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NTV Health Report Program Text (Stomach and Esophagus Diseases)
Topic: Stomach and Esophagus Diseases
Guest: Ege University Faculty of Medicine, Department of General Surgery, Assoc. Dr. Sinan Ersin
Sonay Dikkaya: Hello from the Health Report. In our program, we will talk to our expert guest on diseases related to stomach and esophagus today. You can send your questions about these issues by phone or to our e-mail address saglik@ntv.com.tr. Our phone number is 0212 335 42 60
Sibel Güneş: Hello ... The stomach and esophagus diseases that can occur depending on the nutritional habits and drugs used by modern life, Ege University Faculty of Medicine General Surgery Department Lecturer Assoc. Dr. We will talk to Sinan Ersin. Sir Sinan, welcome. Stomach and esophagus diseases are common health problems. First of all, can we describe the ulcer? Which factors are effective in its formation?
Sinan Ersin: The factors affecting the ulcer also change depending on the 12 finger intestine and the stomach. Environmental factors are also effective, genetic factors are also effective. On an organic basis, ulcers occur due to the secretion of high amounts of acid, the passage of bile from the 12 finger intestine to the stomach, the presence of a microorganism called helicobacter pylori, and a number of defects in the defense mechanism of the cells lining the inside of the stomach or the 12 finger intestine. Of course, the presence of acid is very important here.
Sibel Güneş: Which symptoms are effective in its emergence? Is it possible to watch without symptoms?
Sinan Ersin: It is not too much to watch it without any symptoms. Usually this is a chronic condition. Pain is at the forefront. If it is in the 12 finger intestine, hunger pain is at the forefront. If it occurs in the stomach, fullness pain is at the forefront. If it occurs in the 12 finger intestine, the patient relaxes when he takes food. Again, when we take some medications that we call antacids, these complaints disappear in a short time. And this is an indicator, of course.
Sonay Dikkaya: Questions started to come to our e-mail address. Our audience named Serdar Eksen asked, "I have been suffering from ulcers for 3 years. I have been paying attention to my diet, but I cannot give up smoking, my ailments persist, what is the role of smoking?
Sinan Ersin: Cigarettes really play a role. Smoking both facilitates the formation of ulcers and delays their healing. It delays the repair of this area by reducing blood flow. We recommend that he quit smoking.
Sibel Güneş: Which methods are used in early diagnosis?
Sinan Ersin: It is very important in the diagnosis of endoscopy. However, although patients do not prefer endoscopy much, they have great advantages over the diagnosis made with film. Once you have the opportunity to see that area directly. Second, if there is a suspicious situation, there is an opportunity to take a biopsy from here. Another, for example, if there is bleeding from the ulcer at that time, there is also the possibility to treat it at the same time with an endoscopy. Bleeding can be stopped at that moment, for example, by injecting a drug here. Endoscopy is very important.
Sibel Güneş: Reflux is also a common health problem. Is it possible to confuse it with an ulcer?
Sinan Ersin: From time to time there is a real confusion. The patient goes to the doctor because I have more gastritis. Because we can not fully interpret this pain, where it originates ... My stomach hurts and we sometimes see that it is misdiagnosed. This is also on a prescription basis. When we look at the prescriptions written depending on the diseases related to the upper digestive system, we see that the prescriptions related to the esophagus and reflux occupy a very small place.
Sibel Güneş: You mentioned a microorganism called Helikobakter. A very common bacteria in Turkey. Are there studies showing that this has an effect on the occurrence of stomach cancer?
Sinan Ersin: Yes, there are studies on this. It is not fully proven, but there is quite a lot of publications about it.
Sonay Dikkaya: The question of our audience named Burak Zeytan is as follows: "I have been found to have early stage gastric cancer. What is the success rate of surgery in gastric cancer?" he asked.
Sinan Ersin: The chances of success are very high, especially when stomach cancer is caught early. There is a long survival. Here, the type of tumor detected is as important as the surgery. But since it is an early stage, there is a very long life.
Sibel Güneş: What is the incidence of reflux disease, which can be described as the stomach acid entering the esophagus, can we explain the main risk factors that form the ground?
Sinan Ersin: Actually, the cause of the disease is not fully clarified, but there are many reasons. One of them is that the lower part of the esophagus that acts as a cover does not work well. And ultimately the stomach contents run back here. The other accompanying factor may be a hernia. Reflux does not happen in all, but it happens in some of them. Also, the cells lining the esophagus have some protective effects. Due to their deterioration, reflux disease may occur. If there is a problem with gastric emptying, if there is a delay, this may cause reflux.
Sibel Güneş: Eating in spicy foods and smoking risk factors. Are there regional differences?
Sinan Ersin: Regional differences can not say exactly what something for Turkey. Because there is not much work done. But it really has to do with food. High-fat foods, chocolate, alcohol, and some other fruit juices cause reflux by lowering the pressure of the lower part of the esophagus that acts as a lid. Apart from these, they cause burning complaints in the patient by directly damaging the cells that line the inside of this esophagus.
Sibel Güneş: Can it be held responsible for a problem such as snoring or hoarseness?
Sinan Ersin: Of course, it can be held responsible for the hoarseness. Reflux has an important role in the occurrence of hoarseness, of which the cause is unknown, and formation of edema and polit in the vocal cords. Patients are unaware that they have reflux when they go to bed at night. But acid comes in, destroying the vocal cords. As a result, the patient may experience a significant hoarseness. In addition, reflux has an important role in coughs and asthma attacks of unknown origin.
Sonay Dikkaya: The question of our audience named Aydın Uğurlu as follows: "I have reflux disease. I take care of my food. However, I think that some antibiotics and rheumatism drugs we use worsen my disease. What is your opinion on this?"
Sinan Ersin: Yes, it does. The drugs we have collected under this group of painkillers, the drugs in the group we call calcium channel blockers used by some high blood pressure patients, again cause reflux by lowering the pressure of the lower end of the esophagus. Indeed, these drugs can increase the patient's reflux. It is useful to use it by informing the physician.
Sibel Güneş: Can the course of the disease be corrected by itself if not treated?
Sinan Ersin: It definitely requires treatment. There are some social measures. But these social measures are effective in only 20 percent of reflux patients. The remaining 80 percent need medication or surgical treatment. It must be treated. Because reflux, as we just mentioned, can damage the vocal cords. It can damage the patient's lungs, cause pneumonia, and cause asthma. Apart from this, it may cause some complaints such as bleeding and ulcers in the lower end of the esophagus. More importantly, in some patients, we see that the cells in the lower part of the esophagus change their structure. And this changing structure can actually cause some reduction in patients' complaints. However, this is a change in the esophagus that can cause cancer. Therefore, these patients should be monitored especially carefully.
Sonay Dikkaya: We have a phone. We take Müjgan Spear's question.
Müjgan Spear: I am 75 years old. I was diagnosed with pangastrit. I heard this myself as a result of the bleeding and had an endoscopy. The result is pangastrit. Water is coming out of my mouth. I have a lot of gas.
Sinan Ersin: He talks about a gastritis I call pangastrit. However, his other complaints are compatible with his reflux. Our 75-year-old patient. A medical treatment should be arranged. Surgical treatment can be considered secondary. Because the age of our patient is past middle age. Surgical treatment can only come into question if there is no response to medication.
Sibel Güneş: Which methods do you perform the surgery? There are classical surgical methods, and there are surgical methods that we call closed. Could you evaluate their advantages and disadvantages over each other?
Sinan Ersin: As a result, the surgery performed in the abdomen is actually the same. The same procedure is being performed. But the method is very different. Closed surgery has been performed in the world since 1991. In the following years, it started to be realized in our country. We have been doing that surgery at Ege University since 1998. Here, we intervene the patient by laparoscopic method through very small holes of 1 cm and half cm. Any cutting and removing parts are involved. Here we wrap the upper part of the stomach and the lower part of the esophagus like a tie and create a high pressure zone here. In this way, we prevent stomach contents from escaping back into the esophagus. The closed method is very advantageous to the open method. You can easily see the patients walking around the service the next day, and sometimes we are discharged. But usually we are discharged two days after surgery. The patient is back at work a week later. The cosmetic results are very good. The pain complaints of the patient pass very quickly after the operation.
Sonay Dikkaya: We have another phone. We take Müjde Akgün's question.
Müjde Akgün: I have been on medication for 3.5 years. However, I did not get any results, my reflux still continues at night. They stated that it was 3 cm. Many doctors said surgery, but some said, stay on the waiting phase. Do I need an operation?
Sinan Ersin: Of course, we cannot say directly from here whether surgery is necessary or not, but there are some physicians who are against surgery. Because, not everyone knows laparoscopic surgery very closely, laparoscopic surgery performed on this subject. Because it is done in limited centers in our country. As far as I know, this surgery can be performed in a few universities in Ankara and Istanbul other than Izmir.
Sibel Güneş: Can we say that reflux surgery is now a specialty?
Sinan Ersin: Yes, we can say. There should be physicians who have a special interest in this issue. We even have a reflux team at Ege University. Because this is teamwork. It's not just a surgeon, just a gastroenterologist's work to do. Here, a pathologist, an otolaryngologist, a pulmonologist and a dentist are required. This disease, as it can damage the teeth. In fact, if he uses drugs from the group called proton pump infectors, 80 or 90 percent of them respond to treatment. Up to 10 percent may be treatment-resistant. Of course, we do not know exactly what drugs our patient is using. However, if it is resistant, it is beneficial to have surgery if it is drug treatment.
Sonay Dikkaya: The question of our audience named Celal Pekcan is as follows: I had reflux surgery. After the operation, my complaints decreased, but now I have gas in my stomach after every meal. Could this be due to surgery or could it be a harbinger of another problem? "
Sinan Ersin: I do not guess that he is the harbinger of another problem. This is a surgical problem. This is really happening in some patients. However, reflux is more important here. The reflux complaints of our patient have decreased. This is the good side.
Sibel Güneş: You mentioned that there is a risk factor for esophageal cancer. Is there a time frame for this? If it is not treated and the course of the disease worsens, how soon can it be said that it will turn into cancer?
Sinan Ersin: We cannot say such a thing. We can't give it a while. If the cells in this lower esophagus change type, that's a very stimulating thing. This patient needs to be monitored closely. Because, whether we treat them with surgery or medication, this difference does not come back anymore. Therefore, these patients should be grouped and those with high or low risk groups should be followed up with endoscopy every six months or once a year and every two years. In this type of change, 15 percent of patients develop cancer in the esophagus.
Sibel Güneş: You talked about social measures. What can be done to improve the patient's quality of life?
Sinan Ersin: First of all, what we call social precautions, the physician should inform the patient very well about the disease. This is a chronic disease, after all. Apart from that, raising the head of the bed is a little beneficial at night. Not wearing too tight clothing is another factor ... Apart from that, this patient should also avoid some foods that trigger reflux, either determined by himself or his doctor told him.
Sibel Güneş: When you put drug treatment and surgical treatment side by side, even if you just said that drug-resistant cases are preferred, which one is more effective in the long term?
Sinan Ersin: Of course, when you ask a patient, is it medication or surgical treatment? Most of the patients will prefer drug therapy. But surgical treatment has some advantages over drug therapy. Let's say you are a young patient once. Get reflux. He has a long life expectancy ahead of him. For years, he will have to use medication once or twice a day, 30 years, 40 years… This is something that impairs the quality of life… Also, the drugs used here do not cure the disease. It just controls the acid. It reduces the acid production, the burning complaint of the patient passes. However, the non-acid content continues to rise up from the esophagus. This can also escape into the patient's windpipe. It may continue to damage the vocal cords again. That's why I prioritize surgical treatment. We recommend laparoscopic surgery to our patients as it is very easy.
Sibel Güneş: Today, Ege University Faculty of Medicine, Department of General Surgery Faculty Member Assoc. Dr. We discussed stomach and esophagus diseases with Sinan Ersin. You can access our program content on ntvmsnbc.com. Hope to see you again, stay healthy.
Sonay Dikkaya: Thank you very much. Today, we have come to the end of the Health Report.
Topic: Stomach and Esophagus Diseases
Guest: Ege University Faculty of Medicine, Department of General Surgery, Assoc. Dr. Sinan Ersin
Sonay Dikkaya: Hello from the Health Report. In our program, we will talk to our expert guest on diseases related to stomach and esophagus today. You can send your questions about these issues by phone or to our e-mail address saglik@ntv.com.tr. Our phone number is 0212 335 42 60
Sibel Güneş: Hello ... The stomach and esophagus diseases that can occur depending on the nutritional habits and drugs used by modern life, Ege University Faculty of Medicine General Surgery Department Lecturer Assoc. Dr. We will talk to Sinan Ersin. Sir Sinan, welcome. Stomach and esophagus diseases are common health problems. First of all, can we describe the ulcer? Which factors are effective in its formation?
Sinan Ersin: The factors affecting the ulcer also change depending on the 12 finger intestine and the stomach. Environmental factors are also effective, genetic factors are also effective. On an organic basis, ulcers occur due to the secretion of high amounts of acid, the passage of bile from the 12 finger intestine to the stomach, the presence of a microorganism called helicobacter pylori, and a number of defects in the defense mechanism of the cells lining the inside of the stomach or the 12 finger intestine. Of course, the presence of acid is very important here.
Sibel Güneş: Which symptoms are effective in its emergence? Is it possible to watch without symptoms?
Sinan Ersin: It is not too much to watch it without any symptoms. Usually this is a chronic condition. Pain is at the forefront. If it is in the 12 finger intestine, hunger pain is at the forefront. If it occurs in the stomach, fullness pain is at the forefront. If it occurs in the 12 finger intestine, the patient relaxes when he takes food. Again, when we take some medications that we call antacids, these complaints disappear in a short time. And this is an indicator, of course.
Sonay Dikkaya: Questions started to come to our e-mail address. Our audience named Serdar Eksen asked, "I have been suffering from ulcers for 3 years. I have been paying attention to my diet, but I cannot give up smoking, my ailments persist, what is the role of smoking?
Sinan Ersin: Cigarettes really play a role. Smoking both facilitates the formation of ulcers and delays their healing. It delays the repair of this area by reducing blood flow. We recommend that he quit smoking.
Sibel Güneş: Which methods are used in early diagnosis?
Sinan Ersin: It is very important in the diagnosis of endoscopy. However, although patients do not prefer endoscopy much, they have great advantages over the diagnosis made with film. Once you have the opportunity to see that area directly. Second, if there is a suspicious situation, there is an opportunity to take a biopsy from here. Another, for example, if there is bleeding from the ulcer at that time, there is also the possibility to treat it at the same time with an endoscopy. Bleeding can be stopped at that moment, for example, by injecting a drug here. Endoscopy is very important.
Sibel Güneş: Reflux is also a common health problem. Is it possible to confuse it with an ulcer?
Sinan Ersin: From time to time there is a real confusion. The patient goes to the doctor because I have more gastritis. Because we can not fully interpret this pain, where it originates ... My stomach hurts and we sometimes see that it is misdiagnosed. This is also on a prescription basis. When we look at the prescriptions written depending on the diseases related to the upper digestive system, we see that the prescriptions related to the esophagus and reflux occupy a very small place.
Sibel Güneş: You mentioned a microorganism called Helikobakter. A very common bacteria in Turkey. Are there studies showing that this has an effect on the occurrence of stomach cancer?
Sinan Ersin: Yes, there are studies on this. It is not fully proven, but there is quite a lot of publications about it.
Sonay Dikkaya: The question of our audience named Burak Zeytan is as follows: "I have been found to have early stage gastric cancer. What is the success rate of surgery in gastric cancer?" he asked.
Sinan Ersin: The chances of success are very high, especially when stomach cancer is caught early. There is a long survival. Here, the type of tumor detected is as important as the surgery. But since it is an early stage, there is a very long life.
Sibel Güneş: What is the incidence of reflux disease, which can be described as the stomach acid entering the esophagus, can we explain the main risk factors that form the ground?
Sinan Ersin: Actually, the cause of the disease is not fully clarified, but there are many reasons. One of them is that the lower part of the esophagus that acts as a cover does not work well. And ultimately the stomach contents run back here. The other accompanying factor may be a hernia. Reflux does not happen in all, but it happens in some of them. Also, the cells lining the esophagus have some protective effects. Due to their deterioration, reflux disease may occur. If there is a problem with gastric emptying, if there is a delay, this may cause reflux.
Sibel Güneş: Eating in spicy foods and smoking risk factors. Are there regional differences?
Sinan Ersin: Regional differences can not say exactly what something for Turkey. Because there is not much work done. But it really has to do with food. High-fat foods, chocolate, alcohol, and some other fruit juices cause reflux by lowering the pressure of the lower part of the esophagus that acts as a lid. Apart from these, they cause burning complaints in the patient by directly damaging the cells that line the inside of this esophagus.
Sibel Güneş: Can it be held responsible for a problem such as snoring or hoarseness?
Sinan Ersin: Of course, it can be held responsible for the hoarseness. Reflux has an important role in the occurrence of hoarseness, of which the cause is unknown, and formation of edema and polit in the vocal cords. Patients are unaware that they have reflux when they go to bed at night. But acid comes in, destroying the vocal cords. As a result, the patient may experience a significant hoarseness. In addition, reflux has an important role in coughs and asthma attacks of unknown origin.
Sonay Dikkaya: The question of our audience named Aydın Uğurlu as follows: "I have reflux disease. I take care of my food. However, I think that some antibiotics and rheumatism drugs we use worsen my disease. What is your opinion on this?"
Sinan Ersin: Yes, it does. The drugs we have collected under this group of painkillers, the drugs in the group we call calcium channel blockers used by some high blood pressure patients, again cause reflux by lowering the pressure of the lower end of the esophagus. Indeed, these drugs can increase the patient's reflux. It is useful to use it by informing the physician.
Sibel Güneş: Can the course of the disease be corrected by itself if not treated?
Sinan Ersin: It definitely requires treatment. There are some social measures. But these social measures are effective in only 20 percent of reflux patients. The remaining 80 percent need medication or surgical treatment. It must be treated. Because reflux, as we just mentioned, can damage the vocal cords. It can damage the patient's lungs, cause pneumonia, and cause asthma. Apart from this, it may cause some complaints such as bleeding and ulcers in the lower end of the esophagus. More importantly, in some patients, we see that the cells in the lower part of the esophagus change their structure. And this changing structure can actually cause some reduction in patients' complaints. However, this is a change in the esophagus that can cause cancer. Therefore, these patients should be monitored especially carefully.
Sonay Dikkaya: We have a phone. We take Müjgan Spear's question.
Müjgan Spear: I am 75 years old. I was diagnosed with pangastrit. I heard this myself as a result of the bleeding and had an endoscopy. The result is pangastrit. Water is coming out of my mouth. I have a lot of gas.
Sinan Ersin: He talks about a gastritis I call pangastrit. However, his other complaints are compatible with his reflux. Our 75-year-old patient. A medical treatment should be arranged. Surgical treatment can be considered secondary. Because the age of our patient is past middle age. Surgical treatment can only come into question if there is no response to medication.
Sibel Güneş: Which methods do you perform the surgery? There are classical surgical methods, and there are surgical methods that we call closed. Could you evaluate their advantages and disadvantages over each other?
Sinan Ersin: As a result, the surgery performed in the abdomen is actually the same. The same procedure is being performed. But the method is very different. Closed surgery has been performed in the world since 1991. In the following years, it started to be realized in our country. We have been doing that surgery at Ege University since 1998. Here, we intervene the patient by laparoscopic method through very small holes of 1 cm and half cm. Any cutting and removing parts are involved. Here we wrap the upper part of the stomach and the lower part of the esophagus like a tie and create a high pressure zone here. In this way, we prevent stomach contents from escaping back into the esophagus. The closed method is very advantageous to the open method. You can easily see the patients walking around the service the next day, and sometimes we are discharged. But usually we are discharged two days after surgery. The patient is back at work a week later. The cosmetic results are very good. The pain complaints of the patient pass very quickly after the operation.
Sonay Dikkaya: We have another phone. We take Müjde Akgün's question.
Müjde Akgün: I have been on medication for 3.5 years. However, I did not get any results, my reflux still continues at night. They stated that it was 3 cm. Many doctors said surgery, but some said, stay on the waiting phase. Do I need an operation?
Sinan Ersin: Of course, we cannot say directly from here whether surgery is necessary or not, but there are some physicians who are against surgery. Because, not everyone knows laparoscopic surgery very closely, laparoscopic surgery performed on this subject. Because it is done in limited centers in our country. As far as I know, this surgery can be performed in a few universities in Ankara and Istanbul other than Izmir.
Sibel Güneş: Can we say that reflux surgery is now a specialty?
Sinan Ersin: Yes, we can say. There should be physicians who have a special interest in this issue. We even have a reflux team at Ege University. Because this is teamwork. It's not just a surgeon, just a gastroenterologist's work to do. Here, a pathologist, an otolaryngologist, a pulmonologist and a dentist are required. This disease, as it can damage the teeth. In fact, if he uses drugs from the group called proton pump infectors, 80 or 90 percent of them respond to treatment. Up to 10 percent may be treatment-resistant. Of course, we do not know exactly what drugs our patient is using. However, if it is resistant, it is beneficial to have surgery if it is drug treatment.
Sonay Dikkaya: The question of our audience named Celal Pekcan is as follows: I had reflux surgery. After the operation, my complaints decreased, but now I have gas in my stomach after every meal. Could this be due to surgery or could it be a harbinger of another problem? "
Sinan Ersin: I do not guess that he is the harbinger of another problem. This is a surgical problem. This is really happening in some patients. However, reflux is more important here. The reflux complaints of our patient have decreased. This is the good side.
Sibel Güneş: You mentioned that there is a risk factor for esophageal cancer. Is there a time frame for this? If it is not treated and the course of the disease worsens, how soon can it be said that it will turn into cancer?
Sinan Ersin: We cannot say such a thing. We can't give it a while. If the cells in this lower esophagus change type, that's a very stimulating thing. This patient needs to be monitored closely. Because, whether we treat them with surgery or medication, this difference does not come back anymore. Therefore, these patients should be grouped and those with high or low risk groups should be followed up with endoscopy every six months or once a year and every two years. In this type of change, 15 percent of patients develop cancer in the esophagus.
Sibel Güneş: You talked about social measures. What can be done to improve the patient's quality of life?
Sinan Ersin: First of all, what we call social precautions, the physician should inform the patient very well about the disease. This is a chronic disease, after all. Apart from that, raising the head of the bed is a little beneficial at night. Not wearing too tight clothing is another factor ... Apart from that, this patient should also avoid some foods that trigger reflux, either determined by himself or his doctor told him.
Sibel Güneş: When you put drug treatment and surgical treatment side by side, even if you just said that drug-resistant cases are preferred, which one is more effective in the long term?
Sinan Ersin: Of course, when you ask a patient, is it medication or surgical treatment? Most of the patients will prefer drug therapy. But surgical treatment has some advantages over drug therapy. Let's say you are a young patient once. Get reflux. He has a long life expectancy ahead of him. For years, he will have to use medication once or twice a day, 30 years, 40 years… This is something that impairs the quality of life… Also, the drugs used here do not cure the disease. It just controls the acid. It reduces the acid production, the burning complaint of the patient passes. However, the non-acid content continues to rise up from the esophagus. This can also escape into the patient's windpipe. It may continue to damage the vocal cords again. That's why I prioritize surgical treatment. We recommend laparoscopic surgery to our patients as it is very easy.
Sibel Güneş: Today, Ege University Faculty of Medicine, Department of General Surgery Faculty Member Assoc. Dr. We discussed stomach and esophagus diseases with Sinan Ersin. You can access our program content on ntvmsnbc.com. Hope to see you again, stay healthy.
Sonay Dikkaya: Thank you very much. Today, we have come to the end of the Health Report.
