Gastro-oesophageal Reflux

It is due to decreased function of lower oesophageal
sphincter thus permitting regurgitation of gastric contents
into oesophagus. Other causes of gastro-oesophageal
reflux are pregnancy, hiatus hernia, scleroderma, excessive
use of tobacco and alcohol, and drugs that relax the
smooth muscle (anticholinergic, beta-adrenergic drugs
and calcium-channel blockers).
The symptoms of oesophageal reflux include substernal
pain, heartburn, and regurgitation.
The treatment consists of:
(a) Elevation of the head of bed at night.
(b) Avoiding food at least 3 hours before bed time.
(c) Antacids.
(d) Drugs that increase tone of lower oesophageal
sphincter, e.g. metoclopramide.
(e) H2 receptor antagonists, e.g. cimetidine and ranitidine.
(f) Avoiding smoking, alcohol, caffeine, chocolates,
mints and carbonated drinks.
(g) Antircflux surgery, e.g. Nissen's fundoplication.
Complications 01 Gastro-oesophageal
Reflux
I. Oe ophagus
• Oesophagi tis, oesophageal mucosal erosion and
haemorrhage
• Benign oesophageal stricture
• Barrett's oesophagus (normal squamous epithelium
of oesophagus is replaced by columnar
epithelium as a result of continuous inflammation).
It is a precancerous condition
II. Lung
• A piration pneumonia
• Asthma
• Bronchiectasis
III. Larynx
• Posterior laryngitis causing vague pain in throat,
hoarse ness and repeated throat clearing
• Pachyde rmia laryngis
• Contact ulcers and granulomas
• Posterior glottic stenosis
• Paroxysmal laryngospasm
• Carcinoma larynx
IV. Miscellaneous
• Globus hystencus