The river health clinic in the 1st Affiliated Hospital of Zhengzhou University on June 20th morning, Dr. Ji Feng proposed 74 kinds of diseas
The river health clinic in the 1st Affiliated Hospital of Zhengzhou University on June 20th morning, Dr. Ji Feng proposed 74 kinds of disease treatment, or is caused by gastroesophageal reflux
Reporter Yang Zhendong Wen / Map
Gastroesophageal reflux disease, stomach and duodenal contents reflux into the esophagus causing pantothenic acid, heartburn, chest pain or other symptoms of esophageal mucosal injury. According to the research, because the work is too tight, too frequent, irregular meals entertainment and other reasons, gastroesophageal reflux disease incidence is quietly rising, about every 100 people, 7 to 9 people suffering from the disease, in a big city the prevalence rate of 16.98%. The vast majority of patients can tolerate tolerance, or try to diet or medication to temporarily relieve symptoms, less than two adults will go to hospital for treatment. They may not know that a small stream may affect the health of the entire body, and even life-threatening.
Is gastroesophageal reflux disease pantothenic acid, heartburn, chest pain, only these three typical symptoms? No!
In June 20th, the First Affiliated Hospital of Zhengzhou University newspaper invited the Department of intervention of gastroesophageal reflux in outpatient Dr. Ji Feng presided over the "river health clinic". In the hospital outpatient service building 8 floor of gastroesophageal reflux in clinic, more than 20 patients who were small forward to do lectures, for each of them the interrogation. In the lecture, he expressed his views with a "no".
In fact, this view is a well-known cardiovascular surgery experts, Chinese Academy of Sciences Wang Zhonghao proposed, and the season is a professor Wang personally taught dr.. Wang academician this view, due to his own up to two years of misdiagnosis and mistreatment experience. In the lecture, Dr. Ji affectionately recalled to mentor that stretch from disease to disease by lizhan magical experience.
Two years of mistreatment, Wang Zhonghao found that the true cause of asthma
Hard for three years, the first season Fengcheng rule against "Dr.
"My teacher, Wang Zhonghao, was diagnosed with gastroesophageal reflux disease before, went to the Department of respiration, Department of ENT, was misdiagnosed as asthma, allergic rhinitis." Dr. Ji Feng said, the 2003 SARS epidemic, academician Wang Zhonghao had to battle in the clinic, but the sudden coughing, sneezing, nasal congestion, tinnitus, dizziness and a series of symptoms, let him stick to work. At the hospital, he was diagnosed with asthma and allergic rhinitis. After two years, his asthma is more and more serious, every night will be hold up, and coughed half alive. He has been sent to the hospital 5 times because of abnormal throat tightness, almost no breathing.
The expert's advice is, without exception, considered asthma. But that is not academician Wang Zhonghao because he knew his asthma is not suppress, shortness of breath, no asthma specific wheezing, and could not find evidence to deny the original diagnosis.
The The path winds along mountain ridges. day is coming. Soon, at an international academic conference, India, a digest of experts to remind Wang Zhonghao academicians whether suffering from gastroesophageal reflux disease. Wang Zhonghao returned to the gastrointestinal laboratory to receive a 24 hour esophageal pH monitoring, the results confirmed that it was really gastroesophageal reflux disease: a day and night between reflux occurred a total of 220 times. The case is entirely cleared！ It turns out that fatal respiratory problems are one of the most serious respiratory complications caused by gastroesophageal reflux disease, a type of laryngeal spasm. Later, a doctor in the United States to carry out a fundoplication for his stomach, soon after treatment.
In order to avoid more people being misdiagnosed, academician Wang Zhonghao proposed "gelts theory", and created the first domestic gastroesophageal reflux disease center in Beijing, the Second Artillery General hospital.
In 2007, Ji Feng began under the tutelage of Wang Zhonghao became the first domestic academician, Dr. GERD professional. In April 2012, the First Affiliated Hospital of Zhengzhou University Department of intervention of gastroesophageal reflux professional clinic, led by Dr. Ji Feng. He is good at laparoscopic fundoplication, the eradication rate of asthma is more than 70%.
Case 1: 10 years of treatment of asthma, hormone dependent life, miserable!
Ms. Qu is Inner Mongolia, 49 years old, suffering from bronchial asthma for the past 10 years. Every autumn and winter season is the most difficult when she is not lying, bronchial asthma, or just sitting hunched, even a piss is short of breath, the kind of suffering it shengburusi. Because of the perennial use of hormones, the face of the full moon, buffalo and other side effects of hormones gradually show.
After 24 hours of esophageal pH monitoring, Ms. Qu is gastroesophageal reflux disease. In May 10th, Dr. Ji Feng performed the implementation of the "fundoplication + high selective vagotomy for Ms. qu". After surgery, Qu was pleasantly surprised to find that torture their 10 years of asthma symptoms miraculously disappeared.
Dr. Ji Feng explained that this disease is due to cardiac relaxation caused by other reasons, the contents of the stomach through the esophagus to reflux to the throat, cough, expectoration, caused rhinitis and gastric acid stimulation caused by laryngeal and tracheal spasm, causing airway stenosis or occlusion of the glottis, manifested as breathing difficulties, serious will endanger life.
What is the difference between the "asthma" and the general asthma caused by the gastro - oesophageal? Dr Ji Feng said: asthma often have common allergens such as pollen, dust mites, the disease will change with season or environment aggravated or mitigated, to breath out. While gastroesphago larygotracheal syndrome caused by asthma patients often cannot find allergens, obvious long-term morbidity, Jiuzhibuyu, mainly manifested as throat spasm, breathing difficulties, easy night arousal, some patients accompanied by nausea and heartburn.
Ji Feng said, clinical, 60% of patients with asthma and gastroesophageal reflux disease is closely related.
Case two: "high blood pressure" + "coronary heart disease" + "cerebrovascular disease"? Wrong!
Zhengzhou Mr. Sun said his brother, 46 year old, recurrent chest pain, chest tightness, shortness of breath, dizziness, severe side numbness and weakness, 7 years, the major hospitals in Zhengzhou have been all over, without exception to the hypertension, coronary heart disease, cerebrovascular disease "diagnosis.
For the treatment of coronary heart disease, he has placed three stents in the heart, the treatment of cerebrovascular drugs also eat every day. But these treatments are not good. Mr. Sun's brother a chance to visit a patient by the 1st Affiliated Hospital of Zhengzhou University outpatient doctor season, that gastroesophageal reflux may cause these symptoms he, then the door was not admitted!
In January 24th, Dr. Ji Feng performed for Mr. Sun's brother, the implementation of the "laparoscopic fundoplication surgery". After the surgery, Mr. Sun's brother was surprised to find that the symptoms of their 7 years of suffering miraculously disappeared, hypertension is also completely alleviated, and finally bid farewell to his concomitant with the antihypertensive drugs for 7 years.
In this regard, Dr. Ji Feng said: clinically, a lot of cardiovascular and cerebrovascular diseases and gastroesophageal reflux disease are closely related. Gastroesophageal reflux can cause cardio cerebral vascular spasm and blood pressure by reflex, heart, brain ischemia, severe cramps and even myocardial infarction or cerebral infarction.
In the clinic, they found gastroesophageal reflux in patients with hypertension after antireflux surgery, hypertension can be effectively controlled or even cured, the cure rate was 70%, suggesting that part of the pathogenesis of hypertension with gastroesophageal reflux factors involved in even the only pathogenic factors. Sympathetic hyperfunction is one of the important mechanisms of hypertension caused by gastroesophageal reflux disease, gastrointestinal disorders, hidden behind its sympathetic nerve dysfunction, which may be one cause of hypertension.
Case three: sneezing, stuffy nose, not allergic rhinitis
The next patient is a 30 year old from Xinxiang, Ms. Lee, she said that every day has been sneezing, runny nose and nasal congestion plagued, thought it was cold, repeatedly eat cold medicine every day, then went to the hospital, the doctor diagnosed allergic rhinitis, a multi drug allergy, eat a useful, but a withdrawal is still constantly sneezing, runny nose.
Ji Feng suggested that she have a barium meal, see is not caused by gerd.
Gastroesophageal reflux occurs, the contents of the stomach can be reversed to the nasal cavity, stimulate the nasal mucosa, causing sneezing and other symptoms of rhinitis." Dr. Ji Feng said that although the symptoms of gastroesophageal reflux rhinitis and allergic rhinitis is very similar, but there is a fundamental difference between the two:
1 the former is not obvious seasonal, because gastroesophageal reflux is always there, and allergic rhinitis is essentially different, while the latter has obvious seasonal.
2 the most obvious in the morning and wake up, the latter is in contact with the allergen after the attack.
3 the former is more sensitive to changes in the environment, such as alternating cold and hot air.
Have the symptoms of gastroesophageal reflux in 4 patients in the former part, such as pantothenic acid, heartburn, bloating, belching.
Case four: cough for a long time does not heal, do not cough when cured!
When Dr. Ji Feng was ready to call a patient in the consulting room, excitedly came in a beautiful girl of more than and 20 years old, put a candy lightly on Dr. Ji Feng's diagnosis on the table, smiled and said: "thanks to the season, cure my cough, my boyfriend didn't take away. We are going to get married soon."
In saying good-bye to the bride, Dr. Ji Feng spoke to the people: but a cough cough It is quite common for, just a few months, or even broken ribs to cough, cough syncope, become unconscious, no matter how cure all useless, is always cough, cough, cough, endless! According to this cough, which handsome guy dare to marry?
"Chronic cough involves a variety of causes, not only with the respiratory system, but also with the nose, throat, and digestive system," Dr. Ji Feng said." The research shows that the most common cause of chronic cough and postnasal drip syndrome of cough variant asthma and gastroesophageal reflux, including gastroesophageal reflux caused by chronic cough accounted for a large proportion, from 20% to 40%.
Gastroesophageal reflux cough is a kind of gastroesophageal reflux disease which is caused by the reflux of gastric contents into the esophagus. Some patients with gastroesophageal reflux cough with pantothenic acid, heartburn and other symptoms of chest pain, but there are also many patients without reflux symptoms and symptoms associated with eating, cough is the only performance. Therefore, it is impossible to exclude the possibility of gastroesophageal reflux cough in patients with chronic cough without reflux symptoms.
Case five: chronic pharyngitis, don't take that old pharynx!
"Season, do you think I am a chronic pharyngitis or gastroesophageal reflux?" 28 year old high school teacher Lee asked dr..
Every day, Mr. Li is troubled by throat discomfort, throat dry, something blocked, and sometimes hoarse voice, to the hospital diagnosis is chronic pharyngitis, opened a lot of anti-inflammatory drugs, but the throat is still uncomfortable. That treatment of chronic pharyngitis may be gastroesophageal reflux, and special leave to find Dr. season.
To take this opportunity, Dr. Ji Feng also told you that "reflux pharyngitis" - gastroesophageal reflux caused by chronic pharyngitis.
Because of the high incidence of gastroesophageal reflux disease, in the normal population can account for 10% ~ 30%, so a lot of chronic pharyngitis is caused by reflux or aggravated.
Are there any diagnostic criteria for reflux pharyngitis? Yes, we have。 Dr Ji says there are five major standards, pharyngitis friends can.
1 often have a history of recurrent episodes of acute pharyngitis, or by nasal long-term mouth breathing etc..
2 pharyngeal discomfort, or pain, or itching, or dryness, burning, smoke feeling, comfort; irritating cough, expectoration of morning secretions, even. Over the course of 2 months, often due to a cold, cold, fatigue and other pathogenic.
3 reflux pharyngitis in addition to clinical manifestations of chronic pharyngitis, which is often accompanied with different degrees of gastroesophageal reflux disease symptoms, such as pantothenic acid, heartburn, bloating, belching, stomach pain, chest pain. In addition the pharyngeal symptoms can be aggravated in satiation or supine position.
4 examination: pharynx showed chronic congestion. Pharyngeal mucosa hyperplasia hypertrophy, or dry, atrophy, thinning, there are secretions attached. Esophageal pH value was positive for 24 hours.
5 cases of recurrent pharyngitis, conventional medication ineffective or even effective, but the withdrawal of the recurrence.
Scary: 74 kinds of disease are likely to gastroesophageal reflux
"Not only the above several common disease is easy to misdiagnosis, I specialized statistics, so far, there are 74 kinds of diseases are likely to gastroesophageal reflux. If the disease is not cured, may wish to look at the gastroesophageal reflux." Dr. Ji Feng said.
These 74 diseases are -
The digestive tract: pantothenic acid, heartburn, belching, nausea, bloating, vomiting, diarrhea, dysphagia, constipation; substernal chest pain or discomfort. Easily misdiagnosed as chronic gastritis, stomach cramps, indigestion, constipation, irritable bowel syndrome, enteritis, diaphragmatic spasm, rib cartilage inflammation, pleurisy.
Respiratory: cough, sputum, wheezing, aspiration pneumonia, pulmonary fibrosis, bronchiectasis, dyspnea, laryngospasm, recurrent pneumonia episodes, chest pain, chest tightness, shortness of breath, shortness of breath. It is easy to be misdiagnosed as chronic cough, cold, bronchitis, asthma, pneumonia, pulmonary fibrosis, bronchiectasis, laryngeal spasm, emphysema, pulmonary heart disease.
ENT: pharyngeal foreign body sensation, itching throat, hoarseness, rhinitis, sneezing, runny nose, stuffy nose; tinnitus, ear itch, snoring, arousal, dry throat, itching throat, sore throat, hoarseness, pharyngeal foreign body sensation, such as vocal polyps repeatedly. Easily misdiagnosed as chronic pharyngitis, chronic laryngitis, inflammation, ulcer, glottis glottic, subglottic stenosis allergic rhinitis, chronic rhinitis, sinusitis, nasal septum deviation, nasolacrimal duct obstruction, nervous tinnitus, deafness, otitis media, vocal polyp, vocal cord white spots, epiglottis cyst, laryngeal cancer, sleep apnea, vocal paralysis.
Facial features: dry eyes, eye swelling, itching eyes, such as unclear objects. Misdiagnosed as allergic conjunctivitis, dry eye, cataract, glaucoma.
Oral: oral ulceration, pain, numbness, burning sensation, pain, dental caries, burning sensation of the tongue etc.. Easily misdiagnosed as oral ulcer, halitosis, glossitis, dental caries, gingivitis, Sjogren syndrome.
Heart palpitations, shortness of breath, chest distress, premature, even angina, myocardial infarction, coronary heart disease etc.. Easily misdiagnosed as coronary heart disease, arrhythmia, swallowing arrhythmia, sinus tachycardia, sinus bradycardia, premature atrial contraction, premature ventricular contraction, atrial fibrillation, myocarditis, cardiac neurosis.
Nerve reflex: increase or decrease blood pressure, headache, dizziness, limb weakness, weakness, fever, cold, numbness or soreness, sometimes even syncope feeling of impending death. Easily misdiagnosed as hypertension, hypotension, cerebral vascular disease, migraine, tension headache, migraine, vascular hypertension headache, cervical spondylosis, lumbar disease, autonomic dysfunction, menopausal syndrome, rheumatoid arthritis, vasovagal syncope, deep venous insufficiency, heel the pain.
Other symptoms: insomnia. Easily misdiagnosed as sleep disorder.
Gastroesophageal reflux, the reason why so many parts of the body caused by the disease, in part, is the result of the stimulation of reflux, the overall situation is the result of systemic autonomic nervous disorders.
First, from the local point of view, as the name suggests, gastroesophageal reflux refers to the contents of the stomach acid or bile reflux into the esophagus. If only the reflux feeding tube, it will only appear heartburn, pantothenic acid and other relatively mild symptoms, but if it is high reflux, such as gastric contents into the pharynx, or by inhalation of the trachea and bronchus, lung, will lead to serious cough, sputum, asthma, dyspnea and suffocation. If there is high reflux, patients often do not have symptoms such as heartburn, pantothenic acid, but not stop coughing, wheezing, sneezing, runny nose. Part of the gastroesophageal reflux disease patients will feel throat spasm during nighttime sleep and breathing difficulties, at midnight, easily suffocation woke up, patients with asthma often have nocturnal wheezing. Although gastroesophageal reflux disease symptoms in the pharynx and respiratory tract, but the root cause is in the digestive tract.
From the overall situation, it is well known that the central nervous system is the first human brain, some people say that the digestive system is the second brain. As the digestive tract is the body's longest organ distribution, which has 5 to 6 meters in the small intestine, the colon is between 1 ~ 1.5 meters, like a "headquarters", with the function of self-regulation. For example, the rest of the gastrointestinal tract is still in motion, in addition to participate in digestion and absorption of food, but also to participate in the regulation of other organs in the body, including the impact of human emotions. So, the intestines become the second brain, its role can not be ignored. As a result of frequent reflux, it will lead to functional disorders of the gastrointestinal autonomic nervous system, which can lead to systemic diseases.
Treatment: Daily conditioning, drugs, surgery
For patients with gastroesophageal reflux disease daily conditioning and treatment, Dr. Ji Feng to do a detailed introduction.
At present, the most common treatment for gastroesophageal reflux disease is oral medication. Many patients always hope to get once and for all, "special effects", in fact, gastroesophageal reflux disease and hypertension, diabetes, is a chronic disease, if you choose a conservative treatment, then you need lifelong medication. In addition, some patients with conservative treatment did not have the desired effect. The incidence of gastroesophageal reflux disease is mainly due to the control of the reflux valve, cardiac sphincter relaxation caused by sphincter relaxation, and the lack of effective treatment, so the current drug therapy can improve the symptoms, improve the quality of life, but can't cure.
From the drug, there are three: one is the antisecretory drugs, to prevent excessive gastric acid; the two is to neutralize stomach acid drug, once the reflux is not as corrosion of esophagus; three is to protect the esophagus medicine, enhance the corrosion resistance.
One way to solve the problem of gastroesophageal reflux disease is gastric fundus folding + high selective vagotomy surgery. The so-called "gastric bottom fold" refers to the bottom of the stomach wrapped around the lower esophagus, and suture to the right side of the small bend. In this way, the pressure in the stomach is transmitted to the newly created "collar" surrounding the esophagus and the pressure of the esophagus. This one-way valve function makes the food from the esophagus into the stomach, but not from the stomach into the esophagus. Today, the operation has been very mature. There is no need to open, just in the abdominal wall of patients with 5 to 5 10mm key hole size incision, laparoscopic surgery, surgical recovery time of only 2 to 3 days.