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Reflux Oesophagitis

Medical Questions » Reflux Oesophagitis
Name: Reflux Oesophagitis
Also known as: Gastro-Oesophageal Reflux
The back flow of acid from the stomach up through a normally closed muscle ring into the lower end of the oesophagus (gullet). Most commonly occurs in babies and overweight elderly men.
Causes of Reflux Oesophagitis
Some infants have a defect or temporary weakness in the muscle ring at the bottom of the oesophagus. In adults, factors such as obesity, smoking, overeating, a hiatus hernia, rapid eating, alcohol, stress, anxiety, and poor posture may cause the excessive production of acid in the stomach and/or slackness in the muscle ring.
Symptoms of Reflux Oesophagitis
Infants: pain, crying and irritability. Adults: burning sensation behind the breast bone (heartburn), a bitter taste on the back of the tongue and burping as gas escapes easily from the stomach. Often worse at night after a large meal when the patient is lying down. If attacks are regular, ulcers may develop.
Tests for Reflux Oesophagitis
Proved by gastroscopy or a barium meal X-ray.
Treatment for Reflux Oesophagitis
Children: most will grow out of the problem. Position child with head elevated while feeding, give small frequent thickened feeds, burp the baby regularly, and loosen nappy before feeds. If not adequately helped, preventive medication is given as a mixture. Do not allow child to lie flat after a feed. Adults: weight loss, raising the head of the bed, having the main meal in the middle of the day, avoiding bending and heavy lifting, stopping smoking and reducing alcohol. Antacids to reduce the acid concentration in the stomach, and medication to empty the stomach faster (eg. cisapride) and reduce acid production (eg. nizatadine). In resistant cases is it necessary to resort to quite major surgery.
Complications of Reflux Oesophagitis of its treatment
Scarring and narrowing of the lower end of the oesophagus to the point where it may be difficult to swallow food (Barrett syndrome), severe bleeding from ulcers in the oesophagus, and cancer of the oesophagus.
Likely Outcome of Reflux Oesophagitis
Majority of patients can be controlled with appropriate treatment.
       
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