Anti-reflux Mechanism And Via The Non-pharmacological Treatment Of Gastroesophageal Reflux Disease

Gastroesophageal reflux disease (GERD) refers to the effortless movement of gastric contents from the stomach or duodenum to the esophagus and producing symptoms and signs within esophagus or extra-esophagus. GERD is a chronic relapsing disease caused by upper gastrointestinal tract motility disfunction. Symptoms and esophagitis recur quickly after withdrawal or decrease of drug dosage. Although proton pump inhibitors can relieve symptoms and cure injury of esophagus, long-term therapy is required. This study aimed to investigate the influencing factors of upper gastrointestinal tract motility and find out the alternative therapy for GERD.Methods(1) To evaluate the influencing factors of medication in GERD. (2) To observe inflammation of esophageal mucosa with erosive resophagitis and non-erosive reflux disease. To investigate the effect of mast cell counting and activity in esophageal mucosa on GERD by immunohistochemistry . To investigate the levels of 5-TH , NSE, SP and TGF-α expression in esophageal mucosa by immunohistochemistry in GERD and its relationship with symptoms.(3) To study the roles of diaphragmatic crural barrier and esophageal body clearance in GER and the effect of compositions and amounts of diet in physiological state on frequency of TLESRs and mechanisms of acid reflux episodes in GERD and HS by simultaneous esophageal motility and esophageal pH recording, (4) To evaluated the effect of ANS disfunction on GERD and its relationship with esophageal motility, degree of reflux esophagitis and reflux symptoms. (5) To investigate the effect of diaphragm biofeedback on enhancing the function of EGJ.Results(1) Result of analysis on 156 pts. identified GERD showed that acid supression therapy was effective. 92 pts. (58.9%) requird intermittent maintenance therapy, 59 pts(37.8%) required continuous maintenance therapy and 3(3.3%) pts. showed no effect .The influencing factors of medication therapy in GERD were closely associated with course, symptom score, degree of RE, hiatus hernia and esophageal motility.