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What is gastroesophageal reflux?
Gastroesophageal reflux means one abnormal condition in which the gastric contents go up into the esophagus. This phenomenon occurs for aalteration of the mechanism which is responsible for closing the stomach during digestion. A series of circular muscle fibers is placed at the point where the esophagus joins the stomach: this bundle of fibrocells acts as a sphincter in effect, contracting while the stomach is in full activity. With reference to this structure and its function, experts speak of lower esophageal sphincter. Sometimes the lower esophageal sphincter weakens to the point that part of the stomach slips into the chest cavity: this pathological condition it takes the name of hiatal hernia and is associated with severe gastroesophageal reflux.
Gastroesophageal reflux can be considered a physiological phenomenon especially during and immediately after meals. As long as the episodes remain contained in terms of number and duration there are no serious consequences for our health. In fact, the esophagus of a healthy individual quickly eliminates the refluxed material through a series of cyclic movements (esophageal peristalsis and clearing). There severity of gastroesophageal reflux is proportional to gastric pH and to the amount and time of contact of gastric juices with the esophageal mucosa. THE symptoms which ensue are dominated by the burning felt just behind the breastbone (heartburn) which appears more often on an empty stomach and during the night. In some cases, instead of the burning, there is a pain so severe that it simulates angina.
Consequences and complications of reflux
The complications of gastroesophageal reflux are, in addition to esophagitis, peptic ulcer, hemorrhage and narrowing of the esophagus (stricture). In the most severe cases, pulmonary micro-aspiration of gastric contents can occur: the entry of foreign material into the bronchial tree causes bronchopneumonia (aspiration pneumonia). Over time, a possible complication of GERD is Barrett’s esophagus. The cells that line the esophagus try to defend themselves from the acid by assuming characteristics very similar to those of the gastric cells. We speak of metaplasia by meaning to refer to transformation of a fabric into another fabric of different nature. This complication is considered a pre-cancerous one because the esophageal epithelium, thus transformed, can begin to replicate in an abnormal way and can eventually evolve into a tumor.
Gastroesophageal reflux disease occurs more frequently in moles obese subjects compared to normal weight. The presence of visceral fat beyond the normal limits increases intra-abdominal pressure and makes reflux episodes more likely.
How to behave at the table
There diet in the case of gastroesophageal reflux disease, it is aimed at reducing the frequency and intensity of reflux episodes. The first rule is that of shorten digestion times. Particularly abundant meals and at the same time rich in proteins, fats and carbohydrates require longer digestion times, making reflux episodes more likely. The diet should at the same time have the goal of reducing body weight if this should be above the normal range (Body Mass Index between 19 and 25). How to behave at the table? The rules to follow are the following:
- reduce the volume of meals by increasing the number;
- eliminate foods capable of promoting gastric secretion and among these in particular coffee, tea and alcoholic beverages;
- eliminate carbonated drinks;
- minimize the fat content of individual meals;
- increase the digestibility of protein meals by subjecting them to prolonged cooking;
- avoid taking very cold or very hot foods;
- eliminate foods such as chocolate, mint, onion and garlic which have the ability to reduce the continence of the lower esophageal sphincter;
- eating earlier than bedtime.
Gastroesophageal reflux disease is also associated with some incorrect habits, among these, for example, cigarette smoking, the fact of wearing clothes that are too tight especially during meals, the postural attitude adopted when sitting at the table. Often then there is a tendency to chewing hastily and this prolongs digestion times by increasing the likelihood of experiencing reflux.
Prohibited foods
Foods and drinks to avoid in case of gastroesophageal reflux are:
- tea, coffee and other caffeinated beverages;
- chocolate;
- mint;
- raw tomatoes;
- spirits;
- sodas;
- spices;
- foods rich in fat (fatty red meats, cheeses, fried foods, sausages).
Allowed foods
The list of allowed foods includes all those they require short digestion times and which are capable at the same time of providing a high nutritional value. Here is a list:
- White meat;
- eggs;
- fish;
- seafood;
- seasonal vegetables;
- Whole grains;
- fruit low in citric acid and among this pears, apples, bananas, melons and berries.
The evaluation of a correct food plan and the therapeutic path best suited to individual needs must necessarily be evaluated together with your doctor, gastroenterologist or a nutrition specialist.
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