MEDICAL INFORMATION
GASTROESOPHAGEAL REFLUX DISEASE
Hot and spicy!!! A: Brad Pitt; B: Halle Berry; C: Reflux/Heartburn; D: All of the above
Spring and summer brings great weather, picnics, and of course breaking out our grills. Yeah!!! The tantalizing smell of grilled ribeyes, hamburger and ribs topped off with French fries, a cold beer or margarita on the rocks, and of course apple pie. We eat until we are satisfied, and then we plop down on the couch in front of our new 52 inch plasma TV. We fall asleep only to be awakened by a heart wrenching, painful sensation in our chest and throat. Ouch!
Acid spill- Never good.
What is reflux?
Reflux and heartburn occurs when the stomach contents including the acid can then move upward into the esophagus. This can occur if the "prevention mechanism" the lower esophageal sphincter relaxes or is not properly functioning. Delayed emptying of the stomach may also be a cause. Increased acid production in the stomach may be a contributing factor.
Hey! Loosen up and relax!
Causes and symptoms of reflux
- Weight- excessive weight especially in the abdomen will increase your risk of reflux by increasing the amount of abdominal pressure
- tight clothing- tight fitting clothing- especially pants, skirts, and belts also increase the pressure on the abdominal area and will cause more reflux into the esophagus.
- time of eating- eating a heavy meal within 2 hours of lying down does not give the stomach enough time to empty into the small intestine.
- different foods such as caffeine, acidic foods- oranges, tomato etc, chocolate, peppermint, fatty foods, alcohol, garlic, onions
- hiatal hernia- a hiatal hernia occurs when a portion of the stomach is above the diaphragm, as opposed to the stomach's normal position below the diaphragm. The lower esophageal sphincter is less competent in a person with a hiatal hernia, therefore stomach contents can easily propulse into the esophagus
- stress- stress no doubt increases the risk for reflux and ulcers
- H. pylori- this is a bacteria that also can cause reflux. It is treated with a course of antibiotics, and can be tested via the blood or biopsies of the stomach
- other medical diseases such as connective tissue disease, pregnancy, smoking, medicines (steroids, non steroidal anti-inflammatories)
Symptoms of reflux/heartburn include nausea, regurgitation, chest discomfort, lump in the throat, chronic cough.
Take a peek!
Reflux can be further assessed and diagnosed via multiple methods. The pH (the lower the pH, the more acidic the substance is) of the esophagus can be checked with a probe. An EGD (esophagogastroduodenoscopy) is a procedure where a scope is used to examine and biopsy the esophagus, stomach and the first portion of the small intestine, the duodenum. Reflux disease, ulcers, cancers or infection of these organs can be diagnosed with an EGD. These procedures are commonly performed in an outpatient setting.
Good riddance!
Fortunately, for us and our love of spicy and fried foods, there are remedies for heartburn. These remedies range from homeopathic regimens to surgical intervention.
Treatment:
Over the Counter preparations- Supermarket and pharmacy aisles have a plethora of treatment options available without a prescription. Antacids (Tums, Rolaids, Maalox), bismuth (Pepto-bismol), H2 blockers (Zantac, Pepcid), proton pump inhibitors (Prilosec, Prevacid) are all amongst the available treatment options.
Prescription medications: Some people may opt to use prescription products particularly if advised by your health care provider. These products may include prokinetics (Reglan), which speeds the transit time out of the stomach, therefore less food and acid is available for reflux.
Proton pump inhibitors (eg. Prevacid, Nexium, Aciphex, Dexilant) - proton pump inhibitors prevent the productions of protons (H+) which is an essential element in acid production.
H2 blockers block histamine production. Histamine in the stomach assists with acid production. While most H2 blockers are available over the counter, prescription strengths are also available.
Other treatment options:
Apple cider vinegar, aloe vera, papaya, okra may also help with heartburn. Weight loss no doubt is an important element in reducing the abdominal pressure and reflux.
Antibiotics may be implemented in treating H. pylori associated reflux.
Elevating the head of the bed on blocks helps to prevent reflux.
Surgery- Nissen fundoplication can tighten the lower esophageal sphincter. Repair of the hiatal hernia can also reduce reflux.
Don't get burned!
Chronic or inadequately treated reflux and gastritis can have detrimental, even life threatening consequences.
Complications include, but are not limited to:
- Barretts esophagus- a severe irritation of the esophagus which my lead to cancer
- stricture of the esophagus,
- anemia,
- ulcers which can bleed or perforate (create a hole),
- laryngitis,
- asthma,
- cancer of the esophagus
- dentition problems,
- bad breath
Enjoy your picnics. Don't overeat! If you do, bring along some reflux medications along with the potato salad and hot dogs.
Disclaimer: This information is not intended to replace medical advice provided by your health care provider. Always seek medical attention from your health care provider. We will not be liable for any health or medical information provided.
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Dr. Graham's Professional Affiliations
- American Academy of Otolaryngology
- American Academy of Otolaryngic Allergy
- American Medical Association
- Texas Medical Association
- Hunt-Rockwall-Rains County Medical Association
- NTENT (North Texas ENT)
- Dallas Academy of Otolaryngology
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