Gastroesophageal Reflux: Interview with Dr. Fabio Zannoni
Let’s talk about gastroesophageal reflux with Dr. Fabio Zannoni, specialist in Gastroenterology and Digestive Endoscopy
Gastroesophageal reflux is a very common condition, either occasional or chronic, that occurs when gastric juices flow back from the stomach into the esophagus. This back-flow can cause a retrosternal burning sensation, acid regurgitation, and in some cases extra-esophageal symptoms.
Although many times not a serious condition, an accurate evaluation and proper treatment are essential to prevent potential complications.
We discussed this topic with Dr. Fabio Zannoni, surgeon specialist in Gastroenterology and Digestive Endoscopy at UPMC Salvator Mundi International Hospital.
What is gastroesophageal reflux?
The esophagus and the stomach are separated by a valve that allows food to pass downward while preventing liquids from flowing back up. When this valve doesn’t work properly, gastric contents can rise back into the esophagus, and the acidic fluid can irritate the esophageal lining, causing symptoms and, over time, potential complications.
What are the causes and symptoms?
Today, about 44% of the population experiences gastroesophageal reflux. In addition to the classic heartburn, reflux can cause so-called “atypical” symptoms: persistent sore throat, hoarseness or changes in the tone of voice due to irritation of the vocal cords, and even respiratory issues.
The main cause is a reduced function of the valve, often associated with a hiatal hernia. When a hernia is not present, certain habits can still cause the reflux: smoking, a high-fat diet, very spicy foods, chocolate, and other foods that weaken the valve. Stress can also play a significant role.
How is it diagnosed?
Diagnosis is based on an evaluation of the symptoms and is confirmed conducting specific tests to identify or rule out a hiatal hernia. Exams such as pH monitoring and esophageal manometry assess the valve's function and detect excessive acid exposure in the esophagus.
A gastroscopy is essential to visualize possible alterations in the esophageal lining.
In some cases, more severe lesions may be identified, such as Barrett’s esophagus, which is considered a precancerous condition.
What are the available treatments?
Treatment always begins with changes in lifestyle: lighter meals, quitting smoking, reducing alcohol intake, and avoiding highly processed foods.
There are also pharmacological therapies that have a two-fold function: reducing acid production by stomach cells and making reflux less aggressive, or acting as esophageal mucosal barriers, creating a mechanical protective layer. These two approaches can be combined to optimize treatment results.
When should I consult a specialist?
If you recognize these symptoms or suspect you suffer from gastroesophageal reflux, consulting a specialist is the first step toward an accurate diagnosis and a personalized treatment plan.