Reflux is a normal physiological phenomenon of every person. Meanwhile, gastro-oesophageal reflux disease (GORD) means that your reflux has become pathological. The disease develops as the content of your stomach moves back to the oesophagus more and more often, and the process is repetitive. Many people call this unpleasant sense “increased gastric acidity”. However, according to gastroenterologist of Paediatrics Centre of Vilnius University Children Hospital Vaidotas Urbonas, ASP, a person who can feel acidity of his/her stomach, does not exist. In most cases acidity is the expression of gastric acid access to the oesophagus and the premonition of possible gastro-oesophageal reflux disease.
Repeated access of gastric acid to the oesophagus may cause oesophagitis or damage the organs behind oesophagus, such as vocal chords or airway system. Content of the stomach in the oesophagus may burn wounds and even damage the dental enamel.
GORD in teenagers manifest as heart aches and pains
Main symptoms of the disease are brash, the burning and gnawing sense behind the breastbone and belch with a sour or bitter content. Also, cough, hoarseness, loss of voice, itch deep in the throat, and chest aches and pains resembling to symptoms of myocardium infarction. It must be noted that aches and pains in the thoracic area in adults are more often related to cardiac disorders, while the same in teenagers usually are the signs of GORD. Another symptom of the disease is pain in the upper abdominal area (epigastrium). If the complaints reoccur at least twice a week and last a month or longer, there is a high possibility of having GORD.
Innocent cough can provoke the disease
Two of the most frequent and seemingly least GORD-related symptoms are chronic cough that lasts for months and morning hoarseness. If hoarseness begins without a reason (the patient does not catch cold or something), it can be caused by gastro-oesophageal reflux. GORD may also affect repeated pneumonia, breathlessness and asthma attacks.
On the other hand, the patient often bothered by cough, whooping-cough or pneumonia also risk to have GORD in future. “That is why we have difficulties to identify whether the chronic cough is caused by GORD or vice versa. The differentiation is highly important because it is what treatment depends on,” explained the gastroenterologist.
Reflux may also cause sleep disorders.
Even breast milk may cause reflux pathology
According to V. Urbonas, ASP, GORD can be either a primary disease with unknown or unclear causes or a secondary disease, complication of another disease, with clear causes: “I had the case in my practice: a three-years-old child was referred to us after unsuccessful treatment for GORD and later it appeared he had brain tumour. Luckily, such cases are rare. My patients are usually diagnosed with food allergies that manifest as skin rash, breathlessness, diarrhoea, nausea, vomiting and reflux. There was the child who was having heavy reflux caused by breast milk but was ok on artificial milk, treated at our department. Thus, if a child or adult has reflux or vomits frequently, the predisposing causes of GORD should first be looked for.”
Psycho emotional state (kindergarten, school or home environment) of GORD patients is equally important. Emotional background causes digestion disorders quite often. Overweight, hard manual work and sports, such as swimming, also affect development of the disease.
Proper diet helps half of the patients
According to the gastroenterologist, people eat similar food; most of them tolerate all food well and do not have any digestive disorders. Only a small part has problems. It means that the cause may be insufficient digestive system that does not tolerate particular products.
Many people know by experience that sour, fried, fat, mint-spiced food, flour dishes (flour gluten), carbonated drinks and synthetic products (muesli, potato chips, ketchup and mayonnaise) irritate the digestive system and cause brash. Apple juice and Vitamin C may also have negative effects on digestion. By the way, people, who try to improve their immunity with Vitamin C, bring themselves more harm than use because ascorbic acid may cause oesophageal erosion.
According to V. Urbonas, ASP, food is especially important for GORD patients. Even half of the children under treatment do not require any medication. Well-balanced diet is quite enough.
Untreated disease may end up with cancer
Most often people come to gastroenterologist due to pain, brash and acid reflux. The symptoms are really unpleasant and cannot be tolerated for a long time.
“However, aggressive and improperly treated GORD, when patients find information online or in other sources and engage in self-treatment, may complicate in time. Bleeding wounds may appear in the oesophagus. If bleeding lasts for a month or longer, they may end up with iron deficiency anaemia,” warned the associated professor. “The number of GORD patients in Lithuania has grown 8 times in 15 years; our hospital has over 600 of them annually.”
Repeated inflammations form strictures (scars): food passage to the stomach becomes difficult and thus may cause another complication, oesophageal narrowing.
Barrett’s oesophagus is the pre-cancer stage of oesophagus. If GORD becomes chronic, its exacerbations impose high risk of oesophageal adenocarcinoma. It is one of the most frightening oncological diseases because it is incurable. Number of the patients is increasing annually in Lithuania; there are approximately 200 cases diagnosed a year.
Reduction of gastric acidity is dangerous!
Treatment of gastro-oesophageal reflux disease is quite a difficult process because of almost undetectable causes of the disease. First step of the treatment is elimination of predisposing factors: adjustment of diet as well as work and rest modes. If these do not help, medication is prescribed.
“Naturally, medication of GORD is nothing but symptomatic. Unfortunately, there is no other alternative. Most people try to reduce gastric acidity but it is not a way out. Gastric acids are inevitable for normal gastric function and decomposition of food. Reducing acidity we disconcert digestion. Chemical neutralization of gastric acids turns gastric ferment sterilization factory into bacteria incubator. It has been noticed that patients with serious and chronic diseases treated at intense therapy departments with acidity inhibitors have higher risks of pneumonia and bacterial bronchitis. This is because the stomach bacteria enter airways and provoke the diseases mentioned above. Too low quantities of acids and pepsin in the stomach increase the risk of protein allergy and intolerance of some products,” gastroenterologist V. Urbonas warned about the dangerous aspects of reducing amount of gastric acids.