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|Gastroesophageal reflux disease|
|Other names||British: Gastro-oesophageal reflux disease (GORD); gastric reflux disease, acid reflux disease, reflux, gastroesophageal reflux|
|X-ray showing radiocontrast from the stomach (white material below diaphragm) entering the esophagus (three vertical collections of white material in the mid-line of the chest) due to severe reflux|
|Symptoms||Taste of acid, heartburn, bad breath, chest pain, breathing problems|
|Complications||Esophagitis, esophageal strictures, Barrett''s esophagus. |
Risk factors include obesity, pregnancy, smoking, hiatal hernia, and taking certain medicines. Medications involved may include antihistamines, calcium channel blockers, antidepressants and sleeping pills. Acid reflux is due to poor closure of the lower esophageal sphincter, which is at the junction between the stomach and the esophagus. Diagnosis among those who do not improve with simpler measures may involve gastroscopy, upper GI series, esophageal pH monitoring, or esophageal manometry.
Treatment options include lifestyle changes; medications; and sometimes surgery for those who do not improve with the first two measures. Lifestyle changes include not lying down for three hours after eating, raising the head of the bed, losing weight, avoiding foods which result in symptoms, and stopping smoking. Medications include antacids, H2 receptor blockers, proton pump inhibitors, and prokinetics.
Heartburn Remedies Foods That Fight Hearbturn (🔴 Treat GERD) | Heartburn Remedies Without Medicationhow to Heartburn Remedies for In the Western world, between 10 and 20% of the population is affected by GERD. Occasional gastroesophageal reflux without troublesome symptoms or complications is even more common. The classic symptoms of GERD were first described in 1925, when Friedenwald and Feldman commented on heartburn and its possible relationship to a hiatal hernia. In 1934 gastroenterologist Asher Winkelstein described reflux and attributed the symptoms to stomach acid.
GERD may lead to Barrett''s to dysplasia is uncertain, but is estimated at about 20% of cases. Due to the risk of chronic heartburn progressing to Barrett''s esophagus is seen. Investigation for H. pylori is not usually needed.
The current gold standard for diagnosis of GERD is esophageal pH monitoring. It is the most objective test for 1 last update 10 Jul 2020 to diagnose the reflux disease and allows monitoring GERD patients in their response to medical or surgical treatment. One practice for diagnosis of GERD is a short-term treatment with proton-pump inhibitors, with improvement in symptoms suggesting a positive diagnosis. Short-term treatment with proton-pump inhibitors may help predict abnormal 24-hr pH monitoring results among patients with symptoms suggestive of GERD. The current gold standard for diagnosis of GERD is esophageal pH monitoring. It is the most objective test to diagnose the reflux disease and allows monitoring GERD patients in their response to medical or surgical treatment. One practice for diagnosis of GERD is a short-term treatment with proton-pump inhibitors, with improvement in symptoms suggesting a positive diagnosis. Short-term treatment with proton-pump inhibitors may help predict abnormal 24-hr pH monitoring results among patients with symptoms suggestive of GERD.
Endoscopy[edit the 1 last update 10 Jul 2020 ]]
Endoscopy, the looking down into the stomach with a fibre-optic scope, is not routinely needed if the case is typical and responds to treatment. It is recommended when people either do not respond well to treatment or have alarm symptoms, including dysphagia, anemia, blood in the stool (detected chemically), wheezing, weight loss, or voice changes. Some physicians advocate either once-in-a-lifetime or 5- to 10-yearly endoscopy for people with longstanding GERD, to evaluate the possible presence of dysplasia or Barrett''s esophagus
Reflux changes may not be erosive in nature, leading to "".
Severity for 1 last update 10 Jul 2020 [
Severity may be documented with the Johnson-DeMeester''s shoulders and head, may inhibit GERD for 1 last update 10 Jul 2020 when lying down. Although moderate exercise may improve symptoms in people with GERD, vigorous exercise may worsen them. Severity may be documented with the Johnson-DeMeester''s shoulders and head, may inhibit GERD when lying down. Although moderate exercise may improve symptoms in people with GERD, vigorous exercise may worsen them.
Medications[editHeartburn Remedies What To Eat (🔥 Simples Steps) | Heartburn Remedies Unexpected Foodshow to Heartburn Remedies for ]
Main article: Drugs for acid-related disorders
The primary medications used for GERD are proton-pump inhibitors, H2 receptor blockers and antacids with or without alginic acid. The use of acid suppression therapy is a common response to GERD symptoms and many people get more of this kind of treatment than their case merits. The overuse of acid suppression is a problem because of the side effects and costs.
Proton-pump inhibitors (PPIs), such as omeprazole, are the most effective, followed by H2 receptor blockers, such as ranitidine. If a once daily PPI is only partially effective they may be used twice a day. They should be taken one half to one hour before a meal. There is no significant difference between PPIs. When these medications are used long term, the lowest effective dose should be taken. They may also be taken only when symptoms occur in those with frequent problems. H2 receptor blockers lead to roughly a 40% improvement.
Heartburn Remedies How To Naturally Treat (🔥 10 Drinks) | Heartburn Remedies GERD Diethow to Heartburn Remedies for The evidence for antacids is weaker with a benefit of about 10% (NNT=13) while a combination of an antacid and alginic acid (such as Gaviscon) may improve symptoms 60% (NNT=4). Metoclopramide (a prokinetic) is not recommended either alone or in combination with other treatments due to concerns around adverse effects. The benefit of the prokinetic mosapride is modest.
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Sucralfate has a similar effectiveness to H2 receptor blockers; however, sucralfate needs to be taken multiple times a day, thus limiting its use. Baclofen, an agonist of the GABAB receptor, while effective, has similar issues of needing frequent dosing in addition to greater adverse effects compared to other medications.
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The standard surgical treatment for severe GERD is the Nissen fundoplication. In this procedure, the upper part of the stomach is wrapped around the lower esophageal sphincter to strengthen the sphincter and prevent acid reflux and to repair a hiatal hernia. It is recommended only for those who do not improve with PPIs. Quality of life is improved in the short term compared to medical therapy, but there is uncertainty in the benefits over surgery versus long-term medical management with proton pump inhibitors. When comparing different fundoplication techniques, partial posterior fundoplication surgery is more effective than partial anterior fundoplication surgery, and partial fundoplication has better outcomes than total fundoplication.
Esophagogastric dissociation is an alternative procedure that is sometimes used to treat neurologically impaired children with GERD. Preliminary studies have shown it may have a lower failure rate and a lower incidence of recurrent reflux.
In 2012 the U.S. Food and Drug Administration (FDA) approved a device called the LINX, which consists of a series of metal beads with magnetic cores that are placed surgically around the lower esophageal sphincter, for those with severe symptoms that do not respond to other treatments. Improvement of GERD symptoms is similar to those of the Nissen fundoplication, although there is no data regarding long-term effects. Compared to Nissen fundoplication procedures, the procedure has shown a reduction in complications such as gas bloat syndrome that commonly occur. Adverse responses include difficulty swallowing, chest pain, vomiting, and nausea. Contraindications that would advise against use of the device are patients who are or may be allergic to titanium, stainless steel, nickel, or ferrous iron materials. A warning advises that the device should not be used by patients who could be exposed to, or undergo, magnetic resonance imaging (MRI) because of serious injury to the patient and damage to the device.
Heartburn Remedies Home Remedies (☑ Acid Reflux Every Day) | Heartburn Remedies Natural Remedieshow to Heartburn Remedies for In those with symptoms that do not improve with PPIs surgery known as transoral incisionless fundoplication may help. Benefits may last for up to six years.
Special populations for 1 last update 10 Jul 2020 [
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In pregnancy, dietary modifications and lifestyle changes may be attempted, but often have little effect. Calcium-based antacids are recommended if these changes are not effective. Aluminum- and magnesium hydroxide -based antacids are also safe, as is ranitidine and PPIs.
Babies may see relief with smaller, more frequent feedings, more frequent burping during feedings, holding baby in upright position 30 minutes after feedings, keep baby''gastrooesophageal reflux''s Esophagus. Retrieved on 1 February 2009.