تعريف
Gastroesophageal reflux disease (GERD) is a disorder that results from food and stomach acid backing up into the esophagus from the stomach. GERD is different from gastroesophageal reflux (GER). GER is a common disorder seen in infants, which causes them to spit up. Most infants outgrow GER within 12 months.
This condition can cause serious health issues. Treatment for GERD includes lifestyle changes, medications, and sometimes surgery.
أسباب
Food travels down the esophagus to the stomach. The opening between the esophagus and stomach opens to let food enter the stomach. Normally, it closes as soon as the food enters the stomach. With GERD, the opening does not close tightly. Stomach acid flows into the esophagus, called acid reflux, causing a burning sensation.
The following factors contribute to GERD:
- Abnormal pressure to the lower esophageal sphincter (LES), a valve that keeps food in the stomach
- Increased relaxation of LES
- Increased pressure within the abdomen
عوامل الخطر
The following may increase the risk of GERD in adolescents:
- السمنة
- التدخين
- الكحول
الأعراض
If your teen has any of these symptoms, do not assume it is due to GERD. These symptoms may be caused by other conditions.
قد تشمل الأعراض ما يلي:
- حرقة في المعدة
- ارتجاع
- Abdominal or chest pain
- القيء
- صعوبة في البلع
- سعال جاف
- صوت خشن
- إلتهاب الحلق
- Recurrent pneumonia or worsening asthma
- Weight loss, lack of appetite
التشخيص
Your doctor will ask about your teen’s symptoms and medical history. A physical exam will be done.
قد تشمل الاختبارات ما يلي:
- Upper GI series —a series of x-rays of the upper digestive system taken after drinking a barium solution
- Upper endoscopy with biopsy—a tube is inserted into esophagus to look at the lining and a piece of tissue is taken for testing
- 24-hour pH monitoring—a probe is placed in the esophagus to keep track of the level of acidity in the lower esophagus
- Short trial of medication
العلاج
Talk with your teen’s doctor about the best treatment plan. Treatment options include the following:
تغيير نمط الحياة
Before recommending medication, your teen’s doctor may suggest lifestyle changes. These may include:
- Eating smaller, more frequent meals
- Avoiding late night snacks
- Sleeping with the head of the bed elevated
- فقدان الوزن
- الإقلاع عن التدخين
- Avoid alcohol
Foods to avoid may include:
- الشوكولاته
- Fried foods
- النعناع
- Spicy foods
- Caffeine products
- المشروبات الغازية
- Foods high in fat and acid
الأدوية
Medication will help relieve symptoms and heal any damage to the esophagus. Many medications for GERD are available over-the-counter and by prescription. Your teen’s doctor may recommend the following:
- مضادات الحموضة
- H-2 blockers
- مثبطات مضخة البروتون
إجراءات
In more severe cases, the doctor may recommend surgery or endoscopy. The most common surgery is called fundoplication. During this procedure, the surgeon wraps part of the stomach around the lower esophageal sphincter. This makes the sphincter stronger and prevents stomach acid from backing up into the esophagus. In many cases, this procedure can be done through small incisions in the skin, calledlaparoscopy.
الوقاية
There are no guidelines to prevent GERD.