Thursday, August 28, 2008

Health Care and GERD

Heartburn is an expression of a condition known as gastroesophageal reflux disease (GERD), a phenomenon in which acid and pepsin rise from the stomach into the esophagus, much like water bubbling into a sink from a plugged drain according to the Harvard Health Publications Special Health Report as reported by Everyday Health. The burning sensation is usually felt in the chest just behind the breastbone and often extends from the root of the neck to the lower end of the rib cage. It can last for hours and may be accompanied by the very unpleasant, stinging sensation of highly acidic fluid rushing into the back of the throat. There may also be a sour taste in the mouth.

But, according to the Harvard Health report, the heart of heartburn is the burning behind the sternum. A variety of foods; certain emotions such as anxiety, anger, or fear; and even particular positions, like reclining or bending forward, can aggravate it. While heartburn is obviously a nuisance for many, others seem to live with it quite well. However, people spend countless hours and untold sums of money looking for a way to spell relief. Heartburn can mimic a heart attack but luckily is not life-threatening. About one-third of Americans have heartburn at least once a month, with 10% experiencing it nearly every day. One survey revealed that 65% of people with heartburn may have symptoms both during the day and at night, with 75% of the nighttime heartburn patients saying that the problem keeps them from sleeping, and 40% reporting that nighttime heartburn affects their job performance the following day. This epidemic leads people to spend nearly $2 billion a year on over-the-counter antacids alone. Clearly, it's a major problem.

EverydayHealth.com states that a doctor may be helpful when the symptoms are worrisome to the patient or if they interfere with sleep or daily life. Many people can manage heartburn without seeking medical care, through dietary changes and over-the-counter medications. If you do seek your physician’s advice, providing a detailed account of your symptoms will help him or her make the diagnosis. The doctor will review your medical history and ask detailed questions about the nature of the pain and its pattern of onset. For example, he or she may ask whether symptoms are worse after you eat a heavy meal or known dietary troublemakers such as high-fat foods or dairy products. Your doctor will want to know if bending over to tie your shoelaces or lying down aggravates the symptoms and whether the pain seems linked to anxiety or stress. A physician may ask whether regurgitated stomach contents leave a bitter or acidic taste in your mouth. A sudden outpouring of salty fluid in the mouth, called water brash, can result from salivary secretions stimulated by reflux.

Though simple reflux is uncomfortable according to EverydayHealth.com, it doesn't usually pose a danger to healthy individuals. From half to three-quarters of those with reflux disease have mild symptoms that generally clear up in response to simple measures. Over time, however, serious problems can develop when persistent GERD with frequent relapses goes untreated. These complications can include severe narrowing (stricture) of the esophagus, erosion of its lining, precancerous changes in its cells, and esophageal ulcers. One complication, known as reflux esophagitis, is inflammation that occurs when acid and pepsin, released from the stomach, erode areas of the mucosa, the surface layer of cells that line the esophagus. Besides the burning sensation of heartburn, patients with esophagitis may also complain of pain behind the breastbone spreading into the back or up to the neck, jaw, or even the ears. The pain can be so intense that you may have trouble swallowing and may even think you are having a heart attack. With esophagitis, food may feel as if it sticks in your throat before going down the gullet. Hot drinks are unpleasant to swallow, and you may have some nausea. You may also regurgitate some acid fluid into your throat, resulting in a cough. The inflammation of the esophagus can even lead to bleeding. Endoscopy is necessary to confirm the diagnosis of esophagitis and locate any associated ulcers or strictures.

AstraZeneca gives helpful tips for treatment of GERD. Medical treatment is not the only option for managing GERD symptoms. Changes in diet, nutrition, and routines can be used alone, or combined with a medical treatment, to gain relief from the pain associated with GERD. The following lifestyle changes have been shown to have a positive effect on symptoms associated with GERD in some patients:
--Losing weight
--Quitting smoking
--Wearing loose-fitting clothing
--Eating smaller meals
--Raising the head of the bed when sleeping
--Waiting at least 3 hours before lying down after eating
--Avoiding certain foods and drinks, including:
Chocolate
Peppermint
Alcoholic drinks
Caffeinated beverages
Citrus drinks
Tomato-based foods
High fat and/or fried foods

Make sure that if you experience this health situation that you visit your family doctor or an internist for a complete evaluation. They will be able to diagnose the problem and give helpful treatment advice including medications and other tests to verify the significance of the medical need. Don't postpone getting this health care issue resolved for your own comfort and peace of mind, and for immediate and long term improved health.

Until next time. Let me know what you think.

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