Refluksidii

Refluksidii is a group of disorders characterized by backflow of stomach contents into the esophagus, larynx, or pharynx. The most common form is gastroesophageal reflux disease (GERD), typically defined by troublesome heartburn or regurgitation occurring for weeks or months. In Estonian medical terminology refluksidii refers to this group of reflux-related disorders.

Categories include GERD, non-erosive reflux disease (NERD), and laryngopharyngeal reflux (LPR). Some sources group symptomatic reflux with or without mucosal injury under “reflux disease.”

Causes and risk factors include lower esophageal sphincter dysfunction, hiatal hernia, obesity, pregnancy, delayed gastric emptying, certain foods, alcohol, smoking, and medications that relax the sphincter.

Common symptoms are heartburn and regurgitation; others include chest pain, sour taste, chronic cough, hoarseness, and throat clearing. LPR may present with throat and voice symptoms without classic heartburn.

Diagnosis relies on clinical history; endoscopy to detect esophagitis; ambulatory pH or impedance monitoring for reflux; esophageal manometry to assess motility. Endoscopy helps rule out ulcers, strictures, and Barrett’s esophagus.

Treatment emphasizes lifestyle changes (weight loss, sleep elevation, trigger avoidance) and pharmacotherapy. Proton pump inhibitors are first-line for GERD; H2 blockers for milder cases. Surgery (fundoplication) or endoscopic options may be considered in select patients.

Prognosis is generally favorable with therapy, but complications can include esophagitis, esophageal stricture, Barrett’s esophagus, and rarely esophageal cancer. Long-term management is needed for many patients.