Do you often have acid reflux and heartburn? Learn more about this common disease!

Author: Shang Zhanmin, Chief Physician, Beijing Chaoyang Hospital (West Campus), Capital Medical University

Reviewer: Zhang Yu, researcher at Chinese Center for Disease Control and Prevention

In recent years, due to the development of my country's economy, the improvement of living standards, and the aging of the population, the incidence of gastroesophageal reflux disease has also shown an increasing trend year by year.

Studies have shown that the incidence of gastroesophageal reflux disease has reached about 7%-15%, making it a very common disease.

What are the typical symptoms of gastroesophageal reflux disease? What should you pay attention to in your diet? What are the commonly used drugs? Next, let's talk about these issues that patients are very concerned about.

1. What are the typical symptoms of gastroesophageal reflux disease?

The most common symptoms of GERD are heartburn and acid reflux, and some people may also experience difficulty swallowing.

In addition, there may be some atypical symptoms. If the reflux is severe or the reflux height is relatively high, it may even reflux into the throat, irritating the mucosa of the throat and even the trachea. The patient may also experience symptoms such as cough, asthma, hoarseness, throat discomfort, and even throat pain.

These symptoms are often easily mistaken by patients as ENT or respiratory diseases, and they first go to the respiratory department or ENT department for treatment. Finally, they may be transferred to the gastroenterology department because the treatment is not effective.

There are also some patients who always feel like there is something in their throats and clear their throats repeatedly. Even severe patients may develop lung infections, pulmonary interstitial fibrosis, etc. over time. This situation is also relatively common in clinical practice.

Figure 1 Original copyright image, no permission to reprint

Of course, the most important thing is that the reflux substances flow back into the esophagus, irritating the esophagus and causing gastrointestinal symptoms such as heartburn and acid reflux.

2. What should patients with gastroesophageal reflux disease pay attention to in their diet?

Patients with GERD should try to avoid eating foods that are too sour, too spicy, or too sweet, because these foods can stimulate gastric acid secretion and aggravate reflux symptoms. Patients with GERD should also quit smoking and drinking, and pay attention to losing weight.

In addition, if the patient is prone to reflux at night, the head of his bed can be raised 15-20 cm to reduce the occurrence of reflux.

Figure 2 Original copyright image, no permission to reprint

For mild gastroesophageal reflux disease, or simple mild reflux esophagitis, or non-erosive gastroesophageal reflux disease, most patients can use less medication or even no medication by improving their lifestyle.

3. What are the treatments for gastroesophageal reflux disease?

For patients with more severe gastroesophageal reflux disease who do not respond well to lifestyle improvements, we now have very effective drugs for treatment.

The most important drugs are proton pump inhibitors, which are simply drugs that inhibit gastric acid secretion.

There are many kinds of proton pump inhibitors commonly used in clinical practice, such as omeprazole, rabeprazole, lansoprazole, and esomeprazole. These prazole drugs are actually drugs that inhibit gastric acid secretion, which can relieve symptoms, reduce complications, and improve the quality of life of patients.

In addition, you can also use some drugs that promote gastrointestinal motility. By promoting gastrointestinal motility, the food in the stomach can reach the intestines as quickly as possible. At the same time, these drugs also have a certain effect on enhancing the function of the lower esophageal sphincter, that is, enhancing its barrier function, which can also reduce the occurrence of reflux.

The third type of drug is antacid, also called mucosal protectant. This drug is alkaline and can neutralize stomach acid. It can also form a protective film on the esophageal mucosa or gastric mucosa to reduce the direct erosion of stomach acid on the mucosa. Commonly used drugs in clinical practice include aluminum carbonate magnesium, sucralfate, etc.

These are the three most commonly used categories of drugs in clinical practice.

4. Can gastroesophageal reflux disease cause esophageal cancer?

Gastroesophageal reflux disease can cause Barrett's esophagus, which is a pathological change in the inner surface of the lower esophagus. Some Barrett's esophagus may transform into esophageal adenocarcinoma.

Because dysplasia can occur in the columnar epithelium of Barrett's esophagus, the degree can range from low to high. Sometimes it is difficult to distinguish low-grade dysplasia from normal columnar epithelium, and high-grade dysplasia from carcinoma in situ is sometimes difficult to distinguish, and may progress to invasive cancer.

In Western countries, the probability of Barrett's esophagus transforming into esophageal adenocarcinoma is relatively high, but in our country, this probability is relatively low.

So if Barrett's esophagus occurs, we should not panic too much, just pay attention to regular check-ups.