Gastroenterology
Gastroesophageal reflux disease (GERD): diagnosis and treatment abroad
‘Chronic heartburn’, sour taste in the mouth, unpleasant sensations behind the sternum - the most common symptoms of the disease with a complex name - gastroesophageal reflux disease (GERD).
To date, this disease is widespread, especially among the population of megacities and large cities. Despite a fairly high level of awareness of patients and modern methods of treatment, GERD significantly reduces the quality of life of thousands of people of working age.
Gastroesophageal reflux disease: what is the basis of the disease?
Functional disorders of the lower oesophageal sphincter (a circular muscle that ‘lets’ the food lump into the stomach and prevents it from being thrown back) lead to reflux, i.e. throwing acidic stomach contents into the oesophagus, which is the main mechanism of GERD development. Anatomical prerequisites (diaphragmatic hernia), high body weight, advanced age, irrational diet and smoking are factors that contribute to the development of this disease.
Increase in intra-abdominal pressure against the background of overeating, flatulence, pregnancy, physical effort, etc. - ‘facilitate’ reflux, causing exacerbation of the disease.
Gastroesophageal reflux disease: what happens in this disease?
The impact of the acidic environment on the oesophageal epithelium is felt by the patient as heartburn. Repeated reflux over a long period of time can lead to the development of inflammatory changes in the oesophagus - esophagitis. Erosions and ulcers of the oesophagus, in esophagitis, can potentially be complicated by conditions such as bleeding, gross scarring and narrowing of the oesophagus, with subsequent impairment of its patency. Prolonged inflammation can lead to the development of a precancerous condition called Barrett's oesophagus.
Gastroesophageal reflux disease: diagnosis
In addition to studying the patient's complaints and external examination, a number of instrumental studies may be required to make an accurate diagnosis. In particular, the method of direct imaging - endoscopy, allows you to assess the condition of the mucosa of the oesophagus throughout its length and the stomach, as well as to determine the degree of reflux.
If necessary, during endoscopy the specialist performs a biopsy (takes one or more sections of the oesophageal mucosa for examination).
Radiography of the upper abdominal cavity organs with barium contrast allows to evaluate the contour changes of the oesophagus, stomach and duodenum.
In profile clinics in Europe, in addition to the above studies, they study the motor function of the oesophagus using manometry (determination of the pressure difference in different parts of the oesophagus), and also conduct 24-hour pH metrics.
It should be noted! According to European recommendations, each method of investigation is treated selectively and carried out only if there are clear indications. The undeniable advantages of GERD diagnostics and treatment in European clinics are strict compliance with clinical treatment protocols, high professionalism of specialists, as well as comfort and delicate attitude to the patient.
Gastroesophageal reflux disease: treatment options
To date, all methods of treatment of GERD can be divided into conservative and surgical.
Conservative methods of therapy include the use of certain medications and strict compliance with recommendations for weight correction and diet. Drugs that reduce the secretion of hydrochloric acid by cells of the gastric mucosa are the first-line drugs in the treatment of GERD. By reducing the acidity of gastric juice, it is possible to reduce the negative impact of reflux on the walls of the oesophagus, control inflammation and support the repair of existing mucosal defects (erosions and ulcers).
To reduce the severity of reflux is recommended to carefully follow the recommendations on diet and daily regime. So from the diet exclude spicy and spicy dishes, alcoholic beverages, strong tea and coffee. It is strongly recommended to give up smoking (one of the factors that relax the oesophageal sphincter). It is not advisable to eat less than 2 hours before bedtime.
In case of ineffectiveness of conservative therapy, long-term GERD, as well as in the presence of ‘alarming’ changes in the mucosa of the oesophagus, the question of surgical treatment is considered.
Among possible surgical methods of treatment of patients with GERD in profile clinics of Europe, different variants of bariatric surgery (surgical treatment of obesity), gastric fundus plasty and lower oesophageal sphincter strengthening attract attention.
Contacting experienced specialists at leading European clinics is a crucial step in solving the problem of GERD. Modern diagnostic methods make it possible to make an accurate diagnosis in a short period of time and carry out treatment as effectively and safely as possible.
