All About Acid Reflux | GERD | Gastroesophageal Reflux Disease

Peptic Ulcer Disease (PUD) - Gastrointestinal Disorders - Gastritis

noreply@blogger.com (Feliciana) — Wed, 27 Jan 2010 02:45:00 +0000

What is Peptic Ulcer Disease (PUD)?

A peptic ulcer is a hole in the gut lining of the stomach, duodenum, or esophagus. A peptic ulcer of the stomach is called a gastric ulcer; of the duodenum, a duodenal ulcer; and of the esophagus, an esophageal ulcer.

The two most common causes of peptic ulcer disease are Helicobacter pylori infection and the use of nonsteroidal anti-inflammatory drugs (NSAIDs). As the prevalence of H. pylori infection decreases and NSAID use increases, the relative contribution of each factor to the incidence of peptic ulcer disease (PUD) will change.

What is H. pylori?

Helicobacter pylori (H. pylori) is a type of bacteria. Researchers believe that H. pylori is responsible for the majority of peptic ulcers.

H. pylori infection is common in the United States. About 20 percent of people under 40 years old and half of those over 60 years have it. Most infected people, however, do not develop ulcers. Why H. pylori does not cause ulcers in every infected person is not known. Most likely, infection depends on characteristics of the infected person, the type of H. pylori, and other factors yet to be discovered.

Researchers are not certain how people contract H. pylori, but they think it may be through food or water.

Researchers have found H. pylori in the saliva of some infected people, so the bacteria may also spread through mouth-to-mouth contact such as kissing.

How does H. pylori cause a peptic ulcer?

H. pylori weakens the protective mucous coating of the stomach and duodenum, which allows acid to get through to the sensitive lining beneath. Both the acid and the bacteria irritate the lining and cause a sore, or ulcer.
H. pylori is able to survive in stomach acid because it secretes enzymes that neutralize the acid. This mechanism allows H. pylori to make its way to the "safe" area—the protective mucous lining. Once there, the bacterium's spiral shape helps it burrow through the lining.

Peptic Ulcer Causes

Normally, the lining of the stomach and small intestines are protected against the irritating acids produced in your stomach. If this protective lining stops working correctly, and the lining breaks down, it results in inflammation (gastritis) or an ulcer.

No single cause has been found for ulcers. However, it is now clear that an ulcer is the end result of an imbalance between digestive fluids in the stomach and duodenum. Ulcers can be caused by:

Infection with a type of bacteria called Helicobacter pylori (H. pylori)
Use of painkillers called nonsteroidal anti-inflammatory drugs (NSAIDs), such as aspirin, naproxen (Aleve, Anaprox, Naprosyn, and others), ibuprofen (Motrin, Advil, Midol, and others), and many others available by prescription. Even aspirin coated with a special substance can still cause ulcers.
Excess acid production from gastrinomas, tumors of the acid producing cells of the stomach that increases acid output; seen in Zollinger-Ellison syndrome.
Drinking too much alcohol
Smoking cigarettes or chewing tobacco
Being very ill, such as being on a breathing machine
Radiation treatments
Stress. Although stress per se isn't a cause of peptic ulcers, it's a contributing factor.

A rare condition called Zollinger-Ellison syndrome causes stomach and duodenal ulcers. Persons with this disease have a tumor in the pancreas that releases high levels of a hormone, which causes an increase in stomach acid.

Depending on their location, peptic ulcers have different names:

Gastric ulcer. This is a peptic ulcer that occurs in your stomach.
Duodenal ulcer. This type of peptic ulcer develops in the first part of the small intestine (duodenum).
Esophageal ulcer. An esophageal ulcer is usually located in the lower section of your esophagus. It's often associated with chronic gastroesophageal reflux disease (GERD).

Peptic Ulcer Symptoms

Small ulcers may not cause any symptoms. Some ulcers can cause serious bleeding.

Abdominal pain is a common symptom but it doesn't always occur. The pain can differ a lot from person to person.

* Feeling of fullness -- unable to drink as much fluid
* Hunger and an empty feeling in the stomach, often 1 - 3 hours after a meal
* Mild nausea (vomiting may relieve symptom)
* Pain or discomfort in the upper abdomen
* Upper abdominal pain that wakes you up at night

Other possible symptoms include:

* Bloody or dark tarry stools
* Chest pain
* Fatigue
* Vomiting, possibly bloody
* Weight loss
* Heartburn

Peptic Ulcer Exams and Tests / Peptic Ulcer Diagnosis

To diagnose an ulcer, your doctor will order one of the following tests:

Esophagogastroduodenoscopy (EGD) is a special test performed by a gastroenterologist in which a thin tube with a camera on the end is inserted through your mouth into the GI tract to see your stomach and small intestine. During an EGD, the doctor may take a biopsy from the wall of your stomach to test for H. pylori.
Upper gastrointestinal (upper GI) X-ray. Upper GI is a series of x-rays taken after you drink a thick substance called barium.
Hemoglobin blood test to check for anemia
Stool antigen test. This test checks for H. pylori in stool samples. It's useful both in helping to diagnose H. pylori infection and in monitoring the success of treatment.
Breath test. This procedure uses a radioactive carbon atom to detect H. pylori. The advantage of the breath test is that it can monitor the effectiveness of treatment used to eradicate H. pylori, detecting whether the bacteria have been killed or eradicated.

Peptic Ulcer Treatment

Treatment involves a combination of medications to kill the H. pylori bacteria (if present), and reduce acid levels in the stomach. This strategy allows your ulcer to heal and reduces the chance it will come back.

Take all of your medications exactly as prescribed.

If you have a peptic ulcer with an H. pylori infection, the standard treatment uses different combinations of the following medications for 5 - 14 days:

Two different antibiotics to kill H. pylori, such as clarithromycin (Biaxin), amoxicillin, tetracycline, or metronidazole (Flagyl)
Proton pump inhibitors such as omeprazole (Prilosec), lansoprazole (Prevacid), or esomeprazole (Nexium)
Bismuth (the main ingredient in Pepto-Bismol) may be added to help kill the bacteria

If you have an ulcer without an H. pylori infection, or one that is caused by taking aspirin or NSAIDs, your doctor will likely prescribe a proton pump inhibitor for 8 weeks.

You may also be prescribed this type of medicine if you must continue taking aspirin or NSAIDs for other health conditions.

Other medications that may be used for ulcer symptoms or disease are:

Misoprostol, a drug that may help prevent ulcers in people who take NSAIDs on a regular basis
Medications that protect the tissue lining (such as sucralfate)

If a peptic ulcer bleeds a lot, an EGD may be needed to stop the bleeding. Surgery may be needed if bleeding cannot be stopped with an EGD, or if the ulcer has caused a perforation.

Peptic Ulcer Outlook (Prognosis)

Peptic ulcers tend to come back if untreated. If you follow your doctor's treatment instructions and take all of your medications as directed, the H. pylori infection will be cured and you'll be much less likely to get another ulcer.

Peptic Ulcer Prevention

Avoid aspirin, ibuprofen, naproxen, and other NSAIDs. Try acetaminophen instead. If you must take such medicines, talk to your doctor first. Your doctor may:

Test you for H. pylori first
Have you take proton pump inhibitors (PPIs) or an acid blocker
Have you take a drug called Misoprostol

The following lifestyle changes may help prevent peptic ulcers:

Do not smoke or chew tobacco.
Limit alcohol to no more than two drinks per day.
Avoid nonsteroidal anti-inflammatory drugs (NSAIDs).
Control acid reflux. If you have an esophageal ulcer — usually associated with acid reflux — you can take several steps to help manage acid reflux.

Synonyms and Keywords

aspirin, bleeding ulcer, bowel obstruction, digestive diseases, digestive tract, stomach ulcers, dual therapy, duodenal ulcers, duodenum, fecal-oral transmission, gastric ulcers, gastrointestinal tract, GI tract, Helicobacter pylori, H pylori, H pylori infection, intestinal bleeding, intestinal erosion, intestinal obstruction, intestinal perforation, mucous membranes, mucus, gastric juice, stomach acid, abdominal pain, hydrochloric acid, nonsteroidal anti-inflammatory drugs, NSAIDs, peptic ulcer disease, PUD, small intestine, stomach, triple therapy, pepsin, vagotomy, antrectomy, ulcer, ulcers, peptic ulcer, peptic ulcers

resource: medlineplus

Inflammatory Bowel Disease (Crohn's Disease and Ulcerative Colitis) - Causes, Symptoms, Diagnosis, and Treatment

noreply@blogger.com (Feliciana) — Wed, 27 Jan 2010 02:44:00 +0000

What is Inflammatory Bowel Disease?

Inflammatory bowel disease is the name of a group of disorders that cause the intestines to become inflamed (red and swollen). Inflammatory bowel disease (IBD) is a chronic, nonspecific inflammation of the gastrointestinal tract.

If you have inflammatory bowel disease, you may have abdominal cramps and pain, diarrhea, weight loss and bleeding from your intestines. Two kinds of inflammatory bowel disease are Crohn's disease and ulcerative colitis. Crohn's disease usually causes ulcers (open sores) along the length of the small and large intestines. Crohn's disease either spares the rectum, or causes inflammation or infection with drainage around the rectum. Ulcerative colitis usually causes ulcers in the lower part of the large intestine, often starting at the rectum.

Inflammatory Bowel Disease (IBD) Causes

The exact causes are unknown (idiopathic disease). The disease may be caused by a germ or by an immune system problem. Researchers believe that a number of factors may be involved, such as the environment, diet, and possibly genetics.

An unknown factor/agent (or a combination of factors) triggers the body’s immune system to produce an inflammatory reaction in the intestinal tract that continues without control. As a result of the inflammatory reaction, the intestinal wall is damaged leading to bloody diarrhea and abdominal pain.

Genetic, infectious, immunologic, and psychological factors have all been implicated in influencing the development of IBD.

Inflammatory bowel disease may also cause a delay in puberty or growth problems for some kids and teens with the condition, because it can interfere with a person getting nutrients from the foods he or she eats.

Inflammatory Bowel Disease (IBD) Signs and Symptoms

Inflammatory bowel disease may also have constipation. With Crohn's disease, this can happen as a result of a partial obstruction (called stricture) in the intestines. In ulcerative colitis, constipation may be a symptom of inflammation of the rectum (also known as proctitis).

Symptoms may range from mild to severe and generally depend upon the part of the intestinal tract involved. They include the following:

* Abdominal cramps and pain

* Bloody diarrhea

* Severe urgency to have a bowel movement

* Fever

* Loss of appetite

* Weight loss

* Anemia (due to blood loss)

* Rectal bleeding

* Skin and eye irritations

Inflammatory Bowel Disease (IBD) Diagnosis

The diagnosis of IBD is based on a combination of exams: endoscopic, X-rays, and blood and tissue tests. Upon diagnosis, IBD patients may need additional tests to monitor the disease and diagnose possible complications or side effects of medications.

Laboratory Tests

1. Stool examination

A stool examination is done to eliminate the possibility of bacterial, viral, or parasitic causes of diarrhea.
A fecal occult blood test is used to examine stool for traces of blood that cannot be seen with the naked eye.

2. Complete blood count

An increase in the white blood cell count suggests the presence of inflammation in the body.
If you have severe bleeding, the red blood cell count may decrease and hemoglobin level may fall (anemia).

Endoscopy

Several types of endoscopy are used to determine if the patient has ulcerative colitis or Crohn's disease and how much bowel is affected. All use a thin, flexible tube with a lighted camera inside the tip, which allows doctors to look at the lining of the gastrointestinal (GI) tract. The image is magnified and appears on a television screen. Each procedure is named for the part of the GI tract examined:

1. Sigmoidoscopy.

In this procedure, your health care provider uses a sigmoidoscope (a narrow, flexible tube with a lens and a light source) to visualize the last one-third of the large intestine, which includes the rectum and the sigmoid colon. The sigmoidoscope is inserted through the anus and the intestinal wall is examined for ulcers, inflammation, and bleeding. During this procedure, your health care provider may take samples (biopsies) of the lining of the intestine.

2. Colonoscopy.

A colonoscopy is an examination similar to a sigmoidoscopy, but with this procedure, the entire colon can be examined.

3. EGD (Esophagogastroduodenoscopy)

Examines the lining of the esophagus, stomach (gastro), and duodenum (first part of the small intestine).

4. ERCP (Endoscopic retrograde cholangiopancreatography)

Examines the bile ducts in the liver and the pancreatic duct.

5. Endoscopic ultrasound.

Uses an ultrasound probe attached to an endoscope to obtain deep images of the gut. In IBD, this is most often used to look at fistulas in the rectal area.

6. Capsule endoscopy.

Patients swallow computerized cameras in vitamin-sized capsules to produce images of sections of the small intestine that are beyond the reach of an EGD. Read more on capsule endoscopy.

7. Upper endoscopy.

If you have upper GI symptoms (nausea, vomiting), an endoscope (narrow, flexible tube with a light source) is used to examine the esophagus, stomach, and the duodenum. The endoscope is inserted through the mouth, and the stomach and duodenum are examined for ulceration. Ulceration occurs in the stomach and duodenum in 5-10% of persons with Crohn disease.

Radiology Tests

Radiologic tests provide information that endoscopy cannot. EGD and colonoscopy can visualize only the stomach, the very upper small intestine (EGD) and the colon and very lower small intestine (colonoscopy). Most of the small intestine cannot be imaged by endoscopy, although Mayo is currently evaluating capsule endoscopy for this purpose. Radiographic tests can image the small intestine.

1. Barium x-ray

Upper gastrointestinal (GI) tract: This exam uses x-rays to find abnormalities in the upper GI tract (esophagus, stomach, duodenum, sometimes the small intestine). For this test, you are required to swallow barium (a chalky white substance). When barium is swallowed, it coats the inside of the intestinal tract, which can be documented on x-rays. If you have Crohn disease, abnormalities will be seen on barium x-rays.
Lower gastrointestinal (GI) tract: In this exam, barium is given in an enema that is retained in the colon while x-rays are taken. Abnormalities will be noted in the rectum and colon in persons with Crohn disease and ulcerative colitis.

2. Plain X-rays

Plain X-rays without contrast detect blockage in the small or large intestine.

3. X-rays with Contrast

Contrast X-rays are used with endoscopy in monitoring and treating IBD. These X-rays track special liquid contrast, usually barium, as it passes through the intestine, highlighting specific conditions.

4. CT Scan

A CT scanner takes simultaneous X-rays from different angles to reconstruct images of the internal organs.

5. MRI

Magnetic Resonance Imaging (MRI) is used to evaluate perianal fistulas and abscesses in patients with IBD. Other potential uses are being investigated.

6. White Blood Cell Scan

Inflammation of the GI tract is characteristic of ulcerative colitis and Crohn's disease. Leukocyte scintigraphy (tagged white blood cell scan) detects white blood cell accumulation in inflamed tissue.

7. Ultrasound

In general, ultrasound technology is not useful for examining the bowel, although sometimes it is used in combination with other radiological tests.

Inflammatory Bowel Disease (IBD) Treatment

Aminosalicylates:
These types of medications are among the most commonly used to treat IBD and include agents such as sulfasalazine (Azulfidine®) and mesalamine (Asacol®, Pentasa®, Colazal®).

Steroids:
Steroids such as prednisone and methylprednisolone are commonly used to treat patients with both ulcerative colitis and Crohn's disease. These particular types of steroids are called glucocorticoids and work as anti-inflammatory agents. They are different from anabolic steroids, which are known for their use by body builders and athletes.

6-Mercaptopurine and Azathioprine:
6-mercaptopurine (Purinethol®) and azathioprine (Imuran®) work to decrease the activity of the immune system, which then leads to reduced inflammation in the intestines. They are used both in ulcerative colitis and Crohn's disease to bring active disease under control and to maintain disease in remission. They are given orally as pills.

Methotrexate:
Methotrexate is another medication that works to decrease the activity of the immune system. It is used in Crohn's disease both to bring disease into remission and to maintain remission.

Infliximab:
Infliximab (Remicade®) may be used in moderate to severe Crohn's disease. It is a medication that is given intravenously and works on reducing intestinal inflammation by blocking a part of the immune system know as TNF (tumor necrosis factor).

Source:
http://www.emedicinehealth.com/inflammatory_bowel_disease
http://www.mayoclinic.org

Irritable Bowel Syndrome (IBS)- Causes, Symptoms, Diagnosis, and Treatment

noreply@blogger.com (Feliciana) — Wed, 27 Jan 2010 02:43:00 +0000

Irritable bowel syndrome (IBS or spastic colon) is a functional bowel disorder characterized by chronic abdominal pain, discomfort, bloating, constipation, diarrhea, gas, and alteration of bowel habits in the absence of any detectable organic cause. In some cases, the symptoms are relieved by bowel movements.

Irritable Bowel Syndrome Causes

The cause of irritable bowel syndrome is currently unknown. Triggers for IBS can range from gas or pressure on your intestines to certain foods, medications or emotions. For example:

* from an interplay of abnormal gastrointestinal (GI) tract movements
* increased awareness of normal bodily functions
* a change in the nervous system communication between the brain and the GI tract. * Abnormal movements of the colon, whether too fast or too slow, are seen in some, but not all, people who have IBS.
* Hormones. Because women are twice as likely to have IBS, researchers believe that hormonal changes play a role in this condition. Many women find that signs and symptoms are worse during or around their menstrual periods.
* Foods. For instance, chocolate, milk and alcohol might cause constipation or diarrhea. Carbonated beverages and some fruits and vegetables may lead to bloating and discomfort in some people with IBS. The role of food allergy or intolerance in irritable bowel syndrome has yet to be clearly understood.

Irritable bowel syndrome has also developed after episodes of gastroenteritis.

It has been suggested that IBS is caused by dietary allergies or food sensitivities, but this has never been proven.

Irritable Bowel Syndrome Symptoms

Irritable bowel syndrome affects each person differently. The hallmark of IBS is abdominal discomfort or pain. The following symptoms are also common:

* Abdominal cramping and pain that are relieved after bowel movements

* Alternating periods of diarrhea and constipation

* Change in the stool frequency or consistency

* Gassiness (flatulence)

* Passing mucus from the rectum

* Bloating

* Abdominal distension

The following are not symptoms or characteristics of IBS:

* Blood in stools or urine

* Vomiting (rare, though may occasionally accompany nausea)

* Pain or diarrhea that interrupts sleep

* Fever

* Weight loss

Irritable Bowel Syndrome Diagnosis and Tests

You must have certain signs and symptoms before a doctor diagnoses irritable bowel syndrome. The most important are abdominal pain and discomfort lasting at least 12 weeks, though the weeks don't have to occur consecutively. You also need to have at least two of the following:

* A change in the frequency or consistency of your stool — for example, you may change from having one normal, formed stool every day to three or more loose stools daily, or you may have only one hard stool every three to four days
* Straining, urgency or a feeling that you can't empty your bowels completely
* Mucus in your stool
* Bloating or abdominal distension

Your doctor may recommend several tests, including stool studies to check for infection or malabsorption problems. Among the tests that you may undergo to rule out other causes for your symptoms are the following:

* Flexible sigmoidoscopy. This test examines the lower part of the colon (sigmoid) with a flexible, lighted tube (sigmoidoscope).

* Computerized tomography (CT) scan. CT scans produce cross-sectional X-ray images of internal organs. CT scans of your abdomen and pelvis may help your doctor rule out other causes of your symptoms.

* Lactose intolerance tests. Lactase is an enzyme you need to digest the sugar found in dairy products. If you don't produce this enzyme, you may have problems similar to those caused by irritable bowel syndrome, including abdominal pain, gas and diarrhea. To find out if this is the cause of your symptoms, your doctor may order a breath test or ask you to exclude milk and milk products from your diet for several weeks.

* Blood tests. Celiac disease (nontropical sprue) is sensitivity to wheat protein that also may cause signs and symptoms like those of irritable bowel syndrome. Blood tests may help rule out that disorder.

* Esophagogastroduodenoscopy (Also called EGD or upper endoscopy.) - 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).

* Abdominal X-Rays - a diagnostic test which uses invisible electromagnetic energy beams to produce images of internal tissues, bones, and organs onto film.

* Abdominal Ultrasound - a diagnostic imaging technique which uses high-frequency sound waves and a computer to create images of blood vessels, tissues, and organs. Ultrasounds are used to view internal organs as they function, and to assess blood flow through various vessels. Gel is applied to the area of the body being studied, such as the abdomen, and a wand called a transducer is placed on the skin. The transducer sends sound waves into the body that bounce off organs and return to the ultrasound machine, producing an image on the monitor. A picture or video tape of the test is also made so it can be reviewed in the future.

* Colonoscopy - a procedure that allows the physician to view the entire length of the large intestine, and can often help identify abnormal growths, inflamed tissue, ulcers, and bleeding. It involves inserting a colonoscope, a long, flexible, lighted tube, in through the rectum up into the colon. The colonoscope allows the physician to see the lining of the colon, remove tissue for further examination, and possibly treat some problems that are discovered.

Irritable Bowel Syndrome Treatment

Home Remedies

* Experiment with fiber. When you have irritable bowel syndrome, fiber can be a mixed blessing. Although it helps reduce constipation, it can also make gas and cramping worse. The best approach is to gradually increase the amount of fiber in your diet over a period of weeks. Examples of foods that contain fiber are whole grains, fruits, vegetables and beans.

* Avoid problem foods. Common culprits include alcohol, chocolate, caffeinated beverages such as coffee and sodas, medications that contain caffeine, dairy products, and sugar-free sweeteners such as sorbitol or mannitol. If gas is a problem for you, foods that might make symptoms worse include beans, cabbage, cauliflower and broccoli. Fatty foods may also be a problem for some people. Chewing gum or drinking through a straw can lead to swallowing air, causing more gas.

* Eat at regular times. Don't skip meals, and try to eat about the same time each day to help regulate bowel function. If you have diarrhea, you may find that eating small, frequent meals makes you feel better. But if you're constipated, eating larger amounts of high-fiber foods may help move food through your intestines.

* Take care with dairy products. If you're lactose intolerant, try substituting yogurt for milk. Or use an enzyme product to help break down lactose. Consuming small amounts of milk products or combining them with other foods also may help. In some cases, though, you may need to eliminate dairy foods completely. If so, be sure to get enough protein, calcium and B vitamins from other sources.

* Drink plenty of liquids. Try to drink plenty of fluids every day. Water is best. Alcohol and beverages that contain caffeine stimulate your intestines and can make diarrhea worse, and carbonated drinks can produce gas.

* Exercise regularly. Exercise helps relieve depression and stress, stimulates normal contractions of your intestines and can help you feel better about yourself. If you've been inactive, start slowly and gradually increase the amount of time you exercise. If you have other medical problems, check with your doctor before starting an exercise program.

* Use anti-diarrheal medications and laxatives with caution. If you try over-the-counter anti-diarrheal medications, such as Imodium or Kaopectate, use the lowest dose that helps. Imodium may be helpful if taken 20 to 30 minutes before eating, especially if you know that the food planned for your meal is likely to cause diarrhea. In the long run, these medications can cause problems if you don't use them appropriately. The same is true of laxatives. If you have any questions about them, check with your doctor or pharmacist.

Medical Treatment

Most people with irritable bowel syndrome have problems only occasionally. A few may experience long-lasting problems and require prescription medications.

* Fiber supplements. Taking fiber supplements, such as psyllium (Metamucil) or methylcellulose (Citrucel), with fluids may help control constipation. This theoretically expands the inside of the digestive tract, reducing the chance it will spasm as it transmits and digests food. Fiber also promotes regular bowel movements, which helps reduce constipation. Fiber should be added gradually, because it may initially worsen bloating and gassiness.

* Stress may cause IBS "flares." Doctors may offer specific advice on reducing stress. Regularly eating balanced meals and exercising may help reduce stress and problems associated with irritable bowel syndrome.

* Smoking may worsen symptoms of IBS, which gives smokers another good reason to quit.

* Since many patients with irritable bowel syndrome report food intolerances, a food diary may help identify foods that seem to make IBS worse.

Medications

* Antispasmodic medicines, such as dicyclomine (Bemote, Bentyl, Di-Spaz) and hyoscyamine (Levsin, Levbid, NuLev), are sometimes used to treat symptoms of irritable bowel syndrome. Antispasmodic medicines help slow the action of the digestive tract and reduce the chance of spasms. However, they may have some side effects and thus are not for everyone. Other treatment plans are available, depending on symptoms and condition.

* Antidiarrheal medicines, such as loperamide (Imodium), a kaolin/pectin preparation (Kaopectate), and diphenoxylate/atropine (Lomotil), are sometimes used when diarrhea is a major feature of IBS. Do not take these on a long-term basis without first consulting a doctor.

* Antidepressants may be very effective in smaller doses than those typically used to treat depression. Imipramine (Tofranil), amitriptyline (Elavil), nortriptyline (Pamelor), and desipramine (Norpramin) are some commonly used medicines that may alleviate irritable bowel syndrome symptoms. Some other antidepressants are more commonly prescribed when depression and IBS coexist.

* Anticholinergic medications. Some people need medications that affect certain activities of the autonomic nervous system (anticholinergics) to relieve painful bowel spasms. These may be helpful for people who have bouts of diarrhea, but can worsen constipation.

* Antibiotics. It's unclear what role, if any, antibiotics might play in treating IBS. Some people whose symptoms are due to an overgrowth of bacteria in their intestines may benefit from antibiotic treatment. But more research is needed.

Alternative medicine

The following nontraditional therapies may help relieve symptoms of irritable bowel syndrome:

* Acupuncture. Although study results on the effects of acupuncture on symptoms of irritable bowel syndrome have been mixed, some people use acupuncture to help relax muscle spasms and improve bowel function.

* Herbs. Peppermint is a natural antispasmodic that relaxes smooth muscles in the intestines. Peppermint may provide short-term relief of IBS symptoms, but study results have been inconsistent. If you'd like to try peppermint, be sure to use enteric-coated capsules. Peppermint may aggravate heartburn. Before taking any herbs, check with your doctor to be sure they won't interact or interfere with other medications you may be taking.

* Hypnosis. Hypnosis may reduce abdominal pain and bloating. A trained professional teaches you how to enter a relaxed state and then guides you in relaxing your abdominal muscles.

* Probiotics. Probiotics are "good" bacteria that normally live in your intestines and are found in certain foods, such as yogurt, and in dietary supplements. It's been suggested that people with irritable bowel syndrome may not have enough good bacteria, and that adding probiotics to your diet may help ease your symptoms. Some studies have found that probiotics may relieve symptoms of IBS, such as abdominal pain and bloating, but more research is needed.

* Regular exercise, yoga, massage or meditation. These can all be effective ways to relieve stress. You can take classes in yoga and meditation or practice at home using books or videos.

Synonyms and Keywords

IBS, inflammatory bowel disease, IBD, IBS flare, IBS flares, nervous bowel, spastic colon, gastrointestinal disorder, GI disorder, gastrointestinal endoscopy, abdominal cramping, abdominal pain, bowel habits, functional bowel disease, mucous colitis, digestive tract, cramping, diarrhea, bloating, gas, gassiness, flatus, flatulence, constipation, antispasmodic medication, antidiarrheal medication, antidepressants, dicyclomine, Bemote, Bentyl, Di-Spaz, tegaserod, Zelnorm, alosetron, Lotronex, irritable bowel syndrome, anatomy of the digestive tract, anatomy of the digestive system, chronic gastrointestinal disorder, chronic GI disorder, symptoms of IBS, symptoms of irritable bowel syndrome, IBS symptoms, IBS treatment, treatment of IBS

Source:
- emedicinehealth
- Mayo Clinic

Barrett’s Esophagus - Causes, Symptoms, Diagnosis , and Treatment

noreply@blogger.com (Feliciana) — Sat, 23 Jan 2010 16:05:00 +0000

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When GERD is left untreated it can create other problems. One possible health consequence of GERD is a condition called Barrett’s Esophagus (BE).

Barrett's esophagus is found in 5-15% of patients who seek medical care for heartburn (gastroesophageal reflux disease, GERD)

Barrett's esophagus Causes

Barrett's esophagus is caused by gastro-oesophageal reflux disease, GORD(USA: GERD), which allows the stomach's contents to damage the cells lining the lower esophagus. Researchers are unable to predict which heartburn sufferers will develop Barrett's esophagus. While there is no relationship between the severity of heartburn and the development of Barrett's esophagus, there is a relationship between chronic heartburn and the development of Barrett's esophagus. Sometimes people with Barrett's esophagus will have no heartburn symptoms at all. In rare cases, damage to the esophagus may be caused by swallowing a corrosive substance such as lye.

The exact cause of Barrett's esophagus isn't known. Most people with Barrett's esophagus have long-standing GERD. It's thought that GERD causes stomach contents to wash back into the esophagus, causing damage to the esophagus. As the esophagus tries to heal itself, the cells can change to the type of cells found in Barrett's esophagus.

Barrett's esophagus Sign and Symptoms

Barrett's esophagus signs and symptoms are usually related to acid reflux and may include:

* frequent and longstanding heartburn
* trouble swallowing (dysphagia)
* vomiting blood
* pain under the breastbone where the esophagus meets the stomach
* unintentional weight loss because eating is painful

Diagnosis of Barrett’s Esophagus

Barrett's esophagus is most often diagnosed in people who have long-term gastroesophageal reflux disease (GERD) — a chronic regurgitation of acid from the stomach into the lower esophagus. Only a small percentage of people with GERD will develop Barrett's esophagus.

Diagnosis of Barrett's esophagus requires an examination called upper endoscopy or EGD (esophagogastroduodenoscopy). A barium x-ray is not accurate for detecting Barrett's esophagus. An EGD is done with the patient under sedation. The physician examines the lining of the esophagus and stomach with a thin, lighted, flexible endoscope.

Your doctor determines whether you have Barrett's esophagus using a procedure called upper endoscopy to:

* Examine your esophagus. Your doctor will pass a lighted tube (endoscope) down your throat. The tube carries a tiny camera that allows your doctor to examine your esophagus. Your doctor looks for signs that the esophageal tissue is changing. A person with Barrett's esophagus has tissue that appears different from normal esophageal tissue.

* Remove tissue samples. Your doctor may pass special tools through the endoscope to remove several small tissue samples. The samples are tested in a laboratory to determine what types of changes are taking place and how advanced the changes are.

Determining the degree of tissue changes

A doctor who specializes in examining body tissue in a laboratory (pathologist) will examine your esophageal tissue samples under a microscope. The pathologist determines the degree of changes (dysplasia) in your cells. Grades of dysplasia include:

* No dysplasia. If no changes are found in the cells, the pathologist determines there is no dysplasia.

* Low-grade dysplasia. Cells with low-grade dysplasia may show small signs of changes.

* High-grade dysplasia. Cells with high-grade dysplasia show many changes. High-grade dysplasia is thought to be the final step before cells change into esophageal cancer.

The type of dysplasia detected in your esophageal tissue determines your treatment options.

Treatments and drugs for Barrett’s Esophagus Patients
By Mayo Clinic staff

Your treatment options for Barrett's esophagus depend on the grade of changes in the cells of your esophagus, your overall health and your own preferences.

Treatment for people with no dysplasia or low-grade dysplasia
If a biopsy reveals that your cells have no dysplasia or that your cells have low-grade dysplasia, your doctor may suggest:

* Periodic endoscopy exams to monitor the cells in your esophagus. How often you undergo endoscopy exams will depend on your situation. Typically, if your biopsies show no dysplasia, you'll have a follow-up endoscopy one year later. If your doctor again detects no dysplasia, you may have endoscopy exams every three years. If low-grade dysplasia is detected, your doctor may recommend GERD treatments and another endoscopy in six months. If you're determined to have high-grade dysplasia, then your doctor may offer other treatment options.

Sometimes when endoscopy is repeated, no evidence of Barrett's esophagus is detected. This may not mean that the condition has gone away. The affected portion of the esophagus could be very small, and it may have been missed during the endoscopy. For this reason, your doctor will still recommend follow-up endoscopy exams.

* Continued treatment for GERD. If you're still struggling with chronic heartburn and acid reflux, your doctor will work to find medications that help you control your signs and symptoms. Surgery to tighten the sphincter that controls the flow of stomach acid may be an option to treat GERD. This procedure is called Nissen fundoplication. Treating acid reflux can reduce your signs and symptoms, but it doesn't treat the underlying Barrett's esophagus.

Treatment for people with high-grade dysplasia.

High-grade dysplasia is thought to be a precursor to esophageal cancer. For this reason, doctors sometimes recommend more-invasive treatments, such as:

* Esophagectomy. Surgery to remove the esophagus. During an esophagectomy, the surgeon removes most of your esophagus and attaches your stomach to the remaining portion. Surgery carries a risk of significant complications, such as bleeding, infection and leaking from the area where the esophagus and stomach are joined. When esophagectomy is performed by an experienced surgeon, there's a reduced risk of complications. Still, because of the potential complications of this major operation, other treatments are usually preferred over surgery. One advantage to surgery is that it reduces the need for periodic endoscopy exams in the future.

* Removing damaged cells with an endoscope. Endoscopic mucosal resection is used to remove areas of damaged cells using an endoscope. Your doctor guides the endoscope down your throat and into your esophagus. Special surgical tools are passed through the tube. The tools allow your doctor to cut away the superficial layers of the esophagus and remove damaged cells. Endoscopic mucosal resection carries a risk of complications, such as bleeding, tearing of the esophagus and narrowing of the esophagus.

* Using heat to remove abnormal esophageal tissue. Radiofrequency ablation involves inserting a balloon filled with electrodes in the esophagus. The balloon emits a short burst of energy that burns the damaged esophageal tissue.

* Destroying damaged cells by making them sensitive to light. Before this procedure, called photodynamic therapy (PDT), you receive a special medication through a vein in your arm. The medication makes certain cells, including the damaged cells in your esophagus, sensitive to light. During PDT, your doctor uses an endoscope to guide a special light down your throat and into your esophagus. The light reacts with medication in the cells and causes the damaged cells to die. PDT makes you sensitive to sunlight and requires diligent avoidance of sunlight after the procedure. Complications of PDT can include narrowing of the esophagus, chest pain, difficulty swallowing and vomiting.

If you undergo treatment other than surgery to remove your esophagus, there's a chance that Barrett's esophagus can recur. For this reason, your doctor may recommend continuing to take acid-reducing medications and having periodic endoscopy exams.

Medication and Drugs for Barrett’s Esophagus

The doctor may also prescribe medications to help. Those medications may include:

* Antacids to neutralize stomach acid.
* H2 blockers that lessen the release of stomach acid.
* Promotility agents -- drugs that speed up the movement of food from the stomach to the intestines.
* Proton pump inhibitors that reduce the production of stomach acid.

Lifestyle and home remedies for Barrett’s Esophagus Patients
By Mayo Clinic staff

Most people diagnosed with Barrett's esophagus experience frequent heartburn and acid reflux. Medications can control these signs and symptoms, but changes to your daily life also may help. Consider trying to:

* Maintain a healthy weight. If your weight is healthy, work to maintain that weight. If you're overweight or obese, ask your doctor about healthy ways to lose weight. Excess pounds put pressure on your abdomen, pushing up your stomach and causing acid to back up into your esophagus.

* Eat smaller, more frequent meals. Three meals a day, with small snacks in between, will help you stop overeating. Continual overeating leads to excess weight, which aggravates heartburn.

* Avoid tightfitting clothes. Clothes that fit tightly around your waist put pressure on your abdomen, aggravating reflux.

* Eliminate heartburn triggers. Everyone has specific triggers. Common triggers such as fatty or fried foods, alcohol, chocolate, peppermint, garlic, onion, caffeine and nicotine may make heartburn worse.

* Avoid stooping or bending. Tying your shoes is OK. Bending over for a long time to weed your garden may not be, especially soon after eating.

* Don't lie down after eating. Wait at least three hours after eating to lie down or go to bed.

* Raise the head of your bed. Place wooden blocks under your bed to elevate your head. Aim for an elevation of six to eight inches. Raising your head by using only pillows isn't a good alternative.

* Don't smoke. Smoking may increase stomach acid. If you smoke, ask your doctor about strategies for stopping.

Source: mayoclinic

Laryngopharyngeal Reflux ( LPR )- Definition, Symptoms, Diagnosis, and Treatment

noreply@blogger.com (Feliciana) — Sat, 23 Jan 2010 15:25:00 +0000

Definition of Laryngopharyngeal Reflux (LPR).

There are two sphincter muscles located in the esophagus: The lower esophageal sphincter (LES) and the upper esophageal sphincter (UES). When the lower esophageal sphincter is not functioning properly, there is a back flow of stomach acid into the esophagus. If this happens two or more times a week, it can be a sign of gastroesophageal reflux disease, or GERD.

But what happens when the upper esophageal sphincter doesn't function correctly either?

As with the lower esophageal sphincter, if the upper esophageal sphincter doesn't function properly, acid that has back flowed into the esophagus is allowed into the throat and voice box. When this happens, it's called Laryngopharyngeal Reflux, or LPR.

It usually occurs without heartburn, less than 15% of people with this problem have heartburn. The larynx, trachea, bronchi and lungs are much more susceptible to damage from the stomach juices than the esophagus.

The esophagus is better able to handle the acid than the larynx and pharynx because it has built in protective mechanisms. It also means that it takes even smaller amounts of stomach juices to do the damage.

Digestive juices can get into the upper throat at night as with regular acid reflux or GERD, but more people with LPR have damage occur during the day than at night.

How is LPR different from GERD?

Are the symptoms the same for both diseases? Can people suffer from Laryngopharyngeal Reflux (LPR) without having any symptoms of Acid Reflux (GERD)? Can LPR occur without any heartburn at all? This is totally possible. Some of the people who suffer from LPR do not suffer from heartburn at all! How is this possible? Heartburn occurs when the acids stays in the esophagus and burns the surface. But in LPR, these stomach acids are not staying in the esophagus long enough to cause heartburn. In this case, acid goes past the esophagus and rests in the person’s throat or voice box. As the throat is more sensitive than esophagus, this will result in Laryngopharyngeal Reflux symptoms and not heartburn associated with GERD.

Symptoms of Laryngopharyngeal Reflux are:

* Hoarseness
* Chronic throat-clearing, excessive mucous
* Chronic cough
* Stridor (noisy breathing)
* Difficulty swallowing
* “Lump in the throat “(globus)
* Reactive airway disease (wheezing)
* Chronic bronchitis
* Chronic airway obstruction
* Wheezing
* Apnea
* Aspiration pneumonia
* Nasal obstruction
* Ear pain
* Chronic nasal congestion
* Sore throat
* Gagging

These symptoms are also related to many conditions thought to be aggravated or caused by LPR. These conditons include:

* Otitis media (ear infections)
* Sinusitis
* Chronic nasal congestion
* Vocal cord nodules
* Chronic laryngitis
* Laryngomalacia
* Apnea
* Subglottic stenosis
* Arytenoid fixation
* Laryngospasm
* Recurrent pharyngitis
* Chronic cough
* Exacerbation of asthma or reactive airway disease

Diagnosis of Laryngopharyngeal Reflux

Most often, your doctor can diagnose LPR by examining your throat and vocal cords with a rigid or flexible telescope. The voice box is typically red, irritated, and swollen from acid reflux damage. This swelling and inflammation will eventually resolve with medical treatment, although it may take a few months.

At other times, you may have to undergo a dual-channel pH probe test to diagnose your condition. This involves placing a small tube (catheter) through your nose and down into your swallowing passage (esophagus). The catheter is worn for a 24-hour period and measures the amount of acid that refluxes into your throat. This test is not often necessary, but can provide critical information in certain cases.

Your doctor may do one of the following tests to determine if you have LPR:

* Laryngoscopy
This procedure is used to see changes of the throat and voice box.

* 24-hour pH testing
This procedure is used to see if too much stomach acid is moving into the upper esophagus or throat. Two pH sensors are used. One is located at the bottom of the esophagus and one at the top. This will let the doctor see if acid that enters the bottom of the esophagus moves to the top of the esophagus.

* Upper GI Endoscopy
This procedure is almost always done if a patient complains of difficulty with swallowing. It is done to see if there are any scars or abnormal growths in the esophagus, and to biopsy any abnormality found. This test will also show if there is any inflammation of the esophagus caused by refluxed acid.

Treatment of Laryngopharyngeal Reflux

Treatment for LPR is generally the same as that for GERD. Laryngopharyngeal reflux can be managed effectively with proper treatment.

Lifestyle modifications that may be prescribed include:

* Elevation of the head of the bed four to six inches
* Avoiding alcohol, chocolate and caffeine
* Avoiding overeating
* Eating or drinking nothing two to three hours before bed
* Avoiding greasy, fatty foods
* Losing weight

Medical treatments may include one or a combination of the following:

* Antacids to neutralize excess stomach acid
* Anti-secretory medications that decrease acid production by the stomach
* Surgery to tighten the junction between the stomach and esophagus. The most commonly performed surgery is called the Nissen Fundoplication. It is done by wrapping the top part of the stomach around the junction between the stomach and esophagus and sewing it in place.

Sources:
Charles N. Ford, MD, "Evaluation and Management of Laryngopharyngeal Reflux." JAMA. 2005;294:1534-1540.. The Journal of the American Medical Association. 11 Sep 2007 http://heartburn.about.com/od/gastrictractdisorders/a/whatis_LPR.htm

Acid Reflux & Oesophagitis

noreply@blogger.com (Feliciana) — Thu, 21 Jan 2010 14:34:00 +0000

Understanding the Oesophagus and Stomach

When we eat, food passes down the oesophagus (gullet) into the stomach. Cells in the lining of the stomach make acid and other chemicals which help to digest food. Stomach cells also make mucus which protects them from damage from the acid. The cells lining the oesophagus are different and have little protection from acid.

There is a circular band of muscle (a 'sphincter') at the junction between the oesophagus and stomach. This relaxes to allow food down, but then normally tightens up and stops food and acid leaking back up (refluxing) into the oesophagus. In effect, the sphincter acts like a valve.

What are Reflux and Oesophagitis?

* Acid reflux is when some acid leaks up (refluxes) into the oesophagus.
* Oesophagitis means inflammation of the lining of the oesophagus. Most cases of oesophagitis are due to reflux of stomach acid which irritates the inside lining of the oesophagus.

The lining of the oesophagus can cope with a certain amount of acid. However, it is more sensitive to acid in some people. Therefore, some people develop symptoms with only a small amount of reflux. However, some people have a lot of reflux without developing oesophagitis or symptoms.

Gastro-oesophageal reflux disease (GORD)

This is a general term which describes the range of situations - acid reflux, with or without oesophagitis and symptoms.

What are The Symptoms of Acid Reflux and Oesophagitis?

* Heartburn is the main symptom. This is a burning feeling which rises from the upper abdomen or lower chest up towards the neck. (It is confusing as it has nothing to do with the heart!)

* Other common symptoms include: pain in the upper abdomen and chest, feeling sick, an acid taste in the mouth, bloating, belching, and a burning pain when you swallow hot drinks. Like heartburn, these symptoms tend to come and go, and tend to be worse after a meal.

* Some uncommon symptoms may occur. If any of these symptoms occur it can make the diagnosis difficult as these symptoms can mimic other conditions. For example:

A persistent cough, particularly at night sometimes occurs. This is due to the refluxed acid irritating the trachea (windpipe). Asthma symptoms of cough and wheeze can sometimes be due to acid reflux.
Other mouth and throat symptoms sometimes occur such as gum problems, bad breath, sore throat, hoarseness, and a feeling of a lump in the throat.
Severe chest pain develops in some cases (and may be mistaken for a heart attack).

What Causes Acid Reflux and Who Does It Affect?

The sphincter at the bottom of the oesophagus normally prevents acid reflux. Problems occur if the sphincter does not work very well. This is common, but in most cases it is not known why it does not work so well. In some cases the pressure in the stomach rises higher than the sphincter can withstand. For example, during pregnancy, after a large meal, or when bending forward. If you have a hiatus hernia (when part of the stomach protrudes into the chest through the diaphragm), you have an increased chance of developing reflux. (See separate leaflet called 'Hiatus Hernia'.)

Most people have heartburn at some time, perhaps after a large meal. However, about 1 in 3 adults have some heartburn every few days, and nearly 1 in 10 adults have heartburn at least once a day. In many cases it is mild and soon passes. However, it is quite common for symptoms to be frequent or severe enough to affect quality of life. Regular heartburn is more common in smokers, pregnant women, heavy drinkers, the overweight, and those aged between 35 and 64.

What Tests Might Be Done?

Tests are not usually necessary if you have typical symptoms. Many people are diagnosed with 'presumed acid reflux' when they have typical symptoms, and the symptoms are eased by treatment. Tests may be advised if symptoms: are severe, or do not improve with treatment, or are not typical of GORD.

* Endoscopy is the common test. This is where a thin, flexible telescope is passed down the oesophagus into the stomach. This allows a doctor or nurse to look inside. With oesophagitis, the lower part of the oesophagus looks red and inflamed. However, if it looks normal it does not rule out acid reflux. Some people are very sensitive to small amounts of acid, and can have symptoms with little or no inflammation to see. Two terms that are often used after an endoscopy are:

Oesophagitis. This term is used when the oesophagus can be seen to be inflamed.
Endoscopy-negative reflux disease. This term is used when someone has typical symptoms of reflux but endoscopy is normal.

* A test to check the acidity inside the oesophagus may be done if the diagnosis is not clear.

* Other tests such as heart tracings, chest X-ray, etc, may be done to rule out other conditions if the symptoms are not typical.

What Can I Do to Help with Symptoms?

The following are commonly advised. However, there has been little research to prove how well these 'lifestyle' changes help to ease reflux.

* Smoking. The chemicals from cigarettes relax the sphincter muscle and make acid reflux more likely. Symptoms may ease if you are a smoker and stop smoking.

* Some foods and drinks may make reflux worse in some people. It is thought that some foods may relax the sphincter and allow more acid to reflux. It is difficult to be certain how much foods contribute. Let common sense be your guide. If it seems that a food is causing symptoms, then try avoiding it for a while to see if symptoms improve. Foods and drinks that have been suspected of making symptoms worse in some people include: peppermint, tomatoes, chocolate, spicy foods, hot drinks, coffee, and alcoholic drinks. Also, avoiding large volume meals may help.

* Some drugs may make symptoms worse. They may irritate the oesophagus, or relax the sphincter muscle and make acid reflux more likely. The most common culprits are anti-inflammatory painkillers (such as ibuprofen or aspirin). Others include: diazepam, theophylline, nitrates, and calcium channel blockers such as nifedipine. But this is not an exhaustive list. Tell a doctor if you suspect that a drug is causing the symptoms, or making symptoms worse.

* Weight. If you are overweight it puts extra pressure on the stomach and encourages acid reflux. Losing some weight may ease the symptoms.

* Posture. Lying down or bending forward a lot during the day encourages reflux. Sitting hunched or wearing tight belts may put extra pressure on the stomach which may make any reflux worse.

* Bedtime. If symptoms recur most nights, the following may help:

Go to bed with an empty, dry stomach. To do this, don't eat in the last three hours before bedtime, and don't drink in the last two hours before bedtime.
If you are able, try raising the head of the bed by 10-20 cms (for example, with books or bricks under the bed's legs). This helps gravity to keep acid from refluxing into the oesophagus. If you do this do not use additional pillows, because this may increase abdominal pressure.

What are the Treatments for Acid Reflux and Oesophagitis?

Antacids

These are alkali liquids or tablets that neutralise the acid. A dose usually gives quick relief. There are many brands which you can buy. You can also get some on prescription. You can use antacids 'as required' for mild or infrequent bouts of heartburn.

Acid-suppressing drugs

If you get symptoms frequently then see a doctor. An acid-suppressing drug will usually be advised. Two groups of acid-suppressing drugs are available - proton pump inhibitors (PPIs) and histamine receptor blockers (H2 blockers). They work in different ways but both reduce (suppress) the amount of acid that the stomach makes. Proton pump inhibitors include: omeprazole, lansoprazole, pantoprazole, rabeprazole, and esomeprazole. H2 blockers include: cimetidine, famotidine, nizatidine, and ranitidine.

In general, a proton pump inhibitor is used first as these drugs tend to work better than H2 blockers. A common initial plan is to take a full dose course of a proton pump inhibitor for a month or so. This often settles symptoms down and allows any inflammation in the oesophagus to clear. After this, all that you may need is to go back to antacids 'as required' or to take a short course of an acid suppressing drug 'as required'.

However, some people need long-term daily acid suppressing treatment. Without medication, their symptoms return quickly. Long-term treatment with an acid-suppressing drug is thought to be safe, and side-effects are uncommon. The aim is to take a full dose course for a month or so to settle symptoms. After this, it is common to 'step-down' the dose to the lowest dose that prevents symptoms. However, the maximum full dose taken each day is needed by some people.

Prokinetic drugs

These are drugs that speed up the passage of food through the stomach. They include domperidone and metoclopramide. They are not commonly used but help in some cases, particularly if you have marked bloating or belching symptoms.

Surgery

An operation can 'tighten' the lower oesophagus to prevent acid leaking up from the stomach. It can be done by 'keyhole' surgery. In general, the success of surgery is no better than acid-suppressing medication. However, surgery may be an option for some people whose quality of life remains significantly affected by their condition and where drug treatment is not working well or not wanted long-term.

Are There Any Complications from Oesophagitis?

* Stricture. If you have severe and long-standing inflammation it can cause scarring and narrowing (a stricture) of the lower oesophagus. This is uncommon.

* Barrett's oesophagus. In this condition the cells that line the lower oesophagus become changed. The changed cells are more prone than usual to become cancerous. (About 1 or 2 people in 100 with Barrett's oesophagus develop cancer of the oesophagus.)

* Cancer. Your risk of developing cancer of the oesophagus is slightly increased compared to the normal risk if you have long-term acid reflux.

It has to be stressed that most people with reflux do not develop any of these complications. Tell your doctor if you have pain or difficulty (food 'sticking') when you swallow which may be the first symptom of a complication.

References

Dyspepsia - proven gastro-oesophageal reflux disease, Clinical Knowledge Summaries (June 2008)
The management of dyspepsia in primary care, MeReC Briefing, No 32, 2006.
Dyspepsia: Managing dyspepsia in adults in primary care, NICE Clinical Guideline (2004)

20 Tips Home Remedies for Acid Reflux Disease or GERD

noreply@blogger.com (Feliciana) — Sat, 21 Mar 2009 16:04:00 +0000

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.

14. Drink herbal tea made.

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.

Acid Reflux During Pregnancy

noreply@blogger.com (Feliciana) — Sat, 21 Mar 2009 16:02:00 +0000

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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.

source : Mayo Clinic

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

- remedyforheartburn.
- healthcentral
- foxnews
- babycenter
- acid-reflux-tips

Infant Acid Reflux Alternative Treatments

noreply@blogger.com (Feliciana) — Sat, 21 Mar 2009 15:49:00 +0000

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:

Mastica
Aloe Vera juice
Licorice
Kinesiology
Accupuncture

Resource:
- Pollywog

Infant Acid Reflux Disease

noreply@blogger.com (Feliciana) — Sat, 21 Mar 2009 14:58:00 +0000

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.

Resource:
- By Mayo Clinic staff
- Medicinenet.

Gastrointestinal Gas | Digestive Disorders That Cause Gas

noreply@blogger.com (Feliciana) — Thu, 08 Jan 2009 03:22:00 +0000

What Is Gastrointestinal Gas?

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.

What Causes of Gastrointestinal Gas?

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:

* Celiac disease
* Dumping syndrome
* Food intolerance vs. food allergy: What's the difference?
* Gastroparesis
* GERD
* Irritable bowel syndrome
* Lactose intolerance
* Peptic ulcer
* Short bowel syndrome

How To Reduce The Gas?

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.

resource:
* By Mayo Clinic Staff
* WebMd
* GIResearch
* Asumex
* Fruit Eze
* eMedicine

Gastritis | Definition, Causes, Symptoms, Diagnosis, and Treatment

noreply@blogger.com (Feliciana) — Mon, 06 Oct 2008 13:58:00 +0000

Definition of Gastritis

Gastritis commonly refers to inflammation of the lining of the stomach, but the term is often used to cover a variety of symptoms resulting from stomach lining inflammation and symptoms of burning or discomfort. True gastritis comes in several forms and is diagnosed using a combination of tests. In the 1990s, scientists discovered that the main cause of true gastritis is infection from a bacterium called Helicobacter pylori (H. pylori).

Description of Gastritis

Gastritis should not be confused with common symptoms of upper abdominal discomfort. It has been associated with resulting ulcers, particularly peptic ulcers. And in some cases, chronic gastritis can lead to more serious complications.

1. Nonerosive H. pylori gastritis

The main cause of true gastritis is H. pylori infection. H. pylori is indicated in an average of 90% of patients with chronic gastritis. This form of nonerosive gastritis is the result of infection with Helicobacter pylori bacterium, a microorganism whose outer layer is resistant to the normal effects of stomach acid in breaking down bacteria.

The resistance of H. pylori means that the bacterium may rest in the stomach for long periods of times, even years, and eventually cause symptoms of gastritis or ulcers when other factors are introduced, such as the presence of specific genes or ingestion of nonsteroidal anti-inflammatory drugs (NSAIDS). Study of the role of H. pylori in development of gastritis and peptic ulcers has disproved the former belief that stress lead to most stomach and duodenal ulcers and has resulted in improved treatment and reduction of stomach ulcers. H. pylori is most likely transmitted between humans, although the specific routes of transmission were still under study in early 1998. Studies were also underway to determine the role of H. pylori and resulting chronic gastritis in development of gastric cancer.

2. Erosive and Hemorrhagic Gastritis

After H. pylori, the second most common cause of chronic gastritis is use of nonsteroidal anti-inflammatory drugs. These commonly used pain killers, including aspirin, fenoprofen, ibuprofen and naproxen, among others, can lead to gastritis and peptic ulcers. Other forms of erosive gastritis are those due to alcohol and corrosive agents or due to trauma such as ingestion of foreign bodies.

3. Other forms of gastritis

Clinicians differ on the classification of the less common and specific forms of gastritis, particularly since there is so much overlap with H. pylori in development of chronic gastritis and complications of gastritis. Other types of gastritis that may be diagnosed include:

* Acute stress gastritis--the most serious form of gastritis which usually occurs in critically ill patients, such as those in intensive care. Stress erosions may develop suddenly as a result of severe trauma or stress to the stomach lining.

* Atrophic gastritis is the result of chronic gastritis which is leading to atrophy, or decrease in size and wasting away, of the gastric lining. Gastric atrophy is the final stage of chronic gastritis and may be a precursor to gastric cancer.

* Superficial gastritis is a term often used to describe the initial stages of chronic gastritis.

* Uncommon specific forms of gastritis include granulomatous, eosiniphilic and lymphocytic gastritis.

Causes and Symptoms Gastritis

Gastritis can be caused by drinking too much alcohol, prolonged use of nonsteroidal anti-inflammatory drugs (NSAIDs) such as aspirin or ibuprofen, or infection with bacteria such as Helicobacter pylori (H. pylori). Sometimes gastritis develops after major surgery, traumatic injury, burns, or severe infections. Certain diseases, such as pernicious anemia, autoimmune disorders, and chronic bile reflux, can cause gastritis as well.

Gastritis is associated with various medications, medical and surgical conditions, physical stresses, social habits, chemicals, and infections. Some of the more common causes of gastritis are listed here.

Medications Gastritis

* Aspirin (more than 300 drug products contain some form of aspirin)
* Nonsteroidal anti-inflammatory drugs (NSAIDs, such as ibuprofen or naproxen)
* Steroids (prednisone is one example)
* Potassium supplements
* Iron tablets
* Cancer chemotherapy medications

Swallowing poisons or objects

* Corrosives (acid or lye)
* Alcohols of various types
* Swallowed foreign bodies (paper clips or pins)

1. Nonerosive H. pylori gastritis

Causes :

H. pylori gastritis is caused by infection from the H. pylori bacterium. It is believed that most infection occurs in childhood. The route of its transmission was still under study in 1998 and clinicians guessed that there may be more than one route for the bacterium. Its prevalence and distribution differs in nations around the world. The presence of H. pylori has been detected in 86-99% of patients with chronic superficial gastritis. However, physicians are still learning about the link of H. pylori to chronic gastritis and peptic ulcers, since many patients with H. pylori infection do not develop symptoms or peptic ulcers. H. pylori is also seen in 90-100% of patients with duodenal ulcers.

Symptoms:

Symptoms of H. pylori gastritis include abdominal pain and reduced acid secretion in the stomach. However, the majority of patients with H. pylori infection suffer no symptoms, even though the infection may lead to ulcers and resulting symptoms. Ulcer symptoms include dull, gnawing pain, often two to three hours after meals and pain in the middle of the night when the stomach is empty.

2. Erosive and Hemorrhagic Gastritis

Causes:

The most common cause of this form of gastritis is use of NSAIDS. Other causes may be alcoholism or stress from surgery or critical illness. The role of NSAIDS in development of gastritis and peptic ulcers depends on the dose level. Although even low doses of aspirin or other nonsteroidal anti-inflammatory drugs may cause some gastric upset, low doses generally will not lead to gastritis. However, as many as 10-30% of patients on higher and more frequent doses of NSAIDS, such as those with chronic arthritis, may develop gastric ulcers. In 1998, studies were underway to understand the role of H. pylori in gastritis and ulcers among patients using NSAIDS.

Patients with erosive gastritis may also show no symptoms. When symptoms do occur, they may include anorexia nervosa, gastric pain, nausea and vomiting.

3. Other Forms of Gastritis

Less common forms of gastritis may result from a number of generalized diseases or from complications of chronic gastritis. Any number of mechanisms may cause various less common forms of gastritis and they may differ slightly in their symptoms and clinical signs. However, they all have in common inflammation of the gastric mucosa.

Diagnosis Gastritis

How is gastritis diagnosed?

Gastritis is diagnosed through one or more medical tests:

* Upper gastrointestinal endoscopy. The doctor eases an endoscope, a thin tube containing a tiny camera, through your mouth (or occasionally nose) and down into your stomach to look at the stomach lining. The doctor will check for inflammation and may remove a tiny sample of tissue for tests. This procedure to remove a tissue sample is called a biopsy.

*Blood test. The doctor may check your red blood cell count to see whether you have anemia, which means that you do not have enough red blood cells. Anemia can be caused by bleeding from the stomach.

* Stool test. This test checks for the presence of blood in your stool, a sign of bleeding. Stool test may also be used to detect the presence of H. pylori in the digestive tract.

1. Nonerosive H. Pylori Gastritis

H. pylori gastritis is easily diagnosed through the use of the urea breath test. This test detects active presence of H. pylori infection. Other serological tests, which may be readily available in a physician's office, may be used to detect H. pylori infection. Newly developed versions offer rapid diagnosis. The choice of test will depend on cost, availability and the physician's experience, since nearly all of the available tests have an accuracy rate of 90% or better. Endoscopy, or the examination of the stomach area using a hollow tube inserted through the mouth, may be ordered to confirm diagnosis. A biopsy of the gastric lining may also be ordered.

2. Erosive or Hemorrhagic Gastritis

Clinical history of the patient may be particularly important in the diagnosis of this type of gastritis, since its cause is most often the result of chronic use of NSAIDS, alcoholism, or other substances.

3. Other forms of Gastritis

Gastritis that has developed to the stage of duodenal or gastric ulcers usually requires endoscopy for diagnosis. It allows the physician to perform a biopsy for possible malignancy and for H. pylori. Sometimes, an upper gastrointestinal x-ray study with barium is ordered. Some diseases such as Zollinger-Ellison syndrome, an ulcer disease of the upper gastrointestinal tract, may show large mucosal folds in the stomach and duodenum on radiographs or in endoscopy. Other tests check for changes in gastric function.

Treatment of Gastritis

H. Pylori Gastritis

The discovery of H. pylori's role in development of gastritis and ulcers has led to improved treatment of chronic gastritis. In particular, relapse rates for duodenal and gastric ulcers has been reduced with successful treatment of H. pylori infection. Since the infection can be treated with antibiotics, the bacterium can be completely eliminated up to 90% of the time.

Although H. pylori can be successfully treated, the treatment may be uncomfortable for patients and relies heavily on patient compliance. In 1998, studies were underway to identify the best treatment method based on simplicity, patient cooperation and results. No single antibiotic had been found which would eliminate H. pylori on its own, so a combination of antibiotics has been prescribed to treat the infection.

DUAL THERAPY

Dual therapy involves the use of an antibiotic and a proton pump inhibitor. Proton pump inhibitors help reduce stomach acid by halting the mechanism that pumps acid into the stomach. This also helps promote healing of ulcers or inflammation. Dual therapy has not been proven to be as effective as triple therapy, but may be ordered for some patients who can more comfortably handle the use of less drugs and will therefore more likely follow the two-week course of therapy.

TRIPLE THERAPY

As of early 1998, triple therapy was the preferred treatment for patients with H. pylori gastritis. It is estimated that triple therapy successfully eliminates 80-95% of H. pylori cases. This treatment regimen usually involves a two-week course of three drugs. An antibiotic such as amoxicillin or tetracycline, and another antibiotic such as clarithomycin or metronidazole are used in combination with bismuth subsalicylate, a substance found in the over-the-counter medication, Pepto-Bismol, which helps protect the lining of the stomach from acid. Physicians were experimenting with various combinations of drugs and time of treatment to balance side effects with effectiveness. Side effects of triple therapy are not serious, but may cause enough discomfort that patients are not inclined to follow the treatment.

OTHER TREATMENT THERAPIES

Scientists have experimented with quadruple therapy, which adds an antisecretory drug, or one which suppresses gastric secretion, to the standard triple therapy. One study showed this therapy to be effective with only a week's course of treatment in more than 90% of patients. Short course therapy was attempted with triple therapy involving antibiotics and a proton pump inhibitor and seemed effective in eliminating H. pylori in one week for more than 90% of patients. The goal is to develop the most effective therapy combination that can work in one week of treatment or less.

MEASURING H. PYLORI TREATMENT EFFECTIVENESS

In order to ensure that H. pylori has been eradicated, physicians will test patients following treatment. The breath test is the preferred method to check for remaining signs of H. pylori.

Treatment of erosive gastritis

Since few patients with this form of gastritis show symptoms, treatment may depend on severity of symptoms. When symptoms do occur, patients may be treated with therapy similar to that for H. pylori, especially since some studies have demonstrated a link between H. pylori and NSAIDS in causing ulcers. Avoidance of NSAIDS will most likely be prescribed.

Other forms of gastritis

Specific treatment will depend on the cause and type of gastritis. These may include prednisone or antibiotics. Critically ill patients at high risk for bleeding may be treated with preventive drugs to reduce risk of acute stress gastritis. If stress gastritis does occur, the patient is treated with constant infusion of a drug to stop bleeding. Sometimes surgery is recommended, but is weighed with the possibility of surgical complications or death. Once torrential bleeding occurs in acute stress gastritis, mortality is as high as greater than 60%.

Alternative treatment

Alternative forms of treatment for gastritis and ulcers should be used cautiously and in conjunction with conventional medical care, particularly now that scientists have confirmed the role of H. pylori in gastritis and ulcers. Alternative treatments can help address gastritis symptoms with diet and nutritional supplements, herbal medicine and ayurvedic medicine. It is believed that zinc, vitamin A and beta-carotene aid in the stomach lining's ability to repair and regenerate itself. Herbs thought to stimulate the immune system and reduce inflammation include echinacea (Echinacea spp.) and goldenseal (Hydrastis canadensis). Ayurvedic medicine involves meditation. There are also certain herbs and nutritional supplements aimed at helping to treat ulcers.

Prognosis

The discovery of H. pylori has improved the prognosis for patients with gastritis and ulcers. Since treatment exists to eradicate the infection, recurrence is much less common. As of 1998, the only patients requiring treatment for H. pylori were those at high risk because of factors such as NSAIDS use or for those with ulcers and other complicating factors or symptoms. Research will continue into the most effective treatment of H. pylori, especially in light of the bacterium's resistance to certain antibiotics. Regular treatment of patients with gastric and duodenal ulcers has been recommended, since H. pylori plays such a consistently high role in development of ulcers. It is believed that H. pylori also plays a role in the eventual development of serious gastritis complications and cancer. Detection and treatment of H. pylori infection may help reduce occurrence of these diseases. The prognosis for patients with acute stress gastritis is much poorer, with a 60 percent or higher mortality rate among those bleeding heavily.

Prevention

The widespread detection and treatment of H. pylori as a preventive measure in gastritis has been discussed but not resolved. Until more is known about the routes through which H. pylori is spread, specific prevention recommendations are not available. Erosive gastritis from NSAIDS can be prevented with cessation of use of these drugs. An education campaign was launched in 1998 to educate patients, particularly an aging population of arthritis sufferers, about risk for ulcers from NSAIDS and alternative drugs.

Key Terms

Duodenal
Refers to the duodenum, or the first part of the small intestine.

Gastric
Relating to the stomach.

Mucosa
The mucous membrane, or the thin layer which lines body cavities and passages.

Ulcer
A break in the skin or mucous membrane. It can fester and pus like a sore.

For Your Information

Resources

Periodicals

* Podolski, J. L. "Recent Advances in Peptic Ulcer Disease: H. pylori Infection and Its Treatement." Gastroenterology Nursing 19, no. 4: 128-136.

Organizations

* National Digestive Diseases Information Clearinghouse. 2 Information Way, Bethesda, MD 20892-3570. (800) 891-5389.

Other

* American College of Gastroenterology Page.

* HealthAnswers.com.

Gale Encyclopedia of Medicine, Published December, 2002 by the Gale Group The Essay Author is Teresa Odle.

This article was updated on 08-14-2006

Gastrointestinal Disease | Gastrointestinal Reflux Disease

noreply@blogger.com (Feliciana) — Mon, 06 Oct 2008 13:44:00 +0000

Gastrointestinal Diseases:

Gastroesophageal Reflux Disease (GERD)
Peptic Ulcer Disease
Barrett's Esophagus
Hepatitis
Inflammatory Bowel Disease (Crohn's and Ulcerative Colitis)
Irritable Bowel Syndrome
Hemorrhoids
Diverticulosis

What is Gastrointestinal Disease?
By: Dr. Anshu Gupta

Also called: Digestive Diseases

When you eat, your body breaks food down to a form it can use to build and nourish cells and provide energy. This process is called digestion.

Your digestive system is a series of hollow organs joined in a long, twisting tube. It runs from your mouth to your anus and includes your esophagus, stomach, and small and large intestines. Your liver, gallbladder and pancreas are also involved. They produce juices to help digestion.

There are many types of digestive disorders. The symptoms vary widely depending on the problem. In general, you should see your doctor if you have

* Blood in your stool
* Changes in bowel habits
* Severe abdominal pain
* Unintentional weight loss
* Heartburn not relieved by antacids

Gastrointestinal (GI) disease refer to ulcerative disorders of the upper gastrointestinal tract. Stomach acids and some enzymes can damage the lining of the G.I. tract if natural protective factors are not functioning normally.

The GI research strategy focuses on gaining a better understanding of the genetic basis of GI diseases (e.g., Crohn’s disease) and the pathophysiology associated with these diseases, including mucosal barrier function and innate immunity, and on neural control of motility and perception.

GI concentrates on inflammatory bowel diseases such as Crohn’s Disease and ulcerative colitis, as well as irritable bowel syndrome and gastroparesis.

Symptoms of gastrointestinal disease are indigestion, heartburn, nausea, loss of appetite, abdominal pain that is often worse after eating, and gastrointestinal bleeding (signs of this are vomiting material that looks like coffee-grounds, or having dark stools). Some other symptoms are acid bile reflux in the throat, asthma-like symptoms, often irritable bowel syndrome, chronic poor digestion with sharp abdominal and chest pains, hoarseness and chronic cough.

Causes of gastrointestinal disease are aspirin use, alcohol and tobacco use, poor diet (to many fried, fatty foods, sugar and refined foods), poor food combining, drinking with meals, over eating especially spicy foods, eating to fast or to often, food allergies, candida overgrowth, stress, serious illness.

Various pathogens, which usually get into our body through contaminated food and water, can produce an infection of the gastrointestinal tract. This manifests itself in diarrhea, often accompanied by pains in the stomach, nausea and vomiting. Among the most frequent pathogens at fault are the e-coli bacteria, salmonella and poison from staphylococcus.

Other causes of gastrointestinal disease may be reflux injury (such as bile backing up into the stomach and esophagus, trauma (for example surgery, radiation, chemotherapy, severe vomiting and having swallowed a foreign object), bacterial, viral, fungal and parasitic infections, pernicious anemia and systemic disease for example (Crohn's) disease.

Diet For Gastritis

noreply@blogger.com (Feliciana) — Mon, 06 Oct 2008 05:51:00 +0000

Gastritis Symptoms

Loss of apetite

The main symptoms of gastritis are loss of appetite, nausea, vomiting, headache, and dizziness. There is pain and discomfort in the region of the stomach.

Coated tongue, bad breath

Other symptoms are a coated tongue, foul breath, bad taste in the mouth, increased flow of saliva, scanty urination, a general feeling of uneasiness, and mental depression. In more chronic cases, the patient complaints of heartburn and a feeling of fullness in the abdomen, especially after meals. Often there is constipation, but occasionally, there may be diarrhoea due to intestinal catarrah.

Gastritis Causes

Irregular or excessive eating

The most frequent cause of gastritis is a dietetic indiscretion such as habitual overeating; eating of badly combined or improperly cooked foods; excessive intake of strong tea, coffee, or alcoholic drinks; or habitual use of large quantities of condiments and sauces.

Worry, Anxiety

Other causes include worry, anxiety, grief, and prolonged tension, use of certain drugs, strong acids, and caustic substances.

Home remedies for Gastritis

Gastritis treatment using Coconut

Coconut water is an excellent remedy for gastritis. It gives the stomach the necessary rest and provides vitamins and minerals. The stomach is greatly helped in returning to a normal condition if nothing but coconut water is given during the first twenty-four hours.

Gastritis treatment using Rice

Rice gruel is another excellent remedy for acute cases of gastritis. One cup of rice gruel is recommended twice daily. In chronic cases where the flow of gastric juice is meagre, such foods as require prolonged vigorous mastication are beneficial as they induce a greater flow of gastric juice.

Gastritis treatment using Potato

Potato juice has been found valuable in relieving gastritis. The recommended dose is half a cup of the juice, two or three times daily, half an hour before meals.

Gastritis treatment using Marigold

The herb marigold is also considered beneficial in the treatment of gastritis. An infusion of the herb in doses of a tablespoon may be taken twice daily.

Gastritis Diet

Fasting, Water

The patient should undertake a fast for two of three days or more, depending on the severity of the condition. He should be given only warm water to drink during this period. This will give rest to the stomach and allow the toxic condition causing the inflammation to subside.

All-fruit diet

After the acute symptoms subside, the patient should adopt an all-fruit diet for the next three days and take juicy fruits such as apples, pears, grapes, grapefruit, oranges, pineapple, peaches, and melons.

Avoid alcohol, tobacco, spices, meat, sweet, strong tea/coffee

The patient should avoid the use of alcohol, tobacco, spices and condiments, meat, red pepper, sour foods, pickles, strong tea and coffee. He should also avoid sweet, pastries, rich cakes, and, aerated waters.

Have curd and cottage cheese

Yoghurt and cottage cheese should be used freely. Too many different foods should not be mixed at the same meal. Meals should be taken at least two hours before going to bed at night. Eight to ten glasses of water should be taken daily but water should not be taken with meals as it dilutes the digestive juices and delays digestion. Above all, haste should be avoided while eating and meals should be served in a pleasing and relaxed atmosphere.

Well-balanced diet

He may, thereafter, gradually embark upon a balanced diet consisting of seeds, nuts, grains, vegetables, and fruits.

Other Gastritis Treatment

Warm-water enema, dry-friction

From the commencement of the treatment, a warm-water enema should be used daily for about a week to cleanse the bowels.The patient should be given dry friction and a sponge daily.

Application of heat with a hot compress or hot water bottle

Application of heat with a hot compress or hot water bottle, twice a daily, either on an empty stomach or two hours after meals, will also be beneficial.

Avoid hard physical, mental work, worries.

The patient should not undertake any hard physical and mental work.He should avoid worries and mental tension.

Breathing exercises are essential

He should, however, undertake breathing and other light exercises like walking, swimming, and golf.

resource : Home Remedies

Diet for Gastritis by Diet Health Club:

After the acute symptoms subside, the patient should adopt an all-fruit diet for further three days. Juicy fruits such as apples, pears, grapes, grapefruits, oranges, pineapples, peaches and melons may be taken during this period at five-hourly intervals.

The patient can, there¬ after, gradually embark upon a well-balanced diet of three basic food groups, namely; seeds, nuts and grains, vegetables and fruits as outlined in Chapter 1 on Diet in health and Disease.

The patient should avoid the use of alcohol, nicotine, pieces and condiments, flesh foods, chillis, sour things, pickles, strong tea and coffee. He should also avoid sweets, pastries, rich cakes and aerated waters. Yoghurt and cottage cheese may be taken freely.

Carrot juice in combination with the juice of spinach Is considered highly beneficial in the treatment of gastritis. Six ounces of spinach juice should be mixed with ten ounces of carrot juice in this combination.

Too many different foods should not be• mixed at the same meal. Meals should be taken at least two hours before going to bed at night.

Eight to ten glasses of water should be taken daily but water should not be taken with meals as it dilutes the digestive juices and delays digestion. And above all, haste should be avoided while eating and meals should be served in a pleasing and relaxed atmosphere.

From the commencement of the treatment, a warm water enema should be used daily for about a week to cleanse the bowels. If constipation is habitual, all steps should be taken for its eradication. The patient should be given daily dry friction and sponge. Application of heat, through hot compressor or hot water bottle twice a day either on an empty stomach or two hours after meals, will also be beneficial.

The patient should not undertake any hard physical and mental work. He should, however, undertake breathing exercises and other light exercises like walking, swimming and golf. He should avoid worries and mental tension.

TREATMENT CHART FOR GASTRITIS
A - DIET

I. An all-fruit diet for five days. Take three meals a day of fresh-juicy fruits at five-hourly intervals and use warm water enema during this period.

II. After an exclusive fresh fruit diet, gradually adopt a well-balanced diet on the following lines:-

1. Upon arising: 25 black raisins soaked overnight in water along with water kept overnight in a copper vessel.

2. Breakfast: Fresh fruit and a glass of milk, sweetened with honey.

3. Lunch: A bowl of freshly-prepared steamed vegetable, two or three whole wheat wheat tortilla and a glass of buttermilk.

4. Mid-afternoon: A glass of carrot juice or coconut water.

5. Dinner: A large bowl of fresh green vegetable salad with lemon juice dressing, green gram bean sprouts, cottage cheese or a glass of buttermilk.

6. Bedtime Snack: A glass of milk or one apple.

B - OTHER MEASURES

1. I do not take water with milk, but half an hour before and one hour after a meal.

2. Never hurry through a meal, never eat to full stomach.

3. And do not eat if appetite is lacking.

4. Wet girdle pack for one hour during night daily.

5. Cold hipbath for 10 minutes.

6. Yogic asanas such as uttanpadasana, pavanmuktasana, vajrasana, Yogamudra, bhujangasana, shalabhasana and shavasana.

resource : Diet Health Club

THERAPEUTIC FOOD AND JUICES for GASTRITIS

Gastric distress in stomach owing to excess gas and acid formed by incompatible combinations of foods, stimulating spices, alcohol, coffee and other irritants.

Cleansing-detox is the very first step towards resolving this issue followed by a rejuvenation-diet.

The below foods and juices are therapeutic and healing after your cleansing.

Yogurt: soothes inflammation; neutralizes toxic gas and acids; promotes efficient digestion. Plain yogurt only, may be flavored with a little molasses, if desired.

Carrot, beet and cucumber juice: powerful alkalizing blend; neutralizes stomach acidity; promotes digestion in stagnant stomach; 10 oz/3 oz/3 oz, 1-2 pints daily.

Spinach (raw or juice): detoxifies intestinal tract; restores pH balance; soothes inflammation; consume raw in salad, or as juice, 6 oz with 10 oz carrot juice, 1-2 pints daily.

Grapes: dark grapes, raw 1-2 pounds daily, with no other food, for 1-3 days; or raw juice equivalent; powerful organic alkalizing and detoxifying elements.

Apple cider vinegar: contains malic acid (all other vinegar's contain acetic acid), which is highly beneficial to digestion; balances stomach pH; 2 tsp. in glass of water, 2-3 times daily as needed.

Other beneficial foods: almonds, molasses, raw apples, raw tomatoes, papaya.

Foods to avoid: deep fat fried foods; pickled and smoked foods; salt preserved foods; vinegar (except apple cider vinegar); hot peppers, mustard, alcohol, coffee, sweet carbonated soft drinks.

resource: HPS Health

Herbal Remedies:

Amla (Indian Goosbery): Amla is the richest natural source of Vitamin C. It prevents Indigestion and controls acidity as well as it’s a natural source of anti-ageing. It is one of the supplement used in hyperacidity and Liver disorders. Amla is found to be one of the strongest rejuvenatives in Indian pharmacopoeia.

Ginger (Zingiber officinale) – In India, ginger has been used to aid digestion and treat stomach upset as well as nausea for more than 5,000 years. This herb is also thought to reduce inflammation.

Licorice (Glycyrrhiza glabra) - this herb is a demulcent (soothing, coating agent) that has long been valued for its use in food and medicinal remedies, including treatments for stomach ailments.

Stress Causes Acid Reflux

noreply@blogger.com (Feliciana) — Wed, 17 Sep 2008 03:55:00 +0000

According to a National Heartburn Alliance Survey, over 58 million Americans suffer acid reflux , with 90 percent saying that acid reflux impacts or changes their lives. They also say cost of their medication impedes their ability to treat their conditions.
Although it has not been proven scientifically, many people believe that stress is a major contributor to acid reflux disease. Physiologically, stress can cause the digestive system to come to a screeching halt. Under stress the body sends energy to the muscles, via the blood stream, to help the body cope with a stressful situation. This means that less blood, or energy, is flowing to the digestive system. When digestion is slowed down in this manner, undigested food and gastric juices remain in the stomach much longer enhancing the occurrence of acid reflux.

What is most striking about the results of this survey is that more than half of the respondents say they have a busy or stressful life which increases the onset and the severity of the symptoms of acid reflux. The study does point out that although there is no proven direct link between heartburn and stress, we do know that stress itself causes behavioral changes that contribute to the problem. Increases in smoking, alcohol use, fast food or eating late at night are just some of the few changes a person may undergo during stressful times.

Reducing Stress and Treating Acid Reflux Disease

Whether you suffer from chronic acid reflux and find that stress exacerbates the condition, or you experience occasional acid reflux brought on by bouts of stress, consider the following:

• Take the pressure off yourself - Lining up too many goals to be accomplished in too short a period of time can be very stressful. Do one thing at a time. Learn to relax and learn to say no when others become too demanding. Set your priorities straight and make lists that you can stick to. Go easy on yourself.

• Take your mind off of you - "Loosing your mind" is not the worst thing you can do. Meditation, Tai Chi, Hatha Yoga, Chi Gong and self-hypnotism are all great ways to relieve stress. Focusing on a demanding activity will take your mind off what is causing the stress. Not thinking about yourself can be very beneficial. These arts can also be applied to enhance life with positive improvement.

• Exercise your way to peace of mind - Everyone knows that exercise is essential for good health. Besides the physical benefits it is also an important way to relieve stress. Who has time to think about problems when you're about to win a tennis match! The endorphins produced in your brain while exercising create an opiate-like "good feeling" sensation that can take you far away from the cares of the day. It is important to find a way to make exercise fun, whether it be jogging with your dog or playing ball with your friends.

• "Let it be" - You cannot control everything in life. There will always be planes that are late arrivals or departures. The weather may not cooperate with that family picnic that you planned. Your mother-in-law may show up when least expected and there will always be taxes to pay. It is important to learn to roll with the punches. You can always find something good in an otherwise bad situation, but most importantly don't let it stress you out.

• Maintain an optimistic attitude - Never underestimate the power of positive thinking. Focus on the good things - not the bad things. Be excited about the future and believe that only good is in store for you. Better than projecting the future, concentrate on the present and demonstrate gratitude in the moment. Being optimistic not only affects others in a positive way, it gives you the balance that you need to be stress free.

• Have a good laugh! - Laughter is the great healer. A good laugh can relieve more stress than anything else. Watch a funny movie, go to a comedy club or go see Hunter Blue perform at Mimi's in New York City. Try to associate with people who make you laugh, or at least don't make you frown. Maintain a good sense of humor at all times. Stress cannot exist where there is laughter.

• Love a dog or a cat - Pet animals are a sure cure for stress. Their pure unaffected love and funny antics can blow that stress away. If you can't muster the obligation of responsibility for a pet, borrow someone else's pet or volunteer to be a care taker when they are out of town. Pets have a tranquilizing affect on us and their power to diminish stress should not be overlooked.

• Talk to a friend - It's very therapeutic when a trusted friend gives advice and thoughtful support. We all need objective guidance at times. Sympathy from friends and relatives has a calming affect and can reduce stress. It's almost as if you are not bearing your problems alone anymore and that kind of encouragement is invaluable.

• Get a massage - There is nothing quite as stress relieving as a good massage. I find that going for acupuncture is very relaxing as well. If you can't manage a massage, indulge in a long hot bath, whirlpool or steam shower.

It has been said that stress is a killer. Thankfully, its reduction is not rocket science and is quite easily accomplished. By reducing the stress in our lives, we can minimize the effect of the acid reflux condition. Of course there are other factors involved with acid reflux, but stress is certainly one of the big ones and should be dealt with in a serious manner. Relax!

© 2006 Wind Publishing
By Charles Stewart Richey

Stress Reduction

Relaxation training technique:
Record these directions for yourself by reading them slowly. Use the tape daily to practice the relaxation response:

Settle back as comfortably as you can and close your eyes. Let your self relax to the best of your ability. Now, as you relax like that, clench your right fist. Just clench your fist tighter and tighter and study the tension as you do so. Keep it clenched and feel the tension in your right fist, hand, forearm. Now relax. Let the fingers of your right hand become loose, and observe the contrast in your feelings. Now, let yourself go and try to become more relaxed all over. Once more, clench your right fist really tight Y hold it, and notice the tension again. Now let go, relax; your fingers straighten out and you notice the difference once more. Repeat that with your left fist. Clench your left fist while the rest of your body relaxes; clench that fist tighter and feel the tension. Now relax. Again, enjoy the contrast. Repeat that once more. Clench the left fist, tight and tense. Now do the opposite of tension: relax and feel the difference. Continue relaxing like that for a while. Clench both fists tighter and tighter, both fists tense, forearms tense. Study the sensations. Relax; straighten out your fingers and feel the relaxation. Continue relaxing your hands and forearms more and more.

Now bend your elbows and tense your biceps, tense them harder and study the tension feelings. All right. Straighten out your arms, let them relax and feel that difference again. Let the relaxation develop. Once more, tense your biceps; hold the tension and observe it carefully. Straighten the arms and relax; relax to the best of your ability. Each time, pay close attention to your feelings when you tense up and when you relax. Now straighten your arms. Straighten them so that you feel the most tension in the triceps muscles along the backs of your arms; stretch your arms and feel that tension. Now relax. Get your arms back into a comfortable position. Let the relaxation proceed on its own. The arms should feel comfortably heavy as you allow them to relax. Straighten the arms once more so that you feel the tension in the triceps muscles; straighten them. Feel that tension Y relax. Now concentrate on pure relaxation in the arms without any tension. Get your arms comfortable and let them relax further and further. Continue relaxing your arms even further. Even when your arms seem fully relaxed, try to go that extra bit further; try to achieve deeper and deeper levels of relaxation.

Let all your muscles go loose and heavy. Just settle back quietly and comfortably. Wrinkle up your forehead now; wrinkle it tighter. Now, stop wrinkling your forehead; relax and smooth it out. Picture the entire forehead and scalp becoming smoother as the relaxation increased. Now, frown and crease your brows and study the tension. Let go of the tension again. Smooth out the forehead once more. Now, close your eyes tighter and tighter. Feel the tension. Relax your eyes. Keep your eyes closed, gently and comfortably, and notice the relaxation. Now clench your jaws, bite your teeth together; study the tension throughout the jaws. Relax your jaws now. Let your lips part slightly. Appreciate the relaxation. Now press your tongue hard against the roof of your mouth. Look for the tension. All right. Let your tongue return to a comfortable and relaxed position. Now purse your lips. Press your lips together tighter and tighter. Relax the lips. Note the contrast between tension and relaxation. Feel the relaxation all over your face, all over your forehead and scalp, eyes, jaws, lips, tongue and throat. The relaxation progresses further and further.

Now attend to your neck muscles. Press your head back as far as it can go and feel the tension in the neck now roll it to the left. Straighten your head and bring it forward. Press your chin against your chest. Let your head return to a comfortable position and study the relaxation. Let the relaxation develop. Shrug your shoulders. Hold the tension. Drop your shoulders and feel the relaxation. Neck and shoulders relaxed. Shrug your shoulders again and move them around. Bring your shoulders up and forward and back. Feel the tension in your shoulders and in your upper back. Drop your shoulders once more and relax. Let the relaxation spread deep into the shoulders, right into your back muscles; relax your neck and throat, and your jaws and other facial areas as the pure relaxation takes over and grows deeper, deeper, ever deeper.

Relax your entire body to the best of your ability. Feel that comfortable heaviness that accompanies relaxation. Breathe easily and freely in and out. Notice how the relaxation increase as you exhale. As you breathe out, just feel that relaxation. Now breathe right in and fill your lungs inhale deeply and hold your breathe. Study the tension. Now exhale, let the walls of your chest grow loose and push the air out automatically. Continue relaxing and breathe freely, gently. Feel the relaxation and enjoy it. With the rest of your body as relaxed as possible, fill your lungs again. Breathe in deeply and hold it again. That's fine, breathe out and appreciate the relief. Just breathe normally. Continue relaxing your chest and let the relaxation spread to your back, shoulders, neck and arms. Merely let go. Enjoy the relaxation.

Now let's pay attention to your abdominal muscles; your stomach area. Tighten your stomach muscles, make your abdomen hard. Notice the tension. And relax. Let the muscles loosen and notice the contrast. Once more, press and tighten your stomach muscles, make your abdomen hard. Notice the tension. And relax. Let the muscles loosen and notice the contrast. Once more, press and tighten your stomach muscles. Hold the tension and study it, relax. Notice the general well being that comes with relaxing your stomach. Now draw your stomach in, pull the muscles in and feel the tension this way. Relax again, let your stomach out. Continue breathing normally and easily. Feel the gentle massaging action all over your chest and stomach. Now pull your stomach in again and hold the tension. Push out and tense like that; hold the tension. Once more, pull in and feel the tension.

Now relax your stomach fully. Let the tension dissolve as the relaxation grows deeper. Each time your breathe out, notice the rhythmic relaxation both in your lungs and in your stomach. Try and let go of all contractions anywhere in your body. Now direct your attention to your lower back. Arch your back, making your lower back quite hollow, and feel the tension along your spine. Settle down comfortably again, relaxing the lower back. Just arch your back and feel the tension as you do so. Try to keep the ready of your body as relaxed as possible. Try to localize the tension throughout your lower back area. Relax once more, relaxing further and further. Relax your lower back, relax your upper back. Spread the relaxation to your stomach, chest, shoulders, arms and facial area, these parts relaxing further, further, further, ever deeper.

Let go of all tensions and relax. Now flex your buttocks and thighs. Flex your thighs by pressing down your heels as hard as you can. Relax and note the difference. Straighten your knees and flex your thigh muscles again. Hold the tension. Relax your hips and thighs. Allow the relaxation to proceed on its own. Press your feet and toes downward, away from your face, so that your calf muscles become tense. Study the tension. Relax your feet and calves. This time, bend your feet toward your face so that you feel tension along your shins. Bring your toes right up. Relax again. Keep relaxing for a while.

Now let your self relax further all over. Relax your feet, ankles, calves and shins, knees, thighs, buttocks and hips. Feel the heaviness of your lower body as you relax still further. Now spread the relaxation to your stomach, waist, lower back. Let go more and more. Feel that relaxation all over. Let it proceed to your upper back, chest, shoulders and arms, right to the tips of your fingers. Keep relaxing more and more deeply. Make sure that no tension has crept into your throat; relax your neck and your jaws and all your facial muscles. Keep relaxing your whole body like that for a while. Let yourself relax all over.

Now you can become twice as relaxed as you are merely by taking in a deep breath and exhaling slowly. With your eyes closed you become less aware of objects and movements around you, thus preventing any surface tensions from developing. Breathe in deeply and feel yourself becoming heavier. Take in a long, deep breath and let it out very slowly. Feel how heavy and relaxed you have become.

In a state of perfect relaxation you should feel unwilling to move a single muscle in your body. Think about the effort that would be required to raise your right arm. As you think about raising your right arm, see if you can notice any tensions that might have crept into your shoulder and arm. You decide not to lift the arm but to continue relaxing. Observe the relief and the disappearance of tension.

Just carry on relaxing like that. When you wish to get up, count backward from four to one. You should then feel fine, refreshed, wide awake and calm.

Coping.org is a Public Service of James J. Messina, Ph.D. & Constance M. Messina, Ph.D., Email: jjmess@tampabay.rr.com ©1999-2007 James J. Messina, Ph.D. & Constance Messina, Ph.D. Note: Original materials on this site may be reproduced for your personal, educational, or noncommercial use as long as you credit the authors and website.

Upper Gastrointestinal Tract Conditions as Affected by Probiotics

noreply@blogger.com (Feliciana) — Thu, 24 Jan 2008 05:54:00 +0000

Antioxidant Property of OM-X Probiotic Capsules. Bioactive components of the human diet, such as antioxidants, contribute a significant "flinction" to several plant-based food products. Antioxidants are very important to human health because they play a vital role in reducing the risk of "radical-related" oxidative damage associated with many clinical conditions and degenerative diseases.
By Iichiroh Ohhira

Current 20th Century research focuses on the potential to influence, by dietary means, the functional level of antioxidants in the body. Western research has emphasized the importance of the established antioxidant micronutrients including vitamins A, C, E and beta-carotene. Evidence tends to argue in favor of the possible protective mechanisms underlying the value of these nutrients in reducing the risk of several important degenerative diseases especially cancer, cardiovascular disease and ocular cataracts.

As has been establish by scientific research conducted by a team of Japanese research scientists, headed by Dr. lichiroh Ohhira (the award-winning microbiologist most celebrated as the inventor of OM-X Probiotic Capsules), consumption of OM-X Probiotic Capsules on a regular basis will enhance the capability of the human body to produce badly needed antioxidants. Antioxidants are particularly important because of the role they play in combating certain human degenerative conditions. Worldwide, only OM-X Probiotic Capsules provide the ingredients isolated by Dr. Ohhira and his team of scientists.

Upper Gastrointestinal Tract Conditions and OM-X. The role of probiotics like OM-X in the prevention and treatment of certain conditions have now become evident from research on the microflora of the upper gastrointestinal tract with special reference to the lactic acid bacteria group (LAB). In fact, many research scientists are now convinced that probiotic products, such as OM-X, can assist in the treatment of certain diseases.

The normal microflora of the mouth, stomach and duodenum are a rich ecosystem of enormous complexity containing a large number of species of bacteria. The esophagus and mouth have similar bacterial populations. In a "fasting" condition, the stomach and duodenum contain very few microorganisms and those that are present are mainly derived from the oral cavity and throat The total population and species in the entire ecosystem show dramatic variations along the gastrointestinal tract with the highest concentration of microorganisms residing in the colon.

During fasting, the gastric juice contains only small numbers of bacteria and yeast ranging from 100 to 100,000 per ml. The predominant bacterial group found in the stomach and duodenum include Streptococci, Lactobacillus sp., Veillonelta sp. and Clostridium perfringens.

After a meal, the bacterial counts in the gastric juice increase 100 to 1000 fold. This dramatic increase in transient bacterial counts will return to baseline levels within one to two hours as a result of a decrease in gastric juice volume and pH, as well as the effects of gastric motility.

A wide variation of bacterial types occurs among individuals, however, the number of species and population of bacteria are relatively stable in healthy adults. Within the upper gastrointestinal tract, the normal established "resident" bacterial microflora may be altered by bacteria introduced into the body as a normal part of food ("transient" microflora) or as contaminants ("accidental" microflora). In the upper gastrointestinal tract, these transient bacteria have a much greater effect on the resident microflora because of the lower numbers of the latter being present.

In spite of its stability, the intestinal microflora can vary enormously in the stomach and duodenum dependent on host factors such as level of gastric acid secretion, bile salts, and mucous in the intestinal wall.

In addition, medications, diet, infections, age, stress and climate can also alter the microflora. The contents of microflora may also be influenced by bacterial interaction such as antagonism or symbiosis. Adaptation of intestinal microflora can occur to most substances that enter the intestines from the oral tract or the biliary system. This adaptation occurs within several days with the ability of intestinal microflora to metabolize these substances. Gastric acid inhibits the growth of microorganisms with the stomach of patients having no gastric acid showing an increased number of bacteria.

Lactic acid bacteria (LAB) including lactobacillus, leuconostoc, lactococcus, pediococcus, and bifidobacterium are found throughout the gastrointestinal tract. The predominant population of lactic acid bacteria in the upper gastrointestinal tract is the lactobacillus species. Lactobacilli may colonize the mucosal surface of the duodenum as well as the stomach. For this to occur, lactobacilli must possess certain properties including adhesion, competitive exclusion ability and bacterial inhibitor production.

Only OM-X Probiotic Capsules provide live lactic acid bacteria that is "cultured" by Dr. Ohhira to be 6.25 times stronger than any naturally occurring lactic acid bacteria. Consequently, the "bad" bacteria in the upper gastrointestinal tract is destroyed or "inhibited" by the presence of the "good" bacteria contained in OM-X. Also, the special strains of OM-X's lactic acid bacteria, specifically TH 10, which is isolated from the Malaysian delicacy tempeh, are capable of inhibiting all harmful pathogenic bacteria living in the human "gut" including the MRSA (methicillin-resistant Staphylococcus aureus).

Clearly, OM-X Probiotic Capsules, as developed by Dr. Ohhira, are the world's finest probiotic products. Only OM-X recognizes the challenges associated with maintaining and strengthening the microflora contained in the human "gut" so that the resident "good" bacteria make up at least 85 percent of the bacteria living in the "gut" and not more than 15 percent of "bad" bacteria reside in the human body.

Herbal Teas for Acid Reflux Treatment

noreply@blogger.com (Feliciana) — Thu, 24 Jan 2008 04:38:00 +0000

Herbal teas for acid reflux are very effective and also serve as an anti-cancer agent for your body. Tea has been used for thousands of years to soothe and ease a variety of health problems. Organic herbal tea also has been known to support wellness -- and is a good choice for those searching for a natural heartburn herbal remedy. That means that any herbal teas that you try must be caffeine-free. A few herbal teas for acid reflux:

Green Tea is an excellent choice to help your body digest oily and spicy foods. It can also help calm an upset stomach. Green tea is widely known for its antioxidant properties, and may even help reduce your risk for gastric and esophageal cancers. Again, be sure to choose a green tea that is non caffeinated.
Chamomile tea or Fennel is one of the most popular teas used. Not only that this herbal teas for acid reflux helps prevent acid reflux this could also help relieve indigestion, heartburn, anxiety and sleep disturbances. Chamomile is said to relieve esophageal irritation.
Peppermint tea which is made from the mint leaves that are brewed. This helps calm heartburn, settle upset stomach and relieve gas pain. Although there were doubts that peppermint could help a person with heartburn, there’s also proof that it does. The oil from the peppermint helps stimulate the flow of bile to the stomach. Studies have also indicated that drinking peppermint, spearmint or other strongly spiced teas actually causes the lower esophageal sphincter to relax even more, resulting in additional acid reflux and heartburn.
Chicory Root Tea can also be used to make a great herbal tea. You boil a few cups of this and then let sit for a while. You can then drink the tea with honey if you wish.
Marshmallow tea is make from the marshmallow plant root that is used in herbal medicinal products. It is said to ease bladder infections, coat and soothe the gastrointestinal tract, relieve sore throats, ease respiratory problems and promote healing of the urinary tract.
Lavender Tea is a very special herbal tisane which has calming effects that helps relieve stress, fatigue, headache and insomnia.
Black Tea which are highly concentrated in the tea, have been associated with a number of health benefits that include reduced the risk of stroke and heart disease. According to the USDA flavonoid database, both black and green contain 150 to 190 milligrams of flavonoids per cup. They also provide trace amounts of healthful minerals such as potassium and fluoride.
Ginger Tea can help sooth acid reflux symptoms, and if you can find it in a tea, a cup after a meal might help your stomach settle down for the night. You can mix peppermint with aniseed and lavender for a great tasting and soothing blend. You should boil a few cups of water and a teaspoon of your herbal mix, then drain the herbs after sitting for about ten minutes. If you boil this tea and want to have it sweetened, you might try honey instead of sugar or artificial sweetener. We found a great inexpensive Ginger Tea by Botanic Choice that is perfect to ease these symptoms. Ginger is a natural wonder for occasional stomach upset indigestion and heartburn. It acts directly in the stomach to neutralize certain acids and toxins.
Rooibos Tea contains no colors, additives or preservatives, making it a natural beverage. It contains no caffeine which makes it a perfect warming tea if you have heartburn. Studies also show that this tea contains anti - spasmodic agents, which can relieve stomach cramping and colic in infants.

There are lots of other type of herbal teas for acid reflux that are available but remember that there are some teas that you might be allergic to so in order to make sure that you’re safe to drink it better ask your doctor first. Using the herbal teas acid reflux treatment is a much safer and a natural way of curing or improving your lifestyle.

Instead of drinking coffee everyday try changing it to herbal tea still have similar effects but herbals teas gives you more benefits than health risk. Because too much coffee drinking is one of the major causes of acid reflux and by switching to herbal teas you could help your body be healthy.

Although more expensive, it may be worthwhile to get good quality organic herbs if your aim is to also help you detoxify and cleanse your body system.

Study links Chronic Heartburn to Esophageal Cancer

noreply@blogger.com (Feliciana) — Thu, 24 Jan 2008 04:00:00 +0000

Over the past 20 years, the incidence of esophageal cancer, a highly fatal form of cancer, has rapidly increased in the United States. A recent research study has linked chronic, longstanding, untreated heartburn with an increased risk of developing esophageal cancer. As reported by Lagergren et al. in the study that was published in the New England Journal of Medicine, patients who experienced chronic, unresolved heartburn markedly increase the risk of esophageal cancer, a rare but often deadly malignancy. According to the study, the incidence of adenocarcinoma of the esophagus was nearly eight times more likely among frequent heartburn sufferers (two times a week or more) compared to individuals without symptoms, while among patients with longstanding, severe and unresolved heartburn (e.g. frequent symptoms 20 years duration), the risk of developing esophageal cancer was 43.5 times as great as for those without chronic heartburn.

Persistent symptoms of heartburn and reflux should not be ignored. By seeing your doctor early, the physical cause of GERD can be treated and more serious problems avoided.

Privacy Policy for acid-reflux-dd.blogspot.com

noreply@blogger.com (Feliciana) — Tue, 15 Jan 2008 03:05:00 +0000

If you require any more information or have any questions about our privacy policy, please feel free to contact us by email at kletingkuning@gmail.com.

At acid-reflux-dd.blogspot.com, the privacy of our visitors is of extreme importance to us. This privacy policy document outlines the types of personal information is received and collected by acid-reflux-dd.blogspot.com and how it is used.

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If you wish to disable cookies, you may do so through your individual browser options. More detailed information about cookie management with specific web browsers can be found at the browsers' respective websites.

Serious Complication of Acid Reflux or Gastroesophageal Reflux Disease

noreply@blogger.com (Feliciana) — Mon, 10 Dec 2007 04:49:00 +0000

The more serious long term complications of Acid Reflux or GERD is not treated effectively, the constant acid reflux can irritate the lining of the esophagus, and serious complication that may occur are :

A. Barrett's esophagus.

Acid Reflux or Heartburn that is severe or occurs frequently over a long period of time is a characteristic of Gastroesophageal Reflux Disease (GERD). If GERD is untreated, it can be harmful; the constant acid reflux will irritate the lining of the esophagus, and complications can occur. One of these complication is Barrett's esophagus.

Barrett's esophagus is a condition in which the esophagus, the muscular tube that carries food and saliva from the mouth to the stomach, changes so that some of its lining is replaced by a type of tissue similar to that normally found in the intestine. Those with Barrett's esophagus are 30 to 125 times more likely to develop esophageal cancer than those without this condition.
Barrett's esophagus (BE) is a serious condition in which changes occur in the cells that line the lower esophagus and cause the cells to become abnormal and precancerous.

B. Esophageal cancer.

The esophagus is a hollow tube that carries food and liquids from your throat to your stomach. Early esophageal cancer usually does not cause symptoms. However, as the cancer grows, symptoms may include painful or difficult swallowing, weight loss and coughing up blood.

Esophageal cancer is a disease in which malignant (cancer) cells form in the tissues of the esophagus. Doctors cannot always explain why one person gets cancer and another does not. There is, however, a strong association between gastroesophageal reflux disease (GERD)and esophageal cancer.

C. Laryngeal cancer.

Laryngeal cancer may also be called cancer of the larynx or laryngeal carcinoma. Most laryngeal cancers are squamous cell carcinomas, reflecting their origin from the squamous cells which form the majority of the laryngeal epithelium.

For the purposes of tumour staging, the larynx is divided into three anatomical regions: the glottis; the supraglottis epiglottis, arytenoids and aryepiglottic folds, and false cords); and the subglottis.

Researchers have reported that GERD is significantly associated with the development of laryngeal cancer (cancer of the larynx).

D. Erosive esophagitis.

Esophagitis is an inflammation and swelling of the esophagus, and is most often caused by acid-containing stomach contents refluxing back up into the esophagus.

Esophagitis means inflammation of the foodpipe. This is often characterized by redness of the lining of the foodpipe (erythema)and breaks in the lining of the foodpipe (erosions). One of the causes for the development of esophagitis is gastroesophageal reflux disease (GERD).

E. Esophageal strictures.

An esophageal stricture is a gradual narrowing of the esophagus, which can lead to swallowing difficulties. The esophagus is a relatively simple tubular structure connecting the throat to the stomach. The major functions of the stomach are to transport ingested food from the oropharynx to the stomach and to prevent regurgitation of food and gastric contents from the stomach back up into the esophagus.

Short Term Treatment of GERD or Heartburn

noreply@blogger.com (Feliciana) — Thu, 06 Dec 2007 02:42:00 +0000

Below you will find various options for heartburn treatment and GERD/acid reflux treatment for short-term relief to 24-hour acid control :

A. Drug Medication.

These acid reflux medications for children include antacids and acid reducers such as:

Antacids . Antacids neutralize the acid in your stomach and provide prompt heartburn treatment and heartburn relief.
Maalox.
Mylanta.

B. Histamine-2 receptor antagonists

Axid oral. Nizatidine is used to treat ulcers of the stomach and intestines and prevent them from coming back after they have healed. This medication is also used to treat certain stomach and throat (esophagus) problems caused by too much stomach acid (e.g., erosive esophagitis) or a backward flow of stomach acid into the esophagus (acid reflux disease/GERD).
Carafate oral. This medication is used to treat and prevent ulcers in the intestines. Sucralfate forms a coating over ulcers, protecting the area from further injury. This helps ulcers heal more quickly.
Pepcid oral. Famotidine is used to treat ulcers of the stomach and intestines. It may be used to prevent intestinal ulcers from returning after treatment. This medication is also used to treat certain stomach and throat problems caused by too much stomach acid (e.g., Zollinger-Ellison syndrome, erosive esophagitis) or a backward flow of stomach acid into the esophagus (GERD).
Reglan oral. This medication is used to treat certain conditions of the stomach and intestines. Metoclopramide is used as a short-term treatment (4 to 12 weeks) for persistent heartburn when the usual medicines do not work well enough.
Tagamet oral. Cimetidine is used to treat ulcers of the stomach and intestines and prevent them from coming back after they have healed. This medication is also used to treat certain stomach and throat (esophagus) problems caused by too much stomach acid (e.g., Zollinger-Ellison syndrome, erosive esophagitis) or a backward flow of stomach acid into the esophagus (acid reflux disease/GERD).
Zantac oral. Ranitidine is used to treat ulcers of the stomach and intestines and prevent them from returning after treatment. This medication is also used to treat and prevent certain stomach and throat (esophagus) problems caused by too much stomach acid (e.g., Zollinger-Ellison syndrome, erosive esophagitis) or a backward flow of stomach acid into the esophagus (gastroesophageal reflux disease-GERD).

C. H₂ blockers.

H₂ blockers block stomach acid production and provide acid reflux treatment and relief of heartburn symptoms. However, they do not block acid as completely as proton pump inhibitors.

D. Proton Pump Inhibitor (PPI).

Proton pump inhibitors are highly effective treatments and are used for long-term GERD or acid reflux treatment. Proton pump inhibitors control stomach acid and provide heartburn relief.

ZEGERID. Providing rapid release of the active ingredients and up to 24-hour acid control and heartburn relief.
Aciphex oral. Rabeprazole works by blocking acid production in the stomach. This medication is known as a proton pump inhibitor (PPI). It is used to treat acid-related stomach/intestinal and throat (esophagus) problems (e.g., acid reflux or GERD, ulcers, erosive esophagitis, Zollinger-Ellison syndrome).
Nexium oral. Esomeprazole works by blocking acid production in the stomach. This medication is known as a proton pump inhibitor (PPI). It is used to treat acid-related stomach and throat (esophagus) problems (e.g., acid reflux or GERD, erosive esophagitis).
Prilosec oral. Omeprazole works by blocking acid production in the stomach. This medication is known as a proton pump inhibitor (PPI). It is used to treat acid-related stomach and throat (esophagus) problems (e.g., acid reflux or GERD, ulcers, erosive esophagitis, or Zollinger-Ellison Syndrome). Decreasing excess stomach acid can help relieve symptoms such as heartburn, difficulty swallowing, persistent cough, and trouble sleeping.
Prevacid oral. Lansoprazole works by blocking acid production in the stomach. This medication is known as a proton pump inhibitor (PPI). It is used to treat acid-related stomach and throat (esophagus) problems (e.g., acid reflux or GERD, ulcers, erosive esophagitis, Zollinger-Ellison syndrome).
Protonix oral. Pantoprazole works by blocking acid production in the stomach. This medication is known as a proton pump inhibitor (PPI). It is used to treat acid-related stomach and throat (esophagus) problems (e.g., acid reflux or GERD, erosive esophagitis, Zollinger-Ellison syndrome).

Acid Reflux Repair - Endoscopic Suturing

noreply@blogger.com (Feliciana) — Thu, 06 Dec 2007 02:27:00 +0000

Endoscopic Suturing Non-Invasive, Out-Patient Solution For GERD.

Endoscopic Suturing or Endoscopic Gastroplication is an exciting non-surgical method used by Dr. Anthony Starpoli to treat Gastro Esophageal Reflux Disease (GERD). This treatment is a breakthrough alternative to life-long medical therapy or invasive and costly surgery.

A device, like a tiny sewing machine, is attached to the end of a standard, flexible endoscope or tube. The video endoscope allows the physician to place a suture (stitch) near the LES. Two stitches can be placed and tied together to create a pleat near the LES and treat symptomatic acid reflux.

The specific advantages of endoscopic suturing include :

Lower procedure cost than other treatment alternative.
The procedure can offer patients an alternative to expensive medications that often must be taken for the life of the patient.
It is an outpatient procedure.
The procedure does not require an incision and is more comfortable for patients than surgical alternatives.
Faster recovery time than surgical treatment.

The following patients should probably not undergo endoscopic gastroplication:

History of surgery of the esophagus or stomach.
Barrett’s Esophagus.
Esophageal motility dysfunction.
Inability to receive sedation.
Patients with a large hiatal hernia.
Morbid obesity.
Significant heart or lung disease.

The following patients may be considered:

Patients should show a good response to medical therapy.
Patients who are not markedly over weight.
Those with a small hiatal hernia.
Patients seeking an alternative to chronic medical therapy

learn more : in EndoCinch Clinic

Acid Reflux General Treatment | Gastroesophageal Reflux Treatment

noreply@blogger.com (Feliciana) — Thu, 06 Dec 2007 02:16:00 +0000

Treatment for Acid Reflux Disease:
General measures the patient can take to reduce reflux are:

Eat smaller and more frequent meals.
Avoid eating before going to bed.
Eliminate excessive bending, lifting, abdominal exercises, girdles and tight belts, all of which increase abdominal pressure and provoke reflux.
If overweight, lose weight. Being overweight promotes reflux.
Eliminate the use of nicotine (cigarettes), fatty foods, alcohol, all coffees (yes-including decaf), chocolate and peppermint.
Elevate the head of the bed 8" to 10" by placing pillows or a wedge under the upper part of the mattress. In this way, gravity keeps stomach juices out of the esophagus while the patient sleeps. It is not enough to use two pillows under the head.
Prescription medications - check with the physician regarding side effects of prescription drugs. Some drugs actually lower the strength of the LES muscle. These include anti-spasmotics (Levsin, Librax, Bentyl), calcium channel blocks (Procardia, Cardizem, Calan, Isoptin), anti-depressants (Elavil, Doxepia) and others.

Bravo™ pH Monitoring System Effective to Treatment GERD or Acid Reflux

noreply@blogger.com (Feliciana) — Tue, 04 Dec 2007 05:40:00 +0000

What is the Bravo™ pH Monitoring System?

The Bravo pH Monitoring System is a catheter-free way to measure pH.

The Bravo system involves a pH capsule, about the size of a gel cap, that is temporarily attached to the wall of the esophagus. The Bravo™ pH Capsule measures pH levels in the esophagus and transmits readings via radio telemetry to the Bravo™ Receiver worn on the patient’s belt or waistband. The patient also records symptoms he or she experiences in a diary by pressing buttons on the receiver. The Bravo pH capsule collects pH measurements for up to 48 hours. After the study, data from the receiver is uploaded to a computer and diary information is entered for analysis to aid in the diagnosis and plan treatment. Normal patient activities such as swallowing, eating and drinking should cause the disposable pH capsule to detach and pass through the digestive tract in 5-7 days on average.

How is the Bravo pH capsule attached to the esophagus?

The doctor uses the Bravo Delivery System to insert the pH capsule through the mouth or nose and position it above the lower esophageal sphincter. Once the pH capsule is in place, suction is applied, drawing a small amount of esophageal tissue into the capsule and locking it in place. The delivery system is then withdrawn and the pH capsule can begin measuring pH levels.

How is the Bravo pH capsule attached to the esophagus?

The doctor uses the Bravo™ Delivery System to insert the pH capsule through the mouth or nose and position it above the lower esophageal sphincter. Once the pH capsule is in place, suction is applied, drawing a small amount of esophageal tissue into the capsule and locking it in place. The delivery system is then withdrawn and the pH capsule can begin measuring pH levels.

Study and Research

The study enrolled 23 consecutive patients who had symptoms suggestive of reflux but who previously had shown normal acid exposure and negative symptom association when evaluated with traditional, catheter-based pH monitoring systems. Researchers used standard esophageal acid measurements to analyze total reflux, upright reflux and supine reflux. Acid exposure over 24 hours was the primary outcome of the study. Key findings included:

- More than 1 in 4 patients with a negative pH catheter study had pathological acid exposure during a 48-hour period of wireless pH monitoring.

- Nearly one in two patients had at least one day of pathological exposure during a 96-hour period of wireless pH monitoring (total, upright or supine).

- Prolonged monitoring also increased the number of patients with a significant association between reflux episodes and symptoms.

- Follow-up showed that 6 of 7 patients with positive findings (acid exposure or symptom association) did well after anti-reflux surgery; whereas 6 of 7 patients with entirely negative findings failed to respond to medical therapy.

Researchers indicated that it is unclear as to whether average pH measurement or the single-worst-day measurement is more clinically relevant, noting that either approach increased the diagnostic yield in this study.

Source:
- esophyxny.com

Acid Reflux Diets - What to Avoid?

noreply@blogger.com (Feliciana) — Tue, 04 Dec 2007 05:25:00 +0000

Acid Reflux Diets- It's all about what to Avoid

What To Avoid:	Why To Avoid it:	Natural supplement to stop the problem
Fried Food	Hard to Digest/Acidic	Digestin/BufferpH+
Whole Milk or milk based cooking	Hard to digest	Digestin
Vegetable Oil or Lard	Hard to Digest/Acidic	Buffer pH+
Chocolate or Sweets	Stimulant/Relaxes the flap Acidic	Buffer pH+
Fast Food Restaurants	Hard to Digest/Acidic	Buffer pH+
Spicy Foods	Acidic	Buffer pH+
Citrus, Tomato or Acidic Foods	Acidic	Buffer pH+
High Fat Content Foods	Hard to Digest/Acidic	Digestin/BufferpH+
Alcohol and Regular Coffee and carbonated drinks like soda	Stimulant/Relaxes the flap Acidic	Buffer pH+
Things that cause gas-beans, broccoli	Causes Belching and damage to the flap	Digestin
Smoking	Stimulant/Relaxes the flap Acidic	Buffer pH+

These truly amazing formulas safely helped improve the way my body digested food and reduced the stomach acid to stop the reflux cold.
About Digestin About Buffer pH+

from : Acid Reflux Relief