffering from bronchial asthma are diagnosed with gastroesophageal reflux. Often, to relieve the symptoms of asthmatics, all you need to do is reduce the production of acid in the stomach. Approximately 25% of people feel better after such activities.

An external examination of a patient suffering from esophagitis cannot provide detailed information about this disease. Each person has their own symptoms: some have fungiform papillae on the root of the tongue, while others have insufficient production of saliva to supply the oral mucosa.

Classification of the disease

Today, experts have developed a certain classification of the disease. It does not imply the presence of complications of reflux disease, which include ulcers, strictures, and metaplasia. According to this classification, gastroesophageal reflux is of 3 types:

The non-erosive form is the most common type of disease. This group includes reflux without manifestations of esophagitis.
The erosive-ulcerative form includes pathological processes complicated by an ulcer and stricture of the esophagus.
Barrett's esophagus is a type of disease that is diagnosed in 60% of cases. It is a metaplasia of stratified squamous epithelium caused by esophagitis. The form of the disease presented refers to precancerous diseases.

Diagnostics

Gastroesophageal reflux can be diagnosed using the following methods:

Test containing a proton pump inhibitor. Initially, the diagnosis can be made based on the typical manifestations that the patient experiences. After this, the doctor will prescribe him a proton pump inhibitor. As a rule, Omeprazole, Pantoprazole, Rabeprazole, Esomeprazole are used according to the standard dosage. The duration of such activities is 2 weeks, after which it is possible to diagnose the disease presented.
Intrafood pH monitoring, the duration of which is 24 hours. Thanks to this study, it is possible to understand the number and duration of reflux in 24 hours, as well as the time during which the pH level decreases below 4. This diagnostic method is considered the main one in confirming gastroesophageal reflux disease. It is possible to determine the relationship between typical and atypical manifestations with gastroesophageal reflux.
Fibroesophagogastroduodenoscopy. This diagnostic method for detecting esophagitis helps to identify cancerous and precancerous diseases of the esophagus. A study is carried out when patients suffering from esophagitis are affected, with alarming symptoms, with a prolonged course of the disease, as well as in cases where there is a controversial diagnosis.
Chromoendoscopy of the esophagus. It is advisable to conduct such a study for people who have gastroesophageal reflux disease for a long time and are accompanied by constant relapses.
An ECG allows you to determine arrhythmia and diseases of the cardiovascular system.
Ultrasound of the heart of the abdominal organs helps to detect diseases of the digestive organs and exclude pathologies of the cardiovascular system.
X-ray of the esophagus, chest and stomach. It is prescribed to patients to detect pathological changes in the esophagus and hiatal hernia.
Complete blood count, stool examination for occult blood, baked samples are detected.
Test for Helicobacter pylori. If its presence is confirmed, then radiation treatment is prescribed.

In addition to the diagnostic methods described, it is important to visit the following specialists:

cardiologist;
pulmonologist;
otorhinolaryngologist;
surgeon, his consultation is necessary in case of ineffectiveness of the ongoing drug treatment, the presence of large diaphragmatic hernias, or in the event of complications.

Effective Therapy

Treatment of gastroesophageal reflux disease is based on quickly eliminating the manifestations of the disease and preventing the development of severe consequences.

Taking medications

Such therapy is permitted only after medications have been prescribed by a specialist. If you take certain medications prescribed by other doctors to eliminate missing ailments, this can lead to a decrease in the tone of the esophageal sphincter. These medications include:

nitrates;
calcium antagonists;
beta blockers;
theophylline;
oral contraceptives.

There are cases when the presented group of medications caused pathological changes in the mucous membrane of the stomach and esophagus.

Patients suffering from esophagitis are prescribed antisecretory drugs, which include:

proton pump inhibitors - Pantoprazole, Omeprazole, Rabeprazole, Esomeprazole;
drugs that block H2-histamine receptors - Famotidine.

If bile reflux occurs, then it is necessary to take Ursofalk, Domperidone. The choice of a suitable medicine and its dosage should be carried out strictly on an individual basis and under the constant supervision of a specialist.

For short-term relief of symptoms, antacids are allowed. It is effective to use Gaviscon forte in the amount of 2 teaspoons after meals or Phosphalugel - 1-2 sachets after meals.

Treatment of gastroesophageal reflux in children involves the use of drugs taking into account the severity of the disease and inflammatory changes in the esophagus. If there are no pronounced symptoms, then it is advisable to take only medications aimed at normalizing gastrointestinal motility. Today, effective drugs for children are Metoclopramide and Domperidone. Their action is aimed at enhancing the motility of the antrum of the stomach. Such activities cause rapid gastric emptying and increase the tone of the esophageal sphincter. If Metoclopramide is taken in young children, extrapyramidal reactions occur. For this reason, medications should be taken with extreme caution. Domperidone has no side effects. The duration of such treatment is 10–14 days.

Diet

Diet for gastroesophageal reflux disease is one of the main areas of effective treatment. Patients suffering from esophagitis should adhere to the following dietary recommendations:

Food is taken 4–6 times a day, in small portions, warm. After a meal, it is forbidden to immediately take a horizontal position, tilt the body and perform physical exercises.
Limit the consumption of foods and drinks that increase the formation of acid in the stomach and reduce the tone of the lower esophageal sphincter. These products include: alcoholic drinks, cabbage, peas, spicy and fried foods, brown bread, legumes, carbonated drinks.
Consume as many vegetables, cereals, eggs and oils of plant origin as possible, which contain vitamins A and E. Their action is aimed at improving the renewal of the mucous membrane of the esophagus.

Surgical treatment

When conservative treatment of the presented disease did not produce the required effect, severe complications arose, and surgical intervention was performed. Surgical treatment of gastroesophageal reflux disease can be carried out using the following methods:

Endoscopic plication of the gastroesophageal junction.
Radiofrequency ablation of the esophagus.
Laparoscopic Nissen fundoplication and gastrocardiopexy.

ethnoscience

To eliminate the described disease, you can use folk remedies. The following effective recipes are distinguished:

Flaxseed decoction. This therapy with folk remedies is aimed at increasing the resistance of the esophageal mucosa. It is necessary to pour 2 large spoons of ½ liter of boiling water. Infuse the drink for 8 hours, and take 0.5 cups of nitrogen 3 times a day before meals. The duration of such therapy with folk remedies is 5–6 weeks.
Milkshake. Drinking a glass of cold milk is considered an effective folk remedy in eliminating all manifestations of gastroesophageal reflux disease. Therapy with such folk remedies is aimed at getting rid of acid in the mouth. Milk has a soothing effect on the throat and stomach.
Potato. Such folk remedies can also achieve positive results. You just need to peel one small potato, cut it into small pieces and chew it slowly. After a few minutes you will feel relief.
Decoction of marshmallow root. Therapy with folk remedies that include this drink will not only help get rid of unpleasant symptoms, but will also have a calming effect. To prepare the medicine, you need to put 6 g of crushed roots and add a glass of warm water. Infuse the drink in a water bath for about half an hour. Treatment with folk remedies, including the use of marshmallow root, involves taking a chilled decoction of ½ cup 3 times a day.
When using folk remedies, celery root juice is effective. It should be taken 3 times a day, 3 large spoons.

Alternative medicine involves a large number of recipes; the choice of a specific one depends on the individual characteristics of the human body. But treatment with folk remedies cannot act as a separate therapy; it is included in the general complex of therapeutic measures.

Prevention measures

The main preventive measures for GERD include the following:

Eliminate the use of alcoholic beverages and tobacco.
Limit your intake of fried and spicy foods.
Do not lift heavy objects.
You cannot stay in an inclined position for a long time.

In addition, prevention includes modern measures to detect motility disorders of the upper digestive tract and treat hiatal hernia.

Gastroesophageal reflux disease (GERD) is a pathological condition caused by impaired motility of the upper gastrointestinal tract. It is formed as a result of reflux - regular reflux of stomach or duodenal contents into the esophagus - causing mucous membranes on the surfaces of the esophagus.

What is GERD

What is this disease? GERD (gastroesophageal reflux disease, reflux) is the reflux of gastric or intestinal contents into the lumen of the esophagus. If reflux occurs immediately after eating (infrequently) and is not accompanied by the development of a discomforting condition for the patient, then this is an acceptable physiological norm. But in the case of frequent occurrence of such a condition, accompanied by inflammation of the mucous surfaces of the esophagus, we can talk about the presence of gastroesophageal reflux.

Causes of the disease and provoking factors

Gastroesophageal reflux is the reverse movement of gastric contents into the lumen of the esophagus, caused by impaired functionality of the closing sphincter. Reasons for the formation of GERD:

Eating food quickly and in large quantities. At the same time as eating, a person swallows a large amount of air, which causes an increase in intra-abdominal pressure and the development of reflux.
Decreased tone of the lower esophageal sphincter, slow gastric emptying. This condition can be formed under the influence of the following factors: the toxic effects of nicotine, treatment with antispasmodics, analgesics, calcium antagonists, alcohol intake, the period of pregnancy.
Diaphragmatic hernia.
Ulcerative pathology of the duodenum.
The presence in the diet of a large number of foods that increase intra-abdominal pressure - soda, fatty/fried/spicy foods.

The following factors can provoke gastroesophageal reflux disease:

professional activity of a person - prolonged stay of a person in a half-bent position;
frequent stressful situations;
abuse of nicotine and alcohol;
bearing a child;
presence of extra pounds;
excessive consumption of coffee, fatty foods, chocolate, juices;
treatment with medications that increase dopamine concentrations.

Symptoms

Symptoms of gastroesophageal reflux are usually divided into two large groups - esophageal (esophageal) and extraesophageal. Esophageal manifestations are similar to signs of gastrointestinal (GI) motility disorders. This:

heartburn - worsens when bending over, lying down, after physical activity, when overeating;
belching with a sour or bitter taste;
bouts of nausea ending in vomiting;
hiccups
regurgitation;
heaviness in the epigastric region that occurs after eating;
problems with swallowing;
chest pain not caused by cardiac pathologies;
heavy odor of breath;
increased production of saliva.

Esophageal manifestations of GERD also include damage to the structure of the esophagus. These are Barrett's esophagus, narrowing of the esophagus, reflux esophagitis, adenocarcinoma of the esophagus. Extraesophageal manifestations of GERD are caused by gastric contents entering the respiratory tract.

Symptoms may be as follows: the development of pharyngitis, laryngitis, otitis, runny nose, apnea (short cessation of breathing), cough, shortness of breath that occurs in a person in a lying position, coronary pain, reminiscent of an angina attack, accompanied by arrhythmia.

GERD with esophagitis develops against the background of existing damage to the mucous surfaces of the esophagus. This is the formation of ulcerations, inflammatory processes, pathological narrowing of the lower esophagus, changes in the condition of the mucosa. Typical signs in this case: severe heartburn, belching with a sour taste, pain in the stomach, attacks of nausea.

GERD can develop not only in adults, but also in childhood, in particular in infants. In the latter case, the pathogenesis (origin) of the disease is due to the immaturity of the closing sphincter.

Potential causes of gastroesophageal disease in children include surgical interventions on the esophagus, gastrectomy, cerebral palsy, difficult childbirth and high levels of intracranial pressure, and others.

General symptoms of GERD in children:

spitting up (in babies) and belching;
poor appetite;
pain in the epigastric region;
fussiness during feeding;
frequent vomiting;
hiccups
labored breathing;
night cough.

You can get more detailed information about the course of GERD in childhood.

Classification

The classification of GERD is based on the presence/absence of symptoms of inflammatory processes in the esophagus. It is customary to distinguish the following subspecies. Nonerosive reflux disease. Approximately 70% are diagnosed. There are no symptoms of esophagitis. Ulcerative-erosive form. Gastroesophageal reflux disease in this case is accompanied by narrowing of the esophagus and the formation of ulcers.

Barrett's esophagus. Against the background of esophagitis, metaplasia of stratified squamous epithelium develops - a precancerous condition characterized by the replacement of squamous epithelial cells with cylindrical ones. Additional types of GERD classification can be found in this article.

Diagnosis of GERD

Diagnosis of gastroesophageal reflux is based on instrumental techniques. The doctor may prescribe the following types of studies:

endoscopy – helps determine the presence of inflammation, eroded areas, and ulcers;
daily monitoring of acidity levels in the lower esophagus;
X-ray – allows you to identify a hernia of the diaphragm, ulcers, erosions;
manometric examination of the esophageal sphincter;
scintigraphy with a radioactive substance;
biopsy - a study is prescribed if Barrett's esophagus is suspected;
24-hour Holter monitoring;
Ultrasound examination of the abdominal organs.

Additionally, the patient may be assigned consultations of such specialists as a cardiologist, otolaryngologist, pulmonologist, surgeon. But most often, the diagnosis is made on the basis of the results of FGDS.

How to cure?

There is no specific treatment for GERD. The therapeutic measures taken are aimed at eliminating pathological symptoms, preventing relapses and developing complications. In the initial stages of GERD, therapeutic exercises give good results. Initially, the disease is treated with medication, relieving severe symptoms. But at the same time, weakness of the esophageal sphincter remains.

Exercise therapy exercises are aimed specifically at strengthening the muscles of the esophagus and diaphragm, which prevents pathological castings and improves the well-being of a person as a whole. In accordance with generally accepted practice in gastroenterology, the patient is prescribed antisecretory agents: proton pump inhibitors and H2-histamine receptor blockers. Additionally, the patient may be prescribed prokinetics - recommended for the development of bile reflux, antacids, reparants - drugs that promote the healing of damaged mucous membranes of the esophagus.

H2-histamine receptor blockers

Medicines in this group help reduce the amount of hydrochloric acid produced. To exclude recurrence of the pathology, they are prescribed as a course of treatment. The patient may be prescribed:

Famotidine. Reduces the activity of pepsin, reduces the amount of hydrochloric acid produced.
Cimetidine. The dosage and regimen are selected individually. The drug can cause nausea and dyspeptic symptoms.
Nizatidine. Reduces the amount of hydrochloric acid produced.

Proton pump inhibitors

While taking medications, the level of hydrochloric acid produced decreases. Esomeprazole, Omeprozole, Pantoprozole, Rabeprozole, Lansoprozole are prescribed for use. The choice of remedy depends on the recommendations of the attending physician. For example, pregnant women are prohibited from treatment with Omeprazole. It is replaced with Panto- or Lansoprozole.

Prokinetics

The drugs help to increase the tone and contraction of the lower esophageal sphincter, which reduces the number of pathological reflux of gastric contents. Treatment of gastroesophageal reflux disease is carried out using the following prokinetics:

Domperidone is an antiemetic. While taking it, the development of gastrointestinal disorders cannot be ruled out.
Metoclopramide. Improves motor activity of the esophagus. Has many side effects.
Cisapride. It has a stimulating effect on motility and tone of the gastrointestinal tract, and has a laxative effect.

Antacids

This group of drugs reduces the acidity of gastric juice. Appointments may include:

Phosphalugel. It has absorbent, enveloping and antacid properties.
Gaviscon. Forms a protective film on the surface of the mucous membrane of the esophagus and stomach.
Rennie. Neutralizes the acidity of gastric juice.

When bile is blocked, drugs from the group of prokinetics are used, most often Domperidone or Ursofalk. The drug is included in the category of hepatoprotectors. It helps dissolve gallstones and reduces blood cholesterol levels.

Surgery

The main indication for surgical treatment is the ineffectiveness of previously selected drug therapy. During the procedure, the sphincter tone is restored, which eliminates the development of pathological reflux. Indications for surgical intervention include Barrett's esophagus, peptic ulcer of the esophagus, grade 3–4 esophagitis, and pathological narrowing of the esophagus.

Diet

Effective treatment of gastroesophageal reflux is impossible without following the principles of dietary nutrition. The recommendations are pretty simple. It is necessary to avoid overeating and take a short walk after eating. Dinner should take place 4 hours before bedtime.

The following are prohibited:

fruit juices;
dishes with a spicy taste;
chocolate;
citrus;
radish;
coffee;
alcoholic drinks;
fried foods;
bakery.

The menu of a patient with GERD should include low-fat kefir, milk, cream, low-fat fish, steamed, soups prepared with vegetable infusions, and sweet-tasting fruits. Alkaline mineral waters, tea with added milk, homemade crackers, yesterday's bread, butter, cereals - buckwheat, semolina and rice, watermelon - will be useful. Dieting reduces the risk of reflux. You can read more about dietary nutrition for GERD in this article.

Can GERD be completely cured? No, but it is quite possible to achieve a long period of remission and practically forget about the disease.

Treatment with folk methods

As additional methods of therapy, it is allowed to use traditional medicine recipes. Combinations of drug support and home methods help speed up recovery, eliminate pathological symptoms and improve the patient’s overall well-being.

GERD can be treated in the following ways:

A decoction of flax seeds. Brew 2 tbsp. l. product with boiling water (500 ml). Leave for 8 hours. Filter and take 100 ml before meals. The duration of the course is 6 weeks.
Rosehip or sea buckthorn oil. Drink 1 tsp. three times a day. It acts as an anti-inflammatory, wound healing, strengthening and antibacterial agent.
Decoction of marshmallow roots. So, pour 6 grams of the root with boiling water (200 ml) and simmer in a water bath for half an hour. Drink the filtered product 100 ml three times a day.
Celery root juice. Take 1 tbsp of freshly squeezed juice. l. three times a day. It copes well with the pathological symptoms of the disease.

Treatment of GERD according to Bolotov is becoming increasingly popular. But the proposed method contributes to an increase in the level of acidity of gastric juice, which can cause the development of a relapse of the disease.

Possible complications

The most common complication - found in approximately 45% of all diagnosed cases - is the formation of reflux esophagitis. The ulcerative-erosive damage to the mucous membrane that accompanies the disease can leave rough scars after healing. As a result, the patient experiences a narrowing of the lumen of the esophagus. Worsening patency is indicated by dysphagia (impaired swallowing), frequent belching and heartburn.

Long-term inflammation causes the formation of ulcers. Damage to the wall can extend to the submucosal layers and be accompanied by frequent bleeding. In the absence of adequate treatment, replacement of the esophageal epithelium with cells typical of the stomach or intestines is possible. The degeneration that has occurred is called Barrett's esophagus and is a precancerous condition. In approximately 5% of patients it progresses to adenocarcinoma.

Prevention

Following simple recommendations will help prevent the development of the disease. You need to carefully monitor your weight. The presence of extra pounds is one of the factors provoking pathology. To do this, you need to completely abandon or significantly limit the consumption of fatty/fried foods, sweets and baked goods. After eating, you should not lie down, since in this case the likelihood of gastric contents reflux into the lumen of the esophagus increases several times.

The appearance of pain, regular heartburn and belching is a serious reason to consult a doctor. Gastroesophageal reflux disease is a serious and difficult disease to diagnose. That is why, if characteristic symptoms appear, it is necessary to consult a specialized specialist and, if necessary, undergo a full course of treatment.

What is heartburn - an innocent discomfort, or a symptom of a serious illness? Gastroenterologists note that it occurs when the digestive system is disrupted. Reflux gastroesophageal disease is currently diagnosed in 40% of the population. Doctors insist on the seriousness of the disease and the dangers of ignoring symptoms. Having familiarized yourself with valuable information first-hand from doctors, you can detect and cure the disease in time.

What is gastroesophageal reflux disease

The contents of the stomach can be thrown into the lumen of the esophagus: hydrochloric acid, pepsin (gastric juice enzyme), bile, pancreatic juice components. In this case, unpleasant sensations appear, these elements have aggressive properties, therefore, they damage the mucous membrane of the esophagus. Often occurring heartburn makes the patient go to the clinic, where reflux esophagitis of the esophagus is diagnosed. Over the past decade, this disease has become the most common among diseases of the digestive tract.

Causes of reflux

The risk group for reflux gastroesophageal disease is headed by men. Women are seven times less likely to suffer from esophageal disease. Next come the elderly who have crossed the fifty-year mark. There are many unexplored factors that influence the operation of the valve between the stomach and the conductor of food. It is known that esophageal esophagitis occurs when:

obesity
recurrent gastritis;
alcohol abuse, smoking;
sedentary lifestyle;
the predominance of fatty and protein foods in the diet;
pregnancy;
intensive sports activities, when there is a strong load on the abs;
increased acidity of the stomach;
prolapse of the valve between the stomach and the food duct;
hereditary predisposition.

Symptoms of GERD

Reflux disease is a very serious disease. According to the code in the ICD (International Classification of Diseases) 10th revision, a disease such as bronchial asthma can be a consequence of the reflux of aggressive acidic stomach contents into the esophagus and even into the respiratory tract. Signs of GERD:

belching;
pain in the larynx;
bursting sensations in the chest and esophagus;
morning cough;
frequent diseases of the ENT organs: sore throat;
erosion on the surface of the teeth;
heartburn in the throat;
painful swallowing (dysphagia).

Diagnostic methods

If a person has not known the cause of heartburn for more than five years, then he needs to visit a gastroenterologist. The main and most reliable ways to identify the disease:

Gastroscopy. During an examination of the esophagus, the doctor may see erosive foci or changed epithelium. The problem is that 80% of patients do not experience heartburn very often, so they do not seek help from a doctor.
Daily PH measurements. With this diagnostic method, a thin probe is installed into the lumen of the esophagus, which during the day detects the reflux of acid into the lower esophageal section.

How to treat GERD

Heartburn sufferers take baking soda, milk, or other antacids the old-fashioned way. If you have repeated discomfort after eating for several years, you should not self-medicate. It is not recommended to take medications on your own to relieve symptoms of the disease; this can only harm your health and lead to irreversible processes in the esophagus. It is recommended not to ignore the doctor’s orders, but to follow all his orders.

Medicines

Modern medicine treats gastroesophagitis of the esophagus by influencing the secretion of hydrochloric acid. Patients with reflux disease are prescribed prokinetic drugs that block its secretion in the stomach, reducing the aggressiveness of gastric juice. It continues to be thrown into the esophagus, but does not have such a negative effect. This treatment has a downside: when acidity decreases, pathogenic microflora begins to develop in the stomach, but side effects develop slowly and cannot harm a person as much as regular reflux of acid into the esophagus.

Surgical treatment

Surgical intervention for esophageal disease is inevitable in the following cases:

when drug treatment cannot overcome the disease. With prolonged exposure to drugs, there are cases of addiction to them, then the result of treatment is zero;
progression of reflux esophagitis;
for complications of the disease, such as heart failure, bronchial asthma;
in the presence of stomach or esophageal ulcers;
formation of malignant tumors of the stomach.

Treatment of GERD with folk remedies

Natural methods of control can successfully cope with reflux disease not only at the initial stage, but in a chronic, advanced degree. To treat the esophagus, it is necessary to regularly take herbal decoctions that reduce stomach acidity. Here are some recipes:

Place crushed plantain leaves (2 tbsp), St. John's wort (1 tbsp) in an enamel container, pour boiling water (500 ml). After half an hour, the tea is ready to drink. You can take the drink for a long time, half a glass in the morning.
Fill a teapot with centaury herb (50 g), chamomile flowers with boiling water (500 ml). Wait ten minutes, take instead of tea three times a day.

Diet for GERD

One of the important components of treatment and exclusion of relapse of GERD disease is dietary nutrition. The diet for reflux esophagitis of the esophagus should be based on the following principles:

Eliminate fatty foods from your diet.
To maintain a healthy esophagus, avoid fried and spicy foods.
If you have a disease of the esophagus, it is not recommended to drink coffee or strong tea on an empty stomach.
People prone to esophageal diseases are not recommended to consume chocolate, tomatoes, onions, garlic, mint: these products reduce the tone of the lower sphincter.

Possible Complications

Reflux disease is dangerous due to its complications. The body reacts negatively to constant damage to the walls of the esophagus by mucous acid. With a long course of reflux disease, the following consequences are possible:

One of the most severe consequences is the replacement of the esophageal epithelium from flat to columnar. Experts call this state of affairs a precancerous condition. The name for this phenomenon is Barrett's esophagus. The patient does not feel any symptoms of such a complication. The worst thing is that when the epithelium changes, the severity of the symptoms decreases: the surface of the esophagus becomes insensitive to acid and bile.
The child may develop a narrowing of the esophagus.
Oncology of the esophagus leads to high mortality: patients seek help too late, when it is impossible to cope with the tumor. This is due to the fact that signs of cancer appear only in the last stages.
There is a high risk of developing bronchial asthma and pulmonary disease.

Prevention

To avoid reflux gastroesophageal disease of the esophagus, you need to monitor your health and treat it with care and great responsibility. Many preventative methods will help prevent the development of the disease. This:

giving up bad habits: smoking, alcohol;
exclusion of fatty, fried, spicy foods;
if you have an esophageal disease, you need to limit your intake of hot food and drinks;
eliminate work in an inclined position and stress on the press;
men need to replace the belt that pinches the stomach with suspenders.

Find out what duodenogastric reflux is - symptoms, treatment and prevention of the disease.

Video about gastroesophageal reflux

The article will discuss modern treatment of GERD. What kind of pathology is this? How to get rid of it?

Gastroesophageal reflux disease (GERD) is a pathological condition in which the reflux of what is contained in the stomach occurs into the lumen of the esophagus. This disease can often develop against the background of cardiac insufficiency. This kind of disease can appear at any age, regardless of the person’s gender. In order to cure this pathology, they use not only traditional medicine methods, but also folk remedies.

Treatment of GERD with the help of folk remedies is considered today to be no less effective than therapy that involves taking synthetic medications. But, of course, the only condition immediately before using this or that folk medicine or pharmaceutical product is a mandatory consultation with your doctor. Next, we’ll talk about how GERD is treated, and also consider methods of traditional and drug therapy.

Symptoms of pathology

The main symptoms of this disease are heartburn with belching, which appear at least twice a week for four to eight weeks or longer. Patients may also complain of a feeling of some kind of compression in the epigastric region, which occurs fifteen to forty minutes after eating. This sensation, as a rule, can be provoked by eating foods that stimulate the synthesis of hydrochloric acid in the stomach. These include the following foods: fried and spicy foods along with juices, alcohol, dry red wine, carbonated drinks such as Coca-Cola, Fanta and so on. In addition to them, provocateurs are: coffee with chocolate, cocoa, radishes and butter in excessive quantities.

Often, patients with reflux disease may complain of pain behind the sternum, which radiates to the neck, jaw, shoulder or arm, and also under the left shoulder blade. If there is pain in the area of the left shoulder blade, then a differential diagnosis with angina pectoris should be carried out.

Symptoms and treatment of GERD are often interrelated. Directly with gastroesophageal reflux disease, chest pain is associated with the following factors:

Excessive food consumption, mainly overeating.
Low head position during rest and sleep.

Certain complaints, as a rule, are provoked by physical exertion associated with frequent bending of the body, and in addition, with the fact that the stomach is full of liquid, sweet or fatty foods and alcohol. Unpleasant symptoms may worsen at night. The entry of contents from the esophagus into the bronchial lumen area can lead to bronchial spasms and Mendelssohn syndrome. In this case, it should be noted that for a fatal case to occur, it will be enough if about four milliliters of gastric juice enters the bronchial tree.

How is reflux disease treated?

Drug treatment of GERD is divided into two stages: initial (initial) and secondary.

In the first phase, transitory pump inhibitors are prescribed, for example, substances such as lamprazole or pantoprazole. Preparations based on these components are prescribed for the healing of erosive esophagitis. They also help to completely overcome clinical manifestations. Initial therapy should last four weeks. Next, patients are transferred to a dose that maintains remission over the next month. In the erosive form of the disease, the duration of initial therapy should be from four to twelve weeks, followed by the use of one of the long-term treatment regimens. As part of the generally accepted treatment strategy with antisecretory drugs, double doses of inhibitors are initially prescribed for two months, followed by transition to long-term treatment.

Treatment of GERD (second phase) is expected to be long-term, the goal of which is to achieve remission. Treatment is carried out in three options. First, long-term daily use of inhibitors is prescribed. Secondly, inhibitor therapy is carried out at full dose in a short three-day course in case of increased symptoms. Thirdly, they carry out “weekend” therapy, in which the use of inhibitors in an anti-relapse dosage is prescribed.

If initial therapy is observed to be ineffective within two weeks, esophagoscopy with pH monitoring should be performed. If monitoring indicates nocturnal breakthroughs in acidity, the patient will be prescribed Famotidine or Ranitidine in addition to the double dose of inhibitors. In situations where biliary reflux is indicated, patients are prescribed ursodeoxycholic acid. To achieve resistance of the esophageal mucosa, a decoction of flax seeds is recommended, as well as drugs for the treatment of GERD such as Maalox, Phosphalugel and Gestal.

In this case, Maalox is considered the most effective. Such patients are also prescribed prokinetics in the form of Cisapride or Cerucal, which increase the tone of the esophageal closure and reduce the severity of gastroesophageal reflux. These medications, among other things, reduce acidification of the esophagus. A positive result is achieved through the use of sea buckthorn and rosehip oils. The dose is selected individually: from one teaspoon to three times a day. Let's look at the main methods of treating GERD.

Carrying out endoscopic and surgical treatment

Endoscopic and, in addition, surgical treatment of GERD is recommended for patients in the following cases:

The body's need for long-term drug treatment.
Insufficient effect of drug treatment.
Diaphragmatic hernia of large volume of reflux.
Complications in the form of bleeding, stricture and development of Barrett's esophagus, and in addition, the presence of esophageal cancer.
Personal desire of the patient.

But before this, GERD is most often treated with medication. We will consider the most effective folk remedies below.

The criteria for the effectiveness of therapy in this case are the following goals:

Achieving healing of erosive lesions of the esophagus.
Relief from heartburn.
Improved overall quality of life.

The relapse rate during the first twelve months after successful completion of therapy is usually from forty to sixty-five percent for the erosive type of pathology.

The treatment regimen for GERD is selected by the doctor individually.

What diseases can this pathology be associated with?

The nature of gastroesophageal reflux disease is explained by the fact that the motility of the stomach and esophagus is impaired. This disease develops with a reduced antireflux barrier, decreased tone of the esophageal closure and clearance. Patients who suffer from impaired production of digestive hormones and, in addition, pancreatic enzymes, which occurs due to a decrease in the stability of the esophageal epithelium, are at increased risk of developing symptoms of this disease. A decrease in saliva production is also important, along with a violation of the cholinergic innervations of the esophagus. GERD often develops in patients who are carriers of Helicobacter pylori. For such patients, there is a higher risk of developing stomach ulcers.

What else is included in effective treatment for GERD?

Therapy without leaving home

The most important condition for treating this pathology is changing your usual lifestyle, which involves taking the following measures:

Completely quitting bad habits such as smoking and drinking alcohol.
It is extremely important to reduce excess body weight and lose weight.
It is recommended to avoid horizontal position immediately after eating. Thus, under no circumstances should you go to bed after eating.
You should avoid wearing corsets, as well as various bandages and, in general, anything that can increase intra-abdominal pressure in the body.

Treatment of GERD with esophagitis should be comprehensive. It is equally important that a person is able to change the regime, as well as the nature of his diet:

It is necessary to completely eliminate overeating.
You should not eat food at night.
It is important to try to minimize foods that are high in fat in your diet, such as milk, goose, duck, pork, lamb, coffee and Coca-Cola. You should also not lean on citrus fruits, tomatoes, garlic, and also dry red wines.

Patients who suffer from long-term heartburn for ten years or more are subject to dispensary observation. Patients with an erosive form of pathology and Barrett's esophagus should also be monitored. In cases of development of Barrett's esophagus, patients should be prescribed inhibitors in a double dose for at least three months, followed by a reduction in the amount of the drug to the standard norm. As for endoscopic monitoring with biopsy, it must be carried out annually. In the presence of high-grade dysplasia, an endoscopic examination with multiple biopsies from the affected areas of the mucosa is required. For patients suffering from Barrett's syndrome and dysplasia, endoscopic mucosal resection or surgical esophagotomy is recommended.

There are a lot of reviews on the treatment of GERD.

What drugs are used to treat gastroesophageal reflux disease today?

Today, specialists prescribe the following drugs to treat this pathology:

The medicine "Pantoprazole" is prescribed 20 milligrams twice a day or 40 times a day at night. The therapeutic course is one month. The maintenance dose is 20 milligrams at night for the next month.
The drug "Famotidine" is also prescribed 20 milligrams twice a day: first before breakfast and then before dinner.
The medication "Ranitidine" is taken 150 milligrams twice a day. The most effective remedies for treating GERD are sold at any pharmacy.
The pharmaceutical drug "Sucralfate" is taken 500 milligrams one and a half hours after meals up to four times a day.
The drug "Maalox" is used two packets up to three times a day.
Metoclopramide is taken 20 milligrams three times a day.

GERD and traditional medicine

It is important to understand that traditional medicine will not help eliminate the main cause of the disease, which lies in the weakness of the cardiac sphincter. Traditional methods only help to reduce the intensity of symptoms. Today, people have many means to help normalize the condition of patients with GERD. We are talking about the use of special decoctions prepared from herbs with the addition of, for example, honey. In addition, you can drink mineral water or tinctures. It is important to emphasize that before using any folk remedy, it is recommended to consult your doctor.

What else does treatment of GERD involve using folk remedies?

Application of potato juice

In this case, starch, which is contained in potatoes, which contain a lot of it, has a special healing property. Starch can completely envelop the esophagus, thereby becoming a protection against the negative effects of hydrochloric acid. The use of this remedy, of course, will not make the disease go away, but you will be able to get rid of the feeling of heartburn for a long time.

Using chaga mushroom tincture

This mushroom grows on birch trees. It is widely used to treat diseases of the digestive system. The mushroom must first be chopped and brewed with boiling water. The mixture is then infused for one hour. The medicine is taken several times a day. It perfectly helps eliminate the symptoms of this unpleasant disease. The mushroom has the following beneficial properties:

The product contains many useful microelements that have a stimulating effect on the immune system. In addition, they contribute to the binding of hydrochloric acid, which is secreted by the stomach.
The mushroom contains anti-inflammatory substances; they cope well with inflammation in the esophagus, which is provoked by the aggressive influence of hydrochloric acid.

The disadvantages of using this tool are as follows:

The appearance of allergic reactions in the presence of individual intolerance.
This mushroom is toxic, so it should be used strictly according to the recipe.

Plants and herbs

To effectively treat GERD with folk remedies, herbs with various plants are widely used. The most effective are the well-known chamomile with stinging nettle, St. John's wort, sea buckthorn and lemon balm. But it is very important to know how to brew them so that they have a healing effect. The most effective remedy is considered to be a decoction made from chamomile with St. John's wort and lemon balm. All these herbs need to be taken in equal parts and brewed with boiling water, and then allowed to brew a little. The decoction should be consumed in the form of tea. In order to enhance the beneficial properties, it is recommended to add a little honey. The resulting drink has anti-inflammatory, soothing and wound-healing effects.

Nettle also has an anti-inflammatory effect, so it can be brewed or added to various dishes, such as soups. Sea buckthorn oil is famous for its wound-healing effects, but it can be used in small quantities. It is important to note that only water-based products are allowed to be used to treat this pathology. The use of alcohol tinctures is strictly prohibited due to the fact that ethyl alcohol can have an irritating effect on the mucous membrane of the already affected esophagus.

Aloe juice is often used in the folk treatment of GERD.

Uses of aloe juice

Aloe juice is considered a unique remedy that is rich in a lot of healing properties. This remedy is actively used to treat many diseases that occur in the digestive system. To reduce the symptoms of GERD, you need to mix the juice of this plant with honey, and then dilute it with some water. The resulting medicine is taken throughout the day. It is important to note that it is not advisable to consume pure honey if you have GERD. Thanks to aloe juice, the following beneficial effects can be achieved:

The immune system is activated.
Inflammation is relieved.
It has a wound-healing effect.
It has an enveloping effect.

Treatment of GERD during pregnancy

Treatment of such an ailment as gastroesophageal reflux disease in pregnant women is carried out under the supervision of specialized specialists. If this disease manifests itself during pregnancy, then there is a fairly high probability that it will be temporary, and the symptoms will disappear immediately after childbirth. At the initial stage of this pathology during pregnancy, doctors, as a rule, recommend lifestyle changes along with herbal medicine, and only in the presence of extremely uncomfortable symptoms is it considered appropriate to carry out drug treatment. Basically, therapy for GERD in pregnant women is symptomatic and improves the quality of life along with the well-being of the expectant mother.

Treatment of GERD in children

To treat this pathology in children, the following methods are used:

non-drug therapy;
drug therapy;
surgical correction.

The younger age group is treated non-pharmacologically using postural therapy (changes in body position) and nutritional correction.

To reduce gastroesophageal reflux and reduce the risk of developing esophagitis, you need to breastfeed while sitting at an angle of 50-60 degrees. Overfeeding is unacceptable. After feeding, be sure to hold the baby in an upright position. During sleep - a special elevated position of the body.

In order to correct nutrition, mixtures with anti-reflux properties are selected, which help thicken food and reduce reflux.

Older children should:

eat often in fractional portions;
increase proteins in the diet, reduce fats;
exclude fatty foods, fried foods, spicy foods;
do not drink carbonated drinks;
limit sweets;
be in an upright position after eating for at least half an hour;
do not exercise after eating;
eat no later than three hours before bedtime.

The following can be used as medicine:

proton pump blockers - "Rabeprazole";
prokinetics - Domperidone, Motilium, Motilak;
drugs that normalize gastric motility - Trimebutin;
antacids to neutralize hydrochloric acid (Maalox, Phosphalugel, Almagel).

In more severe cases, surgery is indicated.

What specialists will help with the development of GERD or diagnostic methods?

First of all, you need to contact a gastroenterologist. When examining patients suffering from gastroesophageal reflux disease, the following signs are usually revealed:

The appearance of dry mouth, which is also called xerostomia.
The appearance of hypertrophied fungiform papillae of the tongue, which is the result of the process of gastric hypersecretion.
The presence of a positive left or right phrenicus symptom.
The appearance of signs of laryngitis, which manifests itself in the form of hoarseness.

The diagnosis of reflux disease is confirmed by x-ray when backflow of the contrast agent from the stomach into the esophagus becomes apparent. In addition, the results of 24-hour pH monitoring are being studied. But the main standard for diagnosing GERD is the endoscopic research technique.

Today, there is the following classification of esophageal lesions according to esophagoscopy:

Zero degree, at which the esophageal mucosa is intact.
In the first degree of severity, doctors observe separate signs of erosion that do not merge with each other.
At the second degree of severity, erosions are observed, merging with each other, but they do not spread to a large area of the esophageal mucosa.
At the third degree of severity, erosive lesions occur that occupy a third of the esophagus. In this case, erosions can merge and spread over the entire area of the mucous membrane of the esophagus.
At the fourth degree of severity, doctors observe erosive and ulcerative changes with complications. In this case, stricture of the esophagus with bleeding and mucosal metaplasia with the formation of Barrett's esophagus may be observed.

Specialists are guided by the following diagnostic criteria in case of suspected GERD:

The presence of typical clinical symptoms in the form of heartburn and sour belching.
Carrying out a test with proton pump inhibitors. The study evaluates the effectiveness of a one-week course of using modern inhibitors.
Perform endoscopic confirmation of esophagitis.
Positive results of 24-hour esophageal pH monitoring.

To diagnose GERD symptoms and subsequently treat them, the following techniques are used:

Taking a general blood test with its biochemical examination.
Carrying out a test for Helicobacter pylori.
Taking a biopsy. Such an analysis is indicated if, during endoscopy, there is a suspicion of intestinal metaplasia. This analysis is also necessary for patients suffering from ulcerative lesions of the esophagus, stenosis, and in addition, if there is a suspicion of non-reflux origin of esophagitis.

In conclusion, it should be said that today a disease such as GERD is a very common phenomenon. Its treatment may be effective if targeted therapy is carried out using modern medications. As for traditional methods, they also have the right to be used in this case and are applicable as an additional stimulating treatment.