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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