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Gastroesophageal reflux can cause complications such as ulcers and adenocarcinoma

Gastroesophageal reflux can cause complications such as ulcers and adenocarcinoma

Symptoms are divided between typical and atypical. In the first group we included heartburn or heartburn (retrosternal burning) and regurgitation. In the second group we have feelings of food impaction, chronic cough, asthma, pulmonary fibrosis, pneumonia, chest pain, laryngitis, sinusitis, otitis, ulcers, hoarseness, hawking, halitosis and dental erosion.

Among the causes we can mention hernia (contracted muscle prevents the contents of the stomach from returning to the esophagus), loss of peristalsis of the esophagus (coordinated muscle contractions to drive the food), increased gastric secretion, increased intra-abdominal pressure and stomach too full for an extended time. Other risk factors include obesity, smoking, alcoholism, pregnancy, scleroderma, poor diet, poor eating habits, and certain medications such as beta blockers, bronchodilators, calcium channel blockers for high blood pressure, dopaminergic agonists, sedatives, and tricyclic antidepressants. Among the drugs used we have antacids, H2 antagonists, proton pump inhibitors, prokineotid agents and gastric fund relaxers.

Diagnostic tests include upper digestive endoscopy (which helps in the definition of prognosis and conduct), esophageal phmetria, esophagomanometry and impedancemetry.

Endoscopic examination of the esophagus shows inflammation (esophagitis) in some cases. In a smaller number of patients, especially those with bulky hyaline hernias and chronic reflux, complications such as ulcers, narrowing (stenosis) and columnar metaplasia are observed. The columnar metaplasia in the distal esophagus is a reaction of the esophagus to the presence of gastric reflux. It is especially worrying when we have Barrett's esophagus which is a process of metaplasia in which the stomach epithelium assumes some characteristics of the intestinal epithelium. In this case, we have an increased risk of esophageal cancer, requiring endoscopic follow-up.

Every chronic reflux should be evaluated by a physician, with regular follow-up, aiming not only to resolve the symptoms, but also to prevent or follow up on

Treatment begins with adequate food, seeking to avoid foods that are known to cause reflux, alcohol, citrus foods, caffeine, fizzy drinks, chocolate, tomatoes, some condiments and seasonings , fatty foods, mint and mint. In addition, avoid copious meals, do not lie down for three hours after eating, feed yourself every three hours, stop smoking, avoid obesity and tight clothing and do not exercise after eating. To prevent nocturnal reflux, it is recommended to raise the head of the bed by 15 cm, allowing the refluxed material to return to the esophagus promptly.

Among the medicines used we have antacids, H2 antagonists, proton pump inhibitors, procyanide agents and gastric fund relaxers. As they have precise indications and side effects that include diarrhea, vomiting, gastric polyps, hypomagnesemia, increased risk of gastrointestinal infections and pneumonia, the use of medications should only be done with a medical prescription.

Antireflux surgeries such as Nissen fundoplication are used in selected cases, considering the patient's age, symptoms, anatomical and functional characteristics of the esophagus, reflux complications and patient preferences.


Symptoms of bowel cancer may vary depending on the location of the tumor

Symptoms of bowel cancer may vary depending on the location of the tumor

There are different types of symptoms for bowel cancer. What determines the variant between one type and another is the location of the tumor. However, systemic symptoms such as weakness, decreased appetite, and weight loss may be present in most cases and require attention. In addition, a person should also seek medical advice if they experience alarm symptoms such as: persistent bowel disease (diarrhea or constipation) Abdominal pain Fecal blood Unexplained weight loss Presence of anemia due to chronic blood loss, especially in individuals over 50 years of age Specific symptoms of tumor location may include: (a) Right colon lesions (ascending) May be asymptomatic under investigation of cause of anemia Abdominal pain Stool blood Stool (9%) Changes in bowel habits Fecal blood Fecal blood Abdominal pain (c) Injuries to the rectum Live bleeding in feze s Pain on bowel movement and feeling of "incomplete evacuation" Stools on tape (with a reduced caliber) Examination Before any suspicion, the doctor must carry out the investigation that starts on a physical examination which includes the rectal touch.

(Health)

Inclusion of disabled students in schools grows 6 times

Inclusion of disabled students in schools grows 6 times

The number of young people with disabilities in common classrooms has a significant increase between 2005 and 2015. According to the School Census of Inep (National Institute of Studies and Educational Research Anísio Teixeira), the presence of special students increased 6%, rising from 114,834 to 750,983.

(Health)