|
|
Gastroesophageal Reflux
Disease, heart burn, or reflux
|
|
- Food is brought through the chest from the mouth to the stomach by a tube called the esophagus. Between the end of the esophagus and stomach there is a muscular valve called a sphincter. This valve prevents stomach contents (food, acid, etc.) from going back into the esophagus. When acid from the stomach gets into the esophagus and causes symptoms or medical problems, it is known as gastroesophageal Reflux disease.
- Reflux symptoms occur because: 1) the esophageal sphincter is not working properly and acid Refluxes ("backs up") into the esophagus; 2) acid that gets Refluxed into the esophagus
is not neutralized; or 3) stomach contents are not emptying
properly and things "back upward" to the
esophagus.
|
|
- Heart Burn usually 30-60 minutes after eating
- Heart Burn after lying down or sleeping
- Relief of symptoms from antacids
- Chronic dry cough or wheezing
- Chest pain (not associated with
exercise)
|
|
- Endoscopy -- scope passed from mouth into esophagus. It shows irritation of the esophagus.
- Barium swallow -- sometimes helpful
- pH monitoring of esophagus -- rarely, if diagnosis is unclear
- Esophageal manometry -- measures
esophageal pressures. Also done only if diagnosis is
unclear.
|
|
- Life-style modifications:
- Avoid alcoholic beverages
- Avoid caffeinated beverages and chocolate
- Avoid specific foods that produce your symptoms (individually determined)
- Weight loss -- often helps overweight individuals
- Do not lie down within 3 hours of eating.
- Sleep with block or wedge under
mattress slanted down (head raised to keep acid from
flowing up)
- Antacids (Maalox) helps in milder
cases (may need every four hours)
- H2 receptor blockers, e.g., Zantac, Tagamet
- Proton pump inhibitors (Prilosec)
-- the strongest medicine for suppressing acid
- Reglan
(metochlopramide) -- makes food move forward down
gastrointestinal tract. Benefits some, especially
diabetics.
- Surgery if all medications fail,
strictures recur, or severe inflammation of esophagus is
present. Surgery is called a Nissen fundoplication. With the
advent of the proton pump and inhibitor medications, surgery
is now rarely needed.
|
|
- Barrett's Esophagus -- a condition in which the cells of the lower esophagus become abnormal. It is caused by years of chronic acid irritation from acid Reflux. This condition may turn into cancer, and therefore must be monitored closely. Reflux disease is treated aggressively.
- Peptic stricture -- an area of the
esophagus becomes narrowed and scarred. It is treated with
balloon dilation.
|
| | |
If you want your friend to read or know about this article, Click here
|
|
|