Stanford, CT In this article, you are informed about a disease that is occurring more often in our society. It is commonly referred to as "heartburn" but is more appropriately named acid reflux disease or gastroesophageal reflux disease GERD. Most people suffer from this disease, but think nothing of it. Perhaps they have felt it after a big meal, lying down after eating, during pregnancy, or even when bending over.
GERD is a backflow of contents of the stomach into the esophagus that is often due to the result of weakness of the lower esophageal sphincter LES.
This backflow of gastric acids may often produce a burning pain in the esophagus, commonly known as heartburn. Repeated episodes of reflux may cause esophagitis, peptic esophageal strictures, esophageal ulcers, and dysphagia. Dysphagia, or difficulty swallowing, is a major symptom of GERD.
Dysphagia may be caused by primary or secondary esophageal motor dysfunction Ogorek, In one study, it was found that out of patients with GERD, Aspiration, secondary to food obstruction, occurred in 30 percent of these patients.
Some patients even developed respiration problems Henderson, In uncomplicated cases of GERD, treatment consists of elevation of the head of the bed, avoidance of acid-stimulating foods, and regular administration of antacids and promotility agents Richter, In more extreme cases of GERD, surgical repair may provide relief.
One example of a surgical repair is an anti-reflux surgery, called fundoplication. Fundoplication involves wrapping the stomach fundus around the distal esophagus to improve LES pressure.
However, this procedure had been shown to interfere with LES relaxation which may not allow food to enter the stomach from the esophagus Richter, Many surgical methods can cause serious side effects.
One major side effect is dysphagia, so the surgery can help solve GERD, but may cause other problems as well. GERD during pregnancy is a very common occurrence, effecting up to two thirds of all pregnancies Marrero, The clinical features of GERD do not appear to be different of that in the general population Katz, Symptoms of GERD usually start appearing at about the fifth month of gestation and may increasingly become worse with progression on gestation, even though there have been cases where symptoms start as early as the first trimester.
Symptoms of GERD normally subside soon after delivery. Dysphagia is a symptom of complicated reflux, including motility abnormalities, esophageal stricture, esophageal ulceration, or esophageal cancer.
However, these complications are rare in pregnancy Katz, The origin of GERD is multifactoral, including the loss of intra-abdominal portion of the LES combined with an elevated intra-gastric pressure secondary to the gravid uterus, altered esophageal mucosal resistance, delayed gastric emptying and quantity of acid secretion Baron, Another factor of the decreased LES pressure during pregnancy is due to the increased levels of the female sex organs estrogen, and progesterone.
Studies were performed on opossums to identify whether the decrease in LES function is due to estrogen, progesterone, or both causes the smooth muscle relaxation of the LES. The results of the study showed that progesterone appeared to be the mediator of smooth muscle relaxation of the LES, however, estrogen may be needed for progesterone to act on LES Day, Another factor that may contribute to GERD is an alteration in gastrointestinal transit time.
Studies were done on 15 women in the third trimester of pregnancy, and four weeks postpartum to study the length of time bolus took to travel from the mouth to the stomach. Nine out of 15 women had prolonged transit times during pregnancy. These results show that there also may be delayed gastric emptying, which may promote reflux of gastric contents by increasing the quantity and duration of pooling of gastric secretions Katz, In esophageal peristalsis, pregnant women exhibited a slower wave velocity and lower amplitude than women that were not pregnant.
These changes in esophageal peristalsis may decrease acid clearance, adding to reflux Baron, Decreased acid clearance in the esophagus may lead to esophageal strictures, which is a narrowing of the esophagus due to inflammation, and esophageal ulcers, which is a lesion in the esophagus due to the prolonged exposure of acid in the esophagus These may add to motility problems of the esophagus Katz, The Secret of Getting Rid of Acid and Non-Acid Reflux without Proton-Pump Inhibitors and / or H2 Blockers.
The best book to treat and prevent heartburn, acid reflux, GERD and LPR naturally. Acid reflux is a chronic condition, once some one has it, they usually have it for life. The damage to the esophagus is also lifelong, and if a patient is treated, after the treatment ends, the damage will most likely return, so treatment will have to be used indefinetly.
Gastroesophageal reflux disease (GERD) is a digestive condition in which the stomach's contents often come back up into the food pipe. Dietary changes can help to ease symptoms.
For example, high. Heartburn is a painful burning feeling in your chest or throat. It happens when stomach acid backs up into your esophagus, the tube that carries food from your mouth to .
Acid Reflux (Gastroesophageal Reflux Disease) in Adults (Beyond the Basics) (UpToDate) Acid Reflux (GER and GERD) in Adults (National Institute of Diabetes and Digestive and Kidney Diseases) Also in Spanish; GERD (Mayo Foundation for Medical Education and Research).
This is the first article of a four part series on acid reflux and GERD. Read the second article on the myths of H. pylori and low stomach acid being the major causes, the third article on the main stream medical treatments and the final article on the myths of trigger foods and a GERD diet that works without drugs.