HOW TO DEFEAT THE REFLUX
Supplements to counter reflux
The diseases of the digestive and nervous system are often interrelated and not easy to control and manage with only synthetic drugs . Both in dyspepsia than in other disorders, such as GERD, there are different situations and involved the causes are not always identifiable with the identification of pathogens (eg Helicobacter pilory ) or mechanical considerations ( hiatal hernia , stenosis , etc. . ) . Often this type of disease involving the search for deeper causes where anxiety, stress and disorders of the nervous system and hormonal appear as frequent causes . ( Firenzuoli , 1990; Bottaccioli , 1999) . Gastro -intestinal disorders such as dyspepsia, gastro esophageal reflux disease (GERD ) , irritable bowel syndrome , constipation, also occur in the majority of patients suffering from anxiety . ( Riedl A, Schmidtmann M, Stengel A, Goebel M, Wisser AS, Klapp BF , Mönnikes H. J Psychosom Res 2008 Jun , 64 (6) :573-82 . Epub 2008 April 28 . ) . The pathologies nerve belong on those of the digestive tract , and vice versa , as in the case of irritable bowel syndrome . ( Surgery. 2008 Aug , 144 ( 2 ) :149 -58 . Effect of intestinal inflammation on neuronal survival and function in the dorsal motor nucleus of the vagus . Ammori JB , Zhang WZ , Li JY , Chai BX , Mulholland MW. ) ; ( Curr Mol Med 2008 Jun , 8 (4) :258-73 . Neuropharmacology of stress-induced mucosal inflammation : implications for inflammatory bowel disease and irritable bowel syndrome. Santos J , Alonso C , Vicar M, Ramos L, Lobo B, Malagelada JR. ) .
The anxiety manifestations are normally present in many organic diseases , and not only in those of the digestive tract . For the treatment , when possible , it is certainly resort to medicinal plants, which have fewer side effects than synthetic drugs ( Muller , 1992). The lack of valuable nutrients , such as vitamins and antioxidants , predisposing the organism to the development of organic disease , anxious and depressive disorders . For example, depression has been found in patients with low levels of folate. ( J Altern Complement Med April 2008 , 14 (3) :277-85 . Folate and unipolar depression . Morris DW , Trivedi MH, Rush AJ . ) . The scarcity of nutrients vitamin feeding is associated with a high rate of mental disorders ( Nutr J. 2008 Jan 21; 7:2 . Nutritional therapies for mental disorders . Lakhan SE, Vieira KF . ) . Disturbances of ' mood in childhood ( unipolar and bipolar depression ) are serious, common and persistenti.La depression is the second leading cause of illness and discomfort in most of the world's youth population ( Pediatr Clin North Am 2007 Dec , 54 (6 ) :901 -26 , x . Complementary and alternative medicine therapies to promote ' healthy moods . Kemper KJ , Shannon S. ) . A poor nutrition of micro and macro nutrients is correlated with the development of serious diseases and degenerative diseases of the nervous system such as Alzheimer's disease ( J Nutr Health Aging. 2006 Sep-Oct , 10 (5) :377-85 . Effects of nutrients ( in food) on the structure and function of the nervous system : update on dietary requirements for brain . Part 1 : micronutrients . Bourre JM. ) ; ( J Nutr Health Aging. 2006 Sep-Oct , 10 (5) :386-99 . Effects of nutrients ( in food) on the structure and function of the nervous system : update on dietary requirements for brain . Part 2 : macronutrients . Bourre JM . ) .
Nervous system drugs , such as benzodiazepines and selective serotonin reuptake inhibitors (SSRIs) are commonly used for diseases of the gastro enteric , and also used for the treatment of GERD . ( Gastroenterol Clin North Am 2002 Dec , 31 (4 Suppl ) : S77 -84 . Persistent gastroesophageal reflux disease Symptoms on standard proton -pump inhibitor therapy . Sontag SJ . ) . GERD refers to the symptoms and injuries resulting from the reflux of gastric contents into the esophagus ( Dent J , Brun J , Fendrick amet al. , An evidence-based appraisal of the reflux disease management - The Genval Workshop Report . Gut 1999; 44 : S1 -S16 ) , ( J. de CAESTECKER Oesophagus : heartburn. Br Med J 2001; 323: 736-739 ) . GERD encompasses a spectrum of disorders where at one end there are patients with symptoms related to reflux but without endoscopic lesions of the esophageal mucosa , on the other hand there are those with severe complications such as stenosis or Barrett's esophagus . Between the two extremes are including various grades of erosive esophagitis and esophageal ulcerations . In the Western population , GERD affects 4-30 % of adults . ( Sonnenberg A, . El- Serag HB , Clinical epidemiology and natural history of gastroesophageal reflux disease . Yale J Biol Med 1999; 72:81-92 ; Isolauri J , Laippala P. Prevalence of Symptoms suggestive of gastrooesophageal reflux disease in an adult population . Ann Med 1995; 27:67-70 . ) .
The heartburn and regurgitation , typical symptoms of GERD , subside in 3-10 years only 12-33 % , regardless of the presence of esophagitis at diagnosis ( Nandurkar S , Talley NJ. Epidemiology and natural history of reflux disease . Bailliere 's Clinical Gastroenterology 2000, 14:743-757 ) . In the absence of therapy with H2 antagonists or proton pump inhibitors ( PPIs ) , symptom improvement occurs after 17-22 years in 60% , with disappearance in only 12% .
The esophagitis and / or a pathological pH metry is present in 66% , the Barrett's metaplasia in 10% and the anti- reflux therapy is required in 20% of 60 subjects studied ( Isolauri J , Luostarinen M , Isolauri E et al. Natural course of gastroesophageal reflux disease: 17-22 year follow-up of 60 patients . Am J Gastroenterol 1997, 92: 37-41 . ) . Despite treatment with anti- secretory drugs synthesis , a 10-year follow-up of esophagitis shows that more than 70 % had persistent symptoms and 2% had stenosis ( McDougall NJ , Johnston BT , Kee F et al. , Natural history of reflux oesophagitis : a 10 year follow-up of Its effect on patient symptomatology and quality of life . Gut 1996, 38: 481-486 ) .
Reflux oesophagitis is present in 2-5% of the general population ( Wienbeck M, Barnert J. Epidemiology of reflux disease and reflux esophagitis . Scand J Gastroenterol 1989; 24:7-13 ) . Congenital malformations of gastrointestinal as pyloric stenosis , the sore rotation , hiatal hernia and esophageal atresia favor the persistence of reflux with frequent complications , especially if the reflux is not treated (24 -Johnston BT , Carre IJ , Thomas PS , Collins BJ . Twenty to 40 year follow-up of infantile hernia. Gut 1995, 36: 809-812 ) , ( Krug E, Bergmeijer JH , Dees J et al. , Gastroesophageal reflux and Barrett 's esophagus in adults born with esophageal atresia . Am J Gastroenterol 1999; 94 : 2825-2828 ) .
Despite the influence of the pathophysiological mechanisms may differ depending on the age of the mechanism itself does not change over time. From the pathophysiological point of view of the mechanism of reflux , the tone of the lower esophageal sphincter ( LES) pressure is a barrier against reflux , and it is the most important component of the anti- reflux mechanism at the level of the gastro-esophageal junction . The reflux occurs only if the sphincter tone is low or in response to a relaxation ( generally Bad ) sphincter ( RTSEI ) , that is not a relaxation induced by swallowing ( Penagini R , Carmagnola S , Cantu P. Review article : gastrooesophageal reflux disease - pathophysiological issues of clinical relevance . Aliment Pharmacol Ther . Jul 2002 , 16 Suppl 4:65-71 ) .
The baseline blood pressure of SIX shows considerable diurnal variations in relation to the various phases of the migrating motility complex ( Marzio L, Big L, M Falcucci , Ciccaglione AF , Malatesta MG, Lapenna D. Increase of swallows before onset of phase III of migrating motor complex in normal human subjects . Dig Dis Sci 1996 to MAR; 41:522-7 ) and during meals, and is influenced by diet , by circulating hormones , stress , anxiety and certain medications. Fats , chocolate, peppermint , caffeine , alcohol , theophylline , most of anticholinergics , calcium channel blockers and nitrates decrease the pressure of the SEI. The two typical symptoms of GERD are heartburn and acid regurgitation . The heartburn is a feeling epigastric or retrosternal , often seen as ascending or burning pain in the post-prandial period . The acid regurgitation is reflux of acid into the pharynx and mouth , and may be accompanied by heartburn or less .
Antisecretory agents are the drugs of choice in GERD , treatment of gastro duodenal ulcers and gastritis hypersecretive . They are often associated with drugs that act on the nervous system and anxiety . The two classes of antisecretory drugs are antagonists of histamine receptors , type 2 (H2) and the proton pump inhibitors ( PPIs ) . The proton pump inhibitors ( PPIs ) are the most potent pharmacological agents in acid suppression in the treatment of GERD . They provide superior control of intragastric pH over 24 hours , compared with H2 antagonists and are more effective in improving the symptoms and speed healing endoscopically . By inhibiting the final common pathway of acid secretion , are able to inhibit more acidity than the H2 antagonists , throughout the day . Five PPIs are currently available on the market : omeprazole , lansoprazole, rabeprazole, pantoprazole and esomeprazole . The proton pump inhibitors such as omeprazole and lansoprazole are also used for maintenance therapy [ Koop, H. , Chirurg , 76: 353-358 (2005 ) ; Der , G., Gastroenterol . Nurs . , 26: 182-190 (2003) ] . The proton pump inhibitors have potentially serious side effects. They almost completely abolish the production of stomach acid so that the levels of serum gastrin rise by much.
In mice have developed polyps and malignant lesions of the gastric mucosa (World J Gastroenterol . March 21 2008 , 14 (11) :1646-51 . Gastric cancer : animal studies on the risk of hypoacidity and hypergastrinemia . Fossmark R , G Qvigstad , Waldum HL . ) ; ( J Coll Physicians Surg Pak. 2008 to MAR; 18 (3) :172-3 . Gastric corpus polyps associated with Proton Pump Inhibitors therapy . Yakoob J , Abbas Z , Jafri W , Ahmad Z ) has not yet been discovered whether these drugs are carcinogenic to humans as in mice through a mechanism similar [ Views, A., et al. , Gastric Cancer , 7 : 31-35 (2004) ] .
In any case in the absence of acid , the bacteria may develop in the stomach and their metabolism can develop nitroso compounds which are carcinogenic . [ Views, A., et al. , Gastric Cancer , 7 : 31-35 (2004); Vermeer , IT. , Et al . , Gastroenterology , 121: 517-25 (2001 ) ] . Furthermore, the proton pump inhibitors are correlated with many cases of acute interstitial nephritis , until reaching the renal insufficiency. The proton pump inhibitors are currently the drugs most commonly mentioned as a cause of acute interstitial nephritis in Auckland , New Zealand ( Nephrology ( Carlton) . Oct 2006 , 11 (5) :381 -5). Pump inhibitors have been linked to increased risk of hip fractures (JAMA. 2006 Dec 27 ; 296 (24) :2947-53 . Proton pump inhibitor Long-term therapy and risk of hip fracture . Yang YX , Lewis JD ) . Although benzodiazepines and antidepressants (SSRIs ), commonly used in combination with proton pump inhibitors and drugs for the digestive system, have serious side effects. Benzodiazepines create dependencies , with possible accumulation in elderly patients or those with liver disease , interact with alcohol , they create reactions to sudden withdrawal symptoms suspensions. Antidepressants in turn are correlated with side effects such as constipation , dry mouth , tremor, dizziness and convulsions , tachycardia , visual disturbances, jaundice. ( Firenzuoli , Herbal Medicine . Guide to the clinical use of medicinal plants. P. 341 ) . SSRIs can induce obesity and dyslipidemia ( J Clin Psychiatry. 2006 Dec ; 67 (12) :1974-82 . Obesity , dyslipidemia , and diabetes with selective serotonin reuptake inhibitors : the Hordaland Health Study. Raeder MB , Bjelland I, Emil S Vollset Steen VM).
Source: Naturbene
Supplements to counter reflux