HEALTHWATCH
Reflux action
|
Gastro Oesophageal Reflux has become a common problem. Dr. V. VENKATESH outlines ways and means of controlling it.
|
P.V. SIVAKUMAR
Some of the causes for GERD: Fast food, drinking and smoking
THE oesophagus (food pipe) is a tube-like structure, about 25 cm long, lying in the chest. Two cm of this tube lies below the diaphragm. The main function of the oesophagus is to transfer food from the mouth to the stomach both by voluntary and involuntary movements.
Gastro Oesophageal Reflux Disease (GERD) is a common problem in the modern world. It involves both the stomach and the oesophagus.
One of the most important causes for GERD is changing lifestyle and food habits, stress, long hours of starvation, eating spicy food, smoking and excess alcohol intake. These cause heartburn or regurgitation, cramping pain behind the chest and pressure.
K. PICHUMANI
Lying down aggravates these symptoms. Few may complain of chronic cough, difficulty in breathing and disturbed sleep.
The movement of gastric juices into the food pipe from the stomach is called reflux. There is a sphincter or valve between the stomach and the oesophagus that prevents the food coming back into the food pipe. If it becomes incompetent, reflux occurs. Other symptoms like heartburn can occur and this may move up to the neck.
The main contents of the reflux are acid, pepsins and bile with food.
Most of the time, reflux is associated with hiatus hernia or prolapse of stomach into the food pipe, which is quite troublesome.
Other symptoms include pain while swallowing. This occurs half an hour after intake of food. At times, persistent vomiting can also occur.
Less common symptoms include excess salivation, hoarseness of voice, vomiting blood, iron deficiency, anaemia and even asthma.
Hiatus Hernia is a functional problem of the stomach. Weakness of a band of muscle at the level of the oesophagus joining the stomach causes the hernia.
This occurs due to reflux, muscular degeneration, obesity and other related disorders.
The most common investigation is a chest X-ray after swallowing barium. Flexiable endoscopy has almost replaced all other investigations. PH monitoring sees a tube is passed into the oesophagus to assess the secretion of gastric contents.
An ECG is taken to rule out any cardiac causes for the pain.
REUTERS
A recent development is "wireless capsule" or capsule endoscopy. A monitor is connected to the waist after the capsule is swallowed and the oesophagus, stomach and intestines are screened.
Though a bit expensive, it is a non-invasive procedure and can be tried on patients not otherwise fit for endoscopy.
The treatment recommended for GERD are as follows:
Weight reduction is essential.
Avoid wearing clothes that are tight around the waist.
Avoid lying down immediately after eating and keep the head elevated.
Have a lot of water.
Avoid chocolates, tobacco, alcohol and spices.
Take medications prescribed by the doctor.
Despite all this, if symptoms persist, there may be a need for surgical intervention.
If long-term medications fail, laparoscopic fundoplication could be the best alternative. This is done under general anaesthesia, so is relatively painless. Using a trocar (a narrow tube-like instrument), the surgeon gains access to the abdomen through the navel.
A laparoscope (a tiny telescope) connected to a camera is inserted through the trocar allowing the surgeon a magnified view of the patients internal organs on a monitor. This procedure is safe because there is only minimal blood loss. So there is no need for blood transfusions.
Since the opening is small, there is faster healing. Patient returns to normal health rapidly.
Printer friendly
page
Send this article to Friends by
E-Mail
Magazine
