Reflux: Care and Treatment

Tumor of the esophagus and reflux

Many people fear that gastroesophageal reflux disease may somehow favor the formation of tumor in the esophagus. However, this risk, although still low, is appreciable only in the most serious conditions. The probability that Barret's esophagus will evolve into a precancerous condition is in fact around 10% (remember that Barrett's esophagus is present in about 10% of patients suffering from reflux, therefore 10% of 10% = about 1%).

Like most cancers, the curability of esophageal adenocarcinoma is linked to the timeliness of diagnosis.

Diagnosis

The diagnosis of reflux disease is predominantly clinical. Doctors usually diagnose GERD only after excluding other pathological conditions such as heart problems or hiatal hernia. If these findings are negative and the symptoms persist, therapy with antacid drugs is initiated. If the patient's response to these drugs is positive, further tests are not usually necessary.

If, on the other hand, the symptoms persist or reappear at the end of the therapy, further investigations such as esophagus-gastroduodenoscopy, pHmetry and esophageal manometry should be performed.

Care and Treatment

Treatment of reflux disease is based on lifestyle correction and family therapy.

Medicines

In particular, there are three different classes of drugs, useful for combating the three main causes of gastroesogageic reflux.

Prokinetic drugs, for example, accelerate the stomach emptying time, preventing the slowed evacuation from favoring the onset of the disorder.
The protectors of the esophageal mucosa, as the name implies, protect the wall of the esophagus from the attack of acids.
Last but not least are the so-called PPIs (proton pump inhibitors) and H2 receptor antagonists. Despite the very complex name, the mechanism of action of these drugs is very simple: by reducing the acidity of gastric secretions, they prevent the contents of the stomach from corroding the esophageal muscosa in the event of reflux.

All these drugs are generally capable of giving well-being and total asymptomaticity to patients suffering from reflux disease (about 95% of cases).

For further information: Gastroesophageal reflux drugs

Surgical intervention

The surgical option is indicated in particular cases such as the failure of pharmacological treatment. However, this solution is not completely decisive. There is in fact the risk that the operation will not bring the desired results. A non-negligible number of patients is in fact forced to take antisecretory drugs, perhaps at lower doses, even after the surgical correction of the problem. The choice of resorting to the operating room must therefore be taken with particular caution.

The operation is performed with the help of modern minimally invasive techniques (laparoscopic surgery) and aims to restore the functionality of the gastroesophageal sphincter.

See also: Diet and Gastroesophageal Reflux