Gastroesophageal Reflux Disease (GERD) is a form of digestive disorder, which affects the lower oesophageal sphincters or the muscle ring present between the stomach and the food pipe. GERD incorporates the return of the contents of the stomach back to the oesophagus or food pipe. The functioning of the lower oesophageal sphincter is disrupted.

Causes

Hiatal hernia is a common cause of GERD. An unhealthy lifestyle and diet may also lead to GERD. Intake of an excess amount of chocolates, fried food, coffee or alcohol triggers the chance of a reflux. GERD also occurs in obese people and pregnant women.

Symptoms

Heartburn, also known as acid indigestion, is the primary symptom of GERD. The affected person may feel a burning chest pain which starts from behind the breastbone and reaches up to the throat. The feeling can be defined as food coming back to the throat with a bitter, acidic taste. The burning sensation may last as long as two hours.

Other symptoms include:

    Excess saliva secretion
    Chronic conditions of sore throat
    Laryngitis
    Gum inflammation
    Tooth cavities
    Unpleasant breath

In order to diagnose GERD, several tests may be conducted . They are:

    An X-Ray of the upper part of the digestive system.
    Endoscopy to examine the inner part of the oesophagus.
    Ambulatory acid test for monitoring the amount of acid within the oesophagus.
    An oesophageal impedance test to measure substance movement inside the oesophagus.

Treatment

    A person must make several changes to his daily lifestyle and diet plan for treatment of GERD.
    Food and beverages like chocolates, fatty food, coffee, alcohol and peppermint should be avoided in order to reduce the weakening of the lower oesophageal sphincter. Several food items irritate the damaged oesophageal lining and should also be avoided. They include citrus fruits, tomato and pepper.
    Smoking cigarettes results in weakening of the lower oesophageal sphincter and should be stopped to reduce GERD.
    One should elevate the head of the bed on which he or she sleeps on blocks measuring 6 inches. This reduces the heartburn as gravity minimizes stomach reflux to return to the oesophagus.
    Over the counter medicines can be used to cure GERD. Antacids are a good example and neutralize the acid in the oesophagus and stomach, reducing heartburn. Combining antacids with foaming agents is also effective. A foam barrier is formed over the stomach, preventing the occurrence of acid reflux.
    Medicines for reducing acid in the stomach are prescribed in cases of chronic GERD, which include H2 blockers by the likes of cimetidine, famotidine or nizatidine.

GERD is a digestive disorder, which causes disruption in digestion, as reflux from the stomach is returned to the oesophagus. Proper treatment measures should be taken.


Gastroesophageal Reflux Disease (GERD)

Gastric (stomach) cancer occurs when malignant cells form in the lining of the stomach. By far, it is known to be the second most common cause of cancer-related deaths not only in Asia but also worldwide. Though it can affect both male and female populace, it is seen more commonly in men and in people aged 50 years or older.

Type: Gastric cancers can present as one of the following types - 

Adenocarcinoma: Begins in the glandular cells lining the inside of the stomach. This forms a majority of the stomach cancers.
Lymphoma: Begins in immune system cells present in the walls of the stomach. Occurrence of lymphoma, in the stomach, is rare.
Carcinoid Tumor: Begins in hormone producing cells of the stomach.  Occurrence of carcinoid cancer, in the stomach, is rare.
Gastrointestinal Stromal Tumor (GIST): begins in nervous system cells of the stomach. Occurrence of GIST, in the stomach, is rare.
Gender: It affects both male and female populace.

Etiology: The factors that are associated with increased risk of gastric cancer include the following mostly  

 Helicobacter Pylori  bacterial infection in the stomach is a common cause of gastric cancer of both the intestinal (expanding) & diffuse (infiltrative) type. Furthermore, studies indicate that high salt intake is synergistic with H. Pylori infection in the manner that it is likely to increase the risk of gastric cancer that is induced by H. Pylori bacteria.
Smoking, consuming alcohol, red meat, salty/ smoked/ processed foods, low intake of fruits and vegetables, diets rich in nitroso compounds, eating foods contaminated with aflatoxin fungus etc all.
Atrophic gastritis characterized by chronic stomach inflammation is known to increase the risk multi-fold. Chronic gastric inflammation can lead to atrophy of the gastric mucosa, metaplasia, dysplasia and finally carcinoma.
History of pernicious anaemia, gastric ulcers, adenomatous gastric polyp etc all.
Family history of gastric cancer. Several familial syndromes that have been associated with a pre-disposition to gastric cancer include familial adenomatous polyposis, Lynch syndrome, Peutz-Jeghers syndrome and e-cadherin mutation (diffuse type)
Blood group A, Obesity etc all are known to be associated with diffuse or cardia gastric cancer.
Low socioeconomic status - persistent lifestyle issues/ irregularities including high stress coupled with an improper diet/ dietary pattern.
Epidemiological evidence is indicative of a risk or pre-disposition to gastric/ stomach cancer for people suffering from diabetes mellitus (DM).
Very high dose ionizing radiation exposure is an uncommon risk for gastric cancer.
Features: There are often no early stage symptoms. Early stage symptoms, if any, are non-specific and are likely to be ignored, thus delaying the diagnosis most often. Hence, gastric/ stomach cancer is often detected at an advanced stage where the disease is either locally advanced or metastatic. The various presentations (of signs & symptoms), by stage (early or advanced), of gastric cancer are as enumerated below:

Early Stage   can present with one or more of the following non-specific symptoms/ signs -

Dyspepsia (Indigestion),
Stomach/ Epigastric discomfort,
Bloated feeling after eating,
Mild Nausea/ Vomiting,
Blood in Vomit (Haematemesis),
Heartburn,
Weight loss (Cachexia)
Anaemia,
Occult blood in stool/ Melaena,
Advanced Stage   presents with one or more of the following symptoms/ signs -
GI Bleeding with black tarry stools (Melaena),
Persistent Nausea/ Vomiting,
Blood in Vomit (Haematemesis),
Early Satiety,
Anaemia,
Loss of Appetite (Anorexia),
Weight loss (Cachexia),
Persistent pain in the abdomen,
Fluid build-up in the peritoneal cavity (Ascites),
Edema of the lower extremities,
Liver Enlargement (Hepatomegaly)/ Jaundice,
Difficulty swallowing food (Dysphagia)
Screening: Is generally recommended for asymptomatic populations in high incidence areas or as surveillance for high risk individuals. The goal of screening, as usual, is to be able to detect & diagnose gastric cancer at an early stage which is potentially curable. It is mostly endoscopic/ radiologic.
Diagnosis: Following are the diagnostics employed in gastic cancer - 

Physical Examination: May be remarkable for palpable abdominal mass, weight loss (cachexia), abdominal distension, ascites, hepatomegaly, lower extremities edema and lymphadenopathy for gastric cancers in the advanced stage. For early gastric cancers, however, physical examination is largely uninformative.
Blood: Hb- may be low, ESR   raised, tumor markers CEA & CA-19-9 could be raised sometimes in adenocarcinoma but are not frequently elevated. Abnormal blood test results may be indicative of malignancy, but a follow-up gastroscopy/ biopsy is always the gold standard for accurate diagnosis.
Stool: Occult blood may be +ve
Barium Meal X-Ray: Could show a filling defect at the site of the carcinoma/ cancer growth.
Gastroscopy/ Biopsy: Clinches the diagnosis.
Endoscopic Ultrasound: Maximizes tumor staging as it helps determine the depth of invasion of the tumor.
CT Scan: Of chest, abdomen & pelvis helps detect metastatic disease, if any, and also helps stage the disease (TNM) appropriately.
Bone Scan: Helps detect osseous metastasis (bone mets), if any.
Treatment: Conventional treatment includes surgery, chemotherapy and radiotherapy as contextually appropriate. Surgery (i.e. gastrectomy either sub-total or total), with an adjuvant chemotherapy and/ or radiotherapy as contextually relevant, is the only treatment that is known to cure the disease in light of the prognostic indicators as briefly enumerated in the section below. Chemptherapy and/ or radiation alone cannot be curative. Mostly, it can improve symptoms, and may prolong survival. Simultaneously, an adjunctive or integrative naturopathic treatment with suitable complementary & alternative medicines (CAM) too can help improve clinical outcomes and facilitate recovery as feasible contextually.
Prognosis: For gastric cancer is variable. Preventive measures, earlier diagnosis and right early treatment is key for an effective therapeutic management & better prognosis. Like most other cancers, the chances of cure for an early stage gastric cancer are more. The cure/ recovery chances are influenced by the grade, stage of cancer, recurrence and the patient s general health & vitality etc all. Distal tumors are known to be cured more often than the proximal ones. Again, intestinal-type gastric cancers are known to have a better treatment outlook in comparison to the diffuse-type gastric cancers.

Prevention: Rightly said, prevention is always a better choice. Although genetic risks are difficult to modify, still an adherence to a relative Mediterranean diet, maintaining an ideal body weight and an active lifestyle with due emphasis on regular exercising, de-stressing and relaxation is highly recommended for reducing the risks of many cancers including gastric cancer. A healthy eating plate comprises essentially a low fat diet, fibre rich foods including whole grain cereals, green leafy vegetables cooked using healthy vegetable oils, fresh fruits of all colours as seasonally available and healthy proteins/ fats including fresh fish, poultry, beans, nuts etc all. The consumption of alcohol, if any, has to be strictly in moderation, and is best avoided in a high risk scenario. Smoking is to be avoided too. Again, red meat, butter, refined grains, sweets, sugary drinks including carbonated beverages and other high calorie foods etc all, if any, are to be taken sparingly. Not only it is important to eat healthy, but also it is equally important to eat properly. Insufficient chewing, eating until full, eating meals within a short time etc all are best avoided so as to ease off digestive burden on the stomach/ other organs in the GI tract. Last but not the least, consumption of clean and filtered water, natural probiotics like freshly prepared yogurt/ butter milk, maintenance of cleanliness & hygiene including oral hygiene etc. all can help guard against H. Pylori infections. Breastfeeding is known to be protective against H. Pylori infections too.

Gastric Cancer - In a Nutshell!

The way your day starts can affect your entire day and nothing is worse than fighting constipation in the morning. Along with a feeling of heaviness in the abdomen and bloating, constipation can also cause mood swings and lower your attention span. While laxatives can be temporary quick fixes, they can worsen the problem over time. 

Hence, it is better to treat this disorder with a few simple lifestyle changes and home remedies.

Eat plenty of fibre: A bad diet is one the key factors triggering constipation. Fibre not only fills the stomach, but also helps add bulk to your stool making it easier to pass. Ideally, a person should have 20-40 grams of fibre a day. If you suffer from chronic constipation, you can increase this amount a little as well. As an easy way to increase your fibre consumption is ensure that you eat some form of raw salad with every meal. Other foods that are rich in fibre are oats, almonds, cereals, beans, lentils and fruits.
Ginger tea or mint tea: Ginger is a warming herb, which when had in form of tea can make the body generate more internal heat. This helps activate the digestion process and thereby relieves constipation. The menthol in peppermint has an antispasmodic effect that helps relax the digestive tract muscles and makes it easier for stool to pass through. Dandelion tea can also be used as a mild natural laxative.
Castor oil: Castor oil is a popular natural laxative. This is because one of the components of this oil helps stimulate the small and large intestine. To benefit from castor oil, have 1 or 2 teaspoons of the oil on an empty stomach. You should be able to pass stool within about 8 hours.
Drink plenty of water: Water not only hydrates the body, but also helps food move along the digestive system. Without adequate water, the stool is likely to be hard and difficult to pass. Ideally, you should drink at least 8 glasses of water a day. Do not count artificially sweetened beverages as part of this count as they can actually cause constipation instead of ease it.
Warm lemon water: Lemon juice helps stimulate the digestive system and hence is ideal for treating constipation. When mixed with warm water, it can help eliminate toxins from the body. Adding a little honey to the mixture can also work as a mild laxative. Alternatively, you could add salt in place to honey as this encourages the bowel muscle contraction and is rich in magnesium.

Constipation - 5 Ayurvedic Remedies for Treating it!

Excessive gas can be defined as bloating, belching, flatulence and burping. It does not matter what you call it, but what matters is how you treat it and get relieved from the embarrassing symptoms. 

Here are some ways in which you can avoid gastric problems:

*Avoid eating foods that can cause gas or acidity. Vegetables which are known to cause acidity are Brussels, Onions, Garlic and Broccoli; dairy products like cheese, milk, ice cream and whole grains can cause acidity. The reason is that these products have fiber, starch and sugar which cannot be digested easily, thus causing pain in the intestines. Fruits which contain sorbitol and aerated drinks should also be avoided. Eat everything but in moderation.

*Avoid drinking before meals as the stomach acids are lost and the food cannot be digested well. Water and liquids should be taken half an hour after a meal for a better digestion.

* Food should be eaten slowly. Eating and drinking quickly, allows a lot of air to go into the stomach with the food. This in turn can cause a stomach pain.

* Over the counter drugs can be taken for immediate help in digestion. These medicines contain enzymes which aid in digestion. The enzyme works to dissolve the sugar that is found in many fruit and vegetables.

* Some habits like chewing gum, drinking from a straw and smoking, etc. causes air to fill in the stomach, thereby, leading to gas.

* Artificial sweeteners such as sorbitol should be avoided as these are difficult to digest and can easily lead to a feeling of bloating. 

However, all the pains might not be due to gas and could be a sign of something serious. These could be:

* Lactose intolerance: This is the inability to digest milk and milk products. The sugar in the milk is known as lactose and cannot be digested easily. 

* Irritable bowel syndrome: People who suffer with pain in the lower abdomen constantly might be suffering from IBS.

* Colon cancer: If the pain lasts too long then getting a screening done is a good idea to rule out if one is suffering from colon cancer or not.

* Upper gastrointestinal disorders: If one gets belching occasionally, then it is alright, but a constant belching might be a sign of gastrointestinal disorder in the upper tract. These could be gastroesophageal reflux disease (GERD), gastroparesis, or peptic ulcers.

Gastric Problems - Effective Ways To Manage It!

With the super busy lifestyle that everybody is gravitating to, there is less and less time for everything, including cooking and eating. Thus, more and more processed foods are finding their way into our refrigerators, as they can just be picked up and eaten anytime hunger pangs are felt. And, we do not immediately realize that processed foods are devoid of all the essential ingredients. What we end up eating has less fiber, more salt, and more preservatives (generally not very safe for all), all leading to an unhealthy lifestyle.

Refined flour, white sugar, cheese, canned juices, frozen foods, cheese laden pizzas and breadsare all yummy, but not something that is readily accepted and digested by your stomach. Try eating pizza with loads of cheese for two days and experience the bloated feeling for yourself. Not to scare you, but imagine this; you would have to eat an entire medium pizza to get 2 g of fiber. Where as, your body requires about 25 to 40 g of fiber per day for regular health maintenance.

Biologically, our digestive system requires a lot of fiber, which adds to the roughage. This is very important as it helps in digestion and aid in cleansing the bowel later. The function of the large intestine is to remove water and essential ingredients when food passes through it. Junk food passes through quite quickly, thereby, leading to loss of water and ingredients. A lot of digestive issues are also related to lack of fiber in the food, like polyps, colon cancer, irritable bowel syndrome, high cholesterol, and obesity. 

Most of us are aware, but tend to ignore the fact that junk food is as the name suggests, junk. There is hardly anything of nutritious value in it. On the contrary, it contains lots of salt, fat and artificial chemicals, which though, make it very tasty, but has zero nutrition value. 

Try to eat only junk food for about a week regularly, and you will surely feel:

1. Bloated (a lot of gas due to indigestion)
2. Dehydrated (excessive salt needs more water, which we don't realize)
3. Constipated (lack of fiber leading to reduced bowel movement)
4. Weak and lousy (due to lack of nutrition)

This of course does not include the harmful effects on skin, hair, looks, etc. It does not mean you have to stop eating junk completely and eat only healthy food all the time. The human body is adaptive and can adjust to a lot of variations. It is not wise to try the example above (eating pizza for a week), however, binging on junk food once a week would definitely not hurt. Use your discretion as nobody knows your body as well as you do.

Constipation and Junk Food

Urinary Incontinence is the sudden urine loss that occurs involuntarily in women. Some of the factors which cause urinary incontinence are pregnancy, menopause and childbirth. It should be noted that urinary incontinence by itself is not a disease, but is a symptom of other underlying disorders such as diabetes, infections and other conditions.

Causes of temporary cases of urinary incontinence include:
1. Constipation
2. Urinary tract infections
3. Excess consumption of alcohol and caffeine
4. Consuming carbonated drinks
5. Use of artificial sweeteners
6. High doses of vitamin B and vitamin C
7. Being on sedatives, muscle relaxants, blood pressure and heart medications
8. Eatables which are too spicy, acidic or sugary

However, persistence of incontinence might be due to a more serious condition. Some of the causes are stated below:

Age: The bladder muscles tend to weaken with age. This affects the bladder s urine holding capacity.
Pregnancy: Hormonal changes and increase in weight during pregnancy can cause incontinence.
Menopause: Oestrogen is responsible for the healthy maintenance of the lining of the urethra and bladder. The onset of menopause causes the oestrogen hormone levels to drop. The gradual damage of the bladder tissues causes incontinence.
Childbirth: The bladder control muscles are weakened during normal vaginal delivery, thus leading to incontinence.
Obstruction: Occurrence of tumours in the urinary tract can block the normal flow of urine which can cause incontinence.
Hysterectomy: The same ligaments and muscles support both the bladder as well as the urethra. With removal of the uterus by hysterectomy, the pelvic floor muscles are deteriorated. This leads to urinary incontinence.
Neurological disorders: Conditions such as multiple sclerosis (autoimmune disorder in which the immune system destroys the protective sheath of the nerves), Parkinson s disease (disorder affecting motor functioning of the body), brain tumours, spinal injury or strokes are capable of causing incontinence.

Different forms of urinary incontinence are classified on the basis of their symptoms:

Urge incontinence: Urge or urgency incontinence occurs when there is a leak before the person reaches the toilet.
Stress incontinence: Small amounts of urine leak out during normal physical movements such as sneezing, coughing and exercising. This happens because of the minimum stress exerted on the body, and hence, the name.
Functional incontinence: Sudden leakage of urine occurs due to external deterrents or physical disabilities such as not being able to find a toilet.
Overactive Bladder: This is characterized by frequent and urgent urination.
Overflow incontinence: A full bladder, at times, leads to unexpected leakage.
Transient incontinence: If urine leakage occurs due to temporary situations such as infections, or new medications.

Did You Know - Constipation Can Also be a Sign of Urinary Incontinence

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