Acid Reflux or GERD information,acid reflux causes, complications, gerd symptoms, acid reflux treatment, drug therapy, medication, nutrition, herbal treatment, and other information
The Best Home Remedy to keep Acid Reflux at bay is eating a healthy diet that minimizes the production of stomach acid.
However, if you treat GERD with natural remedies, you get a more permanent solution because they heal the damage caused by refluxed stomach acid and also help restore the esophageal tissues to health. By treating these underlying causes, natural remedies will not only relieve the pain, they will also assure that the condition does not return.
1. Drink a glass of Fat Free Milk.
Drinking small amounts of chilled skim milk every one to two hours will ease the burning sensation associated with acid reflux.
2. Drink water.
Drink plenty of water throughout the day, especially after eating a meal or snack. Water will help the lower esophageal sphincter form a tight seal over the stomach by washing any food particles away.
3. Chew almonds.
A few almonds, taken in the morning and/or after meals, chewed very well, have been hailed as the new miracle treatment for acid reflux by some people.
4. Chamomille or fennel tea.
The soothing effects of chamomile or fennel tea are also known to provide acid reflux relief. The tea should best be sipped, not gulped, and should be of a moderate temperature, not too hot or cold.
5. Eat an apple.
Eating an apple after a meal has also been found to alleviate acid reflux. Choose organic apples and chew well.
6. Candied ginger.
Chew a piece when you're feeling the acid reflux kick in. You can also put a piece of candied ginger in your tea and let it sit for a bit before drinking it if you don't like eating candied ginger.
7. Apple cider vinegar.
Swallow two to three table spoons undiluted for an acute attack, or dissolve the same amount in warm water to drink to prevent acid reflux from recurring.
Look for organic apple cider vinegar with the "mother" in it. It looks like stringy globs of stuff floating around. This sounds disgusting, but the mother contains enzymes that can help with healing. Bragg's Apple Cider Vinegar, available at natural food stores, is usually recommended.
Shake up the apple cider vinegar to distribute the mother throughout the vinegar, and take one tablespoon before every meal. It can work in as little as three days, but usually it takes three to nine months to completely get rid of heartburn symptoms.
8. Papaya enzyme.
Available in the form of papaya enzyme pills, this enzyme has helped end acid reflux symptoms for some people.
9. Aloe.
Despite its consistency which takes some getting used to, aloe juice also is some acid reflux patients favorite remedy.
Aloe vera juice has been used in Europe for many years as a natural remedy for acid reflux. A quarter cup taken about 20 minutes before eating will help to soothe an irritated, inflamed esophagus.
Don't try to squeeze the gel out of the leaves if you have an aloe vera plant, as it contains aloe latex, which is a powerful laxative. Buy only aloe vera juice or gel that specifically says it's for internal use. It can be found at natural food stores.
10. Chew gum.
After your meals, chew sugarless gum for 30 minutes. This stimulates saliva production which in turn like water that you drink dilutes the contents of your stomach and helps wash down anything from your esophagus into your stomach.
11. Licorice
Deglycyrrhizinated licorice, or DGL, helps to stop heartburn by stimulating the production of the protective mucus that lines the digestive tract. This helps to protect the esophagus from stomach acid. It also boosts the immune system and is a very strong anti-inflammatory.
Take two 250-milligram capsules before each meal. Instead of taking DGL with water, it's best to suck on the capsules and let them slowly dissolve in the mouth. This helps the DGL to cover the inflamed tissues in your throat and esophagus.
It can take about four weeks to work, so don't give up too soon.
12. Ginger
Ginger is a very effective herb for digestive problems. It works by relaxing the smooth muscles on the esophagus walls, which helps to prevent acid reflux. You can use powdered ginger or fresh ginger root. Both are readily available at the supermarket.
If you're using ginger capsules, take two capsules twenty minutes before eating. Or you can make tea from the ginger root or the powder. Candied or pickled ginger is very effective, too.
Ginger can be too strong for people with sensitive stomachs. In this case, try ginger tincture. Dissolve 15 drops in a half-cup of water and drink it. If it's not strong enough, you can increase the dose up to 60 drops, but it's always better to start with a smaller dose first.
13. Glutamine
The last on the list of natural remedies for acid reflux is glutamine. This amino acid is an anti-inflammatory that reduces the irritation that goes along with heartburn. It works by encouraging the production of new cells in the gastrointestinal tract, while helping to dispose of damaged cells. Faster healing of irritated tissue in the digestive tract is the result.
Drink herbal tea made with fennel seeds, lavender, and aniseed. To prepare the herbal tea, boil these ingredients in water, strain it into a glass, and add some honey to it.
Herbal tea is taken at night before going to sleep or at any time of the day to reduce acid reflux heartburn.
15. Honey
Swallow a few teaspoons of honey, especially before going to bed. Honey has been used as a healing agent for centuries. It coats the esophageal lining, protecting the damaged tissues from infection and soothing the pain.
16. Pineapples
Pineapple is an effective natural remedy for acid reflux (Sklar and Cohen, 2003). Pineapples contain an enzyme called bromelain among other proteases that are able to breakdown proteins, thus improving digestion and speeding up the natural healing process for acid reflux. Bromelain is only present in raw pineapple or in freshly made pineapple juice. Canned or bottled pineapple juice has bromelain that has been inactivated by heat, so it does not work. Actually, canned or bottle pineapple juice can make acid reflux worse.
17. Chicory Root Tea
Users of chicory root tea recognize it as an herbal remedy for acid reflux. Johnson (2001) mentions chicory as one of the effective herbal remedies against digestive problems such as dyspepsia. Half cup of chicory root should be boiled for 5 to 10 minutes. After cooling the tea is ingested to relieve acid reflux symptoms.
18. Grapefruit
Another natural remedy for acid reflux is grapefruit skin. Evidence of grapefruit skin as an herbal remedy is completely anecdotal so please use your judgment or ask your doctor. Grapefruit skin is dried and then chewed to alleviate acid reflux symptoms. Maybe the effect of this herbal remedy is due to the stimulation of the digestive system because of the chewing action. Organically grown grapefruits is preferable.
19. Lemon Balm
This herb has the homeopathic power to relax and sedate a nervous stomach when used as an infusion or tincture.
20. Peppermint
A nervous stomach and nausea can be treated when you add 15 grams of dried peppermint to 2 cups of water to create an effective infusion recipe. New mothers should refrain from this approach when breastfeeding because this remedy has been known to reduce milk flow.
When looking for ways to treat GERD permanently, the most important thing you can do is learn. You need to learn what is happening to your body and how your digestive tract works. By learning these things, you will have a much better chance of successfully treating this disease.
Q53PBFQRSZ62 Gastroesophageal reflux disease occurs in up to 50% of pregnant women. Many women experience heartburn for the first time during pregnancy — and though it's common and generally harmless, it can be quite uncomfortable.
Heartburn (also called acid indigestion or acid reflux) is a burning sensation that often extends from the bottom of the breastbone to the lower throat. It's caused by some of the hormonal and physical changes in your body.
During pregnancy, the placenta produces the hormone progesterone, which relaxes the smooth muscles of the uterus. This hormone also relaxes the valve that separates the esophagus from the stomach, allowing gastric acids to seep back up, which causes that unpleasant burning sensation. Additionally, the growing fetus causes an increase in intra-abdominal pressure, resulting in an increase in the development of reflux.
Progesterone also slows down the wavelike contractions of your esophagus and intestines, making digestion sluggish. Later in pregnancy, your growing baby crowds your abdominal cavity, pushing the stomach acids back up into the esophagus.
Many women start experiencing heartburn and other gastrointestinal discomforts in the second half of pregnancy. Unfortunately, it usually comes and goes until your baby is born.
It can be tough when you get pregnant. Acid reflux during pregnancy can be one problem that you will have to take care of. The discomforts are common when you are pregnant and some time you may even get pain. You can not use medicine since you are now pregnant. Most of medicines are not tested to the pregnant ladies to prove their safety. They can not do that. You have to bear in mind that using medicines is not safe.
What Causes Acid Reflux During Pregnancy?
Acid reflux during pregnancy can make it difficult for you to get the nutrition you need for yourself and your growing baby. The causes of acid reflux during pregnancy include changes in your hormone levels, the position of your internal organs and your dietary habits. What causes acid reflux during pregnancy.
Prenatal Vitamins. Taking prenatal vitamins may irritate your throat and stomach and cause you to have acid reflux.
Hormones. Heartburn during pregnancy occurs for a number of reasons. Increased levels of hormones in your body while pregnant can soften the ligaments that normally keep the lower esophageal sphincter (LES) tightly closed. If the LES relaxes at inappropriate times, food and stomach acids can reflux back up into your esophagus and throat. Also more pressure is put on your stomach as your body changes and your baby grows. This, in turn, can force stomach contents through the LES and into your esophagus.
Foods. Your food cravings during pregnancy may cause acid reflux, especially if you eat greasy, fatty or spicy foods.
Caffeine. Although you may not be drinking coffee while pregnant, the caffeine in chocolate, hot cocoa and black tea may cause you to have acid reflux.
Eating Too Much. During pregnancy, the capacity of your stomach is smaller and acid reflux may result from eating too much at once.
Fetal Position. The position of your baby may trigger your acid reflux, especially once your baby turns head down and the feet push into your ribs.
Uterine Growth. As your uterus gets larger in the last few months of pregnancy, it pushes your other internal organs into a smaller amount of space, resulting in acid reflux.
How to prevent or Treat Acid Reflux during Pregnancy?
What can be done to prevent or treat gastroesophageal reflux disease in pregnancy? Lifestyle modifications can prevent increases in intra-abdominal pressure and decreases in lower esophageal sphincter pressure that promote reflux. Here's a list of both ways to prevent and treat gastroesophageal reflux in pregnancy. Though you may not be able to eliminate heartburn completely, you can take some steps to minimize your discomfort.
Don't eat foods that are known heartburn triggers. These include chocolate, citrus fruits and juices, tomatoes and tomato-based products, mustard, vinegar, mint products, and spicy, highly seasoned, fried, and fatty foods. For a complete list of foods to avoid, check out this chart. For foods that have a low risk of causing heartburn, check out this chart.
Avoiding caffeine (coffee, tea, cola), chocolate and peppermints. These food groups all lead to a decrease in lower esophageal sphincter pressure.
Avoid alcohol. Alcohol relaxes the LES. Read the article on alcohol and heartburn for more information.
Chewing gum. This increases saliva production and swallowing frequency, which can help clear away acid that has refluxed from the stomach into the esophagus. A clear reduction in acidic esophageal reflux has been documented in patients who chewed sugar-free gum for 30 minutes after a meal.
Avoid drinking large quantities of fluids during meals — you don't want to distend your stomach. (It's important to drink eight to ten glasses of water daily during pregnancy, but sip it between meals.)
Eating frequent, small meals. Eating smaller meals empties the stomach more rapidly. Eating more frequently increases stomach contractions. If the stomach is contracting and empty this will decrease the incidence of reflux. After meals, pregnant women are not supposed to lie down.
Don't eat close to bedtime. Give yourself two to three hours to digest before you lie down.
Don't rush through your meals. Take your time eating, and chew thoroughly.
Wait at least three hours after your last meal before going to bed.
It's important to drink plenty of water during pregnancy (8-10 glasses daily) along with other fluids, but don't drink these only at mealtimes. Large quantities of fluids can distend your stomach, putting more pressure on the LES and forcing it to open inappropriately. Drink some of your fluids in between meals.
You need to make your head higher than your body. Use the wedge pillow or elevate the head of your bed 6-8 inches higher. This means the two feet of your upper part must be elevated while sleeping. This will allow gravity to work for you and it will help keep your stomach acids where they should be--in your stomach and not in your esophagus. Acid reflux during pregnacy can be greatly reduced by the right sleeping position in the pregnant women. Studies have documented that, as compared with patients who sleep flat on their backs, patients who elevate the head of the bed have significantly fewer reflux episodes, and when they do, the episodes that do occur are shorter and produce generally milder symptoms.
Occasionally, reclining chair may be needed if you want a day nap.
Wear loose, comfortable clothing. You need to avoid any tightness around your waist and stomach.
Bend at the knees instead of at the waist. Bending at the waist puts more pressure on your stomach.
Lying on one's left side at night. Sleeping on the left side as opposed to the right side may reduce the frequency and duration of reflux episodes in patients prone to symptoms during the night. It is felt that there are more frequent episodes of decreases in lower esophageal sphincter pressure when patients lie on the left side as opposed to the right side.
Gain a sensible amount of weight and stay within the guidelines your doctor suggests. Too much of a weight, and obesity, puts more pressure on your stomach, and can force stomach contents through the LES and into your esophagus.
Don't smoke. While your doctor may urge you break the habit because you're pregnant, smoking can also increase your odds of experiencing heartburn. Read about smoking and heartburn to find out the reasons smoking increases heartburn.
You should always check with your doctor before taking any over-the-counter remedies while pregnant, but there are a few choices you have that can help eliminate heartburn.
You can try Rolaids, Maalox or Tums. However, anything that contains sodium bicarbonate can cause fluid retention and should only be used under the supervision of a physician. During the third trimester, any antacid that contains magnesium should be avoided because they have been known to interfere with contractions.
Antacids such as Mylanta and Maalox are effective and very safe as they are not absorbed into the bloodstream.
H2 blockers Zantac, Pepcid and Tagamet are effective. These medicines include Pepcid AC and Zantac. While they are absorbed into the bloodstream, studies have not revealed any adverse effects on the developing fetus. H2 receptors work by shutting off the production of acid in the stomach and are effective in cases of mild reflux. H2 receptors: They are relatively inexpensive and provide longer-lasting relief than antacids. Women take them a half-hour before meals or at bedtime.
Proton pump inhibitors Nexium, Aciphex and Prevacid should be used only in severe cases that are not responsive to H2 blockers. While they are felt to be safe, there are no long-term studies available confirming this.
In most cases, acid reflux is easily treated, even in pregnancy. If there are however, more refractory symptoms that result in complications such as gastrointestinal bleeding, difficulty swallowing or weight loss, your obstetrician may refer you to a gastroenterologist. Other conditions such as gallbladder disease, pancreatitis or even cancers of the esophagus and stomach can mimic gastroesophageal reflux disease.
Beware of:
* Tomatoes and Related Sauces (Pizza, Spaghetti, etc.)
* Ketchup
* Mustard
* Horseradish
* Salad Dressings
* Vinegar
* Fried Foods
* Caffeine
* Coffee and Tea (Even decaffeinated products can instigate acid production).
* Chocolate
* Citrus Juices/Foods
* Caffeine
* Products flavored with peppermint (candy, cocoa, etc.)
* Processed Meats
* Cream Sauces (Alfredo)
* Alcohol and Tobacco (Of Course)
Pregnancy is something to be celebrated but it can also be an overwhelming state. If you arm yourself with these remedies for acid reflux during pregnancy you’ll be prepared regardless of what Mother Nature throws your way.
Remember that an increased incidence of GERD episodes during pregnancy is quite common and there are many preventative measures that you can take to avoid those annoying and painful occurrences. The changes may seem small but, collectively, they will make a big difference.
Reflux Medications Taken During Pregnancy Linked to Asthma in Children By : Jan Gambino
A new study indicates that moms who took reflux medications during pregnancy may increase the risk of having a child with asthma symptoms. The study, presented at the American Academy of Allergy, Asthma and Immunology this week examined the health records of 30,000 children. It was found that mothers who took prescription reflux medications such as H2 blockers (Zantac, Axid, Pepcid, and Tagament) and Proton Pump Inhibitors (PPI's) such as Nexium, Prevacid, Prilosec, and Aciphex were significantly more likely (51%) to have a child with asthma symptoms such as wheezing. The study did not look at the effect of taking over the counter antacid medications.
It is estimated that approximately half of all pregnant mothers experience reflux symptoms during pregnancy. However, my own survey of moms indicates that the statistic is closer to 100%! My small frame combined with over sized babies gave me my first real experience with what heartburn and reflux felt like. I remember eating like a bird and propping up my pillows at night so I could sleep. Along with stretch marks and hormone swings, I accepted heartburn as part of the package deal.
Sources:
- "Healthy Pregnancy - Pregnancy - Pregnancy Basics." U.S. Department of Health & Human Services. 21 Jan 2007
- "Heartburn, Hiatal Hernia, and Gastroesophageal Reflux Disease (GERD)." NIH Publication No. 030882 June 2003. NIH Publication No. 030882 June 2003. National Digestive Diseases Information Clearinghouse (NDDIC). 21 Jan 2007
GInfants are being diagnosed and treated for reflux at an alarming rate these days. Prior to, or in addition to medicating your baby you may want to try some alternative treatments for infant reflux.
Positioning as an alternative treatment for infant reflux
Positioning is one alternative treatment that even Western Medicine recognizes. When feeding, the baby should be as upright as possible with a straight spine. Ideally the baby should be in this position for 30-60 minutes after feeding and while sleeping. Find out about reflux wedges that make this an easy task. We especially love the feeding and sleeping wedge combination. During the middle of the night feed the baby upright on a feeding wedge and then put him on a sleeping wedge. You go right back to sleep rather than holding him upright for 60 minutes!
Infant massage as an alternative treatment for infant reflux
In addition to general relaxation, it is believed that massage stimulates the vagus nerve. The vagus nerve increases peristalsis which assists in digestion. Seek a certified Infant Massage Instructor. When practicing massage, be sure to start slowly and listen to your baby. Never attempt to massage a baby without first referring to a book on infant massage. This is also a great way to calm a baby with infant reflux.
Craniosacral or Chiropractor visits as an alternative treatment for infant reflux
It is believed that the process of being carried in the womb or the process of birth (namely C-section or very quick vaginal delivery) can cause imbalances in the central nervous system. Craniosacral treatments are very light fingertip adjustments that correct restrictions in the membranes surrounding the brain and spinal cords. Chiropractor adjustments on infants are also very gentle adjustments on certain parts of the spine typically using a single fingertip or small tool to correct the vertebras positioning and allow the nerve pathways to function efficiently. I have heard of these treatments working with great success for some and with limited to no success for others. We saw moderate improvement in my son's infant reflux.
Slippery Elm as an alternative treatment for infant reflux
Slippery Elm has been used in traditional Chinese medicine as a treatment for gastrointestinal symptoms. It works by coating and soothing the gastrointestinal tract and throat. The theory is that this helps prevent burning that stomach acid can cause. The powder can be brewed into a tea and the capsules can be mixed in with applesauce once your baby begins to eat solids. See www.ajc.com for dosing guidelines and more background information. Because it is so mucilaginous it should not be offered at the same time as other medications. I used this with my son and believe it to be helpful. Please note this will not affect the frequency or amount your baby spits up but it helps to make him more comfortable when it does happen, much like an antacid or an H2RA.
Other alternative treatment mentions
I have heard of the following alternative treatments for infant reflux, although I have no experience with them:
Infant acid reflux occurs when acids and other materials in the stomach flow back into the esophagus. The esophagus is a muscular tube that connects the throat with the stomach. Normally, the esophagus contracts to move food from the throat into the stomach. A tough rim of muscle, called the esophageal sphincter, opens to allow food out of the esophagus, and then contracts tightly to prevent it from re-entering the esophagus. In infant acid reflux, the esophageal sphincter does not work properly, and the acid flows backwards into the esophagus, causing the infant discomfort. Acid reflux is not at all uncommon in infants--up to have of all babies may experience it occasionally.
Most of these babies are healthy and require no special medical intervention. Symptoms of occasional infant acid reflux may include spitting or vomiting, coughing, occasional fussiness or crying after eating (acid reflux can cause an unpleasant burning sensation in the chest and throat), and reluctance to feed due to discomfort.
What Are the Symptoms of Acid Reflux in Infants and Children?
The most common symptoms are:
Frequent or recurrent vomiting
Heartburn, gas, abdominal pain, or colicky behavior (frequent crying and fussiness)
Regurgitation and re-swallowing
Spitting up or gulping with a painful look on the face, as if heartburn
Irritability during or after feedings
Projectile vomit, sometimes out the nose
Sour breath
Persistent hiccups or cough
Excessive fussiness, crying or colic
Sudden bursts of painful crying
Poor day and/or nighttime sleep habits
Constantly wants to nurse or refuses to nurse
Poor feeding habits - arches back, pulls up legs, stiffens or screams while feeding or refuses to eat while still hungry
Prefers upright or inclined positions
Always wants to be held
In young infants and children, some problems may be associated with GERD and include:
Colic (frequent crying and fussiness)
Feeding problems
Recurrent choking or gagging
Poor growth
Breathing problems
Recurrent wheezing
Recurrent pneumonia
When to see a doctor?
Normal infant acid reflux doesn't interfere with a baby's growth or well-being. Contact your baby's doctor if your baby:
Isn't gaining weight
Spits up forcefully, causing stomach contents to shoot out of his or her mouth
Spits up more than a tablespoon or two at a time
Spits up green or brown fluid
Resists feedings
Is irritable after feedings but improves when held upright
Has fewer wet diapers than normal or appears lethargic
Has other signs of illness, such as fever, diarrhea or difficulty breathing
Some of these signs may indicate more serious conditions, such as gastroesophageal reflux disease (GERD) or pyloric stenosis. GERD is a severe version of reflux that can cause pain, vomiting and poor weight gain. Pyloric stenosis is a rare condition in which a narrowed valve between the stomach and the small intestine prevents stomach contents from emptying into the small intestine.
What causes Acid Reflux in infants ?
Reflux in infants is due to a poorly coordinated gastrointestinal tract. Many infants with the condition are otherwise healthy; however, some infants can have problems affecting their nerves, brain or muscles.
Normally, the ring of muscle between the esophagus and the stomach (lower esophageal sphincter) relaxes and opens only when you swallow. Otherwise, it's tightly closed — keeping stomach contents where they belong. Until this muscle matures, stomach contents may occasionally flow up the esophagus and out of your baby's mouth. Sometimes air bubbles in the esophagus may push liquid out of your baby's mouth. In other cases, your baby may simply drink too much, too fast.
Tests and Diagnosis
Diagnosis of infant acid reflux is typically based on your baby's symptoms and a physical exam. If your baby is healthy, content and growing well, tests and treatment aren't usually needed.
If your baby's doctor suspects a more serious condition, such as GERD, diagnostic tests may include:
Lab tests. Your baby's doctor may do various blood and urine tests to identify or rule out possible causes of recurring vomiting and poor weight gain.
Esophageal pH monitoring. To determine if irritability, sleep disturbances or other symptoms are associated with reflux, it may be helpful to measure the acidity in your baby's esophagus. The doctor will insert a thin tube through your baby's nose or mouth into the esophagus. The tube is attached to a device that monitors acidity. Your baby may need to remain in the hospital for the monitoring, which often lasts 24 hours.
Barium swallow or Upper GI series. If the doctor suspects a gastrointestinal obstruction, he or she may recommend a series of X-rays known as an upper gastrointestinal (GI) series. Before the X-rays, your baby may drink a white, chalky liquid (barium). The barium coats the stomach, which helps any abnormalities show up more clearly on the X-rays.
Upper GI Endoscopy. Your baby's doctor may use this procedure to identify or rule out problems in the esophagus, such as narrowing (stricture) or inflammation (esophagitis). The doctor will insert a special tube equipped with a camera lens and light through your baby's mouth into the esophagus, stomach and first part of the small intestine. Samples of any suspicious areas may be taken for analysis. For infants and children, endoscopy is usually done under general anesthesia.
Gastric emptying study. During this test, the child drinks milk or eats food mixed with a safe radioactive chemical. This chemical is followed through the gastrointestinal tract using a special camera.
Treatments and drugs for Infant Acid Reflux
Most cases of infant acid reflux clear up on their own. Treatment is typically limited to simple changes in feeding technique — such as smaller, more frequent feedings, interrupting feedings to burp or holding your baby upright during feedings. If you're breast-feeding, your baby's doctor may suggest that you avoid cow's milk or certain other foods. If you feed your baby formula, sometimes switching brands helps.
For babies who have severe infant acid reflux or GERD, more aggressive treatment may be recommended.
Medication. If your baby is uncomfortable, the doctor may prescribe infant doses of medications commonly used to treat heartburn in adults. The two major pharmacotherapies are H2-blockers and proton pump inhibitors (PPIs), both of which are effective in decreasing acid secretion and have been used safely in children. H2-blockers include cimetidine (Tagamet), ranitidine (Zantac), famotidine (Pepcid) and nizatidine (Axid). PPIs include omeprazole (Prilosec), lansoprazole (Prevacid), pantoprazole (Protonix) or rabeprazole (Aciphex). Another group of drugs, prokinetics, can be prescribed to increase motility. These are usually given with medications that inhibit the acid. Examples are metaclopramide (Reglan) and cisapride (Propulsid). Antacids may be tried first in children with mild symptoms.
Alternative feeding methods. If your baby isn't growing well, higher calorie feedings or a feeding tube may be recommended.
Surgery. Rarely, the muscle that relaxes to let food into the stomach (the lower esophageal sphincter) must be surgically tightened so that less acid is likely to flow back into the esophagus. The procedure, known as fundoplication, is usually reserved for the few babies who have reflux severe enough to interfere with breathing or prevent growth. Although surgery can reduce GERD symptoms, the complications are potentially serious — including persistent gagging during feedings.
Everybody has gas in his or her digestive tract (the esophagus, stomach, small intestine/bowel, and large intestine/bowel). The amount of gas varies and there is a wide range of normal (7-14 Tbsp. or 100-200 ml). What this gas is made up of and how it is distributed through the intestines are determined by how it is produced, how it moves through various areas of the bowel, and how it is eliminated
Intestinal gas can occur in the stomach and upper intestine if you swallow air while eating, drinking or chewing gum. Intestinal gas related to swallowed air is usually passed by burping or belching.
Intestinal gas can also form in the lower, or large, intestine (colon) as a normal byproduct of the bacterial breakdown of undigested food. Intestinal gas related to bacterial action is made up of hydrogen, carbon dioxide and sometimes methane, and is usually passed through your rectum (flatulence).
Most people pass gas rectally several times a day as a normal part of daily activities and food breakdown. Sometimes, excessive intestinal gas can indicate a digestive disorder.
But what causes these noisy, embarrassing, and sometimes foul-smelling eruptions? And is there a way to prevent them? There are several ways by which gas enters the body or is produced by it, and several ways that the body can dispose of it.
Gas enters the digestive tract through:
1. Swallowing of air. People swallow air to varying extents. We get rid of some of the swallowed air by belching. The rest is passed into the intestines. You can increase the chances of swallowing air by: * Smoking * Chewing gum * Drinking through a straw * Sucking on hard candies * Drinking a lot of carbonated beverages * Eating or drinking too quickly * Wearing loose dentures
2. Back-passage of gas from the blood stream into the intestines.
3. The production of gas through chemical reactions within the intestines.
4. As a by-product of the fermentation of food by intestinal bacteria.
5. Foods. What Foods Cause Gas? The foods that are likely to cause gas are carbohydrates. This is because carbohydrates pass through the gastrointestinal tract mostly undigested. When carbohydrates enter the colon they are further broken down by bacterial fermentation. This fermentation can generate gas. The processing of fats and proteins cause little gas.
The following foods are likely to cause gas:
* Starches: Starch is a carbohydrate. Starches such as potatoes, corn,noodles, and wheat all produce gas.
* Dietary Fiber: Fiber is a complex carbohydrate present in edible plants. Though fiber can temporarily cause gas, fiber is important for stoolproduction and regularity. Dietary fiber is divided into two types: Insoluble and Soluble.
Insoluble Fiber: Insoluble fiber is found in fruit and vegetable peels, corn, and wheat bran. Insoluble fiber swells up with fluids and helps to create volume and moisture in the stools. However, since it is not further broken down by bacteria it produces little gas.
Soluble Fiber: Soluble fiber is found in the flesh of fruits and vegetables, seeds, legumes, oats, some grains and can be found in high concentrations in dried fruit. Bacteria is able to break soluble fiber down into a gel that helps to make stools moist, soft and flexible. This bacterial activity can generate gas.
* Sugars: Sugar is a carbohydrate. Sugar can cause gas. The sugars that cause gas are raffinose, lactose, fructose, and sorbitol. Sources of these sugars are:
Raffinose: Raffinose is a complex carbohydrate. It can be found in beans, cabbage, brussels sprouts, broccoli, asparagus, other vegetables, and whole grains.
Lactose: Lactose is the natural sugar in milk and milk products such as cheese and ice cream. It is also found in many processed foods, such as bread, cereal, and salad dressing. Some people have low levels of the enzyme lactase that is needed in order to digest lactose. This can result in gas. With age, enzyme levels may decrease. As a result, some people may experience increasing amounts of gas after eating foods containing lactose.
Fructose: Fructose is a natural sugar present in onions, artichokes,pears, grapes and wheat. It is also used as a sweetener in some soft drinks and fruit drinks.
Sorbitol: Sorbitol is a natural sugar found in fruits, such as apples, pears, peaches, and prunes. Sorbitol is also used as an artificial sweetener in many of the diet industry foods. It can also be found in “sugar free” candy and gum.
Excessive production of gas
Excessive production of gas by bacteria is a common cause of intermittent abdominal bloating/distention. Bacteria can produce too much gas in three ways:
First, the amount of gas that bacteria produce varies from individual to individual. In other words, some individuals may have bacteria that produce more gas, either because there are more of the bacteria or because their particular bacteria are better at producing gas.
Second, there may be poor digestion and absorption of foods in the small intestine, allowing more undigested food to reach the bacteria in the colon. The more undigested food the bacteria have, the more gas they produce. Examples of diseases of that involve poor digestion and absorption include lactose intolerance, pancreatic insufficiency, and celiac disease.
Third, bacterial overgrowth can occur in the small intestine. Under normal conditions, the bacteria that produce gas are limited to the colon. In some medical conditions, these bacteria spread into the small intestine. When this bacterial spread occurs, food reaches the bacteria before it can be fully digested and absorbed by the small intestine. Therefore, the bacteria in the small intestine have a lot of undigested food from which to form gas. This condition in which the gas-producing bacteria move into the small intestine is called bacterial overgrowth of the small intestine (bowel)
Excessive production of gas by bacteria is usually accompanied by more flatulence. Increased flatulence may not always occur, however, since gas potentially can be eliminated in other ways-absorption into the body, utilization by other bacteria, or possibly, by elimination at night without the knowledge of the gas-passer.
Digestive Disorders That Cause Gas
Excessive intestinal gas — belching or flatulence more than 20 times a day — sometimes indicates a digestive disorder such as:
Everyone has to contend with some belching and intestinal gas every day.
But if it's really bothering you, or if you feel that the amount of gas you're producing is excessive, there are some steps you can take. There are a few things you can try which may help to reduce digestive gas:
Avoiding anything that might increase your chances of swallowing air, such as smoking, drinking through straws, and eating too quickly.
Avoiding or cutting down on problematic foods, such as carbonated drinks, beans, and some raw vegetables.
Considering a food diary. If you can't figure out what may be causing your increased gas, try keeping a journal of what you eat. You may find one or two foods that seem to increase your symptoms.
Try cutting back on fried and fatty foods. Often, bloating results from eating fatty foods. Fat delays stomach emptying and can increase the sensation of fullness.
Increase Bacterial Populations. Buttermilk, kefir, yogurt, and Pro-biotic supplements that contain live bacteria can help to increase healthy bacteria in the colon.
Eat Slowly. Eating slowly and chewing your food well can help to cut down on the amount of air that you may swallow.
Increase fluid intake. Fluids are the basis of mucus that helps to moisturize the colon lining. This helps promote healthy bacterial growth. Caution: Drinking a lot of fluid quickly in a very shot period of time can cause painful stomach gas.
Try a cup of peppermint tea. Peppermint oil contains menthol, which appears to have an antispasmodic effect on the smooth muscles of your digestive tract. You may find that a warm cup of peppermint tea can provide relief from gas and gas pain. On the other hand, peppermint may contribute to heartburn and acid reflux
Exercise. Movement, even walking, can help your body to release trapped gases.
Massage. Gentle abdominal massage can help to reduce painful trapped gas.
Medicines are available to help reduce symptoms, including antacids with simethicone and activated charcoal. Antacids, such as Mylanta II, Maalox II, and Di-Gel, contain simethicone, a foaming agent that joins gas bubbles in the stomach so that gas is more easily belched away.
Consult a Doctor. Talk to your doctor if you are having persistent problems with gas, or if you have excessive gas production.
What The Symptoms of Gastrointestinal Gas?
The most common symptoms of gas are:
Belching.
Bloating
Flatulence. Passing out through the anus (flatus).
Abdominal Pain
Excessive or foul-smelling air
Difficult gas evacuation
Belching
Belching, also known as burping, is the act of expelling gas from the stomach out through the mouth. The usual cause of belching is a distended (inflated) stomach caused by swallowed air. The distention of the stomach causes abdominal discomfort, and the belching expels the air and relieves the discomfort. The common reasons for swallowing large amounts of air (aerophagia) are gulping food or drink too rapidly, anxiety, and carbonated beverages. People are often unaware that they are s wallowing air. "Burping" infants during bottle or breast feeding is important in order to expel air in the stomach that has been swallowed with the formula or milk.
Excessive belching is a common gas related complaint that doctors see. Patients who belch a lot accidentally swallow air that gathers in the stomach, and is then released by belching. Often, belching is triggered by an uncomfortable feeling of fullness in the upper abdomen that patients mistake as excessive gas in the stomach. During repeated but ineffective attempts at belching, air is actually drawn into the stomach with increasing discomfort, although some relief may be felt when belching finally does occur. In most of the cases a clear explanation can resolve the problem. The solution is to avoid intentional belching, thereby preventing additional air swallowing. If the upper abdominal discomfort persists, another problem may be present that a doctor will need to diagnose and treat.
Bloating
It is important to distinguish between bloating and distention. Bloating is the subjective sensation (feeling) that the abdomen is larger than normal. Thus, bloating is a symptom akin to the symptom of discomfort. In contrast, distention is the objective determination (physical finding) that the abdomen is actually larger than normal. Distention can be determined by such observations as the inability to fit into clothes or looking down at the stomach and noting that it is clearly larger than normal. In some instances, bloating may represent a mild form of distention since the abdomen does not become physically (visibly or measurably) enlarged until its volume increases by one quart. Nevertheless, bloating should never be assumed to be the same as distention.
There are three ways in which abdominal distention can arise. The causes are an increase in air, fluid, or tissue within the abdomen. The diseases or conditions that cause an increase of any of these three factors are very different from one anther. Therefore, it is important to determine which of them is distending the abdomen.
Flatulence
Flatulence, also known as farting, is the act of passing intestinal gas from the anus. Gas in the gastrointestinal tract has only two sources. It is either swallowed air or it is produced by bacteria that normally inhabit the intestines, primarily the colon. Swallowed air is rarely the cause of excessive flatulence. The usual source is the production of excessive gas by intestinal bacteria. The bacteria produce the gas (hydrogen and/or methane) when they digest foods, primarily sugars and polysaccharides (e.g., starch, cellulose), that have not been digested during passage through the small intestine. Sugars that are commonly poorly digested (maldigested) and malabsorbed are lactose, sorbitol, and fructose. Lactose is the sugar in milk. The absence of the enzyme lactase in the lining of the intestines, which is a genetic trait, causes the maldigestion. Lactase is important because it breaks apart the lactose so that it can be absorbed. Sorbitol is a commonly used sweetener in low calorie foods. Fructose is a commonly used sweetener in all types of candies and drinks.
Starches are another common source of intestinal gas. Starches are polysaccharides that are produced by plants and are composed of long chains of sugars. Common sources of different types of starch include wheat, oats, potatoes, corn, and rice. Rice is the most easily digested starch and little undigested rice starch reaches the colon and the colonic bacteria. Accordingly, the consumption of rice produces little gas. In contrast, the starches in wheat, oats, potatoes, and, to a lesser extent, corn, all reach the colon and the bacteria in substantial amounts. These starches, therefore, result in the production of appreciable amounts of gas.
The starch in whole grains produces more gas than the starch in refined (purified) grains. Thus, more gas is formed after eating foods made with whole wheat flour than with refined wheat flour. This difference in gas production probably occurs because the fiber present in the whole grain flour slows the digestion of starch as it travels through the small intestine. Much of this fiber is removed during the processing of whole grains into refined flour. Finally, certain fruits and vegetables, for example, cabbage, also contain poorly digested starches that reach the colon and result in the formation of gas.
Most vegetables and fruits contain cellulose, another type of polysaccharide that is not digested at all as it passes through the small intestine. However, unlike sugars and other starches, cellulose is used only very slowly by colonic bacteria. Therefore, the production of gas after the consumption of fruits and vegetables usually is not great unless the fruits and vegetables also contain sugars or polysaccharides other than cellulose.
Too much and/or foul-smelling gas -
Some patients complain of bad smelling air, which may become socially disabling. Odor stems from the presence of small quantities of sulfide substances that are produced by specific bacteria in the colon. Other patients complain of too much passage of gas through the anus. The frequency of anal gas evacuation in healthy subjects varies depending on the diet, but is usually around twenty times per day. There are parts in the normal diet that are not completely absorbed in the small bowel and are fermented in the colon. These tend to increase gas production and include:
* Fermentable dietary fiber. * Dietary starch. * Complex carbohydrates, that appear to be the most important source of gas, in beans. * Sugars such as sorbitol and fructose.
Furthermore some substances contained in beans block the intestinal enzyme that normally digests starch so that starch cannot be absorbed in the small bowel and passes into the colon, where it is fermented increasing gas production.
Some diseases, which are easily recognizable by a doctor, affect the normal absorption of nutrients within the small bowel. Patients with these usually treatable diseases may have excessive gas production and evacuation. Regardless of the cause, those with increased gas production and evacuation do not complain of abdominal symptoms unless they have associated irritable bowel syndrome (IBS), because healthy subjects handle most gas loads without difficulty or symptoms.
Abdominal pain and discomfort
Some people have pain when gas is present in the intestine. When pain is on the left side of the colon, it can be confused with heart disease. When the pain is on the right side of the colon, it may mimic gallstones or appendicitis.
Difficult gas evacuation
While some patients have excess gas, others find gas difficult to get rid of. The process of gas evacuation requires effective muscle-nerve coordination, which not everybody has. Lack of coordination may also produce constipation with retention of stool. In some patients these problems can be resolved by biofeedback treatment. When normal coordination is restored there is also less retention of stool, which in turn leads to reduced fermentation time and reduced gas production. Abdominal gas symptoms in IBS and related syndromes
Patients with functional GI disorders such as IBS frequently attribute their abdominal symptoms to gas. Bloating, for instance, where the abdomen feels distended and full, is one the most common and bothersome complaints in many patients with functional GI disorders. These patients usually feel gas as the cause of their symptoms, but there is little experimental evidence to support this feeling.
How To Treatment Gastrointestinal Gas?
Medical Treatment
The goal of treatment of flatulence is to reduce gas and odor. Medical intervention includes treatment with antibiotics if bacterial overgrowth of the GI tract is suspected or evidence of parasitic infection is seen.
* Some promising studies have investigated feeding nonoffensive strains of bacteria to push out the bacteria that are offensive, although no established treatments are available at this time.
* Regulation of bowel function is essential. Constipation should be treated with increased dietary fiber or certain laxatives.
* In cases where anxiety causes you to swallow air, your doctor may suggest you seek mental health counseling to change habit patterns.
Medications
If you do not desire to avoid the foods that cause gas for you, many nonprescription medicines are available to help reduce symptoms.
Beano is an enzyme supplement that may be useful with bean ingestion. It contains the sugar-digesting enzyme that the body lacks to digest the sugar in beans and many vegetables. Beano has no effect on gas caused by lactose or fiber. You can buy the enzyme over-the-counter. Add 3-10 drops per serving just before eating to break down the gas-producing sugars.
Antacids, such as Mylanta II, Maalox II, and Di-Gel, contain simethicone, a foaming agent that joins gas bubbles in the stomach so that gas is more easily belched away. However, these medicines have no effect on intestinal gas. These can be taken before meals. Dosage varies so read the labels.
Activated charcoal tablets (Charcocaps) may provide relief from gas in the colon. Gas can be reduced if tablets are taken before and after a meal. The usual dose is 2-4 tablets taken just before eating and 1 hour after meals.
Certain prescription medicines may help reduce symptoms, especially if you have a disorder such as irritable bowel syndrome. Some medicines such as metoclopramide (Clopra) have also been shown to decrease gas complaints by increasing gut activity.
