What physical exercises are prohibited with the coat of arms. Yoga and gastroesophageal reflux disease (GERD)

For people suffering from gastroesophageal reflux or, scientifically, gastroesophageal reflux disease (GERD), exercise requires a special approach. For some, moderate exercise can relieve the symptoms of GERD, bringing enormous benefits to the body in every way. A 2004 study reported that people who exercised regularly physical exercise experienced GERD symptoms to a much lesser extent compared to those who did not exercise. Not to mention, regular exercise is the best way to maintain a healthy weight, which can also help relieve GERD symptoms. Overweight increases the likelihood of GERD symptoms. obese people(having a body mass index greater than 30) suffer from reflux or esophageal erosion 2.5 times more often than people with normal BMI(from 18.5 to 24.9). They are also three times more likely to develop esophageal cancer than people of normal weight.

Exercise improves the body in many ways and even reduces the likelihood of GERD symptoms. However, for some people, especially in the case of heavy physical activity, sports can aggravate the symptoms of GERD. No, this does not mean that you need to take off your running shoes and put on slippers to treat GERD. The benefits of exercising far outweigh the risk and discomfort of acid reflux. You don't have to stop exercising, just try following a few simple guidelines to get GERD under control.

Digestion takes time. The weight of a full stomach is in itself a serious test for the esophageal sphincter. If we add to this the concussions that occur during sports then you will be in trouble. Make sure that there is at least two hours between meals and training (more time may be required for a particular person and type of food).
Take a bottle of drinking water with you. Water can significantly boost your energy levels by preventing dehydration and aiding in the digestion of food.
"Hold your horses." Exercises with high level Strenuous exercise, such as jogging and vigorous aerobic exercise, can force the contents of the stomach to jolt, which can exacerbate reflux symptoms and discomfort. Therefore, it is better to do something more "smooth" - cycling and roller skating, strength exercises Finally, yoga or just walking. Some people experience an exacerbation in the supine position. In this case, exercises in this position should be avoided - bench press, Pilates, some yoga poses and swimming.
To the doctor. If all of the above recommendations do not help you, consult your doctor. Maybe you need to undergo a course of treatment?

GERD symptoms such as heartburn and chest pain are often indistinguishable from similar signs of serious heart disease because the same nerves are involved. Doctors urge us not to ignore any chest pain. If you feel pain in your chest, whether you're exercising or not, be sure to see a doctor!

Remember that the body of each person is very individual - what is useful for one may cause a problem for another. If you suffer from GERD, then you have to trial and error to find the sport that suits you personally.

- the disease is not easy, so patients need to be attentive to the appearance of symptoms of this disease and be sure to undergo an examination by a specialist.

Only complex therapy will help get rid of reflux esophagitis, so it will be useful for every person who suffers from this disease to know how this disease should be properly treated with the help of a competent doctor.

So let's get started.

Can reflux esophagitis be cured permanently? You can, if you turn to a competent doctor and get modern treatment.

Doctors identify several effective and efficient treatment regimens for reflux esophagitis. All of them are selected strictly on an individual basis for each patient after receiving the results of the examination.

Therapy with one drug. This does not take into account the degree of soft tissue damage, as well as complications. This is the least effective treatment regimen for patients, which can lead to poor health.
Reinforcing therapy. Physicians prescribe different medicines that differ in their degree of aggressiveness. Patients need to strictly follow a diet and take antacids.
Taking strong proton pump blockers. When the symptoms begin to disappear, patients are prescribed prokinetics. This treatment regimen is suitable for patients diagnosed with severe reflux esophagitis.

Reflux esophagitis: treatment regimen

The classical scheme of treatment of the disease is divided into 4 stages:

First degree reflux esophagitis. Patients should take antacids and prokinetics for a long time ().
2 degree of the inflammatory process. Patients need to adhere to proper nutrition and take blockers. The latter contribute to the normalization of the level of acidity.
3 degree of the inflammatory process of a severe form. Patients are prescribed the use of receptor blockers, inhibitors and prokinetics.
The last degree of reflux esophagitis is accompanied by pronounced clinical manifestations. Treatment with medicines will not bring a positive result, so patients undergo surgery in combination with a course of maintenance therapy.

How to cure reflux esophagitis permanently? The duration of therapy depends on the degree of damage. gastrointestinal tract. The initial stage of reflux esophagitis can be cured with a proper and balanced diet. The course of therapy is calculated for each patient individually.

How to treat reflux esophagitis

If the process of digestion of food is disturbed, then the contents of the stomach during a long stay in it causes an inflammatory process and irritation of the walls.

Patients feel heaviness in the intestines, a feeling of fullness in the stomach, nausea and bitterness in the mouth. After eating, the pain becomes severe and becomes acute.

There are several effective methods of treating reflux esophagitis, which are prescribed only by the attending physician after diagnosis and study of the patient's history.

Note! Vitamins for reflux esophagitis are not always prescribed: the need for this is determined by the doctor when choosing therapy, when he decides what to take for reflux esophagitis for you.

Medical treatment

How to get rid of reflux esophagitis? Depending on the form of the course of the disease, doctors prescribe patients to take proton pump blockers or H2-histamine receptor inhibitors. The first group of drugs helps to normalize the work of the glands of the stomach and the mucous membrane of the digestive system. These medicines are prescribed to patients for additional protection of the walls of the esophagus, duodenum and stomach.

With the correct use of blockers, damaged areas of the mucous membrane begin to recover faster. Medicines taken for a long time, and if a patient has been diagnosed with a severe form of reflux esophagitis, then they are prescribed a double dosage for initial stage treatment.

The most effective drugs include:

Features of antacids

These substances help to quickly and effectively cope with the manifestations of heartburn. After using antacids, their main components begin to act on the body after 15 minutes. The main task of such therapy is to reduce the amount of hydrochloric acid, which causes burning and soreness in the chest.

The most effective drugs are:

Rennie;
Maalox;
Gastal;
Phosphalugel;
and others.

Alginates

Gaviscon is an effective and safe new generation alginate. After taking this remedy, hydrochloric acid is neutralized, an additional layer is formed to protect the stomach and the functioning of the gastrointestinal tract is normalized.

Prokinetics

The main task of prokinetics is to improve the motor function of the stomach, muscles and upper small intestine. Physicians advise their patients to use metoclopramide And Domeridon. These medicines will reduce the amount of time the esophagus comes into contact with hydrochloric acid.

Physiotherapy procedures

Amplipulse therapy has been used for a long time to treat reflux esophagitis.

The procedure is carried out in a physiotherapy room and is aimed at relieving pain, eliminating foci of inflammation, improving gastric motility and blood circulation.

If the patient has severe acute pain, then electrophoresis is performed with ganglioblocking agents. Microwave therapy is indicated for patients who, along with reflux esophagitis, have been diagnosed with pathological disorders in the liver, gastric and duodenal ulcers.

Also to the most effective methods physiotherapy treatments include applications with sulfide silt mud and electrosleep.

Medical nutrition and diet

It is important for patients to review the diet and diet. Food should be boiled, steamed or stewed with a minimum amount of oil. An important condition is fractional nutrition in small portions. Patients are not allowed to lie down immediately after eating. Compliance with this rule helps to reduce the intensity and number of attacks at night.

Important! It is unacceptable to eat smoked, fried and salty foods. Under the ban are alcoholic beverages, soda, chocolates, citrus fruits, tea, coffee, garlic, tomatoes and onions.

Patients should not overeat, because when the stomach is full, there is an increase in the reflux of contents into the esophagus.

Learn more about how it should be medical nutrition with this disease, you can.

Surgery for reflux esophagitis

Surgical treatment of reflux esophagitis is carried out in the event that when drug therapy fails. The main goal of surgery is the complete cessation of the reflux of stomach contents into the esophagus. Before the operation, patients undergo a complete comprehensive examination, and only after that a fundoplication is performed.

Access to the stomach can be open or laparoscopic. During surgery, the bottom of the stomach is wrapped around the esophagus to create a cuff. The least traumatic method of the operation is laparoscopic, which has a minimum number of complications.

Treatment with folk remedies

Maybe only after consultation with your doctor. It is possible to use collections of plant components only at the initial stage of the development of the disease.

Aloe juice is effective tool, which envelops the mucosa of the esophagus, reduces the inflammatory process and contact with food.

A decoction of flax seeds acts on the body in a similar way to antacids. After taking such a drug, the level of acidity in the stomach decreases, the esophagus is enveloped and protected.

Breathing exercises for reflux esophagitis

The main feature of this treatment is correct breathing. This technique is independent or used in combination with physical exercises.

Breathing exercises for reflux esophagitis are performed according to the following scheme:

Patients take a comfortable position for themselves - sitting or standing. Take a deep breath and slowly exhale. A person needs to engage the muscles of the abdominal cavity. The optimal number of such approaches is 4 times.
A calm breath is taken and a quick exhalation by the abdominal muscles (up to 10 approaches).
Patients take a deep breath, hold their breath and squeeze the abdominal muscles strongly. It is necessary to make every effort and pause for up to five seconds. After that, a calm breath is taken.

During breathing exercises pauses are necessary because some patients become dizzy. It is important not to rush and do the exercises consistently. How long reflux esophagitis is treated, so much time and it is recommended to perform these exercises, and in most cases even longer, to ensure the stability of the results.

Gymnastics

The following features of gymnastic exercises for reflux esophagitis can be distinguished:

Gymnastics does not help patients get rid of excruciating heartburn. During exercise, the recovery process is accelerated, periods of exacerbation and the number of spasms are reduced.
Each patient will be able to choose for himself the optimal set of gymnastic exercises that will provide real help.
Classes do not belong to the main method of treatment, so they must be combined with drug therapy.

Yoga for reflux esophagitis

Patients diagnosed with reflux esophagitis can practice yoga. Such exercises bring great benefits to the body and internal organs. Static postures or asanas will allow you to fully activate the circulatory system, as well as strengthen muscle mass body.

You can combine static postures with slow movements of the limbs, which will help improve blood circulation in the muscles and internal organs. This unique technique provides patients with the most effective therapeutic effect.

During yoga, all respiratory centers are activated, the saturation of the body with useful oxygen increases, metabolism accelerates, the functioning of internal organs improves, and absolutely all muscle groups are worked out.

Should you sleep on your left side with GERD or not?

Scientists who have studied physiological characteristics The body claims that with reflux esophagitis it is best to sleep on the right side.

This will minimize pressure on the stomach, intestines and liver.

To prevent the reflux of food from the stomach into the esophagus at night in patients it is recommended to sleep on a high pillow.

The scheme of treatment of different types of reflux esophagitis

There are several important rules treatment of different forms of the disease, which may differ from each other. How long is reflux esophagitis treated depending on this?

Treatment of reflux esophagitis with low acidity

The main treatment for patients is to take stomach acid tablets with meals. Such drug therapy helps food move faster into the intestines.

It is important to remember that you should not overdo it with taking pills and take them without a prescription from your doctor, because such an attitude towards your own health can lead to a deterioration in overall well-being. This is due to the fact that the acidic contents of the stomach will not be neutralized with the available amount of bicarbonates.

With this form of the disease, it is important for patients to adhere to a strict diet in order to prevent further progression of the disease and serious complications.

Treatment of reflux esophagitis during pregnancy

Pregnant girls need to take care to prevent constipation, follow a strict diet, eat small portions and not overeat. Fried foods, chocolate, red peppers and spicy foods are excluded from the diet. As a drug therapy, antacids are prescribed, which are not absorbed into the blood and envelop the stomach. Surgical treatment during pregnancy is not carried out.

Distal reflux esophagitis: treatment

It occurs as a result of inflammation of the esophagus after the penetration of viral and bacterial infections. In bacterial pathology, patients are prescribed antibiotics.

Only a doctor can select treatment after diagnosing patients, which takes into account the sensitivity of the body to antibiotic drugs. In the complex, patients are prescribed immunostimulating substances and antiviral drugs.

Reflux esophagitis is a serious disease that requires urgent treatment and therapy. Patients are forbidden to self-medicate and buy medicines without a doctor's prescription.

But they can bring the recovery time closer. But gymnastic exercises will not bring any effect if you do not follow a diet and do not take medication.

Physical exercise can strengthen the condition of the entire digestive system.

Carefully with sports in GERD

Physical activity with functional deviations of the digestive organs is often prohibited. With reflux, there is no strict restriction, but you need to remember the basic rules that will help make the sport completely safe for health and bring maximum benefit.

It is forbidden to exercise immediately after eating. This is due to the fact that the lower esophageal sphincter is weak, which means that activity after eating will cause the contents of the stomach to be expelled up into the esophagus. This will lead to severe heartburn. In view of these circumstances, you need to wait at least an hour after eating and proceed to sports activities. Do not eat an hour after activity. Do not talk about the prohibition of snacking during exercise.

In the process of eating food should not bend and twist forward, do not lift heavy objects. This will cause the same reaction as exercising after eating. In addition, when tilted, the stomach contracts, which increases the load on the gastrointestinal tract.

You need to carefully monitor the breaks between food and sports and then it will not bring harm. In addition, you need to follow healthy lifestyle life.

What loads are contraindicated?

There are certain prohibitions on playing sports with reflux esophagitis. Some doctors recommend giving up only abdominal exercises, as they increase pressure inside the abdominal cavity, which can aggravate the disease.

It is recommended to limit the weight with which you work during training. This rule is suitable for those who have previously worked with a lot of weight. Those patients with GERD who have not exercised with weight lifting should not do so.

In general, no sports are prohibited. It is necessary to follow the recommendations of the attending physician and not to burden yourself too much. Then there will be no harm to health. Sports will go only for the benefit, as it allows you to release negative energy, which will reduce the likelihood of relapse of reflux esophagitis due to stress.

Yoga classes: benefit or harm?

Yoga, like any sport, can be both beneficial and harmful. Doctors do not recommend asanas that put pressure or stress on the abdominal muscles, as this will cause an increase in internal pressure. Therefore, such yoga asanas as bhujansana, shalabhasana and others are prohibited. Yoga exercises that do not load the press (for example, nauli, udiyana), on the contrary, are indicated for patients with GERD.

Yoga is rich in breathing asanas, which are useful for patients.

Is it possible to cure LFK disease?

With reflux esophagitis, it is impossible to cure only with exercises, since no sport will affect the root of the problem. In order to stop the symptoms and get rid of the causes, treatment with pharmaceutical preparations is necessary. Sometimes therapy for reflux cannot be done without surgery.

Physiotherapy will benefit the patient, as it helps to strengthen the diaphragm. Due to this, the esophageal sphincter better holds the contents of the stomach in it, not passing up.

Gymnastics and exercise therapy

The benefits of exercise therapy

Exercise therapy should be prescribed by a doctor, since such activity is differentiated with respect to the degree of the disease and the physical capabilities of each individual patient. If the patient has complicated or advanced reflux esophagitis, physical exercise it is completely contraindicated. The advantages of physical therapy are the following factors:

such exercises improve muscle tone, which improves metabolic processes, promotes tissue regeneration;
Exercise therapy improves the functioning of the human immune system;
proper activity helps to strengthen the diaphragm, which improves the functioning of the esophageal sphincter;
Exercise therapy is used as a preventive measure against GERD;
the right exercises can help get rid of night pains and burning sensations.

Exercise therapy refers to physiotherapy treatment, so the complex is different for each patient. It aims to fulfill specific goals:

strengthen immunity;
develop the muscle layer, which will improve metabolic processes;
heartburn prevention;
improved drug absorption.

Breathing exercises

In order for physical therapy for reflux esophagitis to bring maximum benefit, you need to learn how to breathe correctly. To do this, you need to do breathing exercises. Before class, you need to find the most comfortable position of the body, it is best to stand or sit. You need to inhale deeply and exhale slowly. Repeat 4 times. You need to train on an empty stomach. If the patient has a severe degree of the disease, he should refuse the procedures.

Such training should be done with breaks for rest, as physical education can cause fainting or weakness. You need to train for preventive purposes three times a week. In addition, you need to engage in other activities. Swimming and cardio are useful for reflux esophagitis.

Breathing exercises

At the beginning of the course, everything should be done lying on your back or on your right side on a plane slightly raised to the head. First you need to inhale, bulging your stomach forward and hold out for a few seconds. On exhalation, the abdominal wall relaxes, there is no need to retract the stomach. The duration of the workout is 10 minutes with breaks of 20 seconds every minute.

Then, after a couple of workouts, you can begin to draw in the stomach as you exhale. After a few more sessions, the movement of the legs is added to the breath. After that, you can move on to exercises in a sitting or standing position. The course of physical therapy, which is used to treat GERD, takes about 3 months.

Prohibitions and warnings

Each sport has certain warnings, especially if the person involved in it is sick. Exercise therapy and breathing exercises are no exception. With esophagitis, you need to remember the following requirements:

you can’t exercise after eating, even if it’s a snack (you can’t play sports after a sip of water);
gymnastics is better not to do with exacerbation of GERD;
everything should be done calmly, in moderate pace without putting too much stress on the body.

Esophagitis usually recurs 2 times in 12 months, so courses of physiotherapy exercises and gymnastics are aimed at prevention. The minimum number of workouts per week is 2 times. Exercises should be selected by the attending physician, who is competent in such matters.

Gymnastics is not the only treatment. The patient needs a course of drug therapy. In addition, the patient needs to engage in other sports, lead a healthy lifestyle.

It is important not only to engage in physical education, but to change your lifestyle to one that will favorably affect the body. This will help prevent relapses of the disease, improve well-being, because sports, proper nutrition and the absence of destructive habits are the basis of health.

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Training with gastroesophageal reflux.

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I have heartburn and reflux since childhood, I can’t even brush my teeth calmly (because of the “call signs”). I had a terrible gastritis at the age of 9, I was scared of an ulcer, I was treated by gastroenterologists, BUT at the same time I was seriously engaged in dancing (hip-hop, aerobics) training was 6 hours 3 times a week. danced for 12 years, became bronze medalist Ukraine. Now "pension")))) problems with the stomach began to return, but thanks to Dion, I have not experienced heartburn for a month now.

heartburn is rather secondary and unpleasant - you can just stupidly swallow 2 times)) so that you don’t scare people on sweatpants and skip or replace inclined exercises.

In general, it’s hard to imagine how you can train with this, but somehow people live and train.

Or late at night right before bed?

I have a healthy stomach, and here it is.

City: Sinegorye settlement

City: Moscow Golden-domed

but I need to eat before training so that the break is no more than 1.5 hours - otherwise I have time to get hungry (((

City: By the White Sea

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30 g whole oatmeal, 200 g water, 130 g milk, salt

Rules for playing sports with reflux esophagitis

In the process of treating many diseases of the gastrointestinal tract, patients are often interested in whether they are shown sports, and if so, how exactly and with what intensity. Exercise is an important part of therapy for reflux esophagitis.

Of course, by themselves they will not cure a diseased organ, but in tandem with a therapeutic diet and medical support, they can greatly accelerate recovery and contribute to the overall strengthening of the body.

The nuances of training for GERD

Gastroesophageal reflux disease forces you to draw up a special training plan that takes into account the severity of the disease and the general physical training patient.

A scientifically proven fact is that people who exercise regularly suffer much less from the specific symptoms of reflux disease than physically inactive people with a sedentary lifestyle, and even more so with excess weight.

Excess weight greatly increases the chances of becoming the owner of GERD. People with a body mass index over 30 are more than 2 times more likely to become patients of a gastroenterologist than people with a normal BMI in the range of 18.5–25.

However, the patient should not forget that overload he is contraindicated. In addition, in order not to aggravate your condition, you need to follow the recommendations of the doctor and trainer, and also do not forget about the following rules:

Digestion takes time. By itself, the stomach filled with food is a load on the sphincter of the esophagus, and when shaking and physical stress are added to this, deterioration is inevitable. To prevent this, you need to train only on an empty stomach.
When compiling a diet, you need to focus on your training schedule. Certain foods, especially fatty and legumes (by the way, a diet for reflux esophagitis prohibits such food) are digested for an extremely long time. If training should take place 2-3 hours after a meal, preference should be given to easily digestible carbohydrate foods, with a minimum content of fats and proteins. Before training, you need to exclude the consumption of foods that provoke heartburn and belching.
Avoid overly intense exercise such as fast run, crossfit, aerobics. With such a load, the contents of the stomach are shaken, resulting in discomfort. It is worth giving preference to exercises that keep the body in a “flat” position: yoga, moderate jogging, skating, cycling (you can use an exercise bike or a stepper).
No need to get involved in exercises in the prone position (bench press, Pilates), which provokes the reflux of stomach contents into the esophagus.
Throughout the training session, it is worth monitoring the balance of fluid in the body. In addition to quenching thirst, water stimulates digestion and stabilizes the functional state of all organs.

Benefits of Exercise in GERD

Among the advantages of exercise therapy for reflux esophagitis include:

strengthening the lower esophageal sphincter;
reducing the intensity of reflux of stomach contents into the esophagus and mitigating the course of nocturnal refluxes;
increasing the immune defense of the body;
stimulation of metabolic processes.

Breathing exercises for GERD

The key to effective training for reflux esophagitis is proper, even breathing. Before you give yourself an active load, you need to take a comfortable position (most importantly, not lying down). After that, the patient will have to perform the following tasks in turn:

Inhale deeply and release the air slowly. Repeat the exercise at least 5 times. When exhaling, it is necessary to involve the abdominal organs in the work as much as possible, strongly straining and “blowing out” the stomach.
Slowly inhale the air and release it in a few short exhalations.
The next task: take a slow, deep breath and a sharp, rapid exhalation, actively engaging the peritoneum. Repeat the exercise 8-12 times.
Inhale deeply, hold your breath for 5-7 seconds. Slowly release the air, tensing the abdominal muscles as much as possible. Make several approaches, gradually increasing the period of holding your breath to 17 seconds.
Don't forget to take proper rest between sets. Such breathing exercises can cause dizziness, and an unprepared, physically weak person may even faint.

Breathing exercises with reflux esophagitis reduce the pain of symptoms, reduce intra-abdominal pressure and stimulate the stomach. Any exercise should be done by tensing the abdominal muscles as much as possible and, as it were, exhaling with the stomach.

Prohibited exercises for GERD:

any exercises for the press, especially those associated with lifting the legs in a prone position;
forward torso and all similar exercises;
lifting sports equipment weighing over 10-12 kilograms.

The therapeutic training plan for GERD excludes exercises in a horizontal position, as they intensify the reflux of stomach contents into the esophagus and increase discomfort: heartburn, burning, pain.

Any exercise is best performed in a sitting or standing position. Moderate-intensity exercise is excellent for stimulating digestive function, and sufficient water intake further contributes to this.

In addition to medium-intensity aerobics, with reflux esophagitis, you can do exercises to strengthen the legs, arms and core muscles:

swing legs and arms;
any training combinations in the knee-elbow position;
a variety of dumbbell lifts (total weight should not exceed 15 kilograms) and a bodybar in a sitting and standing position.

By following all of the above recommendations, with patience and patience, and with the support of a trainer specializing in exercise therapy, you can not only reduce the unpleasant symptoms of GERD, but also strengthen and improve the body. In tandem with proper nutrition and medical support (exclusively on the recommendation of the attending physician), recovery is progressing by leaps and bounds.

the attending physician. Copying materials is allowed only with an active link to the source.

GERD AND ACTIVITIES

City Clinical Hospital No. 68; Moscow, Shkuleva st., 4

Department of Emergency Surgical Gastroenterology
Department of acute surgical diseases of the liver and pancreas
Department of Ultrasound Diagnostics

Consultation topics:

ultrasound diagnostics;
all types of minimally invasive surgical interventions under ultrasound control;
surgical gastroenterology;
organization of treatment in Moscow and abroad in all areas;

Write the complaints, the duration of the disease, the treatment used earlier and its effectiveness, the results of FGDS and X-ray of the esophagus.

After receiving the answer, do not forget to rate ("rate the answer"). I am grateful to everyone who found it possible and necessary to rate the answer!

Pariet was prescribed 1 time per day.

Of the symptoms, the stomach is bursting, there is no heartburn, and there is difficulty in breathing (sometimes) as if there is not enough air.

Exercise for gastrointestinal reflux

People who suffer from gastro-food reflux also do not refuse to play sports. But with such a disease, any training should have a special approach. Gastroesophageal reflux disease, as it is called “scientifically”, brings a lot of trouble to a person, and sports in this case can become a source of relief, bring a lot of benefits to the body. This is confirmed by studies that were conducted back in 2004. Then it was noted that all people who went in for sports experienced much less symptoms of GERD than all those patients who did not make friends with sports. Relieves symptoms of GERD and the ability to maintain a healthy weight, which is also possible with exercise. With weight gain, the symptoms of the disease increase markedly and worsen.

It has even been noted that all overweight people suffer from the symptoms of this disease 2.5 times more than people with normal weight. There is a higher risk of developing gastrointestinal cancer in fat people than in people who are not overweight.

In any case, exercise has a beneficial effect on the body. They help to improve it in many aspects, reduce the symptoms of GERD. But there is still a risk of aggravating such symptoms, so you should be careful with sports. Although, this does not mean at all that you should put aside your sneakers and immediately put on slippers to settle on the couch in inactivity. There are more benefits from sports than from inactivity. In this connection, it is not necessary to refuse training at all. It is only important to study a few recommendations and then follow them carefully in order to keep the disease under control, improve your well-being and enjoy the results of sports training.

Rules of conduct for reflux

1. In order for the process of digestion to proceed correctly, it takes a little time. By itself, the weight of a full stomach is a pretty serious test for the sphincter. If you add to all this the concussions that occur during sports, it is clear that the symptoms can quickly worsen. Therefore, it is very important to control meals and exercise. It is desirable that at least two hours pass between them. Although, it all depends on the person, as well as on the type of food. If the lunch was eaten very light, then it may take a little less time to digest. If the diet was heavier, in this case, more time will be required before training.

2. Be very careful about what you eat. Food should be quickly digested and quickly absorbed. Fatty foods will be digested for a long time, as well as protein foods. Before training, it is better to give preference to a diet rich in carbohydrates. It is also advisable to avoid foods that can cause heartburn. But, in any case, no matter what foods you choose, remember that it will take time to digest them.

3. Take a bottle of water with you, as it tends to raise the energy level. After all, it is water that will prevent dehydration, which often becomes a consequence of too intense training. In addition, water is a great aid to digest food.

4. Do not pay too much attention to intense exercise, which includes jogging or, for example, intensive classes aerobics. These movements can only aggravate the condition, because in the process of such training, the contents of the stomach are actively shaken. It is best to choose more "smooth" sports that will not aggravate. Exercises such as yoga, walking, cycling or roller skating will do. There are people for whom exacerbations begin when they take the “lying” position. In this case, it is important to try to avoid such exercises.

Be prepared to consult a doctor

If none of the recommendations help, you need to consult a doctor. After a short study, the attending physician will tell you what must be done in order to remove the discomfort from physical activity. You may need to undergo additional treatment.

GEBE has symptoms such as chest pain and heartburn. But they can occur not only with GEBE, but also become a consequence of other diseases. This is especially true for chest pain, because this symptom can indicate any heart disease. Therefore, with increased pain in the chest, doctors recommend not to ignore it, but to immediately seek advice from the clinic.

Each person has his own characteristics. And the body of each of us is individual. We tolerate diseases differently, we feel the symptoms, everyone has their own level of sensations. Therefore, what is useful for one person can become a big and serious problem for another. And everyone is looking for their own way in sports on their own. This also applies to people who suffer from gastro-food reflux. Each of them must find their preferences in sports. And to do this is not easy, often you have to use the trial and error method.

Lifestyle Changes for GERD

It's a little unusual to hear recommendations from doctors about the need to change something in life in order to safely treat gastroesophageal reflux disease. It is still possible to come to terms with the fact that you will have to take medicinal substances for a long time, but not everyone is ready to change their habits.

It is clear that any disease of the digestive system requires the appointment of a special diet. But why make lifestyle changes for GERD is difficult to comprehend.

Lifestyle changes are part of the treatment plan

Why do doctors focus their attention on the importance of this item in treatment? How can adjusting the work schedule or wearing certain clothes help in the fight against an unpleasant ailment?

At first glance, such “appointments” look ridiculous. But in fact, this is the only way to finally or permanently get rid of a burning annoying problem. What will have to be changed?

It is necessary to avoid lifting weights after eating, to reduce physical activity after any, even light, snack.
Find time for a calm and measured meal (change your food culture - you need to eat at least five times a day).
You'll have to take care of yourself thoroughly: quit smoking and lose weight!
Down with tight-fitting and restrictive clothing - it only worsens the course of the disease.
Do not be nervous. If you are a very vulnerable type of people who always take all the negativity to heart, sign up for courses with a psychologist.

So, in short, you will need to change something, in more detail, work on yourself is as follows.

Be careful with exercise

Proper living with GERD is like studying the exact sciences. If you organize everything from the very beginning, then it will be much easier and clearer. For those who like to play sports, it is important to plan it correctly. For what? This disease is compatible with physical activity, but under certain circumstances.

Due to the weakness of the lower esophageal sphincter (a round muscle that closes the return passage of food from the stomach to the esophagus), any load immediately after eating will lead to a burning sensation due to the reflux of acid or food bolus into the upper digestive system. Therefore, the first rule is eating an hour or an hour after active physical exercise.
The second rule says: you can not eat while playing sports, for the same reason.
The third point concerns non-intensive physical activity, and behavior: do not lift weights and do not bend over while eating. This promotes the reverse movement of food, which causes burning and pain. In addition, when tilting, the stomach is squeezed, which creates an additional burden on the digestive organs.

With reflux disease, it is necessary to clearly distinguish between periods for nutrition and outdoor activities.

Nutrition for GERD

To help your body cope with the disease, it is important to organize nutrition for GERD. It is not only about frequent meals, it is necessary that food enters the body in small portions and proper heat treatment. For what? - everything is very simple, if we consider the features of the course of the disease.

Gastroesophagitis is an inflammatory process of the mucous membrane and esophagus. During the period of exacerbation of the disease, the load on these organs is maximum and the body does not always cope with its functions. If you eat a lot, consuming fatty, spicy and fried foods in large quantities, it will not be fully digested, which a person feels in the form of heaviness, heartburn, and abdominal pain.
With fractional nutrition, the food supply is evenly distributed; due to the small volume, it is processed faster and better.
Boiled, stewed and baked foods do not contain irritants and carcinogens (which are formed if foods are fried), which is easier on the stomach and does not “scratch” the inflamed esophagus.
Last but not least, eat slowly! The process of food processing is also a burden on the body, do not complicate the work of the gastrointestinal tract.

Self care

Another important reason to lose weight is GERD. Lifestyle will have to change, but it's only good. All overweight- harmful not only to the heart and joints, but also to the digestive organs. The belly, enlarged in volume due to fat deposits, supports the stomach. This leads to frequent reflux of hydrochloric acid into the esophagus and inflammation of its lower section. Reduce weight gradually and the body will become much easier.

Smoking and drinking coffee on an empty stomach are the first enemies of the esophagus and gastrointestinal tract. All harmful substances contained in cigarette smoke cause inflammation of the mucous membrane of the digestive system, violate local protection. To recover, it is better to give up these habits.

Peace of mind

Stress at work, problems in the family - these are unnecessary constant nervous strains. It is important to protect your nervous system. Its excessive stimulation causes deep damage to internal organs, including the digestive system. With gastroesophageal disease, nervous disorders aggravate the course of the process. What to do? Need to act:

in difficult emotional periods, drink tea with herbs that normalize the functioning of the nervous system;
take drugs to improve adaptation to stress;
work with specialists - take auto-training courses with a psychologist.

A slight adjustment in lifestyle and nutrition in GERD is not an infringement of one's freedom, but a necessity, important points in the treatment of the disease. Treat such prescriptions with understanding and patience, and the period of taking the drugs may be reduced.

Really not a word about alcohol? Incredible)) Did you just forget to mention or is it not the main trigger?

Igor, can you imagine how many people will take your advice and hurt themselves? Try medicine.

Omez sins with this, try (deleted).

I have been suffering from heartburn for 5 years now, I swallowed an umbrella, the doctor said reflux esophagitis. I took Omez, but it washes out.

Copying materials is allowed if you set an active link to our site.

All information on the site is provided for informational purposes, for all treatment issues, a doctor's consultation is necessary.

Gymnastics Warsaw with GERD: rules and contraindications

Warsaw gymnastics with GERD is prescribed quite often. Physiotherapy only accelerates recovery, keeps a stable state for a long time, reduces the amount of medication consumed. However, only gymnastics can not cure gastroesophageal disease, although the time of recovery will approach.

The benefits of physical education and the rules for its implementation

Exercise therapy for pathologies such as esophagitis, cardia insufficiency, is carried out in accordance with the recommendations of specialists, so as not to harm even more. Gymnastic exercises are characterized by such advantages:

stimulate immunity;
develop the muscles of the human body, which contributes to good nutrition tissues, rapid healing of wounds on the mucous membranes of the gastrointestinal tract;
breathing exercises, as well as yoga, strengthen the sphincter of the lower esophagus, which prevents the contents of the stomach from being thrown back;

reduces reflux disease (its manifestations) at night;
each exercise also avoids the development of reflux esophagitis, as well as pathologies such as cardia insufficiency.

Warsaw gymnastics with GERD must be performed in compliance with certain rules. The complex should be selected by a specialist based on the degree of development of the pathology, general condition patient. Physical exercise must be combined with diet and other forms of treatment.

Features of breathing exercises

If a person has cardial insufficiency or esophageal disease, there is no need for intensive physical training. Correct breathing is essential. The following actions will be useful:

Gymnastics must be performed in a comfortable position: sitting. After the patient has decided, he should slowly take a deep breath and exhale. At the second stage, the internal organs of the abdominal cavity are involved in the process. Repeat the exercise 4 times.
The next movement involves a slow breath (deep). At the same time, air must be released quickly. This is done in the abdominal cavity. The number of repetitions is 10.
Take a deep slow breath and hold the air inside for 5 seconds. With simultaneous tension of the abdominal muscles, a gradual exhalation is made. The air hold over time can be increased up to 15 seconds.
The last exercise is also not difficult. The patient just needs to take a deep breath, and then release the air, but in stages. You can even watch a video showing exactly how it's done.

Too much oxygen, which comes as a result of gymnastics, causes dizziness and even fainting. Therefore, you should be careful.

In addition to breathing exercises, such a violation requires aerobic exercises: brisk walking, jogging, cycling. If a person goes in for sports, then he needs to take into account that manipulations are prohibited, in which the abdominal muscles are very tense.

Warnings and indications

To find out if it is possible to play sports with GERD, it is better to contact a specialist who will conduct an examination and determine the degree of development of the pathology. It is also important to know if cardia insufficiency has been diagnosed. Lifestyle changes for GERD can help cure.

Exercises for people with this disease must be done carefully, as there are certain contraindications:

You can not do physical education if the inflammation in esophagitis is severe.
Gymnastics is performed on an empty stomach, even water should not be drunk.
If cardia insufficiency is present, then a person should do gymnastics in a position that will allow him to completely relax and calm down.

If the cardiac sphincter is too weak, it must be strengthened, as it will not prevent the ejection of the contents of the stomach back into the esophagus. Exercise should be done to prevent GERD. At the same time, the level of difficulty is gradually raised. However, too intense training is contraindicated.

WORKOUT

For people suffering from gastroesophageal reflux or, scientifically, gastroesophageal reflux disease (GERD), exercise requires a special approach. For some, moderate exercise can relieve the symptoms of GERD, bringing enormous benefits to the body in every way. A 2004 study reported that people who exercised regularly experienced far fewer symptoms of GERD compared to those who did not exercise. Not to mention, regular exercise is the best way to maintain a healthy weight, which can also help relieve GERD symptoms. Being overweight increases the likelihood of GERD symptoms. Obese people (having a body mass index greater than 30) suffer from reflux or esophageal erosion 2.5 times more often than people with a normal BMI (18.5 to 24.9). They are also three times more likely to develop esophageal cancer than people of normal weight.

Digestion takes time. The weight of a full stomach is in itself a serious test for the esophageal sphincter. If you add to this the concussions that occur during sports, then you will have problems. Make sure that there is at least two hours between meals and training (more time may be required for a particular person and type of food).

Gastroesophageal reflux disease (GERD) - Conservative treatment

The success of therapy lies not only in adequately carried out medical correction, but also in changing the lifestyle and dietary habits of the patient.

changes in body position during sleep;
nutritional changes;
abstinence from smoking;
abstinence from alcohol abuse;
if necessary, weight loss;
refusal of medications that induce the occurrence of GERD;
exclusion of loads that increase intra-abdominal pressure, wearing corsets, bandages and tight belts, lifting weights of more than 8-10 kg on both hands, work associated with forward bending of the torso, physical exercises associated with muscle strain abdominals.

Recovery muscle tone diaphragms are recommended special exercises not related to torso.

Exception strictly horizontal position during sleep allows you to reduce the number of reflux episodes and their duration, as esophageal clearance is increased due to the action of gravity. The patient is advised to raise the head end of the bed by 15 cm.

it is necessary to exclude overeating, "snacking" at night;
lying down after eating;
after eating, avoid bending forward and horizontal position;
foods rich in fat (whole milk, cream, fatty fish, goose, duck, pork, fatty beef, lamb, cakes, pastries), drinks containing caffeine (coffee, strong tea or cola), chocolate, foods containing peppermint and pepper (all of them reduce the tone of the lower esophageal sphincter);
citrus fruits and tomatoes, fried foods, onions and garlic, as they have a direct irritating effect on the sensitive mucosa of the esophagus;
limited consumption of butter, margarine;
3-4 meals a day are recommended, a diet with a high protein content, since protein foods increase the tone of the lower esophageal sphincter;
the last meal - at least 3 hours before bedtime, after eating a 30-minute walk.
sleep with the head end of the bed raised; exclude loads that increase intra-abdominal pressure: do not wear tight clothes and tight belts, corsets, do not lift weights of more than 8-10 kg on both hands, avoid physical exertion associated with overexertion of the abdominal press; to give up smoking; maintaining normal body weight;

For prophylactic purposes, it is necessary to prescribe cocktails proposed by G.V. for 2-3 weeks. Dibizhevoi: cream or fermented baked milk 0.5 liters + beaten egg white + 75 ml. 3% tannin. Apply 8-10 times a day, several sips through a straw before and after meals.

Avoid taking drugs that reduce the tone of the lower esophageal sphincter (anticholinergics, tricyclic antidepressants, sedatives, tranquilizers, calcium antagonists, beta-agonists, drugs containing L-dopamine, narcotics, prostaglandins, progesterone, theophylline).

Treatment in most cases should be carried out on an outpatient basis. Treatment should include general measures and specific drug therapy.

Indications for hospitalization

Antireflux treatment for complicated course of the disease, as well as for the ineffectiveness of adequate drug therapy. Carrying out endoscopic or surgical intervention (fundoplication) in case of ineffectiveness of drug therapy, in the presence of complications of esophagitis: Barrett's esophagus stricture, bleeding.

Includes the appointment of prokinetics, antisecretory agents and antacids.

Brief description of drugs used in the treatment of gastroesophageal reflux disease:

1. Antacids

Mechanism of action: neutralize hydrochloric acid, inactivate pepsin, adsorb bile acids and lysolicetin, stimulate the secretion of bicarbonates, have a cytoprotective effect, improve esophageal cleansing and alkalization of the stomach, which helps to increase the tone of the lower esophageal sphincter.

For the treatment of gastroesophageal reflux disease, it is better to use liquid forms of antacids. It is better to use conditionally insoluble (non-systemic) antacids, such as those containing non-absorbable aluminum and magnesium, antacids (Maalox, Phosphalugel, Gastal, Rennie), as well as antacids, which include substances that eliminate symptoms of flatulence (Protab, Daigin, Gestid).

Of the huge variety of antacids, one of the most effective is Maalox. It is distinguished by a variety of forms, the highest acid-neutralizing ability, as well as the presence of a cytoprotective effect due to the binding of bile acids, cytotoxins, lysolecithin and activation of the synthesis of prostaglandins and glycoproteins, stimulation of the secretion of bicarbonates and protective mucopolysaccharide mucus, almost complete absence of side effects and a pleasant taste.

Preference should be given to third-generation antacids such as Topalkan, Gaviscon. They include: colloidal alumina, magnesium bicarbonate, hydrated silicic anhydrite and alginic acid. When dissolved, Topalkan forms a foamy antacid suspension, which not only adsorbs HCI, but also, accumulating over a layer of food and liquid and getting into the esophagus in case of gastroesophageal reflux, has a therapeutic effect, protecting the mucosa of the esophagus from aggressive gastric contents. Topalkan is prescribed 2 tablets 3 times a day 40 minutes after meals and at night.

The pharmacological action of these drugs is to increase antropyloric motility, which leads to accelerated evacuation of gastric contents and an increase in the tone of the lower esophageal sphincter, a decrease in the number of gastroesophageal refluxes and the time of contact of gastric contents with the esophageal mucosa, improvement of esophageal clearance and elimination of delayed gastric evacuation.

One of the first drugs in this group is the central dopamine receptor blocker Metoclopramide (Cerukal, Reglan). It enhances the release of acetylcholine in the gastrointestinal tract (stimulates the motility of the stomach, small intestine and esophagus), blocks central dopamine receptors (impact on the vomiting center and the center for regulating gastrointestinal motility). Metoclopramide increases the tone of the lower esophageal sphincter, accelerates evacuation from the stomach, has a positive effect on esophageal clearance and reduces gastroesophageal reflux.

The disadvantage of metoclopramide is its undesirable central action ( headache, insomnia, weakness, impotence, gynecomastia, increased extrapyramidal disorders). Therefore, it cannot be used for a long time.

A more successful drug from this group is Motilium (Domperidone), which is an antagonist of peripheral dopamine receptors. The effectiveness of Motilium as a prokinetic agent does not exceed that of metoclopramide, but the drug does not penetrate the blood-brain barrier and practically does not side effects. Motilium is prescribed 1 tablet (10 mg) 3 times a day before meals. As monotherapy, it can be used in patients with grade I-II GERD. It is important to note that taking Motilium cannot be combined in time with taking antacids, since its absorption requires an acidic environment, and with anticholinergic drugs that neutralize the effect of Motilium. The most effective treatment for GERD is Prepulsid (Cisapride, Coordinax, Peristil). It is a gastrointestinal prokinetic devoid of antidopaminergic properties. Its mechanism of action is based on an indirect cholinergic effect on the neuromuscular apparatus of the gastrointestinal tract. Prepulsid increases the tone of the LES, increases the amplitude of contractions of the esophagus and accelerates the evacuation of the contents of the stomach. At the same time, the drug does not affect gastric secretion, so it is better to combine Prepulsid with antisecretory drugs for reflux esophagitis.

The prokinetic potential of a number of other drugs is being studied: Sandostatin, Leuprolide, Botox, as well as drugs acting through 5-HT 3 and 5-HT 4 serotonin receptors.

3. Antisecretory drugs

The goal of antisecretory therapy for GERD is to reduce the damaging effect of acidic gastric contents on the esophageal mucosa. In the treatment of GERD, histamine H2 receptor blockers and proton pump inhibitors are used.

4. Histamine H2-receptor blockers

There are currently 5 classes of H2-blockers available: Cimetidine (I generation), Ranitidine (II generation), Famotidine (III generation), Nizatidine (axide) (IV generation), and Roxatidine (V generation).

The most widely used drugs are from the groups of Ranitidine (Ranisan, Zantak, Ranitin) and Famotidine (Kvamatel, Ulfamid, Famosan, Gastrosidin). These drugs effectively reduce the basal, nocturnal, food and drug-stimulated secretion of hydrochloric acid in the stomach, and inhibit the secretion of pepsins. If possible, preference should be given to Famotidine, which, due to greater selectivity and lower dosage, has a longer effect and does not have the side effects inherent in Ranitidine. Famotidine is 40 times more effective than cimitidine and 8 times more effective than ranitidine. In a single dose of 40 mg, it reduces nocturnal secretion by 94%, basal secretion by 95%. In addition, Famotidine stimulates the protective properties of the mucous membrane by increasing blood flow, bicarbonate production, prostaglandin synthesis, and enhancing epithelial repair. The duration of action of 20 mg Famotidine is 12 hours, 40 mg - 18 hours. The recommended dose for GERD treatment mg per day.

5. Proton pump blockers

Proton pump blockers are currently considered the most powerful antisecretory drugs. The drugs of this group are practically devoid of side effects, since in the active form they exist only in the parietal cell. The action of these drugs is to inhibit the activity of Na + /K + -ATPase in the parietal cells of the stomach and block the final stage of HCI secretion, while almost 100% inhibition of hydrochloric acid production in the stomach occurs. Currently, 4 chemical varieties of this group of drugs are known: Omeprazole, Pantoprazole, Lansoprazole, Rabeprazole. The progenitor of proton pump inhibitors is Omeprazole, first registered as Losek by Astra (Sweden). A single dose of 40 mg of omeprazole completely blocks the formation of HCI for 24 hours. Pantoprazole and Lansoprazole are used in dosages of 30 and 40 mg, respectively. A drug from the Rabiprazole Pariet group has not yet been registered in our country, clinical trials are underway.

Omeprazole (Losek, Losek-maps, Mopral, Zoltum, etc.) at a dose of 40 mg allows healing of esophageal erosions in 85-90% of patients, including patients who do not respond to therapy with histamine H2-receptor blockers. Omeprazole is especially indicated for patients with stage II-IV GERD. In control studies with omeprazole, there was an earlier subsidence of GERD symptoms and a more frequent cure compared with conventional or double doses of H 2 blockers, which is associated with a greater degree of suppression of acid production.

Recently, a new improved form of the drug “Losek” has appeared on the drug market, manufactured by Astra, “Losek-maps”. Its advantage is that it does not contain excipient allergens (lactose and gelatin), is smaller than a capsule, and is coated with a special shell for easier swallowing. This drug can be dissolved in water and, if necessary, used in patients with a nasopharyngeal tube.

Currently, a new class of antisecretory drugs is being developed that do not inhibit the work of the proton pump, but only prevent the movement of Na + /K + -ATPase. The representative of this new group of drugs is ME.

Misoprostol (Cytotec, Cytotec) is a synthetic analogue of PG E2. It has a broad protective effect on the gastrointestinal mucosa:

reduces the acidity of gastric juice (suppresses the release of hydrochloric acid and pepsin, reduces the reverse diffusion of hydrogen ions through the gastric mucosa;
increases the secretion of mucus and bicarbonates;
increases the protective properties of mucus;
improve the blood flow of the esophageal mucosa.

Misoprostol is given at 0.2 mg four times a day, usually for grade III gastroesophageal reflux disease.

Venter (Sucralphate) is the ammonium salt of sulfated sucrose (a disaccharide). It accelerates the healing of erosive and ulcerative defects of the esophagogastroduodenal mucosa by forming a chemical complex - a protective barrier on the surface of erosions and ulcers and prevents the action of pepsin, acid and bile. Has astringent property. Assign 1 g 4 times a day between meals. The appointment of Sucralfate and antacids should be divided by time.

With gastroesophageal refluxes caused by reflux of duodenal contents (alkaline, bile reflux) into the esophagus, usually observed in cholelithiasis, a good effect is achieved when taking non-toxic ursodeoxycholic bile acid (Ursofalk) at 250 mg per night, which in this case is combined with Coordinax. The use of cholestyramine is also justified (an ammonium anion exchange resin, a non-absorbable polymer, binds to bile acids, forming a strong complex with them, excreted with feces). Accepted pg / day.

Dynamic monitoring of detected secretory, morphological and microcirculatory disorders in GERD confirms the currently proposed various schemes for drug correction of gastroesophageal reflux disease.

The most common are (A.A. Sheptulin):

a scheme of "stepwise increasing" therapy, which involves the appointment of drugs and combinations of different strengths at different stages of the disease. So, at the first stage, the main place in the treatment is given to lifestyle changes and, if necessary, taking antacids. If clinical symptoms persist, at the second stage of treatment, prokinetics or H 2 blockers of histamine receptors are prescribed. If such therapy is ineffective, then at the 3rd stage, proton pump inhibitors or a combination of H 2 blockers and prokinetics are used (in especially severe cases, a combination of proton pump blockers and prokinetics);
the scheme of "phasing down" therapy involves the appointment of proton pump inhibitors from the very beginning, followed by the transition, after achieving a clinical effect, to the intake of H2-blockers or prokinetics. The use of such a scheme is justified in patients with severe disease and severe erosive and ulcerative changes in the mucosa of the esophagus.

Options for drug therapy, taking into account the stage of development of GERD (P.Ya. Grigoriev):

With gastroesophageal reflux without esophagitis, Motilium or Cisapride is prescribed orally for 10 days, 10 mg 3 times a day in combination with antacids, 15 ml 1 hour after meals, 3 times a day and 4 times before bedtime.
For reflux esophagitis I degree severity - H 2 blockers are prescribed orally: for 6 weeks - Ranitidine 150 mg 2 times a day or Famotidine 20 mg 2 times a day (for each drug, taking in the morning and evening with an interval of 12 hours). After 6 weeks, if remission occurs, drug treatment is stopped.
With reflux esophagitis of the II degree of severity, Ranitidine 300 mg 2 times a day or Famotidine 40 mg 2 times a day or Omeprazole 20 mg after lunch (in hours) are prescribed for 6 weeks. After 6 weeks, drug treatment is stopped if remission occurs.
With reflux esophagitis of the III degree of severity, Omeprazole 20 mg is prescribed orally for 4 weeks, 2 times a day, in the morning and evening with a mandatory interval of 12 hours, and then, in the absence of symptoms, continue taking Omeprazole 20 mg per day or another proton pump inhibitor 30 mg 2 times a day for up to 8 weeks, after which they switch to taking histamine H 2 receptor blockers in a maintenance half dose during the year.
In case of reflux esophagitis of the IV degree of severity, Omeprazole 20 mg is prescribed orally for 8 weeks 2 times a day, in the morning and evening with a mandatory interval of 12 hours or another proton pump inhibitor 30 mg 2 times a day and, upon the onset of remission, they switch to constant intake of H 2 blockers of histamine. TO additional funds therapy for refractory forms of GERD include Sucralfate (Venter, Sukratgel) 1 g 4 times a day 30 minutes before meals for 1 month.

a mild disease (reflux esophagitis of 0-1 degree) requires a special lifestyle and, if necessary, taking antacids or H2-receptor blockers;
with moderate severity (reflux esophagitis of II degree), along with constant adherence to a special lifestyle and diet, long-term use of H 2 receptor blockers in combination with prokinetics or proton pump inhibitors is necessary;
in severe disease (reflux esophagitis III degree), a combination of H 2 receptor blockers and proton pump inhibitors or high doses of H 2 receptor blockers and prokinetics are prescribed;
the lack of effect of conservative treatment or complicated forms of reflux esophagitis are an indication for surgical treatment.

Considering that one of the main reasons leading to an increase in spontaneous relaxation of the lower esophageal sphincter is an increase in the level of neuroticism in patients suffering from GERD, testing is extremely relevant to assess the personality profile and correct the identified disorders. To assess the personality profile in patients with pathological gastroesophageal refluxes detected by pH-metry, we conduct psychological testing using a computer modification of the Eysenck, Schmishek, MMPI, Spielberger questionnaires, the Luscher color test, which allows us to identify the dependence of the nature and severity of gastroesophageal refluxes on individual personality traits and, accordingly, with this in mind, develop efficient schemes treatment. Thus, it is possible to achieve not only a reduction in the duration of treatment, but also significantly improve the quality of life of patients. Along with standard therapy, depending on the identified anxious or depressive personality type, patients are prescribed Eglonil 50 mg 3 times a day or Grandaxin 50 mg 2 times a day, Teralen 25 mg 2 times a day, which improves the prognosis of the disease.

Treatment of gastroesophageal reflux disease in pregnancy

It has been established that the main symptom of GERD - heartburn - occurs in 30-50% of pregnant women. The majority (52%) of pregnant women experience heartburn in the first trimester. The pathogenesis of GERD is associated with LES hypotension in basal conditions, increased intra-abdominal pressure, and delayed gastric evacuation. Diagnosis of the disease is based on clinical data. Conducting (if necessary) endoscopic examination is considered safe. In treatment, lifestyle changes are of particular importance. At the next stage, “non-absorbable” antacids are added (Maalox, Phosphalugel, Sucralfate, etc.). Considering that Sucralfate (Venter) can cause constipation, the use of Maalox is more justified. In case of treatment refractoriness, H 2 blockers such as Ranitidine or Famotidine can be used.

The use of Nizatidine during pregnancy is not indicated, since in the experiment the drug showed teratogenic properties. Given the experimental data, the use of omeprazole, metoclopramide and cisapride is also undesirable, although there are isolated reports of their successful use during pregnancy.

Anti-relapse treatment of gastroesophageal reflux disease

Currently, there are several options for anti-relapse treatment of GERD (permanent therapy):

H 2 blockers in a full daily two-time dose (Ranitidine 150 mg 2 times a day, Famotidine 20 mg 2 times a day, Nizatidine 150 mg 2 times a day).
Treatment with proton pump inhibitors: Omeprazole (Losek) 20 mg in the morning on an empty stomach.
Taking prokinetics: Cisapride (Coordinax) or Motilium at half the dose compared to the dose used during an exacerbation.
Long-term treatment with non-absorbable antacids (Maalox, Phosphalugel, etc.).

The most effective anti-relapse drug is omeprazole 20 mg in the morning on an empty stomach (88% of patients remain in remission within 6 months of treatment). When comparing Ranitidine and placebo, this figure is 13 and 11%, respectively, which casts doubt on the advisability of long-term use of Ranitidine for anti-relapse treatment of GERD.

A retrospective analysis of prolonged permanent use of small doses of Maalox suspension 10 ml 4 times a day (acid-neutralizing capacity 108 mEq) in 196 patients with stage II GERD showed a rather high anti-relapse effect of this regimen. After 6 months of permanent therapy, remission was maintained in 82% of patients. None of the patients experienced side effects that led to the discontinuation of prolonged treatment. Data on the presence of phosphorus deficiency in the body has not been received.

American experts estimate that a five-year full-fledged antireflux therapy costs patients more than $6,000. However, when you stop taking even the most effective drugs and their combinations there is no long-term remission. According to foreign authors, recurrence of GERD symptoms occurs in 50% of patients after 6 months after discontinuation of antireflux therapy, and in 87-90% after 12 months. There is an opinion among surgeons that adequately performed surgical treatment of GERD is effective and cost-effective.

Medical Expert Editor

Portnov Alexey Alexandrovich

Education: Kyiv National Medical University them. A.A. Bogomolets, specialty - "Medicine"

On the way to a cure for GERD, exercise will help. Physical exercise will not only speed up recovery, but also have a beneficial effect on the body. Taking on this or that physical complex, you need to understand that you should not expect a therapeutic effect from loads, they are not able to eliminate heartburn - the main symptom of the disease. But they can bring the recovery time closer. But gymnastic exercises will not bring any effect if you do not follow a diet and do not take medication.

Physical exercise can strengthen the condition of the entire digestive system.

Carefully with sports in GERD

It is forbidden to exercise immediately after eating. This is due to the fact that the lower esophageal sphincter is weak, which means that activity after eating will cause the contents of the stomach to be expelled up into the esophagus. This will lead to severe heartburn. In view of these circumstances, you need to wait at least an hour after eating and start sports activities. Do not eat an hour after activity. Do not talk about the prohibition of snacking during exercise.

You need to carefully monitor the breaks between food and sports and then it will not bring harm. In addition, you need to adhere to a healthy lifestyle.

What loads are contraindicated?

In general, no sports are prohibited. It is necessary to follow the recommendations of the attending physician and not to burden yourself too much. Then there will be no harm to health. Sport will only benefit, as it allows you to release negative energy, which will reduce the likelihood of a relapse of reflux esophagitis due to stress.

Yoga classes: benefit or harm?

Yoga is rich in breathing asanas, which are useful for patients.

Is it possible to cure LFK disease?

Physiotherapy exercises will benefit the patient, as it helps to strengthen the diaphragm. Due to this, the esophageal sphincter better holds the contents of the stomach in it, not passing up.

Gymnastics and exercise therapy

The benefits of exercise therapy

Exercise therapy should be prescribed by a doctor, since such activity is differentiated with respect to the degree of the disease and the physical capabilities of each individual patient. If the patient has a complicated or advanced reflux esophagitis, physical activity is completely contraindicated for him. The advantages of physical therapy are the following factors:

such exercises improve muscle tone, which improves metabolic processes, promotes tissue regeneration;
Exercise therapy improves the functioning of the human immune system;
proper activity helps to strengthen the diaphragm, which improves the functioning of the esophageal sphincter;
Exercise therapy is used as a preventive measure against GERD;
the right exercises can help get rid of night pains and burning sensations.

Exercise therapy refers to physiotherapy treatment, so the complex is different for each patient. It aims to fulfill specific goals:

strengthen immunity;
develop the muscle layer, which will improve metabolic processes;
heartburn prevention;
improved drug absorption.

Breathing exercises

The benefits of physical education and the rules for its implementation

stimulate immunity;
develop the muscles of the human body, which contributes to good tissue nutrition, rapid healing of wounds on the mucous membranes of the gastrointestinal tract;
breathing exercises, as well as yoga, strengthen the sphincter of the lower esophagus, which prevents the contents of the stomach from being thrown back;

reduces reflux disease (its manifestations) at night;
each exercise also avoids the development of reflux esophagitis, as well as pathologies such as cardia insufficiency.

Warsaw gymnastics with GERD must be performed in compliance with certain rules. The complex should be selected by a specialist based on the degree of development of the pathology, the general condition of the patient. Physical exercise must be combined with diet and other forms of treatment.

Features of breathing exercises

If a person has cardial insufficiency or esophageal disease, there is no need for intense physical training. Correct breathing is essential. The following actions will be useful:

Gymnastics must be performed in a comfortable position: sitting. After the patient has decided, he should slowly take a deep breath and exhale. At the second stage, the internal organs of the abdominal cavity are involved in the process. Repeat the exercise 4 times.
The next movement involves a slow breath (deep). At the same time, air must be released quickly. This is done in the abdominal cavity. The number of repetitions is 10.
Take a deep slow breath and hold the air inside for 5 seconds. With simultaneous tension of the abdominal muscles, a gradual exhalation is made. The air hold over time can be increased up to 15 seconds.
The last exercise is also not difficult. The patient just needs to take a deep breath, and then release the air, but in stages. You can even watch a video showing exactly how it's done.

Too much oxygen, which comes as a result of gymnastics, causes dizziness and even fainting. Therefore, you should be careful.

Warnings and indications

Exercises for people with this disease must be done carefully, as there are certain contraindications:

You can not do physical education if the inflammation in esophagitis is severe.
Gymnastics is performed on an empty stomach, even water should not be drunk.
If cardia insufficiency is present, then a person should do gymnastics in a position that will allow him to completely relax and calm down.