Diagnosing reflux

More than 50% of all humans suffer occasionally from the consequences of a Refluxes of the Magens?e into those. This occurs sporadically after a?igen meal and is mostly not further st?nd. With repeated attacks that becomes the complaints increasingly the Wohlbefinden.Urs?lich is present a Schw?e in the range of the lower Schlie?uskels of the Speiser?e. Schw?e knows a St?ng of the emptying of stomach by a Zwerchfellbruch, in addition, by some medicines (z. basis of the asthma therapy) caused its is consequence of a chronic Druckerh?ng in the abdominal cavity, above all through?erern?ung, chronic blockage, Bindegewebsschw?e or. With 20 % the western Bev?erung is more or less more ausgepr?er. Women are in a Verh?nis 2:1?ers. Although the complaints arise to 50 usually after that lebensjahr, ever more j?ere patients with these complaints come to the physician in the last years. Meaning wins the Reflux?phagitis lately also as a cause f?die clear increase of the Speiser?enkrebses. Sodbrennen is the result of the R?flusses of sour stomach secretion. This is with a special mucous membrane?rzogen, those by the Magens?e is heavily gesch?gt characteristic burning (80 %) can the Entz?ung to Vernarbungen in the Speiser?e f?en and thus swallowing difficulties causes exists apart from burning a sour Aufsto?n and otherwise not more erkl?arer. The sour stomach secretion continues to arrive not only into the Speiser?e but also into the Luftr?e. Meaning of the Refluxes as a cause f?die chronic bronchitis recognized. With gro?n a Zwerchfellbruch existing at the same time the patients complain?r a Druckgef? behind the breastbone (45 %). indicated complaints are often confounded with heart pain and primely? left oberbauch and in the R?en of special chocolate is not no more stood. Zitrusfr?te and kohlens?eh?ige Getr?e f?en to complaints. These arise both in peace as well as during load, characteristic-prove however with the B?en and couches. Patients at night with the symptoms up, or the complaints are in the morning. Usually the patients bear the complaints for many years, before they visit the physician, because the self medication no more. Often are the symptoms already in such a manner qu?nd that a heavy Beeintr?tigung of the Lebenswertgef?es is the result. The diagnosis can be often already placed by the anamnesis. Occasional Refluxepisoden, for example after a rich meal continues to need not abgekl? each case an endoscopic investigation will take place the correct diagnosis to be best?gt, also the Ausma?der arrangement after the degree of the Schleimhautsch?gung. Degree: individual small Entz?ungsherde in....Schleimhaut?rganges of the Speiser?e. Degree: l?sgestellte streifenf?ige L?onen in the lower. Degree: merging, fl?enartige Entz?ungen the entire. Degree: Ulcerationen, Stenosen (restricting), or complete change Biopsien are to be recognized necessarily around Ver?erungen of cell architecture, there thereby entz?liche and tumor? Geschw?. From one bar-save mucous membrane one speaks, if it in the lowest Speiser?enabschnitt to the Ver?erung. The cells in the again formed mucous membrane?eln rather the cells of the gastric mucosa and k?en different degrees of the degeneration exhibit. A R?genuntersuchung of the Speiser?e shows the Ausma?eines Zwerchfellbruches quite clearly and is with very gro?n Br?en also. An operation?rlegt are zus?liche investigations. A pressure measurement of the Speiser?e gives?r the strength and co-ordination of the muscle hose to explanation. Measurement of the S?e becomes at the 24 hours pH Metrie in the Speiser?e. The investigation gives?r the duration and Intensit?der Refluxepisoden to explanation, so that between a normal or diseased Reflux can be differentiated. Prim?s a goal is the free andness of the patient first step by a complete S?eblockade mostly reaches so-called Protonenpumpeninhibotoren (briefly PPI.s called, z. Zurcal, Pantoloc, Pariet or Losec) causes a blockade the hydrogen potassium pump at the gastric mucosa cell membrane. Thus an almost total blockade of the HCl secretion can reached. The pH value in the stomach and in the Speiser?e ascends. Values?r 4, whereby healing the entz?lichen Ver?erungen m?ich. Because of the different admission of the active substance must be waited for the effect entrance up to 48 hours per day is mostly sufficient, whereby acute complaints with a high. Rapidly however often not sufficiently entz?lichen L?onen and causes a certain protection gegen?r that. These medicines are present as tablets, shower powders and suspensions and make a four times gift per day necessary. Since it concerns thereby no urs?liche therapy, it comes to setting the medicines off often rapidly to recent complaints, into 20 %. places itself here, particularly with j?eren patient, the indication to a causal therapy. By the new techniques the operation with minimum can invasiven. Zur?verlagert with the operation zun?st the stomach into the abdominal cavity and the zwerchfell with few N?en. Anschlie?nd is put to the Reflux with the highest stomach portion a seal around the Speiser?e, those prevents one between the Fundoplicatio in nissen (complete seal) and the procedure after Toupet (3/4 seal, depending upon function of the Speiser?enmotorik). Since none is necessary gro?r belly cut, the patients are rapidly again mobile and k?en mostly at the 3. A simple and a low-risk concerns with this interference. Very rare, but m?iche complications concern creation of the Pneumoperitoneums (air insufflation into the belly), bleedings in the area of operations or injuries of Speiser?e or. Vor?rgehend does not come it to swallowing difficulties and also a R?sen is to the operation any longer m?ich. Patient also?r a long-range post office-operational indulgence to. Alternative ones to these procedures become at present in several studies. For this above all the endoscopic techniques, with which an inert material in the lower is injected?ophagusmuskel, z?en over the pressure there locally too erh?n. are sketched, those endoscopic used and a seam of the Speiser?e without Er?nung of the abdominal cavity erm?icht. durchf?bar and take a half hour. Unfortunately the good have themselves. Swain so far to reproduce not accordingly leave.