DEFINITION

The ebb gastroesofágico consists of the step of the gastric content to the esophagus, across the sphincter esofágico low.

The refluid material can be contained of the stomach or of the intestine.

The regurgitation consists of the ascent to the mouth or pharynx of material originated from the stomach or from the esophagus. The ebb gastroesofágico can study asymptomatically without causing injuries in any person.

INCIDENCE

The ebb gastroesofágico is frequent, since 7 % of the persons has pirosis every day and 15 % every month. It is more 27 % of the persons more than two times take antacids a month.

Most of these persons have ebb gastroesofágico and half of them esofagitis injuries. In the persons older than 50 years it is more frequent.

SYMPTOMS

• The pirosis, is the most frequent. It is a sensation of intense heat or ardor behind the breastbone up to the neck more frequent with certain food (fats, chocolate, alcohol, coffee and tobacco).
• The disfagia or difficulty for deglutir food.
• Mouth dryness.
• More frequent dental infections.
• Chronic cough or asthma.
• Bled I conceal for ulcers in the mucous membrane esofágica.

CAUSES

They are diverse partly they owe to:

• Relaxation of the sphincter esofágico low. The alteration of the motilidad of the sphincter esofágico low for alteration of diverse mediators (VIP, péptido YY, motilina, colecistoquinina and neurotensina).
• The aclaramiento esofágico diminished for:
  1. Decrease of the activity peristáltica esofágica.
  2. The salivation increases (more viscose and with pH higher) in case of Ebb Gastroesofágico, like defense mechanism. The tobacco, it diminishes the aclaramiento esofágico, reducing the salivation.
• The mucous membrane esofágica. It is not a mucous membrane prepared to bear the acid of the stomach, for it he gets injured with facility. It tries to defend itself by means of a more intense salivation.
• The activity motorboat of the stomach and the delay of the gastric emptying help to favor the ebb Gastroesofágico.
• Other secondary causes of ebb gastroesofágico are:
  1. Pregnancy
  2. Estenosis pilórica
  3. Respiratory illnesses
  4. Systemic illnesses (colagenosis)
  5. Hiatus hernia
  In most cases it is a question of a mixed ebb due to the sum of the factors.

  COMPLICATIONS

  If the ebb is normal it can give pirosis and little more, but if it is pathological it goes so far as to produce esofagitis injuries.
  The esofagitis is an inflammation of the mucous membrane esofágica, that if he persists in the time degenerates into precancerous injuries (esofagitis of Barret) and in cancer.

  The esofagitis can be a cause or be secondary to the hiatus hernia, which is the step of a part of the stomach towards the thoracic cavity, across the diaphragm.

  DIAGNOSIS

  A radiological exploration is realized with contrast, and diverse positions take, standing, knocked down etc... to observe big liquids movements between the intestinal cavities. It serves to diagnose big ebbs.

  Another exploration is the gastroscopia by means of a pipe of cold light and vision in a monitor. It is used to observe the injuries of the mucous membrane esofágica and the proper ebb.

  To know the characteristics of the ebb there are realized studies of the pHmetría of 24 hours, which must differ between a normal or pathological ebb.

  The normal ebb ó physiological appears in episodes of ebb lower than 5 minutes, being exceptional to find an episode with a duration superior to 10 minutes. When we monitor for pHmetría esofágica to a normal subject for 24 hours the time in which the pH remains below 4 in the esophagus he is a minor of 3,4 %. The pathological ebb studies for ebb episodes with pH <4 in a lot of time, and of appearance in the night or in decubitus - knocked down-.

  TREATMENT

  • Changes of life style, diet and reduction of weight, in case of obesity.
  • To raise the head of the bed 3 to 8 cm.
  • To have for dinner or to take any meal 3 ó 4 hours before sleeping or before lying down.
  • To avoid certain food that relax the sphincter esofágico low, caffeine, alcohol, tobacco, spices, mint, chocolate.
  • Medication
    • They are used antiH2, that diminish the action of the histamine on the gastric cells and for it they diminish the gastric acidity. Cimetidina (Tagamet ®), ranitidina (Zantac ®), famotidina.
    • Inhibiting of the bomb of protons, which dry the acids production in the stomach. Omeprazol (Losec ®), lansoprazol.
    • Stimulating of the motilidad of the sphincter esofágico. Metaclopramida (Primperam ®) and urecholine (Betancol ®).
  • The surgery is realized for uncontrolled symptoms or for complications of esofagitis of Barret. Principally he tries to correct the ruptures (of slide) of hiatus, returning the stomach to the abdominal cavity and blocking the way along the diaphragm so that it does not happen again.

  WHAT DOCTOR CAN TREAT ME?

  Select a province A Coruna Alava Albacete Alicante Almeria Asturias Avila Badajoz Barcelona Burgos Caceres Cadiz Cantabria Castellón Ciudad Real Cordova Cuenca Gipúzcoa Girona Granada Guadalajara Huelva Huesca Illes Balears Jaen La Rioja Las Palmas León Lleida Lugo Madrid Malaga Murcia Navarre Ourense Palencia Pontevedra Salamanca Santa Cruz Tenerife Segovia Seville Soria Tarragona Teruel Toledo Valencia Valladolid Biscay Zamora Saragossa

  Service offered for