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What is reflux? Why and how is it formed?

The word “reflux” means “reverse current”. Gastroesophageal reflux refers to the reverse movement of stomach contents into the esophagus. Reflux occurs after a breach of the closure mechanism located at the junction of the esophagus and stomach occurs. In principle, there is no closure mechanism as such. If we imagine an inverted inkwell, then this is a system that prevents the acid from leaking up. After its opening, this disease begins.

What are the symptoms of reflux?

Patients with reflux come to us with a wide variety of symptoms. The most common complaint in our country is the pain in the back of the chest, as we say – in the retrosternal region. We also receive patients with such complaints as bitterness in the mouth, a feeling of heaviness, chest pain, hoarseness, coughing (especially at night), asthma attacks.


How is reflux diagnosed? What actions are performed?

Initially, a personal meeting with the patient and a detailed anamnesis help to form an opinion whether the patient has reflux, following which with the help of gastroscopy it is possible to diagnose with an accuracy of almost one hundred percent.

In some patients in whom, on the basis of their complaints, we presume reflux, it is not always possible to detect it by means of an endoscope. In this case, we use an advanced examination method called Ph Metre. After local application of the anesthetic spray, a thin cable 2-3 mm in diameter is pushed through the nose of the patient to the lower corner sections of the esophagus. The device the size of the purse, to which the cable is connected, records the acidity of the patient’s stomach within 24 hours and determines the possible reflux. The device is extracted the next day, after which we set the diagnosis of reflux using a special program based on mathematical data.


What methods are used to treat reflux?

Treatment of reflux is only surgical. We recommend special methods only to those for whom surgical methods are unacceptable. First of all, this is a special attention to habits related to nutrition. The first is not to drink beverages that contain excessive acid, if possible, to avoid taking pain medication, refrain from alcohol and cigarettes, avoid eating dishes with an abundant amount of spices, avoid fatty foods and overeating (so as not to stretch the walls of the stomach).

In addition, it is also useful to increase the number of meals. Meals at smaller intervals yet in smaller amounts also provide a protective effect, however the definitive treatment is still surgical. These are only measures that we can take for protection.


What is laparoscopic surgery? What is the solution for reflux?

Laparoscopic surgery is the ultimate solution for reflux. This surgical operation is carried out, as we say, in a closed manner. This is an operation that is performed through five openings in the abdomen, each with a diameter of five to ten millimeters. The operation takes approximately one hour, and at the end of this hour the patient can be transferred to his department. Our patients can eat on the same day, they are discharged the next day and can return to their daily activities about a week later.


Is it possible to medicate reflux?

Medication of reflux is impossible. We can offer this method only to very old patients. But this is a disease that is considerably more frequent in patients who are thirty and forty years old. With the help of medication, we can remove complaints in cases where we can not offer surgery in view of the patient’s very old age (when the age is over seventy and there are concomitant diseases). Is it possible to take medicines throughout one’s life? No, it isn’t. Since it is impossible to prescribe a thirty-year-old patient to use drugs for forty, fifty years, we recommend surgical treatment.


With which diseases are the symptoms of reflux confused most often?

Reflux very often occurs in patients who are referred to us from ENT, chest diseases, cardiology. We have patients who have come to us with chronic pharyngitis, hoarseness, cough, bad breath, chest pain. Moreover, reflux may also be confused with stomach gastritis, ulcer, gallstones


Is reflux possible in pregnant women and children?

Reflux can also occur in pregnant women and children, but it usually disappears on its own with delivery or with the child’s growth.

Reflux that may occur due to increased intra-abdominal pressure after the third month in pregnant women disappears after delivery.

The cause of reflux in children is incomplete formation of the anatomical structure, which prevents the flow of gastric juice into the esophagus. As a rule, it automatically improves within 1-2 years along with the development of the child.


What problems lead to reflux?

Considering reflux in terms of general surgery, the difficulty of swallowing due to chronic irritation of the extreme lower part of the esophagus can lead to cancer in the subsequent stages. But is it common? No, it isn’t. We can prevent this with the help of endoscope control. However, if reflux leads to Barrett’s syndrome, then it is necessary to prepare for surgical intervention.


What should patients with reflux do?

Patients with reflux must reconsider their eating habits. They must be sure to reduce fat consumption and especially alcohol consumption. Reflux is also strengthened by tea, coffee, garlic, onions, tomatoes, mint. Our patients should refrain from all this, as well as avoid carbonated drinks and eat more often but in smaller portions. Our patients with reflux should avoid wearing very tight clothes and slightly raise their pillow for sleep so that their head lies higher than usual.


Is there any statistical data on reflux? Is it compiled by country?


For our country, the rate is from twenty to thirty percent. This is largely due to eating habits. In America, it reaches some 40 percent. Because of Americans’ habit to eat fast food, their reflux rate is higher.