Gastroenterology — dr andrea rajnakova
Burn in the Gullet
Stomach acids flowing back into the oesophagus is a condition that can be resolved.
SOME OF THE DIAGNOSTIC TEST INCLUDES:
GASTROSCOPY. This allows the inspection of the gullet and
stomach and detection of inflammation at the lower oesophagus.
Tissue sample could be obtained for further testing of cell changes
to rule out Barrett’s oesophagus.
24-HOUR PH MONITORING is to test the acidity of the oesophagus.
HOW IS REFLUX TREATED
The most important components for treatment are lifestyle and
dietary changes. The purpose is to minimise acid refluxing from
the stomach and reduce the potential damage to the oesophageal
lining. Certain food may worsen reflux. Medications are prescribed
to reduce acid secretion in the stomach, and to improve motility
and stomach emptying (prokinetics). Antacids may be given to
neutralise gastric acid. Most patients do not need surgery.
Burn in the gullet is the most typical symptom of reflux, which
is an irritation of the oesophagus (gullet) by the acid that comes
up from the stomach. This irritation causes troublesome symptoms
and may result in complications. It happens because the junction
between the gullet and the stomach does not function normally.
During swallowing, food passes down the throat through the
esophagus into the stomach. Normally, a muscle valve at the
end of the oesophagus (called the lower oesophageal sphincter)
opens to allow food into the stomach; then it closes again. When
this muscle does not close tight enough and remains open (called
hiatus hernia), stomach acid can reflux, or wash back, into the
oesophagus, causing damage to its lining.
People usually have heartburn pain when reflux happens, while
others feel nothing. Other symptoms of reflux include burping,
belching, sour or bitter taste in your mouth, coughing at night, dry
throat, sore throat, hoarseness in the morning, or worsening asthma.
ACID REFLUX MAY CAUSE:
OESOPHAGITIS, an inflammation of the oesophagus; it may be
associated with ulcers (breaks in the lining of the oesophagus).
Food That Should Be Avoided During Reflux Episodes
These foods can relax the muscle responsible for stomach closure
(lower oesophageal sphincter), allowing stomach juice and acid to
reflux into the oesophagus:
·· Chocolate, sweet deserts, high-fat or spicy foods, curry, citrus fruits,
garlic, onion and tomatoes or tomato-based products
·· Certain beverages, including citrus juices, alcohol, coffee, black tea
Lifestyle Habits That Improve reflux
Eat regular meals and small portions at each time, and avoid eating
for 2-3 hours before going to bed. If you are overweight, lose some
weight, and stop smoking. When you sleep, elevate the head of
your bed 6 to 8 inches. Lastly, avoid stress.
In today’s hectic lifestyle, many are affected by stress which may
lead to development of digestive problems affecting the stomach,
oesophagus and bowel. To minimize these stress related digestive
problems, avoid fast food and gulping the food due to lack of time,
eat regular meals and find some time to relax.
STRICTURE, which is the narrowing of the swallowing tube as a
result of longstanding inflammation.
BARRETT’S OESOPHAGUS, which may occur when longstanding
inflammation leads to changes of the cells of the lower
oesophagus. Patients with Barrett’s oesophagus have higher risk
of oesophageal cancer compared to general population.
How Is reflux detected
When duration of symptoms is short and reflux improves after
medication, no diagnostic tests are required. If the symptoms
persist even with medication, further investigation is mandatory.
p. 62
Dr Andrea Rajnakova
Consultant
MD (Hons), M.Med (Int Med), MRCP (UK), FAMS ( Gastroenterlogy), PhD (NUS)
Andrea's Digestive, Colon, Liver and Gallbladder Clinic
#12-10 Mount Elizabeth Medical Centre
3 Mount Elizabeth
Tel: 6836 2776
www.andrea-digestive-clinic.com