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  • Title: [Gastroesophageal reflux disease].
    Author: Castillo Rosales T.
    Journal: Rev Gastroenterol Peru; 1991; 11(1):7-18. PubMed ID: 1804331.
    Abstract:
    The gastroesophageal reflux is a common clinical manifestation and it can be present under normal physiologic circumstances or may cause esophageal mucosal damage. This disease is currently believed to be ultifacorial in etiology, but the key in the dysfunction of the antireflux barrier, prolonged esophageal acid clearance and gastric emptying and lack in the esophageal mucosal resistance. The exposición repeatedly to clorhidric acid, pepsin and sometimes to bile salts and pancreatic enzymes may cause mucosal damage. The typical symptoms are heartburn and regurgitation, but the spectrum of manifestation include typical symptoms and extra digestive manifestation, specially pulmonary manifestations. For the diagnostic management several different tests are available for to know is the reflux is present, if the patient's symptoms are due to reflux and to evaluate the effect of reflux on the mucosa. The procedures of choice are endoscopy and 24 hour pH probe ambulatory monitoring. However in our country a good clinical history, barium swallow, endoscopy and biopsy permit us a reasonable diagnostic management. The medical treatment to be directed toward reduction the reflux, acid inhibition and accelerated clearance of acid. The elevation of the head of the bed and the change of lifestyle can pay large dividends in the treatment and must to maintain all the life. H2 receptor antagonist are the therapy of choice in esophagitis who have severe esophagitis or reflux symptoms unresponsive to H2 receptor antagonists may be treated with omeprazole. Antireflux surgery can be effective for those patients with complications.
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