Definition

Gastrpesphageal reflux disease is the contents of the stomach or duodenal reflux into esophagus and cause inflammatory irritation in the esophageal mucosa; it is also called reflux esophagitis.

The disease often coexists with chronic gastritis, peptic ulcer, or hernia of esophageal hiatus; but it may also exist alone.

Pathogenesis

Mainly attributed to anti-reflux dysfunction of the highly-pressurized esophagus and stomach area ( also known as the lower esophageal sphincter, LES ).

Because of abnormalities of protective mechanisms about preventing the reflux of gastric juice from stomach into esophagus;, acid, chyme, bile and pancreatic secretions cause the esophageal mucosal injury.

Etiology

• Having too big a volume of food in the stomach : over eating.
• Increased intra-abdominal pressure : body flexion, bending, obesity, and ascites.
• Causes of the lower esophageal sphincter with decreasing pressure:
• Over cold or heated diet, smoking, drinking, coffee, tea, soft drinks, and cola.
• Pregnancy : increased progesterone reduces lower esophageal sphincter pressure.
• Diseases : such as Scleroderma.
• Drugs : such as Theophylline, Progesterone, Calcium channel blockers, alpha adrenergic agents, and diazepam.
• Position : lie down.

Symptoms

1. Heartburn, the most common symptom.
2. Retro-sternal pain.
3. Reflux of gastric fluid causing acidic and bitter feeling inside your mouth.
4. Hoarseness especially in the morning.
5. Feeling throat tightness as if there is a piece of food stuck in there; patients could suffer from nocturnal wheezing or persistent dry cough.
6. Some symptoms like regurgitation of bitter acid and heartburn become worse after eating, while bending over, or lying down.
7. Short-term complications: esophageal ulcer, bleeding, or aspiration pneumonia.
8. Long-term complications: esophageal stenosis, esophageal cancer.

Self-Care at Home

1. Avoid spicy, fatty or greasy foods, chocolate, caffeine, cocoa, tea, mints, rice, bananas, citrus, tomato, pineapple, soft drinks, cola and other foods; and abstain from alcohol and tobacco.
2. Avoid over cold or heated food.

3. Low fat and high-protein food are suggested.
4. Eat less but more frequently. Overeating could cause excessive gastric acid secretion and increase intra-gastric pressure.
5. Chew and swallow slowly; drink moderately to assist food going down.
6. After eating, do not lie down right within 2 hours.
7. Don't eat within 3 hours of bedtime.
8. Elevate the head of your bed 6 inches with blocks.
9. Sleep facing left in order for gravity to retain gastric juice in the stomach.
10. Stay relaxed and happy, properly relieve your stress.
11. Avoid wearing tight clothes, and do not bend down when working.
12. Lose excess weight.