Gastroesophageal reflux (GER)


What is gastroesophageal reflux (GER)?

GER is a chronic disease featuring frequent exacerbations. Because of impairments in food advancement from the esophagus to the stomach, the contents of the stomach and duodenum is regurgitated into the esophagus and causes inflammation there. When no treatment is provided, GER progression occurs. The erosive (i.e. associated with erosion of the esophageal mucosa) and nonerosive forms of the disease are possible.

What is the prevalence of GER?
GER affects 12-30% of population. Heartburn, which is the main symptom of GER, occurs in 20-40%.

What are GER risk factors?
GER risk factors include
-stress;
-obesity;
-diaphragma perforation;
-pregnancy;
-smoking;
-esophageal hernia; -some drugs (aspirin, paracetamol, diclofenac, etc.)
-spiced and fat food, chocolate, coffee, chips, alcohol, carbonated drinks, salt nuts etc.

What is the immediate cause of GER?
Regurgitation of stomach contents (hydrochloric acid, pepsin, etc) and duodenal contents (which is alkaline) and their prolonged contact with esophageal mucosa result in its severe lesions.

What are the main symptoms of GER?
Esophageal symptoms:
-heartburn;
-difficulties in food swallowing and propulsion through the esophagus;
-pain along the esophagus upon swallowing and the sensation of weight in the esophagus;
-the sensation of discomfort along the esophagus before, in the course of, and after food intake;
-accelerated satiety;
-eructation (acid or bitter taste) and the sensation of too much liquid in the mouth.
Extraesophageal symptoms:
-bronchopulmonary symptoms include cough, dyspnea (usually in the supine position), prolonged relapses of bronchitis and laryngitis and bronchial asthma; -otolaryngologic symptoms include husky voice and salivation;
-stomatologic symptoms include caries progression to chalicosis and dental erosion;
-gastric symptoms include accelerated satiety, nausea, vomiting, and abdominal swelling;

-cardiologic symptoms include retrosternal burning, similar to that in ischemic heart disease, and anginal pain.
Many symptoms of GIR are reminiscent of other diseases. Besides, it should be minded that gastrointestinal diseases may follow an atypical course. Therefore, if you start to experience any of the above symptoms, it is highly advisable to seek the attention of gastroenterologist. Only your visit to specialist followed by examination of your gastrointestinal tract may help to make the exact diagnosis and to start treatment in time. Fear not physicians, fear diseases!

What examination are required when GER is suspected?
When GER is suspected, the patient should be thoroughly examined. The examination should include the following: -clinical blood tests including blood group and rhesus factor determination;
-feces testing for cryptic blood;
-general urine tests;
-blood serum test for iron;
-electrocardiography;
-esophagogastroscopy (combined with histological examination, where necessary);
-esophagus and stomach endoscopy, where necessary.
All of the above are available at LenMedCenter.

What if you do not receive treatment?
Then GER will become chronic. This disease compromises life quality and reduces workability and some of its symptoms, especially nocturnal, are just torturous. Untreated GER significantly increases the risk of serious complications including esophageal jaundice, hemorrhage, and strictures. There is a possibility of development of other diseases, such as Barrett esophagus, which is a precancerous condition. This occurs in every tenth GER patient, most likely upon long-standing GER. It should be noted that the specific features of Barrett syndrome are such that 30% of patients do not experience heartburn, the main symptom of GER. Some authors provide evidence that GEG promotes larynx cancer.

Do not wait until GER will interfere with your way of life or cause complications! Seek the advice of an expert! At LenMedCenter you may be provided not only with necessary diagnostics but, also, with appropriate treatment. A wealth of experience in this field is gained by gastroenterologists working at LenMedCenter including its Head, Prof. Elena Nikolayevna Lapteva MD, Highest Category Doctor in gastroenterology and dietetics.