September 17, 2023
Between 20 and 30 percent of the population suffers from the disease, which manifests as coughing, wheezing or chest tightness. Interview with gastroenterologist Dr. Jos Ignacio Cueli.
Gastric reflux is a pathology affecting the stomach Between 20% and 30% A variety of symptoms may occur in the population. It is one of the most common digestive disorders in Western society and manifests itself when stomach acid frequently flows into the esophagus.
he The American College of Gastroenterology says more than 70 million Americans experience heartburn at least once a month At least 15 million per day.
To this question, Olavarria gastroenterologist José Ignacio Cueli agrees that gastric reflux “is a very common condition in the office. Two to three out of 10 patients he sees have it.”
In medical terms, Dr. Qualley explains, “This is basically the reflux of acidic stomach contents, rising up into the esophagus and causing a feeling of discomfort and discomfort.”
Symptoms are varied and easy to recognize: “Fever due to rising stomach acid, acid reflux, and chest pain, of course first to rule out heart disease.” There are other, less common symptoms that may be sinusitis, laryngitis, cough, asthma, dental problems Fall off.”
One of these that is very typical is cough, which requires frequent referral from the pulmonologist to a gastroenterologist.. “Patients with cough, asthma or chest tightness, many of whom improve with reflux treatment” Dr. Kweli pointed out.
“If it’s a cough, you always have to rule out other causes. In cases of reflux, use omeprazole and a gastroprotectant and the symptoms will disappear,” he added.
Regarding the origins, Dr. Cueli mentions more than just an anatomical issue: “Diet can have a huge impact on reflux when a person eats foods that contain fatty, fried ingredients, but it is known that those in between Patients who have some changes in their “separation” of their esophagus and stomach can have stomach acid rise and cause this discomfort.”
“There are other causes, such as hiatal hernia, which is an alteration of the sphincter between the esophagus and stomach, which creates reflux; there is also increased acid production. Swallowing saliva often contributes to the onset of reflux. Obesity is another reason for its existence” Sure.
“I don’t want to forget that stress is also a cause of reflux, so in addition to eating a healthy, bland diet and drinking water, it’s always recommended to lower your stress levels slightly as it can affect these digestive symptoms,” he warns.
There are non-pharmacological palliative treatments for gastric reflux, one of which is to elevate the head of the bed by about ten centimeters. Dr. Kweli explains this and other measures.
“Treatment includes hygienic dietary measures. When it comes to food, that includes eating slowly, taking your time, and not eating too much.eat foods with low fat content, still drink alcohol, don’t drink alcohol,” he noted.
He talked about behaviors such as not going to bed immediately after eating and using more pillows when sleeping. “Elevating the head of the bed can be a big help for people with severe nocturnal reflux, as can eating and not exercising right away,” he adds.
If these measures don’t work or the reflux is severe, medication or surgery may be needed.
“Often people try to avoid surgery in the first place. The most commonly used drug treatments, which are most effective, are proton pump inhibitors, such as omeprazole, pantoprazole, lansoprazole and dexlansoprazole, the theory goes. There’s not much difference between them,” Dr. Cueli said.
“The most popular is omeprazole, which is always taken on an empty stomach because it inhibits the acid-producing pumps,” he noted, although he cautioned that “treatments are good, but you have to try to pinpoint what is necessary. “
“Treatment sometimes helps with diagnosis” explain.
“In patients with very severe reflux, when you do the endoscopy, their esophagus is very inflamed and they have ulcers, so the recommendation is to continue using omeprazole,” he noted.
“In milder cases, treatment can be started continuously and then as needed, or every two or three days. Although PPIs have no side effects, they can have some adverse effects in the long term,” he noted.
Dr. Cueli pointed to a drug widely used to treat these conditions that has been withdrawn from the market: ranitidine.
At Christmas 2020, ANMAT decided to preventively suspend the sale in the country of all medicines containing ranitidine as an active pharmaceutical ingredient (API), in oral pharmaceutical form, either as a single medicine or in combination with other APIs, and all their attention and speeches .
“Some effects have been seen, now that it has been replaced by famotidine, which is from the same family and does not have those effects observed with ranitidine, especially at the cardiovascular level,” Olawaria the gastroenterologist added.
For patients who do not respond to treatment, he recommends an endoscopy to rule out some complications of reflux or other related pathology.
“There are complications such as ‘barrel esophagus,’ which is damage to the lower part of the tube that connects the mouth to the stomach, and it’s important to monitor that. “Don’t just take omeprazole and let it go,” he said.