GASTRO OESOPHAGEAL REFLUX DISEASE

 GERD (gastroesophageal reflux disease, or chronic acid reflux) is a condition in which acid-containing contents in your stomach persistently leak back up into your esophagus, from stomach.

Risk Factors

1. due to intra gastric pressure - Large meals, chronic cough

2. decreased oesophageal stricture- Alcohol, Smoking Benzodiazepines, Calcium channel blockers, Tricyclic antidepressants, NSAIDs, , previous history of surgery, 

3. Obesity

3. Pregnancy


CLINICAL PRESENTATION

1. Heartburn or a burning sensation in the center of the chest, after meal or after lying down position.

2. Burning chest pain

3.An acid taste in the back of the throat

4.Regurgitation of foods or liquids

5.Nausea and/or vomiting

6. Difficulty swallowing or food getting stuck

7. painful swallowing

8. persistence hoarseness

9. persistence sore throat

10. waking up in the middle of the  night with a choking sensation


HOW IS GERD DIAGNOSED?

A comprehensive history and physical exam will help to diagnose  GERD REFLUX, If you have symptoms of acid reflux but no evidence of complications or more serious disease, a trial of lifestyle modifications and medication may be recommended prior to more invasive testing.

INVESTIGATIONS

1. UPPER ENDOSCOPY

If patient has symptoms like unexplained weight loss, recurrent vomiting, jaundice9 yellowish skin, sclerae) occult or gross gastro intestinal bleeding, palpable mass or adenopathy, family history of gastro intestinal malignancy better to do upper endoscopy.

2. 24 HOUR ESOPHAGEAL PH STUDY

. 24-hour esophageal pH study — This test directly measures the acidity in your   esophagus by endoscopic capsule or catheter method.

3. Esophageal manometry

if your lower esophageal sphincter (or LES) is functioning properly. This test involves swallowing a tube that measures the muscular contractions of your esophagus.




 

What are the complications associated with GERD?


1. Peptic ulcer disease
2. Stricture or  a narrowing of the lining  of the esophagus
3. Lung and throat problems
4. Barrett esophagus
5. Esophageal cancer

TREATMENT

Patients with GERD should limit ethanol , caffeine , chocolate, tobacco use due to to their effects on the Lower Esophageal Sphincter  .and patients may be advised to reduce intake fat and spicy foods.

The treatments for GERD may include food choices, lifestyle changes, medications, and possibly surgery. Initial treatment is frequently with a proton-pump inhibitor such as omeprazole. In some cases, a person with GERD symptoms can manage them by taking over-the-counter drugs

Some guidelines recommend treat symptoms with an H2 antagonist like Cimetidine or Ranitidine,  because of cost and safety concerns.














Comments

Post a Comment

Popular posts from this blog

Eczema (Atopic Dermatitis)

Image
 Eczema is a condition where in patches of skin become inflammed ,itchy ,cracked and rough .But sometimes can also cause blisters. SYMPTOMS The symptoms of atopic dermatitis can vary depending on the age of person who has it. Atopic Dermatitis is common in infants, with dry and scaly appearing on the skin. These patches are often intensely itchy  Continuous rubbing and scratching can lead to skin infection. In most cases, however, eczema is mild. The most common symptoms of atopic dermatitis include; 1. dry,scaly skin 2. skin flushing 3. itching 4. open crusted, or weeping sores       People with severe eczema will need more  intensive treatment to relieve their symptoms Most people with this condition develop it before the age of 5 years . However an estimated 60% of children will no longer show symptoms by adolescence . Symptoms in infants rashes on scalp and cheeks , rashes on cheeks, rashes that bubble up before leaking fluid, rashes that can cause itch...
Read more

YOUR EARS CAN INDICATE YOUR HEALTH; DON'T IGNORE THIS FACTORS

Image
Ear wax has a protective function and indicate the state of our health.  Ear wax is not a body waste , It's kind of body protection, it keeps the ear canal lubricated and prevents the ear from itching, prevents different pollutants from entering the inner ear and surprisingly it has anti bacterial properties. It is a hygienic procedure to clean our ears once every few weeks. However not all of us know that ear wax can also indicate the state of our health. EAR WAX OF GREY COLOR If you ear wax is gray without any other symptoms ,there is nothing to worry about it, It may look scary but it is probably just dust, This  color of ear wax is a regular thing for city dwellers because the air in cities rather polluted, If you see such a color ,your ear wax succeeds in protecting your inner ear from anything that isn't supposed to enter the ear canal. But if along with the wax of such a color you feel itchiness , have dry or crackling skin inside the ear canal ,there is threat of SEBOR...
Read more

5 SIGNS OF DEPRESSION THAT SHOULD NEVER BE IGNORED

Image
  DEPRESSION IS A COMMON ILLNESS WORLDWIDE, WITH AN ESTIMATED 3.8% OF THE POPULATION AFFECTED, INCLUDING 5.0% AMONG ADULTS OLDER THAN 60 YEARS. APPROXIMATELY 280 MILLION PEOPLE IN THE WORLD HAVE DEPRESSION.  DEPRESSION IS A BRAIN ILLNESS THAT CAN BE FATAL. HERE ARE THE TOP HABITS SOMEONE WITH DEPRESSION 1. WANTING TO BE ALONE IF YOU ARE SUFFERING FROM DEPRESSION YOU PROBABLY DON'T LIKE TO LEAVE YOUR HOUSE YOU PROBABLY WANT TO BE ALONE WITH YOUR THOUGHTS. IN MOST CASES WANT TO FEEL SORRY FOR YOURSELF WITHOUT ANYONE BOTHERING YOU. MANY PEOPLE WHO SUFFER FROM DEPRESSION THEY WANT SPEND THEIR TIME ALONE, THEY MAY COMPLETELT GIVE UP COMMUNICATING WITH OTHERS.THEY MAY ALSO ISOLATE THEMSELF AND MAY GIVE UP ON DAILY ROUTINE. SUCH AS,  MAY IGNORE CALLS STOP SHOWING UP TO WORK STOP GOUNG TO SCHOOL STOP PAYING BILLS SO LIST GOES ON MANY PEOPLE WHO SUFFERING  FROM DEPRESSION THEY WILL NOT SEEK HELP, BECAUSE THEY BELIEVED THEY  CAN DEAL WITH IT ON THEIR OWN. SO ...
Read more