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Reflux refers to the reflux
of stomach juices up into the lower esophagus. Symptoms commonly include a burning in the upper abdomen
or mid chest area often after a meal. Regurgitation of stomach contents especially when laying flat can occur.
The symptoms can range from disabling to mild. But even mild reflux causes damage to the lower esophagus. Repeated
exposures of the lower esophagus to the stomach juices and can even lead to cancer. The number of people suffering
from reflux is increasing markedly.
Diagnostic Tests.
Typically an upper endoscopy
can visualize the damage and a biopsy done at that time confirms the diagnosis. An Upper gastrointestinal xray provides
important information as well such as the presence and size of a hiatal hernia, esophageal motility and gross reflux.
Other tests can be done to further confirm the degree of reflux.
Conservative Treatment
The first steps are life style changes. Examples are removing items from the diet known to worsen reflux such as caffeine,
chocolate, alcohol. Sleeping with chest and head proped at 30 degree angle. Avoiding large meals several
hours before sleep. Avoiding extremes in temperature with liquids. And, if all these measures are not helpful,
medications are available.
Medical Treatment
The use of anti ulcer medications to prevent
the symptoms of reflux is often very successful. These medications stop the production of acid in the stomach.
Examples include Prevacid, Nexium, Aciphex, Prilosec. Note however, the medications may greatly improve the
symptoms but do not stop the reflux itself. Damage to the lower eosphagus can still be taking place.
If the reflux contents contains a lot of bile in addition to acid, symptoms and damage can be substantial.
Surgical Treatment
Surgery changes the anatomy to prevent reflux. Successful surgery frequently
allow the patient to live a life free of both the symptoms of reflux and the medications. Studies show the damage
to the lower esophagus and the future incidence of cancer are both greatly reduced.
Surgery for Reflux
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