The relationship between nutrition and reflux ...
Gastroesophageal reflux (GER) is the name given to the backflow of food and acid in the stomach to the esophagus. It is known as “chest burn arasında among people because it burns in the chest. Reflux is very common in our country and all over the world. It is said that at least 20% of those who feed on industrial, refined foods have reflux, and this figure exceeds 50%.
Acid-reducing drugs are in the first or second place among the best-selling drugs in many countries as a group. Although there are those who argue otherwise, these drugs are of no therapeutic nature. Despite the tremendous advances in medicine, despite the discovery of a pile of modern stomach medications, the number of people suffering from reflux complaints is rising to one side with rocket speed !!
Professor Dr. In this article, written by Ahmet Aydın, you will learn how the treatment of complaints such as heartburn (reflux) and heartburn without medication that uses acid-reducing drugs can be improved without diet.
How do you improve your reflux (heartburn) by regulating your diet?
Gastroesophageal reflux (GER) is the name given to the backflow of food and acid in the stomach to the esophagus. It is known as “chest burn arasında among people because it burns in the chest. Reflux is very common in our country and all over the world. It is said that at least 20% of those fed with industrial, refined foods have reflux, and this figure exceeds 50%. In a study conducted in our country, gastroesophageal reflux disease was found in 20% of the population. The majority of cases are obese, elderly and pregnant. Diaphragmatic hernia (hiatal hernia) is an important but not very frequent cause of reflux that facilitates reflux.
Formation mechanism of reflux
In order to prevent or regress the disease, it is necessary to first learn how reflux occurs.
Where the lower end of the esophagus joins the stomach, there is also a muscular valve-like structure called the lower esophagus sphincter. This pucker loosens as food descends to the stomach, and shrinks if it goes up the stomach again. Food that normally enters the stomach through the esophagus rarely returns to the esophagus. This is because the shrinkage at the lower end of the esophagus is shrinking again. This means that this normally opens only during the swallow function.
The reflux esophagus loosens when the lower pusher should be closed and the stomach content escapes back into the esophagus. Stomach bloating reduces the current state. Retrieval rarely depends on the insufficiency of the tone of this pucker (certain contraction). This event occurs frequently at different times of the day (1).
Cells lining the stomach surface are resistant to the strong acid secreted by the stomach. However, the floor of the esophagus has no property to be protected from this strong acid. If it is exposed to stomach acid for a long time, inflammation develops here; this is called esophagitis. Esophagitis can cause esophageal cancer in the long term.
Although gastric acid plays an important role in the mechanism of reflux, there is no gastric acid excess secretion in patients with reflux (2). Even in many reflux patients (especially the elderly), gastric acid secretion is low (3). Therefore, the use of acid-reducing drugs in these patients further increases digestive problems.
What are the clinical symptoms?
The patient often feels reflux as a “burning” and ”pressure altında beneath the breastbone, and sometimes this burning sensation is reflected in the throat. These symptoms, which are burning and pressing, increase after the meal and may last for hours. Sometimes sour water may come into the mouth. Asthma, laryngitis (hoarseness), difficulty swallowing. Rarely, it can also cause pneumonia as described above.
What are the side effects of reflux?
If reflux is not treated, it can cause stenosis and bleeding in the esophagus. Reflux underlies one third of childhood asthma. A number of pre-cancerous changes can be seen in the esophageal mucosa (mucous membranes), which encounter an acidic fluid for a long time. This is called Barrett's esophagus. Symptoms of dysphagia, bleeding, drowning, coughing, hoarseness and weight loss in a person with long-term reflux should suggest esophageal cancer.
How is it diagnosed?
If the patient's complaints are evaluated well, the diagnosis of reflux is usually made easily without resorting to any laboratory methods. Considering an important underlying anatomical cause, the following examinations are performed.
1- Esophagus-stomach - duodenum film
2- Gasroscopy: direct visualization of the esophagus and stomach with a flexible tube
3- Esophageal manometer: Examination of lower esophagus pressure
4- pH meter: A very thin flexible tube can be sent from the esophagus to the stomach to measure the pressures and ascites.
Classic reflux therapy
1. Drugs that reduce stomach acid: There are three groups; anti acids, H2 receptor blockers and proton pump inhibitors
Acid-reducing drugs are in the first or second place among the best-selling drugs in many countries as a group. Although there are those who argue otherwise, these drugs are of no therapeutic nature. Despite the tremendous advances in medicine, despite the discovery of a pile of modern stomach medications, the number of people suffering from reflux complaints is rising to one side with rocket speed !!
2. Prokinetic drugs: It facilitates the passage of substances in the stomach to the intestine faster.
3. If medication does not resolve the patient's complaints or complications such as bleeding, Barrett, stenosis, surgical methods are used.
Diet and reflux
Most obese people have complaints of reflux and stomach. It has been suggested that excess fatty foods cause reflux. However, it has been shown that reflux is related to obesity and not to the amount of fat in the diet (4).
On the other hand, the excess dietary refined sugars cause reflux. In a study, it was shown that when foods with high glycemic index in the diet of patients with reflux were removed, symptoms of disease improved within a week (5).
Even the patients who participated in this study continued to have bad habits such as alcohol, smoking and coffee, but their reflux symptoms improved. The aforementioned patients discontinued all gastric medications.
Our observations are the same. Reflux disappears spontaneously within a few days (almost all) of people who follow a low-sugar diet, the “stone age diet”. The mechanism by which a low sugar diet can relieve reflux is not well known. My personal opinion is as follows.
Insulin resistance and reactive hypoglycemia (reactive blood sugar low) are observed in those fed with flour and sugar-rich food. The sympathetic system is stimulated in the body to correct hypoglycemia. Closure of the lower end of the esophagus is related to the parasympathetic nervous system. Hypoglycemia as a result of excessive stimulation of the sympathetic nervous system, although not swallowing the lower esophagus esophagus and stomach contents backward escapes.
Reflux treatment without medication
The first step of emergency treatment is to drink 4 liters of water per day. This can be reduced by up to two liters when complaints are reduced.
The second important step is the significant reduction of refined sugars, flour and sugar-made foods (see stone age diet www.beslenmebulteni.com). The diet should be continued after the disappearance of ivegenic symptoms.
The third important step is to eat at least 3-4 cloves of garlic per day. Garlic should be consumed within the first half an hour after crushing (garlic pills have little effect). Garlic inactivates all pathogenic microorganisms in the gastrointestinal tract, including helicobacter. As it is known, the bacteria called helicobacter cause ulcers.
The fourth important step is to drink 0.5-1 liters of kefir buttermilk. Kefir increases the number of beneficial microbes in the intestine, produces enzymes that facilitate digestion, and synthesizes many vitamins (K, niacin, biotin, etc.). Kefir relaxes your stomach, prevents constipation, reduces allergies, strengthens the immune system and is protective against cancer. Take the kefir yeast from the importer or a neighbor and make it yourself at home.
Pneumonia-stomach medications
According to a study conducted in the USA, it was performed on 364,683 patients who applied to primary care centers (6). Primary pneumonia (pneumonia) was detected in 5,551 of these patients. The prevalence of pneumonia was 2.45% in patients who used drug that reduced acid secretion for at least one year, and 0.6% in those who did not use such drugs; that is, four times less pneumonia.
One of the important functions of gastric acid is to kill the germs we take with our food.
As well as stomach acid is one of the most important members of our immune system. In the above-mentioned study, the fact that pneumonia is seen 4 times more in users of gastric acid-lowering drugs further emphasizes the importance of this issue.
Vitamin B12-stomach medications
Reduction of stomach acid prevents dietary protein B12 from being separated from dietary proteins. Vitamin B12 deficiency has increased tremendously in recent years. The main reasons for this are the ban on eating red meat and stomach medications (7). Vitamin B12 deficiency can lead to anemia, fatigue, poor concentration, and even severe symptoms of dementia.
To prevent B12 deficiency, acid-reducing drugs should be discontinued and fed with a diet rich in vitamin C or other natural acidic foods.
Gastric remedies and indigestion
Protein digestion is greatly impaired because gastric drugs reduce acid secretion or inactivate the existing. As a result, undigested protein particles pass through the blood. As a result, a mass of allergic, inflammatory or autoimmune diseases (Hoshimoto thyroiditis, multiple sclerosis, rheumatoid arthritis, lupus, ulcerous colitis, asthma, etc.) may develop.
Stomach drugs and absorption of minerals
Reduction of stomach acid also reduces the absorption of dietary minerals such as calcium and iron. For example, antacids contain much calcium, but they are not a good source of calcium because they reduce stomach acidity.
Cancer and reflux drugs
It is assumed that drugs that reduce stomach acid need to reduce Barett's esophagus, and we would expect the esophageal cancers to decrease in the last 15-20 years. However, esophageal cancers increased by 3-4 times during this period !! (8-10).
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