Author: Wuhan Third Hospital, Department of Pharmacy, Lu Jiang, Xiong Di
Our stomach contains a lot of gastric juice, gastric juice contains gastric acid and pepsin, which is conducive to digestion; gastric acid can kill bacteria in food, ensure the safety of the stomach and intestines, while increasing the activity of pepsin, but also help digestion!
However, when there is a problem with the anti-reflux mechanism of the esophagus itself, such as: the "automatic gate" to prevent acid reflux is loosened, that is, the subesophageal sphincter in the mouth of the doctors, or the movement of the esophageal body is abnormal, and the stomach acid that should be "going down with the trend" is actually "rushing forward", "going up against the current", "letting go of the self", the stomach acid of the reflux can have no direction, not only will it flow backwards to the esophagus, but also may reach the throat, nasal cavity, trachea and other parts, which causes gastroesophageal reflux.
< h1 class="pgc-h-arrow-right" data-track="6" > symptoms</h1>
Heartburn and reflux are typical symptoms of gastroesophageal reflux, and there are some atypical symptoms, including chest pain, belching, bloating, repeated coughing, difficulty swallowing, etc., and even some patients will also show uncommon symptoms such as retrosternal pain, asthma, chronic cough, etc., which will lead to misdiagnosis and affect the treatment of the disease.
<h1 class="pgc-h-arrow-right" data-track="49" > medication</h1>
1. Acid suppressants
Effective reduction of the role of injury factors, is the main measures in the treatment of this disease, for the first time to receive treatment or patients with esophagitis should be treated with proton pump inhibitors (PPI) in order to quickly control symptoms, cure esophagitis, acid suppressants including PPI and H2 receptor antagonists.
(1) PPI drugs have a strong acid-suppressing effect: the efficacy is better than that of histamine H2 receptor antagonists, and it is suitable for patients with severe symptoms and severe esophagitis.
(2) H2 receptor antagonists: such as ranitidine, famotidine, etc. This drug can reduce the secretion of gastric acid by 50%-70% for 24 hours, but it cannot effectively inhibit the secretion of gastric acid caused by eating stimulation, so it is suitable for patients with mild and moderate symptoms.
2. Pro-gastrointestinal motility drugs
Such as domperidone, moszapride, itopride, etc., such drugs can improve esophageal peristalsis function, promote gastric emptying, thereby reducing the esophageal reflux of gastric contents and reducing its exposure time in the esophagus. Because the efficacy of these drugs is limited and uncertain, they are only indicated in mild patients or as adjunctive therapy in combination with acid suppressants.
3. Antacids
It is only used in patients with mild symptoms and intermittent episodes as a temporary relief of symptoms.
4. Others
Gastroesophageal reflux disease is caused by a variety of factors and mechanisms, in addition to drug treatment, it is also very important to improve eating habits and lifestyle, which can reduce or avoid recurrence of the disease.
<h1 class="pgc-h-arrow-right" data-track="54" > which foods to avoid</h1>
1. In order to reduce the occurrence of reflux, avoid eating greasy, fried and pickled foods. Drink as little as possible such as chicken soup, fish soup, rib soup, etc., and avoid fatty meat and meat skin. Foods with a higher fat content can aggravate reflux;
2, eat less or do not eat sticky foods, such as glutinous rice, rice cakes, Lantern, rice dumplings, etc., these foods are not easy to digest, especially for the elderly. These foods can delay the speed of gastric emptying, increase the chance of reflux, and are also prone to indigestion such as bloating and belching;
3. All foods that can reduce the pressure of the lower sphincter in the lower esophagus should be avoided as much as possible, including coffee, strong tea, fruit juice, carbonated drinks, chocolate, etc.;
4, less salt, avoid irritating foods and condiments, high salt and irritating food will stimulate excessive secretion of stomach acid, cherish the digestive tract, away from salted fish, cured meat and so on;
5, make people feel happy sweets will also stimulate excessive gastric acid secretion, so pastry candy should be eaten less.
<h1 class="pgc-h-arrow-right" data-track="56" > which foods to eat</h1>
General vegetables and fruits do not cause or worsen reflux symptoms.
1. Fruits and vegetables are rich in vitamins and fiber, which can promote gastrointestinal motility and reduce reflux, such as berries, apples, citrus, tomatoes, etc.;
2, can take more food rich in dietary fiber, especially fresh vegetables, dietary fiber can promote the peristalsis of the gastrointestinal tract, help food quickly pass through the gastrointestinal tract, promote gastric emptying, and avoid excessive pressure in the stomach to cause reflux;
3. Eat low-cholesterol and high-protein foods, such as tuna, salmon, cashew nuts, almonds and lentils.
Finally, we must adhere to good living habits and maintain an optimistic mood!
Review expert: Wuhan Third Hospital Deputy Director Pharmacist Meng Junhua
The above is the original work of the volunteers of the "Drug Safety Cooperation Alliance", if you reprint, please indicate the author and source!
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