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Gastroesophageal Reflux Disease (GERD)

Discussion in 'JF Doctor' started by mgeni10, Mar 25, 2012.

  1. mgeni10

    mgeni10 JF-Expert Member

    Mar 25, 2012
    Joined: Nov 29, 2010
    Messages: 1,104
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    Gastroesophageal Reflux Disease (GERD) is the back flow
    of the stomach contents into the esophagus (the tube that
    connects the mouth to the stomach) with or without
    esophageal inflammation.
    Heartburn is the most common symptom of GERD. Sixtyfive
    percent of Americans suffer from this condition which
    occurs at all ages.
    Infants and children may experience persistent vomiting,
    coughing, or other respiratory symptoms.
    What causes GERD?
    A number of factors can contribute to GERD and some
    people may have a combination of them.
    They include:
    • A poorly functioning lower esophageal sphincter (LES)
    caused by:
    - Medications, such as nitrates, bisphosphonates, estrogen,
    oral contraceptives, progesterone, alpha adrenergic agents,
    theophylline, calcium channel blockers, benzodiazepines,
    anticholinergics, and tricyclic antidepressants can weaken
    - Smoking, eating just before bedtime, and drinking alcohol.
    These can all decrease the muscle's effectiveness.
    - Foods such as chocolate, caffeinaled beverages,
    peppermint, spearmint, greasy or spicy foods, onions,
    garlic, tomato products, and citrus juices.
    • Slow stomach emptying (eg, in diabetes mellitus)
    • Poor removal of acid from the esophagus
    • Too much acid in the stomach
    • Fragile, tender esophageal lining
    • Hiatal hernia (see panel) - causes include coughing,
    vomiting, straining, sudden physical exertion that
    increases abdominal pressure, obesity, or pregnancy
    • Increased abdominal pressure during pregnancy
    Recognizing the symptoms
    Heartburn - A burning sensation, or pain in the middle
    of the chest, moving to the neck and throat. This may
    worsen when lying down or bending over. The
    burning/pain can begin within an hour of eating and can
    last as long as 2 hours
    • Acid or bitter taste in the mouth
    • A feeling that food is coming back into the mouth
    • Difficulty swallowing
    • Asthma-like symptoms - coughing and wheezing.
    • Hoarseness, laryngitis, earache
    • Tooth decay, bad breath, gum problems such as
    gingivitis (inflammation of the gums)
    The symptoms of GERD may include:
    In some cases a reflux attack may be so severe that it
    can mimic the chest pain experienced during a Heart
    Attack. Individuals with GERD may also have an increased
    risk of Barret fs esophagus and esophageal cancer.
    Saliva (the liquid • In the stomach, the
    produced in the food mixes with acid
    mouth) provides a and other digestive
    protective mechanism enzymes.
    for the esophagus The LES prevents
    because it has a digested food,
    neutralizing effect on stomach acid, and
    acid. other digestive
    Chewed enzymes from food mass
    (bolus) moving back into the
    After being chewed • If the LES is weakened,
    and swallowed, food or relaxes at the wrong
    travels down the time, tthe contents of
    esophagus. the stomach can go
    backwards (called
    The muscular action ""flux) into the
    of the esophagus esophagus.
    (called peristalsis) The stomach acid and
    propels the food enzymes can be very
    towards the stomach. irritating and even
    damaging to the lining
    of the esophagus.
    The lower esophageal • The esophagus can
    sphincter (LES) initially protect itself
    relaxes to allow the from damage by its
    food to move down into own muscular action
    the stomach where it is (peristalsis). This
    further digested. would normally
    propel the partially
    digested food and
    fluids back into the
    stomach again.
    A common test used is a Barium Meal (also called a Barium
    Swallow Test). This involves digesting a special liquid which
    shows up on an x-ray and helps to indicate activity in the
    stomach. In more complex cases, an Endoscopy might be required. An
    endoscopy is a procedure where a thin, flexible tube, containing
    a miniature camera, is placed into the patient's mouth and down into the
    esophagus to look at the lining for damage. This also helps to rule out other,
    more serious conditions.ln another procedure, a monitor ma be laced
    in the esophagus Endoscope
    to test the acid content r-------~----I
    (Esophageal pH
    This can help to record
    acid reflux in the
    If symptoms show a history of uncomplicated GERD, then a
    period of drug treatment - together with dietary and/or lifestyle
    changes - may be all that is required to resolve the condition.
    Your healthcare provider should review your current medications to see if any
    aggravate your GERD. In rare, severe, cases surgery may be required .
    .udrugs con be grouped together by how they wOO<(ie. tbeir sptdfic mode 01_). The list below iDcIudes
    allbe dilIamt types 01drugs .,..,.".... for use in Ibe _ 01Ibis condition at Ibe lime of puIoIiQlion.
    (Updat.td information is also avUb.bIe online ~ www din.ltl .,..,.,.••• era )
    Drug Type
    AhoII,o •••••• _looIIIIIIc8oft ~ if_ haw _~ --- •• --. about Ibe medlcalioa _ •••••••• -= Efled
    Prokinetic Agents Enhance stomach muscle action
    Increase gastric emptying into the
    small intestine.
    (in alphabetical order)
    Histamine H2
    Proton Pump
    Help neutralize acid in the esophagus
    and stomach.
    Help to reduce or stop heartburn.
    Stimulate muscle contractions in the
    gastrointestinal tract, causing increased
    movement in the esophagus and stomach.
    Reduce stomach acid. Effective in reducing
    symptoms and damage to the esophageal
    If taking on an "as needed" basis, take
    before a meal, especially one that might
    cause reflux.
    Reduce stomach acid. Very effective in
    reducing symptoms and damage to the
    esophageal lining.
    Surgical corrections for GERD are only used in patients who
    have failed a combination of aggressive nonmedical and
    medical therapies, or who have had additional complications
    from GERD itself.
    A Hiatal Hernia is a condition in which
    a portion of the stomach protrudes into
    the chest cavity through the
    sphincter diaphragm.
    Part of the stomach
    protruding through the
    Surgical Repair
    In some cases, surgery may
    be required (known as
    a fundoplication) in order to
    relocate the esophageal
    void large, fatty meals.
    • Decrease meal portions.
    • Avoid foods that you suspect
    may contribute to the symptoms.
    • Discontinue, or strictly limit, the use of all caffeinecontaining
    • Try to allow time for your food to digest at each meal.
    • Exercise regularly to improve your general well-being.
    • Avoid tobacco and alcohol.
    • Try to lose weight if you are overweight.
    • Avoid wearing tight clothing.
    • Avoid eating 2-3 hours before
    • Elevate the head of the bed
    by 6 inches to reli e some
    of the symptoms and provide
    restful sleep.
  2. P

    PACHOTO JF-Expert Member

    Feb 3, 2015
    Joined: Dec 30, 2011
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    Thanx, ugonjwa huo unanisumbua sna