Serious Complication of Acid Reflux or Gastroesophageal Reflux Disease

The more serious long term complications of Acid Reflux or GERD is not treated effectively, the constant acid reflux can irritate the lining of the esophagus, and serious complication that may occur are :

A. Barrett's esophagus.

Acid Reflux or Heartburn that is severe or occurs frequently over a long period of time is a characteristic of Gastroesophageal Reflux Disease (GERD). If GERD is untreated, it can be harmful; the constant acid reflux will irritate the lining of the esophagus, and complications can occur. One of these complication is Barrett's esophagus.

Barrett's esophagus is a condition in which the esophagus, the muscular tube that carries food and saliva from the mouth to the stomach, changes so that some of its lining is replaced by a type of tissue similar to that normally found in the intestine. Those with Barrett's esophagus are 30 to 125 times more likely to develop esophageal cancer than those without this condition.
Barrett's esophagus (BE) is a serious condition in which changes occur in the cells that line the lower esophagus and cause the cells to become abnormal and precancerous.

B. Esophageal cancer.

The esophagus is a hollow tube that carries food and liquids from your throat to your stomach. Early esophageal cancer usually does not cause symptoms. However, as the cancer grows, symptoms may include painful or difficult swallowing, weight loss and coughing up blood.

Esophageal cancer is a disease in which malignant (cancer) cells form in the tissues of the esophagus. Doctors cannot always explain why one person gets cancer and another does not. There is, however, a strong association between gastroesophageal reflux disease (GERD)and esophageal cancer.

C. Laryngeal cancer.

Laryngeal cancer may also be called cancer of the larynx or laryngeal carcinoma. Most laryngeal cancers are squamous cell carcinomas, reflecting their origin from the squamous cells which form the majority of the laryngeal epithelium.

For the purposes of tumour staging, the larynx is divided into three anatomical regions: the glottis; the supraglottis epiglottis, arytenoids and aryepiglottic folds, and false cords); and the subglottis.

Researchers have reported that GERD is significantly associated with the development of laryngeal cancer (cancer of the larynx).

D. Erosive esophagitis.

Esophagitis is an inflammation and swelling of the esophagus, and is most often caused by acid-containing stomach contents refluxing back up into the esophagus.

Esophagitis means inflammation of the foodpipe. This is often characterized by redness of the lining of the foodpipe (erythema)and breaks in the lining of the foodpipe (erosions). One of the causes for the development of esophagitis is gastroesophageal reflux disease (GERD).

E. Esophageal strictures.

An esophageal stricture is a gradual narrowing of the esophagus, which can lead to swallowing difficulties. The esophagus is a relatively simple tubular structure connecting the throat to the stomach. The major functions of the stomach are to transport ingested food from the oropharynx to the stomach and to prevent regurgitation of food and gastric contents from the stomach back up into the esophagus.

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Short Term Treatment of GERD or Heartburn

Below you will find various options for heartburn treatment and GERD/acid reflux treatment for short-term relief to 24-hour acid control :

A. Drug Medication.

These acid reflux medications for children include antacids and acid reducers such as:

• Antacids . Antacids neutralize the acid in your stomach and provide prompt heartburn treatment and heartburn relief.
• Maalox.
• Mylanta.

B. Histamine-2 receptor antagonists

• Axid oral. Nizatidine is used to treat ulcers of the stomach and intestines and prevent them from coming back after they have healed. This medication is also used to treat certain stomach and throat (esophagus) problems caused by too much stomach acid (e.g., erosive esophagitis) or a backward flow of stomach acid into the esophagus (acid reflux disease/GERD).
• Carafate oral. This medication is used to treat and prevent ulcers in the intestines. Sucralfate forms a coating over ulcers, protecting the area from further injury. This helps ulcers heal more quickly.
• Pepcid oral. Famotidine is used to treat ulcers of the stomach and intestines. It may be used to prevent intestinal ulcers from returning after treatment. This medication is also used to treat certain stomach and throat problems caused by too much stomach acid (e.g., Zollinger-Ellison syndrome, erosive esophagitis) or a backward flow of stomach acid into the esophagus (GERD).
• Reglan oral. This medication is used to treat certain conditions of the stomach and intestines. Metoclopramide is used as a short-term treatment (4 to 12 weeks) for persistent heartburn when the usual medicines do not work well enough.
• Tagamet oral. Cimetidine is used to treat ulcers of the stomach and intestines and prevent them from coming back after they have healed. This medication is also used to treat certain stomach and throat (esophagus) problems caused by too much stomach acid (e.g., Zollinger-Ellison syndrome, erosive esophagitis) or a backward flow of stomach acid into the esophagus (acid reflux disease/GERD).
• Zantac oral. Ranitidine is used to treat ulcers of the stomach and intestines and prevent them from returning after treatment. This medication is also used to treat and prevent certain stomach and throat (esophagus) problems caused by too much stomach acid (e.g., Zollinger-Ellison syndrome, erosive esophagitis) or a backward flow of stomach acid into the esophagus (gastroesophageal reflux disease-GERD).

C. H₂ blockers.

H₂ blockers block stomach acid production and provide acid reflux treatment and relief of heartburn symptoms. However, they do not block acid as completely as proton pump inhibitors.

D. Proton Pump Inhibitor (PPI).

Proton pump inhibitors are highly effective treatments and are used for long-term GERD or acid reflux treatment. Proton pump inhibitors control stomach acid and provide heartburn relief.

• ZEGERID. Providing rapid release of the active ingredients and up to 24-hour acid control and heartburn relief.
• Aciphex oral. Rabeprazole works by blocking acid production in the stomach. This medication is known as a proton pump inhibitor (PPI). It is used to treat acid-related stomach/intestinal and throat (esophagus) problems (e.g., acid reflux or GERD, ulcers, erosive esophagitis, Zollinger-Ellison syndrome).
• Nexium oral. Esomeprazole works by blocking acid production in the stomach. This medication is known as a proton pump inhibitor (PPI). It is used to treat acid-related stomach and throat (esophagus) problems (e.g., acid reflux or GERD, erosive esophagitis).
• Prilosec oral. Omeprazole works by blocking acid production in the stomach. This medication is known as a proton pump inhibitor (PPI). It is used to treat acid-related stomach and throat (esophagus) problems (e.g., acid reflux or GERD, ulcers, erosive esophagitis, or Zollinger-Ellison Syndrome). Decreasing excess stomach acid can help relieve symptoms such as heartburn, difficulty swallowing, persistent cough, and trouble sleeping.
• Prevacid oral. Lansoprazole works by blocking acid production in the stomach. This medication is known as a proton pump inhibitor (PPI). It is used to treat acid-related stomach and throat (esophagus) problems (e.g., acid reflux or GERD, ulcers, erosive esophagitis, Zollinger-Ellison syndrome).
• Protonix oral. Pantoprazole works by blocking acid production in the stomach. This medication is known as a proton pump inhibitor (PPI). It is used to treat acid-related stomach and throat (esophagus) problems (e.g., acid reflux or GERD, erosive esophagitis, Zollinger-Ellison syndrome).

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Acid Reflux Repair - Endoscopic Suturing

Endoscopic Suturing Non-Invasive, Out-Patient Solution For GERD.

Endoscopic Suturing or Endoscopic Gastroplication is an exciting non-surgical method used by Dr. Anthony Starpoli to treat Gastro Esophageal Reflux Disease (GERD). This treatment is a breakthrough alternative to life-long medical therapy or invasive and costly surgery.

A device, like a tiny sewing machine, is attached to the end of a standard, flexible endoscope or tube. The video endoscope allows the physician to place a suture (stitch) near the LES. Two stitches can be placed and tied together to create a pleat near the LES and treat symptomatic acid reflux.

The specific advantages of endoscopic suturing include :

• Lower procedure cost than other treatment alternative.
• The procedure can offer patients an alternative to expensive medications that often must be taken for the life of the patient.
• It is an outpatient procedure.
• The procedure does not require an incision and is more comfortable for patients than surgical alternatives.
• Faster recovery time than surgical treatment.

The following patients should probably not undergo endoscopic gastroplication:

• History of surgery of the esophagus or stomach.
• Barrett’s Esophagus.
• Esophageal motility dysfunction.
• Inability to receive sedation.
• Patients with a large hiatal hernia.
• Morbid obesity.
• Significant heart or lung disease.
  

The following patients may be considered:

• Patients should show a good response to medical therapy.
• Patients who are not markedly over weight.
• Those with a small hiatal hernia.
• Patients seeking an alternative to chronic medical therapy
  

learn more : in EndoCinch Clinic

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Acid Reflux General Treatment | Gastroesophageal Reflux Treatment

Treatment for Acid Reflux Disease:
General measures the patient can take to reduce reflux are:

• Eat smaller and more frequent meals.
• Avoid eating before going to bed.
• Eliminate excessive bending, lifting, abdominal exercises, girdles and tight belts, all of which increase abdominal pressure and provoke reflux.
• If overweight, lose weight. Being overweight promotes reflux.
• Eliminate the use of nicotine (cigarettes), fatty foods, alcohol, all coffees (yes-including decaf), chocolate and peppermint.
• Elevate the head of the bed 8" to 10" by placing pillows or a wedge under the upper part of the mattress. In this way, gravity keeps stomach juices out of the esophagus while the patient sleeps. It is not enough to use two pillows under the head.
• Prescription medications - check with the physician regarding side effects of prescription drugs. Some drugs actually lower the strength of the LES muscle. These include anti-spasmotics (Levsin, Librax, Bentyl), calcium channel blocks (Procardia, Cardizem, Calan, Isoptin), anti-depressants (Elavil, Doxepia) and others.

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Bravo™ pH Monitoring System Effective to Treatment GERD or Acid Reflux

What is the Bravo™ pH Monitoring System?

The Bravo pH Monitoring System is a catheter-free way to measure pH.



The Bravo system involves a pH capsule, about the size of a gel cap, that is temporarily attached to the wall of the esophagus. The Bravo™ pH Capsule measures pH levels in the esophagus and transmits readings via radio telemetry to the Bravo™ Receiver worn on the patient’s belt or waistband. The patient also records symptoms he or she experiences in a diary by pressing buttons on the receiver. The Bravo pH capsule collects pH measurements for up to 48 hours. After the study, data from the receiver is uploaded to a computer and diary information is entered for analysis to aid in the diagnosis and plan treatment. Normal patient activities such as swallowing, eating and drinking should cause the disposable pH capsule to detach and pass through the digestive tract in 5-7 days on average.

How is the Bravo pH capsule attached to the esophagus?

The doctor uses the Bravo Delivery System to insert the pH capsule through the mouth or nose and position it above the lower esophageal sphincter. Once the pH capsule is in place, suction is applied, drawing a small amount of esophageal tissue into the capsule and locking it in place. The delivery system is then withdrawn and the pH capsule can begin measuring pH levels.

How is the Bravo pH capsule attached to the esophagus?



The doctor uses the Bravo™ Delivery System to insert the pH capsule through the mouth or nose and position it above the lower esophageal sphincter. Once the pH capsule is in place, suction is applied, drawing a small amount of esophageal tissue into the capsule and locking it in place. The delivery system is then withdrawn and the pH capsule can begin measuring pH levels.

Study and Research

The study enrolled 23 consecutive patients who had symptoms suggestive of reflux but who previously had shown normal acid exposure and negative symptom association when evaluated with traditional, catheter-based pH monitoring systems. Researchers used standard esophageal acid measurements to analyze total reflux, upright reflux and supine reflux. Acid exposure over 24 hours was the primary outcome of the study. Key findings included:

- More than 1 in 4 patients with a negative pH catheter study had pathological acid exposure during a 48-hour period of wireless pH monitoring.

- Nearly one in two patients had at least one day of pathological exposure during a 96-hour period of wireless pH monitoring (total, upright or supine).

- Prolonged monitoring also increased the number of patients with a significant association between reflux episodes and symptoms.

- Follow-up showed that 6 of 7 patients with positive findings (acid exposure or symptom association) did well after anti-reflux surgery; whereas 6 of 7 patients with entirely negative findings failed to respond to medical therapy.

Researchers indicated that it is unclear as to whether average pH measurement or the single-worst-day measurement is more clinically relevant, noting that either approach increased the diagnostic yield in this study.

Source:
- esophyxny.com

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Acid Reflux Diets - What to Avoid?

Acid Reflux Diets- It's all about what to Avoid

What To Avoid: Why To Avoid it: Natural supplement to stop the problem Fried Food Hard to Digest/Acidic Digestin/BufferpH+ Whole Milk or milk based cooking Hard to digest Digestin Vegetable Oil or Lard Hard to Digest/Acidic Buffer pH+ Chocolate or Sweets Stimulant/Relaxes the flap Acidic Buffer pH+ Fast Food Restaurants Hard to Digest/Acidic Buffer pH+ Spicy Foods Acidic Buffer pH+ Citrus, Tomato or Acidic Foods Acidic Buffer pH+ High Fat Content Foods Hard to Digest/Acidic Digestin/BufferpH+ Alcohol and Regular Coffee and carbonated drinks like soda Stimulant/Relaxes the flap Acidic Buffer pH+ Things that cause gas-beans, broccoli Causes Belching and damage to the flap Digestin Smoking Stimulant/Relaxes the flap Acidic Buffer pH+

These truly amazing formulas safely helped improve the way my body digested food and reduced the stomach acid to stop the reflux cold.
About Digestin About Buffer pH+

from : Acid Reflux Relief

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Acid Reflux Natural Remedies Treatment

We recommend that you increase your intake of water, to around 2 litres a day, helping to normalise the pH in your stomach, (your urine should always be a pale yellow).

Other natural remedies treatment :

1. Primebiotic. Will help many people move towards a more normal stomach flora. Primebiotic contains the highest quality, nutrient dense, green superfoods, pre-digested with 13 synergistic, live bacteria.
2. Liquorice Capsules. One of the better known folk uses of liquorice in Europe has been in the treatment of gastric ulcers, and gastric distress and acidity are often quickly relieved. Ayurvedic medicine recommend Liquorice as an excellent remedy for hyperacidity, and clinical tests prove that it is good for relieving pain, discomfort and other symptoms caused by acid matter in the stomach.
3. Alka-Vita. Just a few drops a day will help to alter the pH of the entire body to a more alkaline state. It quite remarkable that just 4 drops of Alka-Vita (Daily therapeutic dose 40 drops, maintenance dose 20 drops), will raise the pH of a glass of water to a highly alkaline pH, typically pH9.
4. Organic Silicon. For long term strengthening of the entire system, including the digestive apparatus.
5. Dietary Changes.

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Acid Reflux Symptoms | GERD (Gastroesophageal Reflux Disease) Symptoms

The pain of acid reflux is the result of the splashing up of fluids from the stomach into the esophagus. These stomach fluids are composed of hydrochloric acid (HCL), pepsin and occasionally bile from the liver. Stomach fluid helps break down the food we eat so that it can be digested. The hydrochloric acid in the stomach fluid helps prevent harmful bacteria from multiplying in the stomach and intestines.

The main symptoms of Acid Reflux are as follows:

A. Heartburn.

Heartburn is the primary symptom of Acid Reflux or GERD. It is a burning sensation that radiates up from the stomach to the chest and throat. Heartburn is most likely to occur in connection with the following activities:

• After a heavy meal.
• Bending over.
  
• Lifting.
• Lying down, particularly on the back.

B. Dyspepsia.

Up to half of GERD patients have dyspepsia, a syndrome consisting of the following:

• Pain and discomfort in the upper abdomen.
• Fullness in the stomach.
• Nausea after eating.

People can have dyspepsia without having GERD.

C. Acid Regurgitation.

Regurgitation is the feeling of acid backing up in the throat. Sometimes acid regurgitates as far as the mouth and be experienced as a "wet burp." Uncommonly, it may come out forcefully as vomit.

D. Pain in The Chest

Patients may have the sensation that food is trapped behind the breastbone. Chest pain is a common symptom of GERD. It is very important to differentiate it from chest pain caused by heart conditions, such as angina and heart attack.

E. Sore Throat.

Less commonly, GERD may produce symptoms that occur in the throat:

• Acid laryngitis. A condition that includes hoarseness, dry cough, the sensation of having a lump in the throat, and the need to repeatedly clear the throat.
• Trouble swallowing (dysphagia). In severe cases, patients may even choke or food may become trapped in the esophagus, causing severe chest pain. This may indicate a temporary spasm that narrows the tube, or it could also be an indication of serious esophageal damage or abnormalities.
• Chronic sore throat.
• Persistent hiccups.
  

F. Coughing and Respiratory Symptoms.

Asthmatic symptoms like coughing and wheezing may occur. In fact, in one study, GERD alone accounted for 41.1% of cases of chronic cough in nonsmoking patients. The incidence was even higher when GERD and asthma were combined.

G. Chronic Nausea and Vomiting.

Nausea that persists for weeks or even months and is not attributable to a common cause of stomach upset may be a symptom of acid reflux. In rare cases, vomiting can occur as often as once a day. All other causes of chronic nausea and vomiting should be ruled out, including ulcers, stomach cancer, obstruction, and pancreas or gallbladder disorders.

Nighttime GERD/acid reflux symptoms can be more severe than daytime symptoms.

When acid reflux occurs at night, you may experience the most common acid reflux symptoms such as heartburn and acid regurgitation and potentially other nighttime symptoms related to GERD such as:

• nighttime cough
• restlessness
• loss of sleep
• snoring
• breathlessness
• fatigue

For many patients, GERD symptoms that occur at night may be more severe than GERD symptoms that occur during the day. Wait at least 2-3 hours before going to bed after a meal to avoid aggravation of heartburn symptoms.

So know the symptoms of Acid Reflux detect them early and get them looked after.

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Acid Reflux Diagnosis | Diagnosing of GERD or Heartburn

The following is the diagnostic of Acid Reflux or GERD approach by a physician:

1. Taking a medical history
2. Considering a medical history
3. The Physical examination
4. Valuable information you should provide to your doctor
5. Clinical Presentation. When patients present with typical symptoms and no complications, the diagnosis of GERD is usually straightforward. The classic symptoms are heartburn and regurgitation, which may also include dysphagia.
6. Diagnostic tests that help. Blood and Stool Tests. Stool tests may show traces of blood that are not visible. Blood tests for anemia should be performed if bleeding is suspected.
7. Response to Omeprazole. A recent study demonstrated a potential role for a proton pump inhibitor, omeprazole (Prilosec), in the diagnosis of GERD.
8. Radiologic. Only one third of patients with GERD have radiologic signs of esophagitis. Findings include erosions and ulcerations, strictures, hiatal hernia, thickening of mucosal folds and poor distensibility.
9. Endoscopy. It is widely used in GERD, including for identifying and grading severe esophagitis, for periodic monitoring of patients with Barrett's esophagus or for screening people at high risk, or when other complications are suspected. It is also now employed as part of various surgical techniques.
10. Ambulatory pH Monitoring. Generally considered the diagnostic gold standard for use in patients with GERD. In this study, a pH monitor is placed in the esophagus above the lower esophageal sphincter, and the pH is recorded at given moments in time.
11. Manometry. Manometry is a technique that measures muscular pressure. As the muscular action of the esophagus exerts pressure on the tube in various locations, a computer connected to the tube measures it.

Other Diseases. Many gastrointestinal diseases (e.g., inflammatory bowel disease, ulcers, intestinal cancers) can cause GERD, but they are often easily identified, since they have other symptoms and affect other areas of the intestinal tract.

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What Causes Of Acid Reflux? | 10 Causes of GERD (Gastroesophageal Reflux Disease)

There are many causes of acid reflux. Understanding what they are can help you seek the appropriate treatment to the pain and discomfort that you are experiencing.

1. Eating habits - Eating large meals, eating soon before bedtime.
2. Lifestyle - Use of alcohol or cigarettes.
3. Diet- Fatty and fried foods, chocolate, garlic and onions, drinks with caffeine, acid foods such as citrus fruits and tomatoes, spicy foods, mint flavorings, delayed stomach emptying.
4. During Pregnancy - Increase pressures within the abdomen (body trunk), pushing the stomach contents back into the esophagus. Some patients have stomachs that empty their contents into the intestines very slowly.
5. Stress - stress is a major contributor to acid reflux disease.
6. Malfunction of the Lower Esophageal Sphincter (LES) Muscles
7. Impaired Stomach Function - The stomach muscles do not contract normally, which causes delays in stomach emptying, increasing the risk for acid back up.
8. Adult-ringed oesophagus- This condition is characterized by an esophagus with multiple rings and persistent trouble with swallowing (including getting food stuck in the esophagus). It occurs mostly in men.
9. Hiatal Hernia - This is where a small section of the stomach becomes trapped in a natural hole in the diaphragm. This process in itself is not one of the causes however it affects the lower oesophageal sphincter and results in it not being able to close completely. As mentioned above, this then leads to stomach acid making its way up the oesophagus and causing the damage associated with the condition.
10. Genetic Factors
    

• Asthma - At least half of asthmatic patients also have GERD. Some experts speculate that the coughing and sneezing accompanying asthmatic attacks cause changes in pressure in the chest that can trigger reflux.
• Eradication of Helicobacter Pylori - Helicobacter Pylori, also called H. pylori, is a bacterium found in the mucous membranes and is now known to be a major cause of peptic ulcers.
• Over-reactive Immune Response - The immune system reacts with an exaggerated (or hyper-reactive) response, triggering the release of certain factors that end up causing inflammation and possibly injury.
• Medication or drug that increase the risk of Acid Reflux - Nonsteroidal anti-inflammatory drugs (NSAIDs), including aspirin, ibuprofen (Motrin, Advil, Nuprin), and naproxen (Aleve) common causes of peptic ulcers, may also cause acid reflux and increase severity in people who already have GERD.

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What is Acid Reflux or GERD?

* When you eat or drink something, the food or liquid reaches your stomach by passing from your throat, behind your voice box, and then through a muscular tube called the esophagus to arrive in your stomach.
* Once the food reaches your stomach, your stomach puts out acid and pepsin (a digestive enzyme) to digest the food.
* Your esophagus has two sphincters (bands of muscle fibers that close off the tube) to help keep the digested food, acid, and pepsin where they belong.

1. The first sphincter is at the top of the esophagus at its junction with the upper throat just behind the larynx.
2. The second sphincter is at the bottom of the esophagus at its junction with the stomach. Normally this remains closed until the bolus of food and/or liquid reaches it. However, in many individuals including children, the muscle tone is poor. The sphincter remains open, allowing stomach contents to "reflux" up the esophagus and into the throat.
3. The refluxed stomach contents may even be aspirated into the trachea, bronchi, and lungs, causing further difficulties.There may also be a hiatal hernia associated with acid reflux. This is a condition in which part of the stomach slides up above the diaphragm into the chest. Not only do symptoms of reflux occur, but there may be pain around the lower part of the sternum.

What is GERD or LPR?

* Acid Reflux occurs when stomach contents pass up into the esophagus and sometimes into the throat. There are two types of reflux which may occur independently or together.

* GERD (Gastroesophageal Reflux Disease):
This occurs with an excessive amount of reflux of stomach acid up through the lower sphincter and into the esophagus. This is commonly associated with "heartburn", which occurs in almost 100% of patients with GERD.

* LPR (Laryngopharyngeal Reflux):
This occurs when reflux into the esophagus extends above the upper sphincter into the throat. The structures and tissues of the larynx (voice box), throat, trachea, bronchi, and lungs are more sensitive to stomach acid and digestive enzymes than the esophagus. It usually occurs without heartburn. Only 14% or less of the patients with this problem experience heartburn.

GERD occurs chiefly because of the following three reasons:

1. The esophagus's normal defenses are overwhelmed by the acid content of the stomach.
2. The contents of the stomach are too acidic .
3. The food is not cleared from the esophagus fast enough.

The Type of Acid Reflux:

1. When "refluxed" stomach acid touches the lining of the esophagus, it causes a burning sensation in the chest or throat called heartburn. Heartburn that occurs more than twice a week may be considered GERD
2. The fluid may even reach the back of the mouth, and this is called acid indigestion.

Long-term effects of acid reflux:

Acid reflux into the esophagus and throat may cause the following:

• Barrett's esophagitis
• Cancer of the esophagus
• Adult-onset asthma
• Possibly cancer of the larynx
  

resource : Dochazenfield

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