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GERD
GERD or gastroesophageal reflux disease is used to describe acid reflux, a
condition in which the liquid stomach contents back up into the esophagus. This
liquid contains stomach acid and the digestive enzyme pepsin, and may also
contain bile that has backed-up into the stomach from the duodenum, or beginning
of the small intestine. Acid is believed to be the most injurious component of
this reflux, which causes inflammation and eventually damages the
esophagus,
GERD is often confused with common heartburn but GERD is far more serious. GERD
is a chronic condition that may persist for the individual’s entire life, and
can damage the tissue that lines the esophagus. This may result in another
chronic condition called esophagus, which is also a chronic condition. Once a
diagnosis of GERD is made, the treatment will usually be lifelong.
Most individuals experience the reflux of the stomach's liquid contents into the
esophagus occasionally, sometimes even as often as a GERD patient. In GERD,
however, the liquid contents are primarily composed of acid, which remains in
the esophagus for a longer time.
The body tries
to protect itself from this acidic assault. When the sufferer is awake and in an
upright position gravity usually returns the refluxed liquid back to the
stomach. Also, the awake individual repeatedly swallows which carries any
refluxed liquid back to the stomach. Another defense is provided by the
bicarbonate-containing saliva produced by the salivary glands that neutralizes
the acid. These protective mechanisms work only when individuals are in the
upright position. While sleeping, gravity is not in effect, swallowing stops,
and the secretion of saliva is reduced. Therefore, reflux that occurs at night
is more likely to result in acid remaining in the esophagus longer and causing
greater damage.
The cause of
GERD is unknown, but certain conditions predispose an individual to developing
it. Many women first experience GERD during pregnancy and the reason is
twofold; hormone levels lower the pressure in the lower esophageal sphincter,
and the fetus increases abdominal pressure. Both of these effects would be
expected to increase reflux. Patients who suffer from scleroderna or mixed
connective tissue diseases, which weaken the esophageal muscles, are susceptible
to develop GERD. Also, hiatal hernia often leads to GERD, as do some lifestyle
factors such as, smoking, obesity and use of alcohol.
Food is often a
trigger for GERD, in particular citrus fruit, chocolate, caffeine, fatty,
including fried, foods, garlic and onion, spices and tomato based sauces.
Avoiding these foods, and alcohol, is the first of several lifestyle changes
that is the first step in effective GD management. Others changes that will
help alleviate symptoms include losing weight and stopping smoking. You will be
advised to wear loose fitting clothing, to eat less at each meal, and to remain
upright for at least 3 hours after eating. It is helpful to raise the head of
your bed 6 to 8 inches. Your doctor may recommend that you take over the
counter antacids or Gaviscon, which is a foaming agent that covers your stomach
contents with foam to prevent reflux. Pepcid AC and Tagamet are H2 blockers and
stop acid production. All of these medications have side effects, so discuss
taking them with you doctor and let he or she decide which is the best for you.
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