GERD is a digestive disorder that affects the lower esophageal sphincter, which is the ring of muscle between the esophagus and stomach. Gastroesophageal reflux is the backward flow of acids from the stomach into the esophagus. Doctors believe that some people usually suffer due to a condition called hiatal hernia. Pregnant women usually suffer from heartburn or acid indigestion caused by Gastroesophageal Reflux Disease.

The primary goals in the treatment of this disease are relief from symptoms, healing of erosive esophagitis and prevention of complications of esophagitis. The symptoms include heartburn and regurgitation. The setting includes a proton pump inhibitor (PPI). Patients suspected due to GERD with non-cardiac chest pain are recommended to have diagnostic evaluation before institution of therapy. For diagnosing GERD, barium radiographs should not be used.

The other points that must be remembered to diagnose GERD are
1. Endoscopy is recommended only in case of alarming symptoms. Even in typical symptoms, the upper endoscopy is not recommended.
2. For preoperative evaluation, esophageal manometry is recommended, but it has no role in diagnosing GERD.
3. Ambulatory reflux monitoring is a test that can assess association of reflux symptoms.

Management:
The suggested lifestyle modifications for the patients with GERD are

    Weight loss is recommended for patients who are overweight. So, avoid large meals and decrease dietary fat intake.
    Avoid alcohol, chocolate, onions, garlic, acidic foods and peppermint.
    Do not lie down within 3 to 4 hours after meal (recommended for nocturnal GERD patients).
    For symptom relief and to heal erosive esophagitis, a 8-week course of PPIs is the therapy of choice.
    Medications that help in potentiating GERD symptoms, including alpha-adrenergic agonists, nitrates, calcium channel blockers and theophylline should be avoided.
    For patients without diagnostic evaluation, therapy for GERD other than acid suppression, including prokinetic therapy should not be used.
    For patients with partial response to PPI therapy, additional symptom relief can be achieved by increasing the dose twice daily or switching to a different PPI.
    It is recommended to elevate the head of the bed 10 to 20 cm.
    Avoid wearing clothes which are tight around the waist.
    If patients experience heartburn relief, Histamine-receptor antagonists (H2RA) therapy can be used as a maintenance option in patients without erosive disease.

Some surgical options
1. For long-term therapy for patients suffering with GERD, surgical therapy is the best treatment option.
2. In patients who have no evidence of erosive esophagitis, preoperative ambulatory pH monitoring in mandatory.
3. Gastric bypass is the preferred operation for patients who are suffering with obesity and are contemplating surgical therapy for GERD.

Apart from these, there are potential risks that are associated with PPIs such as switching them can be considered in setting of side effects and the therapy can be a risk factor for Clostridium difficile infection.

Management of Gastroesphageal Reflux Disease (GERD)

Gastroesophageal reflux disease is a condition which occurs due to unhealthy food habits and sudden lifestyle changes. This condition causes the stomach acid to travel in a reverse direction and enter the esophagus. If changes in your food habit and lifestyle do not cure you of this condition, then a surgical procedure is recommended.

What are the different surgical methods of treatment for gastroesophageal reflux disease?
The different forms of surgery that can be used to treat this condition have been explained below:

Fundoplication: Fundoplication is one of the most common surgical methods recommended to patients suffering from gastroesophageal reflux disease. The lower esophageal sphincter or LES is tightened with the help of this surgery. The strengthening procedure is accomplished by wrapping the upper part of the stomach around the outer part of the lower esophagus. Both open and laparoscopic surgical options are available for this surgery.
Transoral Incisionless Fundoplication or TIF: In this surgical procedure you do not have to undergo any incisions. A barrier is made between the esophagus and the stomach. This barrier will work to prevent the acid of the stomach from entering the esophagus. A special device is inserted through the mouth of the patient which helps in creating several folds at the base of the esophagus, these folds form a new valve or barrier. Thus you do not have to undergo any incisions at all if you opt for this procedure. Those who are looking for a non-invasive method to treat their gastroesophageal reflux disease, this procedure is no doubt one of the best.
Bard EndoCinch System: This is a special type of surgery that is accomplished with the help of an endoscope. Although it is not one of the common methods to treat the problem. In this procedure, several stitches will be made in your lower esophageal sphincter so that they result in the formation of valves.
Stretta Procedure: This procedure is also performed with the help of an endoscope. But this is an outpatient procedure and you will be discharged on the same day. A flexible tube is inserted into your esophagus and the other end of this tube has an electrode. This electrode will help in heating the tissues of your esophagus. It will also form small cuts in it. The scar tissue that results from this procedure helps in stopping the acid from flowing in the reverse direction. It also strengthens the muscles that are present in the surrounding area.
These surgical procedures are very successful and have the ability to give you long-term results. Many complications such as the inflammation of the esophagus, can be avoided if you opt for a surgical treatment as a cure for gastroesophageal reflux disease. 

Gastroesphageal Reflux Disease - How Surgery Can Be Of Help?

Nuts and dry fruits are probably the oldest and traditional superfoods which our mothers have diligently offered us for our good health. Packed with proteins, iron, magnesium, healthy fats, vitamin B and fiber, these nutritional powerhouses are a must in our diet, but only in a limited quantity. Yes, taking almonds, dates, cashews, pistachios, and walnuts in excess amount can lead to excessive body heat, giving rise to nasty pimples and rashes. Not more than 2 tablespoons of dry fruits are recommended in a day because of their sugar content, they can easily help to put on weight by adding excess calories.

But, how true is the claim or is it a myth? Let's find out.

Here is a brief overview of how overconsumption of dry fruit is detrimental to health:

Weight gain: Studies conducted by researchers over the years has revealed that it takes over 3500 calories to gain 1 pound of weight. However, consuming just 250 calories from dry fruits can result in over 2 pounds of weight in a single month. A sudden increase in weight can bring in other complications such as obesity, menstrual problems in women, high blood pressure, etc. It is therefore imperative to avoid excess intake of dry fruits. To ensure minimum intake of calories, we could focus on dates, apricot, cranberries, blueberries, etc.
Asthma: Sulphur dioxide is often used to process dry fruits. Studies revealed that this foul-smelling gas isn t very harmful when consumed in limited quantities. But, as per food safety experts, the permissible limit of Sulphur dioxide in humans should not be more than 20 mg per day as it can cause asthma, allergic reaction and skin rashes in an individual.
Gastrointestinal problems: Food items with high fiber content help in regular bowel movement and smooth blood flow. However, consuming too much fiber can lead to bloating, diarrhea, flatulence, cramps and constipation. This is exactly the case with dry fruits as well. They contain fiber and have the capacity to wreak havoc in the intestinal lining on overconsumption. Gradual and steady consumption of dry fruits over a period of time can mitigate this risk. 
Tooth decay: Dry fruits that are available in the market come with a thick coat of sugar so that they do not infuse moisture and stick to each other. This sugar significantly contributes to tooth decay. This is the reason why overconsumption of dry foot should be avoided.
Sugar crash: Most dry fruits have a high glycaemic index which can quickly surge blood sugar levels and spike energy levels. Therefore, patients suffering from high pressure should strictly refrain from dry fruits.
While the cons appear frightening, do not cross the nuts off the grocery list completely. Dry fruits when consumed under control, can be really helpful. So remember that moderation is the key. And in case you have a concern or query you can always consult an expert & get answers to all your questions!

Dry Fruits - 5 Reasons Why You Must Not Eat Too Many!

The production of gas in the body is a natural process as long as it is within normal limits. Whether it makes you burp or causes flatulence, excessive gas can be embarrassing. Gas can also make you uncomfortable and cause bloating. This is simply the buildup of excessive gas in the stomach before it is ready to be released. Here are a few simple tips that can help you prevent the buildup of excessive gas.

Avoid eating gaseous foods: Beans, broccoli, milk, cheese and fruits like pears and apples; these are some of the foods to avoid if you suffer from frequent bouts of gaseousness. This is because they contain fiber and sugar that is difficult to digest and creates gas. If you cannot avoid them completely, try steaming them instead of frying or baking them. Some people may also react to certain food combinations such as fruits and proteins by producing gas. Keeping a food diary may help identify such combinations.
Drink a glass of water before meals: Drinking water while you are eating can hinder digestion. When water mixes with solid food, it interferes with the way stomach acid breaks down food. Instead, drink a glass of water half an hour before your meals. In this way, the water flushes your system and prepares it for the digestion process.
Eat slowly: Grabbing a bite on the go is one of the leading causes of indigestion. When you eat anything, ensure that you chew it properly and do not swallow large bites of food. This prevents air from collecting in your stomach and thus prevents gaseousness.
Probiotics: Probiotics boost the production of  good gut bacteria  that is essential for digestion. Probiotics can also help ease bloating. If you suffer from gas, try including probiotics like yogurt, pickles, kimchi and buttermilk in your diet or get yourself a probiotic supplement.
A cup of chamomile tea: Chamomile not only calms the body but can also fight indigestion and gas. A cup of chamomile tea after a heavy meal helps speed up the digestion process. This helps relieve bloating, as the faster the stomach is emptied, the faster gas can move out of the stomach and into the intestines. Fennel, dill, peppermint and ginger can also be used as alternatives to chamomile.
Digestive aids: Gas is a fairly common problem faced by a number of people and hence digestive aids are easily available over the counter. Look for medication that contains activated charcoal or digestive enzymes.
If gaseousness persists over a long period of time and is not eased by any of these remedies, consult a doctor at once.


Intestinal Gas - How It Can Be Treated?

Hectic lifestyle, unhealthy food habits, poor bowel movements, and stress can all add up to one condition called the GERD. Gastroesophageal reflux disease or GERD refers to a particular type of digestive disease, and mainly affects the LES or lower esophageal sphincter, which is a muscle ring between the stomach and the esophagus resulting in the symptoms such as burning sensation in the chest or difficulty in swallowing.

Treatment options
While the moderate or mild GERD can usually be treated with healthy lifestyle changes, diet, and medications, when the condition gets severe, surgery becomes the only option to prevent the issue from deteriorating further. Here are some of the common surgical options available for treating GERD:

Fundoplication: This surgical procedure is the most common and standard surgical option for treating GERD. It focuses on tightening and reinforcing the LES by wrapping the upper portion of the stomach around the outer side of the lower esophagus which strengthens the sphincter.
Transoral Incisionless Fundoplication: Transoral incisionless fundoplication or TIF is another surgical procedure available for treating GERD and can be performed when an open fundoplication cannot be performed. It is performed by creating a barrier between the esophagus and the stomach which prevents the stomach acid from reflux or going backwards.
Stretta: This surgical procedure is performed as an outpatient option using an endoscope. Here, a flexible tube is passed into the esophagus where the electrode present at the tip of the tube creates tiny cuts on the esophagus by heating the esophageal tissues. As a result, the scar tissues formed, block the nerves that are responsible for acid reflux.
Bard EndoCinch System: This surgical procedure also uses an endoscope to create stitches to make pleats in the lower esophageal sphincter, which strengthens the LES. However, this surgical treatment option is not as common as other GERD treating procedures.
Linx Surgery: In Linx surgery, a special device called Linx, a ring containing microbeads of magnetic titanium, is wrapped around the sphincter to make it strong. As the beads are magnetized, they help in keeping the opening between the esophagus and stomach closed, while letting the food pass normally.
Recovery
As long as the surgical option is laparoscopy, they are the least time-consuming as well as less painful with lesser downtime, but may not be ideal for everyone. When it comes to traditional surgical treatment options like fundoplication, it takes around minimum six weeks to resume the daily activities. However, for laparoscopic fundoplication, the downtime is one or two weeks. Linx surgery is a minimally invasive surgical option and therefore, the recovery time is shorter than other traditional surgeries for treating GERD. Depending on the patient's health conditions and response to surgery, the recovery time may vary for each surgical treatment options for GERD.

So, seek the advice of your gastroenterologist for the best possible treatment option to get completely cured of the condition.

Treating GERD: 5 Surgery Options That Can Help!

A great alternative to refined sugar, honey is packed with essential nutrients and is really delicious to eat. There are many health benefits of honey. It can be easily added to any diet as a topping, say for fruit salads, ice-creams or as a spread. But are you aware that the jars of this tasty golden liquid can sometimes not be honey at all but syrup that tastes exactly like honey? So, How do you evaluate if you are buying real honey?

In order to boost profits, honey manufacturers dilute their product with adulterants such as flour, syrup or molasses and even sand and chalk. If you want to get the most out of this tick liquid, you should buy only pure honey.

What Is Pure Honey?
Real honey is not produced in factories but from bees. Usually, organic and natural honey are referred to as pure honey. However, it is not always feasible to tell if the honey is pure by just looking at it. Natural honey is made only by honey bees and when these bees are fed only at organically grown flowers, the honey they produced is classified as organic.

What Is Fake Honey?
Also known as artificial, adulterated or impure, fake honey contains additives including corn syrup, glucose, molasses, sugar syrup, dextrose, invert sugar, flour or starch apart from the floral nectar.

How To Find Fake Honey?
Listed below are a few simple tips that you can carry out at the comfort of your home to determine whether the honey you are buying is genuine or fake.



Read The Label: In addition to buying well-known and reputed brands of honey, ensure that you check the label for the logo and brand name. This will guarantee that the jar you pickup is not only good quality but also genuine. The label on the jar should list only one ingredient, honey, no additives, or flavourings.
The Warm Water Test: Add a teaspoon of honey to a glass of warm water. If the honey is pure, then it will sink to the bottom of the glass as a lump or stick to the spoon when the mixture is stirred. If the honey is adulterated with any kind of syrup, it will dissolve in the water.
The Thumb Test: Put a drop of honey on your thumb. If it spreads or spills, then it is not pure. Pure honey is thick in texture and would remain intact on your thumb.
The Flame Test: Honey is inflammable and easily catches fire. Dip a dry matchstick in honey, then strike the matchbox. If the matchstick lights with ease and continues to burn, then the honey is pure. Due to the moisture present as an adulterant in fake honey, a matchstick dipped in fake honey will not light easily.
The Foam Test: Add 2-3 drops of vinegar essence to the honey and mix well. If it becomes foamy within 2-3 minutes, then the product you have purchased is not pure and contains additives.
The Tissue Paper Test: Put a drop of honey on a piece of tissue paper. If it gets absorbed and leaves the paper wet or a watermark on the paper, then it is adulterated and not pure honey.
The Heat Test: If the honey is pure, then on heating, it will caramelize. However, fake honey tends to form bubbles on heating and does not caramelize.
The Bread Test: Pure honey when spread on the bread, makes the bread hardened within a few minutes. On the other hand, the slice of bread remains soft and moisturized if there are any additives present in the honey.
The Crystallization Test: Pure honey has a natural tendency to crystallize over time because of the presence of glucose oxidase, an enzyme that removes water/moisture from honey. Fake honey does not become thick, when stored.
The Egg Yolk Test: When honey is mixed will egg yolk in a bowl and both are blended together, the yolk looks like it is cooked. However, fake honey does not produce this effect on the egg yolk.
You might sometimes be able to spot fake honey by its taste and smell, though not always. Honey being a natural product and produced from the nectar of different flowers, it does not always taste or smell the same. It is also not possible to taste honey before buying it if as the product comes in a sealed bottle or jar. Therefore, it is recommended to only pick branded or organic honey to ensure that the honey you are buying is pure and genuine.

Honey - How To Spot If It Is Fake Or Not?

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