The prevalence of reflux disease is on the rise due to sedentary lifestyles and dietary habits dominated by processed and ready-to-eat foods, alongside the escalating global issue of obesity. Reflux not only has a detrimental impact on an individual’s quality of life but can also impose limitations on their daily activities. Addressing the factors that give rise to reflux is essential for effective treatment. What measures should be taken in managing reflux disease and how can it be treated?
REFLUX: A COMMONLY ENCOUNTERED CONDITION
Reflux disease often leads to symptoms such as chest burning, the presence of bitter fluids in the mouth, regurgitation of ingested food, and nighttime coughing, significantly impacting an individual’s quality of life. These conditions can impose substantial limitations on daily activities, prompting patients to seek medical advice or resort to medication repeatedly. Presently, reflux disease affects nearly 35%, equating to one in every 3 individuals. Diagnosis of reflux disease relies on patient history and endoscopic examinations. Additionally, the use of a PH meter, measuring the extent of acid escaping into the esophagus, plays a crucial role in diagnosis. Treatment plans are tailored according to the outcomes of these diagnostic measures.
ADDRESSING REFLUX NATURALLY TAKES PRECEDENCE
In the realm of reflux, the foremost approach is to naturally treat the patient, steering clear of any medication and, if feasible, avoiding any interventional interventions. To achieve this, patients are encouraged to make adjustments to their lifestyle and dietary habits and, if applicable, shed excess weight. If these modifications prove ineffective, the focus shifts to medication treatments. Typically, the drugs employed in this context are those that diminish stomach acid, commonly referred to as stomach protectors. However, it is crucial that these drugs are used for a specific duration. Prolonged use of stomach protectors carries the potential for certain side effects, and extended usage can result in drug dependence. Attempting to discontinue continuous use of stomach medication triggers what is known as “rebound acid secretion,” wherein the stomach starts secreting acid at a rate 3-5 times higher than normal. This phenomenon leads the patient to experience stomach complaints, even in the absence of any actual issues. When the patient refrains from taking the medication for 1-2 days, anticipating discomfort, they may revert to medication, perpetuating a cycle that can, in essence, lead to drug dependence.
TREATMENT COMMENCES WITH IDENTIFYING THE UNDERLYING CAUSE
Various conditions may lead to issues in the stomach, including gastritis, ulcers, the presence of the stomach bacteria known as helicobacter pylori, or a laxity in the valve that connects the stomach and esophagus. It is imperative to uncover the root cause. If the patient is diagnosed with helicobacter pylori bacteria, antibiotic treatment is administered. Additionally, recommendations include reducing alcohol and coffee consumption, and if there is excess weight, addressing this concern through weight loss. However, some patients may find themselves in a situation where continuous medication is necessary. The most prevalent cause for this scenario is the looseness of the valve connecting the esophagus and stomach. Unfortunately, rectifying this laxity with medication is often not entirely feasible. In recent years, interventional methods have emerged, offering an endoscopic and non-surgical approach to correct this issue. The ARMA (Antireflux Mucosal Ablation) method stands out as one of the most frequently utilized treatments for reflux disease.
ARMA METHOD: A NON-SURGICAL ENDOSCOPIC PROCEDURE
The ARMA method is a non-surgical, entirely endoscopic approach that not only alleviates the patient’s daily complaints but also liberates them from drug dependence. Utilizing a device known as argon plasma, a superficial burn is applied to the valve connecting the esophagus and stomach. This superficial burn area undergoes healing through contraction. Within approximately a month, the valve tightens, returning to a completely normal state. Consequently, the upward escape of acid is prevented. The procedure is remarkably straightforward, and its success rate has been notably high in recent years. While this innovative method has been practiced globally for 3-5 years, it has been implemented in our country for about 2-3 years. It is imperative that these procedures be performed by specialist physicians in fully-equipped hospitals.