Backward flow gastro-?sophagien

backward flow gastro-?sophagien is the increase (backward flow) of gastric liquid or of the contents ofstomach (food) towards?sophage person in charge for feeling of burn rétrosternale and sometimes of respiratory disease or ORL.

Normally, the?sophage is separated from the stomach by one sphincterphysiologic who opens in the passing food in the stomach and who is closed afterwards, preventing the backward flow. The texture of the wall?sophagienne does not support the acidity of the gastric contents and, so backward flows can cause burns of this wall and symptom called pyrosis. These backward flows are sometimes physiological and of short duration without consequences, other times it are due to a failure of the sphincter, for example because of one hernia hiatale

Synopsis

1 Symptoms
- 1.1 Adults
- 1.2 Backward flow gastro-?sophagien in pediatry
2 Diagnosis
3 Pathophysiology
4 Classification of Los Angeles
5 Treatment
6 External bonds

Symptoms

Adults

The most frequent symptom is it pyrosis, a feeling of ascending extreme pain on the level of the chest, had with the increase of gastric liquid energy of the stomach towards the mouth.

The rarest symptoms:

Pain of chest
Dysphagie (difficulties to swallow)
Halitose (bad breath)
Régurgitation, who corresponds to the food increase in the mouth without effort of vomiting,

Complications:

Important symptoms of warning:

Dysphagie
Hématémèse or Maelena

Backward flow gastro-?sophagien in pediatry

Break of staturo-ponderal curve
repeating Rhino-pharyngo-bronchitis
Asthma and bronchiolite
Weaken

Diagnosis

Pathophysiology

Classification of Los Angeles

Rank 0: anamnèse typical of backward flow without detectable mucous lesions to the endoscopy.
Rank A: One or more "lesion mucous membrane", inférieure(s) or égale(s) to 5 mm
Rank B: At least a "mucous lesion" of more than 5 mm but which do not pass from one top to the other of a mucous crumpling.
Rank C: At least a "mucous lesion" which exceeds two or several mucous crumplings but noncircumferential.
Rank D: "mucous lesion" circumferential.

Treatment

treatment can be medical or surgical. The drugs (aluminium salts, anti-H antihistamines₂, IPP) are very effective, often tolerated very well and especially allow to pass in addition to or, in all cases, to reduce of modes painful and antisocial.

Prevention: to avoid the worsening factors

Certain food and ways of life tend to support the backward flow gastro-?sophagien:

Medicamentous treatment

The catch ofantacides before the meals or symptomatically after the appearance of the symptoms can reduce the gastric acidity (by increasing it pH).
The catch ofanti-H antihistamines₂ gastric such ranitidine or famotidine can reduce the secretion of gastric juice acid.
IPP (inhibiting of the pump with protons) such itoméprazole are in general more effective as regards reduction of the gastric secretion of acid.
Agents procinetic. cisapride, a member of this class was withdrawn from the market in certain countries (risk of "block of branch" and of twist of Point), in others (for example Belgium), it is the subject of a regulation and an increased monitoring. One uses more easily nerve sedatives like dompéridone or it métoclopramine.