| What is GERD?Gastroesophageal reflux disease or | | | | smoke weaken or relax the LES. Obesity places |
| GERD occurs when the acidic gastric juices | | | | added pressure on the upper abdomen, |
| from the stomach flow up into the esophagus. As | | | | and during pregnancy the LES weakens for unknown |
| these juices are allowed to flow into and irritate the | | | | reasons.GERD TreatmentWhen symptoms of |
| lining of the esophagus, a burning | | | | heartburn are not controlled with modifications in |
| sensation is felt in the lower chest. If these symptoms | | | | lifestyle, |
| of heartburn are not controlled with modifications in | | | | and over-the-counter medicines are needed two or |
| lifestyle, and | | | | more times a week, or symptoms remain unresolved |
| over-the-counter medicines are needed two or more | | | | on the medication you are taking, you |
| times a week, you should see your physician. When | | | | should consult your physician.Treatment should be |
| GERD is not treated, serious | | | | designed to: 1) eliminate symptoms; 2) heal esophagitis; |
| complications can occur, such as severe chest pain | | | | and 3) prevent the relapse of esophagitis or |
| that can mimic a heart attack, esophageal stricture | | | | development of complications in patients with |
| (the narrowing of the esophagus), | | | | esophagitis.In many patients, GERD is a chronic, |
| bleeding, or a pre-cancerous change in the lining of the | | | | relapsing disease. The goals of long-term |
| esophagus known as Barrett's Esophagus.What are | | | | maintenance are to control the symptoms and |
| the causes of GERD?One possible GERD cause is | | | | prevent complications. Maintenance therapy will vary in |
| the weakness of the muscle at the base of the | | | | individuals ranging from basic lifestylemodifications to |
| esophagus that connects and controls the flow of | | | | prescription medication as treatment.Lifestyle |
| food in to the stomach, known as the lower | | | | Modification In order to decrease the amount of gastric |
| esophageal sphincter (LES). As food travels down | | | | contents that reach the loweresophagus, certain |
| the esophagus, the sphincter opens to let food flow | | | | simple guidelines should be followed:Raise the Head of |
| into the stomach. Normally it closes as soon as the | | | | the Bed or use under-mattress foam wedge to |
| food enters the stomach. With | | | | elevate the headabout 6-10 inches. Pillows are not an |
| heartburn, the sphincter does not close tightly. This | | | | effective alternative for elevating the head in |
| allows stomach acid to flow back up into the | | | | preventing reflux. |
| esophagus (often called acid reflux), | | | | Change Eating and Sleeping Habits. Avoid lying down |
| causing a burning sensation.Other causes include | | | | for two hours after eating. Do not eat for at least two |
| excess acid production and other diseases that | | | | hours before bedtime. Thisdecreases the amount of |
| interfere | | | | stomach acid available for reflux. |
| with food passing through the esophagus.GERD | | | | Reduce your weight if obesity contributes to the |
| SymptomsFrequent heartburn is the most common | | | | problem. |
| GERD symptom. However, patients may also | | | | Change Your Diet. Avoid foods and medications that |
| experience some of the following:sour or bitter | | | | lower LES tone (fats and chocolate) and foods that |
| tastebitter stomach fluid coming into the mouth, | | | | may irritate the damaged lining ofthe esophagus (citrus |
| especially during sleephoarsenessrepeatedly feeling a | | | | juice, tomato juice, and probably pepper). |
| need to clear the throatdifficulty swallowing food or | | | | Avoid Habits That Contribute to GERD. Both smoking |
| liquidwheezing or coughing at nightworsening of | | | | and the use of alcoholic beverages lower LES |
| symptoms after eating, or when bending over or lying | | | | pressure, which contributes to acidreflux. |
| downDiagnosing GERDDiagnostic tests for GERD | | | | Avoid foods and beverages that contribute to |
| may include:Upper GI Series-a series of x-rays of the | | | | heartburn: chocolate, coffee, peppermint, greasy or |
| upper digestive system taken | | | | spicy foods, tomato products andalcoholic beverages. |
| after drinking a barium solution | | | | Stop smoking. Tobacco inhibits saliva, which is the |
| 24-hour pH Monitoring-a probe placed in the | | | | body's major buffer. Tobacco may also stimulate |
| esophagus to keep track of the level of acidity in the | | | | stomach acid production and relax themuscle between |
| lower esophagus. This is done | | | | the esophagus and the stomach, permitting acid reflux |
| over a 24-hour period. | | | | to occur.The goal of each treatment is to decrease |
| Manometry-measures muscle pressures of the lower | | | | the amount of acidic stomach fluidleaking back into the |
| esophagus (LES) | | | | esophagus or make that fluid less irritating to the lining |
| Endoscopy-looking at the esophagus and stomach | | | | of the esophagus.GERD DietYour doctor may |
| through a thin, lighted flexible tube that is passed down | | | | recommend avoiding:caffeine |
| the throat | | | | chocolate and peppermint |
| Biopsy-removing a small sample of esophageal tissue | | | | spicy and/or tomato-based foods like pizza, wings, |
| to measure the amount of acid or pressure in the | | | | sausages |
| esophagusGERD ComplicationsHeartburn can feel like | | | | fruits from the citrus family like oranges and tomatoes |
| the pain associated with a heart attack. Never assume | | | | fried and fatty foods |
| | | | peppermint and spearmint |
| that chest pain is heartburn or indigestion. Seek | | | | whole milk |
| medical care if you're not sure.Complications occur | | | | cold cuts, bacon, fatty meat, chicken skin |
| when GERD is severe or long-standing. Constant | | | | cream-based soupsMedical Treatment of |
| irritation of | | | | GERDGERD has a physical cause, and frequently is |
| the esophagus by stomach acid can lead to | | | | not curtailed by these lifestyle factors alone. If you are |
| inflammation, ulcers, and bleeding. Anemia or low blood | | | | using |
| count may develop. Over time, scarring and | | | | over-the-counter medications two or more times a |
| narrowing of the esophagus can also develop, making | | | | week, or are still having symptoms on the prescription |
| it difficult to swallow and pass food through the | | | | or other medicines you are taking, |
| esophagus. This narrowing is called a | | | | you need to see your doctor. If results are not |
| stricture.Some patients develop a condition called | | | | forthcoming, medications may be used to neutralize |
| Barrett's Esophagus, which is a serious | | | | acid, increase LES tone, or improve |
| change in the cells lining the esophagus. Barrett's | | | | gastric emptying. Promotility Agents increase lower |
| Esophagus may be a precursor of esophageal | | | | esophageal sphincter pressure, which helps prevent |
| cancer.GERD PreventionCertain diet and lifestyle | | | | acid reflux, and improves the movement |
| choices can contribute to the condition. For example, | | | | of food from the stomach. H2 blockers and Proton |
| certain foods increase acid production, and fatty | | | | Pump lnhibitors decrease the flow of stomach |
| foods increase the time food remains in the stomach. | | | | acid.Beth Guida is an author for e-Healthcare Solutions, |
| Chocolate, peppermint, coffee, | | | | Inc. in Ewing, NJ. |
| alcoholic beverages, and especially nicotine in cigarette | | | | |