OTHER NAMES

* Acid reflux,
* Heartburn,
* Heartburn.

DEFINITION

The acidity of the stomach is a burning sensation that is sometimes painful. May occur at or above the sternum in the throat or stomach down on itself, usually spread throughout this area from the neck to the abdomen.

COMMENTS

The cause of this acidity is the presence of secretions in the stomach (very acidic) to other parts of the digestive system, esophagus, which are not prepared to withstand this level of acidity, so give a burning sensation or irritation.
It may be because the normal acids of the stomach pass up into the esophagus, or because there is an excess of acid in the stomach.

THE MOST FREQUENT CAUSES OF STOMACH ACIDITY

* Gastroesophageal Reflux.
* Esophageal spasm or contraction.
* Hiatal hernia.
* Drugs acidifiers or irritation of the gastric mucosa such as aspirin or non steroidal antiinflammatory drugs.

CARE AND TREATMENT

* Avoid drugs that may be causing heartburn, if not essential. In any case you should consult with your doctor to put the issue of appropriate alternatives.
* The diet should avoid foods that can stimulate the secretion of stomach acid, such as coffee, alcohol, snuff, copious meals and citrus (lemon, orange, grapefruit, etc. …).
* To prevent reflux is not good to lie down or lie down with food in the stomach.
* Do not eat 2 or 3 hours before bedtime and avoid tight clothing.
* The head of the bed is lifted about 10 to 12 cm. It should also be losing weight if necessary.

Depending on the cause will be an appropriate treatment.

WHEN TO ASK YOUR DOCTOR

When heartburn is accompanied by vomiting, especially if they are color or black blood type coffee. If there is diarrhea or stools black. In this case it can be serious and should be consulted as soon as possible.

If heartburn is frequent or prolonged or is weight loss, you should consult a doctor but without urgency.

When it is associated with difficulty swallowing or swallowing food, you should consult with a certain immediacy.

EXPLORATIONS WE CAN MAKE YOUR DOCTOR

To make a study of the causes of heartburn, your doctor may perform a medical history and then apply for some tests such as:

* Study with a radiological gastrointestinal transit of barium contrast.
* Gastroscopy.
* Study of Helicobacter pylori in blood or breath.

DEFINITION

Obesity surgery should be considered only in selected cases of morbid obesity (severe obesity drugs).

RISKS

The risk of all surgical interventions is similar. Mortality is high, and the most frequent cause of death is not related to the technique, but with pulmonary embolism, other medical complications (lung, heart, etc.). And the degree of obesity.

EFFECTIVENESS

Morbid obesity is very difficult to heal and time has shown that with medication and even surgery is a very disease resistant to all treatments. Generally, simple interventions have a high failure rate in the long term. Current interventions can lose 50% of overweight, and do much the rest, and its effects often last for life.

Many, however, fail to do so, and also affect the quality of life of the operation. In some operations it is common to have to re-operated on the wrong technique in weight loss.

TECHNIQUES

* The Vertical Banding Gastroplasty (GVA). In the long term represents a rate of re-operated between 25 and 50 percent. Half of the failures are due to the operation and the other half to the patients themselves, who keep eating high calorie foods that make them gain weight. Quality of life is not good because, for life, the patient is doomed to “not enjoy” a meal.
* The laparoscopic adjustable band. It can be applied by laparoscopy (direct view of the abdomen by fiber-optic tube through a tiny incision), ie without opening the abdomen, but has not been able to demonstrate that long-term results are better than the GVA
* The Gastric Bypass: Is the operation that most surgeons are among the experts on obesity. The index is very low re-operated. Weight losses, higher in all the statistics to the GVA and adjustable ring. The cure rate is over 80% and the rest of the patients, if not cure, the better. Side effects to watch but it is minimal and controllable.
* The Crossing duodenal or pancreatic Bypass: Is the operation more effective. “Cure” for more than 90-95% of patients, and the rest better. Gives the best quality of life because they can eat all kinds of foods without restrictions in most cases. The rate of re-operated does not exceed 2%. Is best in more obese patients because they need to lose more weight on a permanent basis. Up to 3 years may lose so much weight as the complications of iron, calcium and vitamins should be corrected.

Indications. Not all obese children are equal and therefore they should not make the same statement. More obese patients (those superobesos) need more aggressive operation that makes possible the most effective return to normality. In just under obese, gastric bypass is the most widely used intervention, usually by laparoscopy.

RESULTS

Weight loss is not immediate but gradual and slow.

Will depend on the degree of severity of obesity. The more obese lose more weight and also has more weight to lose. It can be 5-8 kilos per month at first to go when reducing the months pass and the weight loss is lower.

It is very difficult to lose weight. The best results with all types of operations is when the patient is weighing at least 10% above ideal weight. No surgeon can predict the final weight with any of the transactions. Individual variations are so large that there is no consistency or the same type of operation.

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