Is it reflux? Take medicine!

Http://blog.sina.com.cn/s/blog_473788260100mx2m.html

The heart is not an adjective. In many people, it is a real feeling. The symptoms are known as heartburn, and some are also accompanied by acid resistance. This symptom is most likely caused by gastrooesophageal reflux. As indicated in the name of the disease, the main cause of the disease is that the stuff in the stomach flows back into the esophagus.
Although it is a very common disease, its diagnosis has undergone an interesting evolution and is still under debate. The transformation process can be seen from the internal medicine used by undergraduates. In the earliest textbooks, this disease is also called "reflux esophagitis ". Since it is called inflammation, there must be a manifestation of inflammation, pathological inflammation of the "red and swollen hot pain" moved here, the diagnosis of reflux esophagitis will see the end of the esophagus with congestion, edema and erosion. However, many patients have obvious symptoms, but the gastroscopy is normal. If only a few people do this, but in fact, most reflux patients do not have inflammation during gastroscopy. In this way, although the people with gastroscopy are definitely reflux, but the gastroscopy is OK, but reflux cannot be ruled out. The Clinical doctor's requirements for diagnostic tools not only allow the discovery of real patients, but also the elimination of truly diseased people. A gastroscope is not as good as the diagnosis of ulcer and gastric cancer in the diagnosis of gastrophoesophageal reflux disease.
The doctor asked the patient to perform the examination to provide evidence and details for the diagnosis, so as to guide the treatment. Since the goal cannot be achieved through a gastroscope with eyes, can other methods be used? For example, since we know that there is a major possibility of gastroesophageal reflux, it is mainly because of the reverse flow of things in the stomach to the esophagus, and that there is acid in the stomach, can we detect whether there is reflux in the pH of the esophagus? However, even normal people may occasionally experience reflux, but this reflux time is short, and the impact will be quickly eliminated through esophageal peristalsis and liquid neutralization. Therefore, accurate evaluation of reflux requires a long period of monitoring. This check has been carried out in many hospitals, and the method is a bit similar to 24-hour dynamic ECG monitoring. People who receive the check also need to carry a small box 24 hours a day, but the electrode is not placed in the front chest, instead, they are placed in the patient's diet. The patient also needs to write down the time every day when there is an acid problem, when to lie down, when to sit, and when to eat. Finally, the computer is used to analyze the occurrence of acid reflux, including the number of acid reflux times, the number of reflux times greater than 5 minutes, and whether there is burning acid reflux in the patient. This check was once considered a golden standard for the diagnosis of gastrooesophageal reflux.
It is a chronic disease, and the so-called chronic disease itself is good or bad. Taking a drug that suppresses stomach acid may make the examination results normal. In addition, just like a 24-hour dynamic electrocardiogram, there are often unlucky patients who are not having an attack during the 24-hour period of the examination. Although some people have tried to extend the monitoring time to 48 hours, it is difficult to keep a pipe in your nose.
Considering that the symptoms of this disease are easily controlled by acid inhibitors, Chinese and foreign experts began to tend to use the treatment effect as the touchstone for disease diagnosis. For example, if a patient has the problem of heartbleed acid reflux, the patient will be given an acid suppression drug directly without performing any tests. if the drug is effective, the patient will be considered as a gastrophoesophageal reflux disease, continue to take the medicine. The diagnosis is clear. If it is not effective, consider other tests, such as gastroscopy and esophageal pH testing.
Clinical Use of therapeutic effects as a basis for disease diagnosis, for example, effective oral nitric acid glycerol can be used as a basis for the diagnosis of angina, but can only be used as a reference value; for patients who suspect that tuberculosis infection cannot find a basis for survival or death, they can also perform experimental anti-tuberculosis treatment, which is regarded as tuberculosis effectively. This is a mandatory approach. However, there are not many diseases that take the treatment effect as the main basis for diagnosis, such as gastrophoesophageal reflux disease. With the deepening understanding of this disease, we may find simple and accurate diagnostic methods in the future. But is it reflux? It depends on the effect of governance.