What is gastro

Jan 13, 2024

According to the Istituto Superiore di Sanità, 1 in 3 people in Italy suffer from it and the likelihood of its occurrence increases with age, although infants and pregnant women also frequently suffer from it.

Gastro-oesophageal reflux is a condition in which stomach contents back up into the oesophagus in such quantity and frequency that the oesophagus is unable to clear and self-clean efficiently.

This occurs when the lower valve (lower oesophageal sphincter) of the oesophagus does not function properly, causing material to back up from the stomach.

Reflux is facilitated by the presence of a hiatal hernia, which is a leakage of the stomach through an opening in the diaphragm (hiatus).

A little reflux, especially after meals, is to be considered normal, but if there are frequent symptoms or they become chronic, then we speak of Gastroesophageal Reflux Disease (MRGE or GERD in English).

In particular, they are differentiated:

In general, the symptoms of gastro-oesophageal reflux disease can be summarised

A) in typical symptoms, such as:

B) atypical or extra-oesophageal symptoms, such as:

In some individuals, who also present with significant clinical manifestations, gastro-oesophageal reflux can lead to complications such as:

In addition to diet and a correct lifestyle, the classic modality for treating gastro-oesophageal reflux involves the use of drugs (antacids, alginates, proton pump inhibitors, H2-receptor antagonists, prokinetics, etc.) which often have to be used for long periods of the patient's life and act mainly to

Be careful, however, because these drugs can

The gold standard for correcting a malfunctioning oesophageal valve is fundoplication, performed using various techniques (such as the Nissen, Toupet and Dor) which, by bending the bottom of the stomach, create a 360°, 270° and 180° neovalve.

In some cases, this procedure is also associated with a hiatoplasty to correct a hiatal hernia.

However, the operation, performed under general anaesthesia and lasting from 1 to several hours, may discourage the patient because of

An alternative to surgery for a malfunctioning oesophageal valve is transoral fundoplication with an Esophyx® device: an endoscopic technique that involves bending the bottom of the stomach with a special disposable device that is introduced through the mouth.

This particular procedure follows the same principles as the Nissen surgical method, in which the gastric fundus, i.e. the uppermost section of the stomach, is folded around the oesophagus, creating a new valve that prevents the gastric material from rising, but in this case the plication is performed inside the stomach and no cuts are made.

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