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Reflux syndrome
Last reviewed: 07.07.2025
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Reflux syndrome is a group of pathological conditions caused by the reverse flow of fluids in hollow organs or vessels due to a violation of the pressure gradient in them or imperfection of the valve or sphincter systems. The process is passive. Reflux syndrome most often develops in three systems of the body: the gastrointestinal tract, the venous system and the urinary tract. Surgeons mainly encounter the first two, and reflux syndrome of the urinary tract is the responsibility of urologists and nephrologists.
[ Reflux syndrome in the gastrointestinal tract
Gastroesophageal reflux syndrome - the flow of stomach contents into the esophagus develops with insufficiency of the cardiac sphincter, which most often develops with diaphragmatic hernias or anatomical defect of the muscular ring, i.e. with insufficiency of the esophagogastric sphincter. Reflux syndrome can develop with gastritis, peptic ulcer, cholecystitis, especially during exacerbation, after gastric resection, with gastric cancer and carcinomatosis, can occur during pregnancy, i.e. in cases where gastric motility is impaired or increased intra-abdominal pressure is created. As a result, esophagitis develops, up to the formation of a peptic ulcer. The main manifestations: heartburn; sometimes with burning pain, occurring in a horizontal or inclined position, usually decreases in a vertical body position. Confirmation of the diagnosis - with the help of FGDS, and this is enough. Conservative treatment by a gastroenterologist.
Duodenogastric reflux syndrome develops with peptic ulcer, duodenitis, cholecystitis, pancreatitis, after gastric resection. The alkaline environment and bile acids wash away the protective mucus of the stomach with the formation of erosive gastritis, up to the formation of erosive ulcers, and sometimes polyps. It is manifested by the clinical picture of gastritis. It is confirmed by FGS, and this is enough. Conservative treatment by a gastroenterologist.
Pancreatobiliary reflux syndrome is formed with gross pathology of the duodenum and the ampulla of Vater. With high hypertension in the common bile duct, pancreatic juice enters the bile ducts, causing severe enzymatic (often with destruction of the walls) cholangitis. This is accompanied by liver damage with the development of jaundice, severe intoxication of the body and requires urgent surgical treatment. The diagnosis is confirmed by FGS with retrograde pancreatocholangiography. Although ultrasound can provide information on the state of the bile ducts.
Choledochopancreatic reflux syndrome can develop only with a combined common bile and pancreatic duct in case of pathology of the Vater's papilla and sphincter of Oddi, or in case of violation of the technique of performing retrograde cholangiography. Bile entering the pancreatic duct leads to damage to the wall and the development of severe pancreatic necrosis. Treatment is surgical, urgent, in the abdominal surgery department.
Reflux syndrome in the venous system
It is most often observed in the veins of the lower extremities, where, as a result of venous valve insufficiency, it manifests itself in the form of varicose veins.