What is Reflux?

Reflux disease is the displacement of gastric secretions consisting of acid, bile and mucus up to the esophagus or mouth. Reflux disease manifests itself with a bitter taste and food sensation in the mouth. Atypical reflux, on the other hand, may cause a feeling of a lump in the throat after edema that develops in the inner part of the esophagus. Likewise, it may cause complaints such as chest pain due to spasm that occurs after irritation. It can also be confused with heart diseases, especially due to chest pain. Apart from this, it can also cause complaints such as hoarseness, dry cough, painful swallowing or difficulty swallowing, or hiccups.

Symptoms

What are the Symptoms of Reflux?

Reflux disease can be examined under two headings as typical and atypical symptoms. Among the most common typical reflux symptoms ; burning in the stomach, sourness, feeling a bitter taste in the mouth, pain in the chest or coming to the mouth of the food you eat.

Atypical reflux findings are often confused with otolaryngological diseases. The most common atypical reflux symptoms  are;sinusitis,dry coughbad breathfindings such as hoarseness or tooth decay.

Because reflux disease often causes chest pain, heart or with chest diseases is often confused. Reflux can cause many diseases. For example, one of the most common causes of chronic pharyngitis is reflux disease. Likewise, if the fluids in the stomach go up to the trachea and mix with the lungs, it can cause reflux, lung diseases or asthma in the long term.

Diagnostic Methods

Reflux Diagnosis

For the diagnosis of reflux , first of all, patient complaints are taken into consideration. However, in some patients, no complaints or symptoms may be observed. Generally , the first diagnosis to be made for the diagnosis of reflux is gastroscopy. With gastroscopy , the gastric valve is examined, whether there is a gastric hernia and damage to the esophagus. If the physician deems it necessary, tissue samples may be taken from the stomach. Apart from gastroscopy, another diagnostic method used in reflux is pHmeter .

The pHmeter is used to measure the amount of acid that has escaped into the esophagus. Apart from these, the manometer procedure is one of the procedures used in the diagnosis of reflux. The manometer procedure is used to examine if there is another problem in the esophagus that could cause reflux.

Treatment Methods

How Is Reflux Treated?

Reflux treatment usually begins with a lifestyle change. For example, it is necessary not to lie down after eating, to eat little and often, and to avoid carbonated and alcoholic beverages. Again, it is necessary to use the drugs that will be recommended by the physician, antacids, and the drugs that will ensure the regular functioning of the esophagus and stomach.

Surgery in Reflux Treatment

If reflux disease is caused by an anatomical problem such as gastric hernia, which cannot be improved with lifestyle changes or reflux medications , then surgical treatment can be applied. Again, reflux surgery may be considered in young patients if no results can be obtained after long-term treatment or if they need lifelong treatment .

What Is Good For Reflux?

Among the things that are good for reflux ;

  • Not starving for long periods of time
  • Meals should be chewed well, consumed sparingly and frequently.
  • It is necessary to take fluids half an hour before or after a meal, not with meals.
  • It is very important to cut the last meal at least two hours before going to bed and not to sleep on a full stomach.
  • Since the meals eaten before going to bed can increase the stomach pressure, the reflux complaint will increase considerably.

How should the diet of those with reflux be?

Reflux occurs when stomach acid escapes into the esophagus as a result of the gastric valve not performing its function. Reflux disease can be controlled by changing the eating habits. People with reflux disease should avoid certain foods.

People with reflux disease;

•  Spicy foods,

•  Alcoholic beverages,

•  Coffee,

•  Carbonated drinks,

•  Oily foods,

•  Chocolate,

•  Onion, garlic,

• It is  recommended to stay away from the consumption of foods that will trigger reflux, such as pickles.

Reflux in Babies

In infants, reflux usually begins in the first year of vomiting. However, it is very normal to see physiological reflux, called physiological reflux, in babies in the first year. Reflux symptoms in babies ; how many times a day and how he vomits, the baby’s sleeping position, how much he feeds, and whether the baby is gassed or not, these symptoms should be investigated thoroughly. It is very important to distinguish well between reflux and physiological reflux.

In the treatment of reflux in infants , parents are informed about the lying position, feeding style and amount. If reflux persists after one year despite all these applications, the treatment of the baby is started by the physician. 

Reflux in Children

In children, just like in adults, there are structures called “lids” between the stomach and the esophagus, even if they are not in the form of a real valve, due to their functions. This valve, if functioning normally, prevents the acid contents of the stomach from escaping into the esophagus. Otherwise, this acid content can cause damage by escaping into the esophagus and this is called reflux disease.The most important factors causing reflux are impaired esophagus and stomach movements, increased intra-abdominal pressure (obesity), impaired acid regulation systems in the stomach, inappropriate physical activity, some drugs, hormones, various fatty foods, cigarette smoke, gastric hernia and genetic factors. can be counted.

Reflux disease can also be seen in children , but it is necessary to distinguish physiological reflux, which occurs especially in the first six months, from reflux disease. The cover in question develops as the child grows. However, just as the baby cannot hold his head or walk when he is first born, this valve does not work properly in the first times of life and physiological reflux occurs. This will go away on its own as you get older.If a baby or child is not gaining enough weight, is vomiting constantly, is refusing to eat and has no appetite, reflux disease may be one of the conditions to be considered.

In some patients, since it is not treated, progressive reflux may cause the child to become unable to swallow food, although rarely.

Children may not be able to describe the burning sensation at the upper end of the esophagus where it meets the mouth , and in children older than one year old, the teeth may decay from the inside and bad breath may occur, and reflux may be seen in children in the form of persistent hoarseness, chronic cough and excessive belching .

What Happens If Reflux is Not Treated in Children?

If the appropriate treatment of reflux disease is not performed, esophageal inflammation may occur, and the normal tissues of the esophagus may change, resulting in a condition called ” Barrett’s esophagus “.

Dental caries, anemia, growth retardation and esophageal stricture may also occur in cases where reflux is not treated .

Diseases Accompanying Reflux

  • Resistant iron deficiency anemia
  • Hoarseness
  • Laryngitis that does not go away due to continuous leakage and irritation from bottom to top
  • Pharyngitis
  • Sinusitis
  • Otitis
  • Re-growth of adenoid despite surgery
  • Treatment-resistant asthma
  • Tooth decay, bad breath
  •  Sandifer Syndrome (child’s head constantly throwing back for comfort)
  • Sleep disorders
  • Inability to sleep comfortably
  • Constant waking up at night
  • Recurrent pneumonia (pneumonia)

Diagnosis of Reflux in Children

Physical examination and taking a detailed medical history play an important role in the diagnosis of reflux disease in children . While the diagnosis can be made by history and physical examination, especially in classical reflux disease, further investigation may be required in younger children and patients presenting with different complaints.In the story, it is necessary to question how the child is fed, his relationship with excessively spicy, oily, sugary and cocoa foods that may prevent the closure of this valve and cause the stomach contents to go into the esophagus, and whether the cough increases when lying down.

In the physical examination, height and weight measurement and growth evaluation are important.

If the child does not have alarm findings, control treatment can be started first, but in cases where alarm findings are present, direct endoscopic examinations can be decided.

In the endoscopy , the esophagus is visualized and it is seen whether there is an anatomical defect in its entrance and exit.

When necessary, barium graphy, scintigraphy, 24-hour pH monitoring, manometer, multichannel impedance monitoring and wireless pH monitoring can be used as a more detailed examination and diagnosis method.

Reflux Treatment in Children

In the treatment of reflux disease, the lifestyle of the child needs to be changed. It can be recommended that a child diagnosed with reflux not go to bed too full and not drink night milk in the first two years. It is very important that these children do not wear tight clothes, eat little and often, and keep them away from spicy, spicy, fatty and cocoa foods and acidic beverages.Lying on the left side, raising the head of the bed, weakening overweight children, and treating constipation, if any, can be extremely effective in reflux disease.

In addition, it is recommended that parents choose appropriate sports for their children and keep their children away from sports that require a handstand, such as gymnastics.

While the main treatment of reflux disease in children can be achieved by changing the eating-drinking habits and lifestyle, some patients can use drugs that reduce acid secretion in the stomach, protect the stomach surface, and regulate stomach movements for an average of three to six months.Although surgical treatment is rarely the preferred approach in children, it can be applied in some cases.

Reflux during pregnancy

Reflux is one of the most common diseases encountered during pregnancy . It occurs when the hormonal balance is disturbed and the baby puts pressure on the stomach as the baby grows. Pregnant women should avoid coffee, chocolate, yeast dough and fatty foods.Pregnant women should adjust the head of the bed so that the head is up at night, or keep the head up by supporting it with a pillow and avoid clothes that tighten the abdomen. If your reflux complaint does not regress despite these precautions, you can use reflux medications that may be recommended by your doctor .

What are the Differences Between Reflux and Gastritis?

Reflux disease may develop due to dietary habits and gastric hernia . Most of the time, uncontrolled use of rheumatic drugs and painkillers cause gastritis . After excessive drug use, deterioration and inflammation of the protective stomach wall are observed.

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