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arWhat is Gastroesophageal Reflux?
Gastroesophageal reflux disease—commonly known as GERD—is a condition in which the contents of the stomach, including acidic fluid, flow back into the esophagus. This is a highly prevalent digestive disorder in the general population. Under normal circumstances, a muscular ring located at the lower end of the esophagus, known as the lower esophageal sphincter (LES), acts like a valve to prevent stomach contents from moving upward. However, if this valve does not function properly or relaxes involuntarily, stomach acid and undigested food can leak back into the esophagus.
The inner lining of the esophagus does not have the same protective mechanisms as the stomach to resist acidic content. As a result, prolonged contact with acid can cause irritation, inflammation, and eventually more severe damage to the esophagus. Occasional reflux may be considered normal, but if it occurs two or more times per week and negatively affects the person’s quality of life, it is then diagnosed as gastroesophageal reflux disease. In its simplest terms, GERD is a chronic condition caused by dysfunction of the stomach valve.
The symptoms of gastroesophageal reflux can vary in severity and from person to person. The most common and typical symptom is a burning sensation felt behind the breastbone that radiates upward toward the throat. This is known as heartburn and often worsens after consuming heavy, fatty, or spicy foods, when bending forward, or when lying down immediately after eating. Another common symptom is regurgitation, which refers to the sour or bitter-tasting stomach contents rising into the mouth. These two symptoms are the most prominent signs of reflux.
However, GERD symptoms are not limited to these. The disease can also cause atypical symptoms that affect organs outside the digestive system. For example, chronic and unexplained dry cough, hoarseness, a persistent lump-in-the-throat sensation, difficulty swallowing, and sore throat are frequently observed. These symptoms occur because stomach acid can reach the vocal cords.
In some patients, chest pain can be so severe that it is mistaken for a heart attack. Therefore, people experiencing chest pain should first undergo a cardiological evaluation. Other less common symptoms include bad breath, erosion of tooth enamel, and asthma attacks. Severe nighttime symptoms that wake the person from sleep are referred to as reflux crises. During these episodes, the burning sensation, coughing, and bitter fluid reaching the throat can become extremely disturbing.
As seen, the answer to the question “What are the symptoms of reflux?” is quite extensive, and accurate diagnosis requires evaluating all these symptoms together.
The main underlying mechanism of GERD is the malfunction of the lower esophageal sphincter (LES), as previously mentioned. But why does this valve not function properly? There are several answers to the question “What causes reflux?” One of the primary causes is a hiatal hernia. This occurs when the upper part of the stomach pushes up through the diaphragm muscle, which separates the chest cavity from the abdominal cavity. This condition reduces the natural pressure on the LES, causing it to relax and allowing acid to escape.
Obesity is one of the most important risk factors for reflux. Increased intra-abdominal pressure compresses the stomach and makes it easier for the contents to flow back into the esophagus. A similar mechanism occurs during pregnancy, when the growing uterus presses against the stomach, and hormonal changes further contribute to reflux.
Dietary habits also have a direct impact. Highly fatty, fried, or spicy foods, as well as chocolate, mint, onions, and garlic, can cause the LES to relax. Coffee, alcohol, and carbonated drinks not only increase stomach acid but also impair valve function, triggering reflux.
The diagnosis of gastroesophageal reflux is often made based on the patient’s description of typical symptoms. The physician carefully listens to the patient's medical history. If there are clear signs such as heartburn and regurgitation, a preliminary diagnosis can usually be made without further testing, and treatment may begin. This initial treatment often involves medications known as proton pump inhibitors (PPIs), which protect the stomach lining. The patient's response to this treatment plays an important role in confirming the diagnosis.
However, if atypical symptoms are present, or if there are warning signs such as difficulty swallowing, weight loss, or bleeding, or if medication is ineffective, further testing may be necessary. The most common advanced test is endoscopy. Endoscopy involves examining the esophagus, stomach, and duodenum with a flexible tube equipped with a camera. This technique allows direct observation of acid-related damage in the esophagus, ulcers, strictures, or more serious conditions like Barrett’s esophagus—and biopsies can be taken if necessary.
When appropriate, it is important to consult a specialist for these advanced diagnostic procedures. For example, centers specialized in reflux treatment in Bursa apply these techniques carefully to create the most suitable treatment plans for patients.
The treatment of gastroesophageal reflux generally consists of three main stages: lifestyle changes, medication, and surgical intervention. The foundation and first step of treatment involves modifying lifestyle and dietary habits. In mild cases, these changes alone may be sufficient, or they can enhance the effectiveness of medication. The active participation of the patient during the treatment process is of great importance.
If lifestyle adjustments are not enough, medication is initiated. There are various types of reflux medications used for this purpose:
Antacids: These are syrups or tablets that neutralize stomach acid instantly and provide quick relief.
H2 receptor blockers: These reduce acid production in the stomach, offering longer-term relief.
Proton pump inhibitors (PPIs): These are the most effective group, strongly inhibiting acid production and allowing the esophagus to heal. They are usually taken on an empty stomach in the morning and form the backbone of treatment.
In selected individuals whose symptoms persist despite strong medication, who cannot tolerate drugs due to side effects, or who do not want long-term medication use, surgical treatment may be a viable alternative. A common surgical procedure is laparoscopic Nissen fundoplication, in which the upper part of the stomach is wrapped around the lower esophagus to reinforce the LES, creating an artificial valve. This minimally invasive technique is highly effective in providing a long-term solution.
In short, the answer to the question "How is reflux treated?" lies in a carefully tailored combination of these treatment stages, based on the patient’s specific condition.
Paying attention to dietary habits is one of the most important parts of managing reflux. Certain foods can directly trigger symptoms by relaxing the lower esophageal sphincter (LES) or increasing stomach acid production. Therefore, people suffering from reflux are advised to avoid or limit the intake of specific foods and drinks.
Foods high in fat and fried foods slow down stomach emptying and increase reflux risk. Examples include hamburgers, French fries, and fatty meats.
Tomatoes and tomato-based products, along with citrus fruits like oranges, grapefruits, and lemons, may intensify the burning sensation due to their acidic nature.
Spicy and hot foods can exacerbate irritation in the esophagus.
Chocolate contains methylxanthine, which can relax the LES and is a major trigger.
Mint and mint-flavored products have a similar effect.
Pregnancy is a unique period during which about half of all women experience reflux symptoms or find that their existing symptoms worsen. This is due to two main reasons:
Hormonal changes: Pregnancy hormones such as progesterone and relaxin relax smooth muscles in the body, including the lower esophageal sphincter (LES). This makes it easier for the stomach valve to open.
Physical pressure: As pregnancy progresses, the growing uterus exerts pressure on the abdominal organs and the stomach. This pressure facilitates the upward flow of stomach contents into the esophagus.
Pregnancy-related reflux is usually harmless and resolves on its own after childbirth, when hormone levels normalize and intra-abdominal pressure decreases. In terms of treatment, the first steps are lifestyle changes and antacids that are considered safe during pregnancy.
Reflux in infants is different from that in adults and is generally considered physiological, meaning normal. Infant reflux occurs because their digestive systems are not yet fully matured. The lower esophageal sphincter is weak, and it is very common for some milk to flow back after feeding. This usually resolves on its own by the time the baby turns one year old.
However, if reflux prevents the baby from gaining weight, causes severe restlessness and crying episodes, leads to feeding refusal, or results in respiratory issues, it may be diagnosed as gastroesophageal reflux disease (GERD) and requires medical evaluation.
Common symptoms of infant reflux include excessive vomiting after feeding, failure to gain weight, irritability, sleep problems, and arching of the back. In such cases, treatment should be conducted under a doctor's supervision. It’s also important to hold the baby upright for a while after feeding and to elevate the head and upper body during sleep. Using a reflux wedge pillow for infants can help prevent stomach contents from flowing back by making use of gravity.
Reflux in children may be due to underdeveloped digestive systems, as seen in infants, or—especially in older children—may arise from causes similar to those in adults. Symptoms vary according to age:
In young children, signs may include recurrent vomiting, poor appetite, and developmental delay.
In older children, symptoms resemble those of adults, such as heartburn, chest pain, and a sour taste rising into the mouth.
However, atypical symptoms are more frequently observed in children. These may include:
Recurrent ear infections
Chronic coughing
Asthma-like wheezing
Hoarseness
Tooth decay
These can all be indicators of underlying reflux.
Diagnosis and treatment are similar to those in adults, but dosages and techniques must be adjusted based on the child’s age and weight.
There are many techniques that can help alleviate reflux symptoms and support medical treatment, while also improving comfort in daily life. The answer to the question “What helps relieve reflux?” lies in simple yet effective lifestyle changes.
Adjusting sleeping position is very important. Elevating the head of the bed by 15–20 cm helps prevent acid from flowing back into the esophagus at night due to gravity. Instead of stacking pillows, it’s more effective to place blocks under the bed's headboard legs. Specially designed reflux wedge pillows or beds (such as those by Yataş) provide a sloped surface to support this purpose.
Chewing gum stimulates saliva production, which helps neutralize acid that may escape into the esophagus.
High-fiber and alkaline foods like oatmeal, bananas, melons, and green vegetables help balance stomach acid.
Herbal teas such as chamomile or ginger tea have a soothing effect on the stomach.
An appropriate nutrition plan for reflux patients should include foods that are gentle on the stomach, do not increase acid production, and are easy to digest. The diet should be personalized, and triggering foods should be identified through observation.
In general:
High-fiber foods help regulate the digestive system and are beneficial for stomach health.
Complex carbohydrates such as whole grains, oats, and brown rice are preferred.
As protein sources, lean red meat, skinless chicken or turkey, and fish prepared by boiling, baking, or grilling are suitable options.
Although both reflux and gastritis can cause a burning sensation in the stomach, they are two different digestive disorders. The main difference lies in the origin and mechanism of the problem:
Reflux is a mechanical issue caused by the backward flow of stomach contents into the esophagus due to weakness in the lower esophageal sphincter (LES). In other words, the problem is that the acid goes to the wrong place.
Gastritis, on the other hand, is inflammation of the stomach lining, typically due to infection or medication use.
In reflux, the burning is usually felt in the chest and radiates upward, while in gastritis, the burning is more localized in the upper abdomen.
Reflux is a chronic digestive system disorder characterized by the backward flow of stomach acid into the esophagus. This occurs due to a malfunction in the lower esophageal sphincter. If left untreated, it can lead to inflammation, ulcers, narrowing of the esophagus, and complications like Barrett's esophagus—so it is a health issue that must be taken seriously.
The most basic difference lies in the location and mechanism of the disorder. Reflux is caused by acid escaping the stomach and flowing back into the esophagus due to a valve problem, while gastritis involves inflammation of the stomach lining, typically due to infection or medication. Reflux causes burning in the chest that spreads upward; gastritis causes localized burning in the upper stomach.
Yes, there are highly effective medications used in the treatment of reflux. Treatment usually follows a stepwise approach. There are:
Antacids for quick relief
H2 receptor blockers for longer-lasting effect
Proton pump inhibitors (PPIs), the most powerful group, which stop acid production and help the esophagus heal
These medications should only be used under medical supervision.
Reflux patients should avoid foods that may trigger symptoms. These include:
Fatty and fried foods
Spicy and hot foods
Acidic foods such as tomatoes and citrus fruits
Mint, chocolate, garlic, and onions
Beverages like caffeinated drinks, alcohol, and carbonated drinks
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