Pathophysiology Of Reflux

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Reflux has many symptoms. Often vary from person to person. The main, generally, are: Heartburn, Regurgitation, Difficulty in swallowing, Excessive salivation. Are the so-called typical symptoms, those that are present in most cases. Although not necessarily have to be present all at once. In addition to these to these, they often have other less common.

The main ones are:
chest pain is a symptom rather frequent reflux. Is in 20-30% of cases. It’s a pain in the chest. The painful sensation may also involve the neck and shoulders. This is a symptom rather hard that can be frightening because it can be mistaken for pain associated with heart problems.
Odynophagia is a fairly common symptom of reflux, especially when there are complications. It’s a pain that you hear when you swallow.

Respiratory symptoms: the reflux is often accompanied by respiratory disorders. The main ones are: asthma, bronchitis and chronic cough, recurrent bronchopneumonia.

ENT Symptoms: Sometimes reflux can cause disorders such as laryngitis, hoarseness, gingivitis, halitosis and tooth decay. This happens when the material comes from the stomach acid backs up into the throat or mouth.

The possibility of an interdisciplinary approach allows us also to assess and treat simultaneously all aspects of reflux disease.

Pathophysiology of reflux
The term “gastro-esophageal reflux disease” is commonly referred to the anomalous passage of gastric contents beyond the confines of the stomach. Our digestive system has protective mechanisms to counteract the potential to cause injury of the gastric juices. The special lining of the stomach has a protective barrier, capable of operating even when the relationship between agent prejudices and defences is not altered or increased acidity or to the detriment of the barrier itself.

The muscles and their contractile properties of the oesophagus has a muscular specialized device called a “primary or lower esophageal sphincter, often indicated by the initials LES (lower esophageal sfincter), located at the end of the oesophagus, which deals normally prevent, or at least limiting, the slope of the oesophageal to gastric juices. The sphincter mechanism is then duplicated in the higher level (between oesophagus and pharynx) from a new barrier, usually only during swallowing and known as “upper esophageal sphincter (UES). Occasional brief episodes of reflux confined to the lower portion of the oesophagus usually occur in physiological conditions, especially after meals, and have no pathological significance, but when these episodes become more frequent and last for a longer time, the reflux from simple physiological phenomenon may become a cause of disease.

Reflux of gastric juice causes lesions in this case directed at the level of unprotected structures, causing inflammation and structural changes in the mucosal lining. Besides direct caustic action of acids, one must not forget the ability of lytic enzymes produced by the stomach, although essential for the digestion of food, they can cause damage even at the same mucosal lining with which they touch.

Several factors help to facilitate the motor in coordination of the structures oesophagi-gastric and thus aggravate the problem of reflux, as we said, within certain limits and physiology, among them smoking, alcohol, fatty meals, obesity Some hormonal factors as well as drugs of common use.

It ‘necessary to specify that “hiatal hernia”, “esophagitis” and “gastroesophageal reflux” are not absolutely synonymous and indicate different conditions. The presence of hiatal hernia or prolapse of the bottom of the stomach through the diaphragm is often described in association with reflux disease but in addition to patients with hiatal hernia and reflux disease are patients with hiatal hernia without reflux and others with hernia without reflux.

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