What is reflux?
It is the escape of stomach contents into the esophagus. This content can be acidic or alkaline. This content that escapes into the esophagus can not only stay in the esophagus, but also go to the throat, pharynx, oral cavity, into the ear via the Eustachian tube, to the respiratory system and the lungs.
Is reflux normal? When is it considered a disease?
It is a condition that can be seen under normal conditions. It can be seen in newborns, pregnancy and in case of overeating. Reflux disease, pathological reflux is mentioned when it causes complaints that impair the quality of life. Gastro-esophageal reflux disease is mentioned in case of frequent reflux, chest pain, burning sensation.
With which complaints does reflux occur?
The leakage of stomach contents into the esophagus (regurgitation) and heartburn (burning sensation in the chest), a feeling of being stuck in swallowing (dysphagia), painful swallowing (odynophagia) are seen as typical complaints. Acidic or alkaline stomach contents that can reach the mouth can also cause atypical reflux, complaints-symptoms- (non-typical) problems such as ear inflammation, pharyngitis (throat inflammation), cough, hoarseness, dental caries, respiratory tract infections (pneumonia), allergic asthma. .
With which method is the diagnosis of reflux disease made?
Although pH-etri (24-hour acid measurement under the esophagus) method is known as the gold standard in diagnosis, it is not necessary for every patient in practice. Today, the diagnosis is made by gastroscopy (endoscopy). Is endoscopy necessary for every reflux patient? If we answer the question, we can say that the rational approach is to perform endoscopy at the right time, at the right place and by an experienced gastroenterologist. Delaying endoscopy causes misdiagnoses or delayed diagnosis. While the insurance systems of the western world set standards that limit and delay the use of endoscopy in certain conditions, eastern countries such as Japan and China recommend easier endoscopy applications. In this way, they can make a better diagnosis and differential diagnosis of reflux. In childhood reflux burns, scintigraphic methods (investigation of the passage of foods labeled with radioactive substances from the esophagus or reflux in nuclear medicine) are preferred rather than gastroscopy.
What is the place of impedance in the diagnosis of reflux?
Unlike the Impednas ph-metri method, it can evaluate whether the contents in the esophagus have both acid and bile properties. This assessment is not often required. However, in cases of alkaline reflux gastritis in patients who have undergone gastric surgery, reflux measurement and, if applicable, impedance measurement may be useful. Apart from this, impedance measurements may be required, since there may be bile reflux in the case of gastric motility (catchy stomach movements) defects.
Are reflux and esophageal cancer related?
If reflux disease causes changes in the mucosa (cover) at the lower end of the esophagus and causes it to transform into Barrett’s epithelium (change to the stomach lining), a 10% risk of adenocarcinoma – cancer may occur under the esophagus. In addition, reflux disease has a relationship with laryngeal cancer (pharyngeal cancer). The risk of developing cancer in reflux patients in Turkey is much lower than the rates in Western countries such as America, England and Germany. Although we do not have reliable statistical information, it is possible to put forward this view with our long experience in the field of gastroenterology.
What is esophagitis? With which complaints is esophagitis suspected?
It is an inflammation (inflammation) of the esophagus lining due to various reasons.
There may be chest pain (retrosternal pain), a feeling of being stuck when swallowing (dysphagia), or a burning sensation (pyrosis). These complaints can occur even without taking a bite.
How does esophagitis occur?
It can occur acutely (sudden) or chronic (continuous). Acute esophagitis can occur with drugs such as aspirin and tetracycline, or it can occur with the intake of corrosive substances (acidic or alkaline) substances: saline, bleach, etc. cleaning materials. Chronic esophagitis can often develop due to hiatus hernia (stomach hernia), gastroesophageal reflux disease.
Is there a relationship between esophagitis and esophageal cancer?
If esophagitis is due to reflux or ingestion of corrosive substances (salt spirit, washing soda, etc.), it may be associated with cancer. There is a risk of developing esophageal cancer during the course of akalsia (insufficient opening at the lower end of the esophagus).
Why does esophageal cancer develop?
Cancer of the esophagus is unfortunately among the most common cancers. It may occur with complaints such as a feeling of being stuck in swallowing (dysphagia), painful swallowing (odynophagia), anemia (iron deficiency anemia), chest pain (retrosternal pain), weight loss, loss of appetite. In order to make an early diagnosis, it is important for the doctor to consider these complaints as well as early admission. When it occurs, it is likely to have spread to surrounding tissues. Different types are available. There are different treatment methods according to the type of cancer. Therefore, treatment success rates are different. There is a chance for endoscopic or surgical treatment after diagnosis with endoscopic procedure. Chemotherapy (drug therapy) and radiotherapy (radiation therapy) are other treatment methods.
What does dysplasia mean in esophageal biopsy?
Dysplasia in biopsies taken during endoscopic intervention, as in the evaluation of every tissue, means that there is a risk in terms of cancer development. As can be understood from the nomenclature of low-grade and moderate dysplasia, it indicates that a change and metamorphosis towards cancer in the cells of the tissue from which biopsy was taken may occur with a low probability, but it does not have cancer characteristics yet. A high degree of dysplasia has a bad meaning and indicates the suspicion that there are changes very close to cancer. Such a result requires re-evaluation in a short time. According to this result, the gastroenterologist can repeat the procedure or immediately evaluate whether there is cancer with another method.
