Gastroesophageal Reflux Disease (GERD) / Heartburn

Definition Of Acid Reflux:
The medical terminology for acid reflux is gastroesophageal reflux disease (GERD). It refers to the varied clinical manifestations of reflux of stomach and duodenal contents into the esophagus. Gastroesophageal reflux disease (GERD) is a digestive disorder that is caused by gastric acid flowing from the stomach into the esophagus.

Gastroesophageal refers to the stomach and esophagus, and reflux means to flow back or return. Gastroesophageal reflux (GER) is the return of acidic stomach juices, or food and fluids, back up into the esophagus.

Symptoms Of Acid Reflux (GERD):
Heartburn is the most common symptom of GERD. It can vary from an occasional mild burning after overeating to a persistent severe discomfort that severely limits a person's lifestyle. It may be accompanied by regurgitation of gastric contents into the mouth or respiratory tree. This latter group of people may complain of night-time wheezing, coughing, hoarseness, a need to clear the throat repeatedly, or a sensation of deep pressure at the base of the neck.

Heartburn, also called acid indigestion, is the most common symptom of GERD. Heartburn is described as a burning chest pain that begins behind the breastbone and moves upward to the neck and throat. It can last as long as two hours and is often worse after eating. Lying down or bending over can also result in heartburn.

People with significant GERD often has difficulty in swallowing. Swallowing may also be accompanied by pain. Blood loss may result from esophageal erosion and shallow ulcers over a long period of time, leading to iron deficiency anemia. People who vigorously and repeatedly abuse alcohol are prone to develop severe erosive esophagitis with bleeding. Digestinol can help you from Symptoms Of Acid Reflux and Cure.

What causes GERD?
GERD is believed to be the result of condition called hiatal hernia, which affects the lower esophageal sphincter (LES). The typical cause of heartburn is when acid from the stomach backs up into the esophagus. The LES, a muscle located at the bottom of the esophagus, opens to let food in and closes to keep it in the stomach. When this muscle relaxes too often or for too long, acid refluxes back into the esophagus, causing heartburn.

Other lifestyle contributors to GERD may include the following:
being overweight
overeating
consuming certain foods, such as citrus, peppermint, chocolate, fatty, and spicy foods
caffeine
alcohol
smoking
use of nonsteroidal anti-inflammatory (NSAIDs) drugs such as aspirin and ibuprofen

Other medical causes of heartburn may include the following:
gastritis - an inflammation of the stomach lining.
ulcer disease

Complications Of Acid Reflux / GERD):
Esophageal Stricture (Narrowed Esophageal Lumen):
People who develop strictures have had deep ulceration of the esophageal mucosa due to reflux damage. This may lead to esophageal obstruction.

Barrett's Esophagus (Columnar Epithelium):
In people who have suffered from chronic reflux esophagitis, the normal squamous epithelium of the esophageal mucosa is replaced with specialized Columnar Epithelium, which is an indication of severe reflux. This condition can also lead to esophageal tumors, a cancer that is rising rapidly especially in white men, possibly related to obesity.

Pulmonary Aspiration:
If refluxed material breaches the esophageal sphincter, it may easily spill into the larynx and the tracheo-bronchial tree resulting in wheezing, hoarseness, or coughing.

How is GERD diagnosed?
In addition to a complete medical history and physical examination, diagnostic procedures for GERD may include the following:

• upper GI (gastrointestinal) series (Also called barium swallow.) - a diagnostic test that examines the organs of the upper part of the digestive system: the esophagus, stomach, and duodenum (the first section of the small intestine). A fluid called barium (a metallic, chemical, chalky, liquid used to coat the inside of organs so that they will show up on an x-ray) is swallowed. X-rays are then taken to evaluate the digestive organs.

• esophagogastroduodenoscopy (Also called EGD or upper endoscopy.) - An EGD (upper endoscopy) is a procedure that allows the physician to examine the inside of the esophagus, stomach, and duodenum. A thin, flexible, lighted tube, called an endoscope, is guided into the mouth and throat, then into the esophagus, stomach, and duodenum. The endoscope allows the physician to view the inside of this area of the body, as well as to insert instruments through a scope for the removal of a sample of tissue for biopsy (if necessary).

• Bernstein test - a test that helps to confirm that the symptoms are a result of acid in the esophagus. The test is performed by dripping a mild acid through a tube placed in the esophagus.

• esophageal manometry - this test helps determine the strength of the muscles in the esophagus. It is useful in evaluating gastroesophageal reflux and swallowing abnormalities. A small tube is guided into the nostril, then passed into the throat, and finally into the esophagus. The pressure the esophageal muscles produce at rest is then measured.

• pH monitoring - measures the acidity inside of the esophagus. It is helpful in evaluating gastroesophageal reflux disease (GERD). A thin, plastic tube is placed into a nostril, guided down the throat, and then into the esophagus. The tube stops just above the lower esophageal sphincter, which is at the connection between the esophagus and the stomach. At the end of the tube inside the esophagus is a sensor that measures pH, or acidity. The other end of the tube outside the body is connected to a monitor that records the pH levels for a 12 to 24 hour period. Normal activity is encouraged during the study, and a diary is kept of symptoms experienced, or activity that might be suspicious for reflux, such as gagging or coughing. The pH readings are evaluated and compared to the patient's activity for that time period.

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