Gastroesophageal reflux disease (GERD) is also called as acid reflux. It is a long-term digestive disorder that affects the lower esophageal sphincter, the ring of muscle between the esophagus and stomach which causes the stomach contents to come back up into the esophagus resulting in either symptoms or complications. Gastroesophageal reflux disease is mild acid reflux that occurs at least twice a week or moderate-to-severe acid reflux which occurs at least once a week.

Epidemiology

In western populations, GERD affects approximately 10% to 20% of the population and 0.4% newly develop the condition. In developed nations, the prevalence rate of GERD is associated with age; with adults aged 60 to 70 being the most commonly affected.

Signs and Symptoms

Esophageal symptoms include:

Heartburn
Regurgitation of food or sour liquid
Dysphagia
Sensation of a lump in the throat
Extraesophageal symptoms include:

Coughing and/or wheezing
Hoarseness, sore throat, or 
Otitis media
Noncardiac chest pain
Enamel erosion or other dental manifestations
New or worsening asthma
Disrupted sleep
Risk Factors

Obesity
Pregnancy
Hiatus hernia
Scleroderma and systemic sclerosis
The use of medicines such as prednisolone 
Delayed stomach emptying Zollinger-Ellison syndrome which can show an increase in gastric acidity because of gastrin production
A high blood calcium level which can increase gastrin production, leading to increased acidity
Visceroptosis or Gl nard syndrome, in which the stomach has sunk in the abdomen upsetting the motility and acid secretion of the stomach.
Factors that can increase acid reflux involve:

Smoking habit
Eating heavy meals or eating late at night
Eating fatty or fried foods
Drinking certain beverages, such as alcohol or coffee
Medications, such as aspirin
Tight clothes
Increased intra-abdominal pressure
Differential Diagnosis

Heart disease causing chest pain
Laryngopharyngeal reflux OR extraesophageal reflux disease
Infection
Peptic ulcer
Esophageal spasm
Complications

Narrowing of the esophagus (esophageal stricture): Stomach acid causes the formation of a scar tissue which narrows the food pathway.
An open sore in the esophagus (esophageal ulcer): Acid causes an open sore which bleeds, causes pain, and makes swallowing difficult.
Precancerous changes in the esophagus (Barrett's esophagus): Damage from acid can cause changes in the tissue lining the lower esophagus
Anemia
How to arrive at the diagnosis?

Upper gastrointestinal endoscopy/esophagogastroduodenoscopy
Esophageal manometry
Ambulatory 24-hour pH monitoring
Treatment

The goals of treatment are controlling symptoms, healing esophagitis, and prevention of recurrent esophagitis or other complications. Lifestyle modifications include the following:

Losing weight (if overweight)
Eating small and frequent meals instead of large meals
Waiting 3 hours after a meal to lie down
Elevating the head end of the bed by 8 inches
Avoiding bending or stooping positions
Medications

H2 receptor antagonists (ranitidine, cimetidine)
Proton pump inhibitors (omeprazole, pantoprazole)
Prokinetic agents (aluminum hydroxide)
Antacids (magnesium hydroxide)
Surgery

Transthoracic and transabdominal fundoplication
Placement of a device to augment the lower esophageal sphincter

Gastroesophageal Reflux Disease - What Causes It?

The uneasy feeling in our abdomen, feeling inflated or growing in size is a common problem faced by people anywhere in the world. Medical professionals refer to this as  bloating,' i.e., a feeling of a full, tight, abdomen. The abdominal system includes organs such as the stomach, liver, pancreas, gallbladder, intestines, etc. It is when the gastrointestinal tract is filled with gas, pain due to bloating arises. Such bloating brings pain in different parts of the body (which would be continuously shifting) along with a feeling of a swollen tummy (though not physically swollen actually). 

This article shares the common causes of bloating and tries to help its readers find a solution.

Overeating: Many of us can recall exactly how many times we have ignored the level of consumption in a particular meal and then felt an irritable stomach pain. Overeating refers to the consumption of food more than the amount of energy an organism can produce in one process. Along with weight gain and obesity, bloating might also result from overeating. The fact is, overeating is completely voluntary, and hence, a person can choose to avoid over-consumption of food and thereby, the pain from bloating.
Lactose intolerance: The terminology might not be familiar, yet over 65% of the global population is lactose intolerant. It varies with age and gender, and anyone has either of the four different types of lactose intolerance   primary, secondary, developmental, and congenital. Though lactose intolerance does not cause damage to the gastrointestinal system, inability to digest thesugar in milk (lactose) can cause abdominal pain, bloating, diarrhea, etc.
Irritable bowel syndrome: People with irritable bowel syndrome (IBS) are yet to know what caused it in the first place. Though the exact causes of IBS are yet to be known, many doctors blame the miscommunication between the brain and the intestinal tract of a person which causes abnormal expansion and contraction of the intestinal walls. This results in irritable pain and abnormal bowel movement. 
Two cases might arise due to IBS

The abnormal movement of the intestinal walls might speed up the excretion process and hence, the passage of stool   diarrhea.
The spasms might slow down the excretion process resulting in constipation.
Irritable bowel syndrome (IBS) can occur over the years, and the absolute cure is yet to be found. Additional symptoms of IBS are   bloating and excess gas, pain in the lower belly, mucus in stools, etc.

Solutions to bloating
Bloating can be easily taken care of if the person is ready to implement certain dietary changes. For example, avoiding gassy foods such as cabbage, broccoli, lettuce, reduces the formation of gas in the stomach. Limiting the amount of fatty foods and foods with high fiber content, quitting milk products (if lactose intolerant), can help a lot. A diet plan, getting active and regularly exercising can help to eliminate the problem of gas and bloating.

Conclusion
Even though bloating can be uncomfortable and painful at times, it is not a cause for concern. Bloating can be remedied quite easily with a proper diet chart and routine exercise.

Bloating - Why It Happens?

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)

Bloating isn't a medical condition. It doesn't necessarily mean that a person has eaten too much. It can be a case of eating wrong food which has not been digested by the body. Bloating occurs when air and water get trapped inside the stomach or intestine. As a result, the stomach gets swollen well past its normal level.

Culprits of bloating:
Bloating can result from a number of cases. Fatty or junk foods are one of the biggest culprits of bloating. It hinders the digestion process and doesn't let the stomach empty on time. Carbohydrates too can cause bloating. Even carbonated drinks can play spoilsport. It creates bubbles in the stomach leading to indigestion and bloating. Some food items related to gas include cauliflower, lettuce, hard candy, beans, Brussels sprouts, broccoli etc. Apart from this, consumption of excessive junk food and soft drinks can lead to bloating.

Steps to avoid bloating:
The best way to avoid bloating is to refrain from bloat causing foods as mentioned earlier. If you wear dentures, it should be ensured that it fits properly. There are instances when excess air gets inside the stomach due to an improper fixture of denture leading to bloating. Eating or drinking slowly is another good way of staying away from bloating. When you eat slowly, there are fewer chances of extra air getting inside the stomach. In the case of beverage consumption, avoiding the straw is a good idea. This way the unwanted air cannot make their way inside the tummy and play foul.

Taking a small walk after every meal is another good way of staying away from bloating. This way the gas inside the tummy cannot rise above the surface. The practice of calming technique such as yoga, deep breathing and meditation also goes a long way in giving relief from bloating.

Some home remedies to get rid of bloating include:
a. A cup of ginger, lemon and honey in a cup of hot water once everyday
b. 1 cup of herbal peppermint tea freshly prepared in boiled water
c. In the case of regular stomach bloating, intake of one caraway seed on a daily basis fetches immediate results
d. Consumption of a cup of baked pumpkin twice a week
e. Consumption of warm lemon water before you start your day is another good way of keeping bloating at bay.

Bloating can also be a symptom of other intestinal related problems as well. If the general method of control and measured diet doesn't suffice, it is time to visit a doctor to find the underlying cause of your problem. Doctors perform a series of tests to understand the problem and prescribe the required medicine to control or cure the problem.

Bloating: The Causes & Solutions

The only thing that can ruin a great meal is the feel of a bloated tummy afterwards! Usually any abnormal swelling or increase in diameter of the abdominal area is termed as bloating. The condition has become very common and is experienced by people around the world. Poor diet, sedentary lifestyle, high level of stress and need for daily medications seem to be making people more prone to this epidemic. It can sometimes also be a result of an underlying health issue that you might be unaware of. The good thing is that there are signs of it which can be watched out for.

What to Keep an Eye Out For: To start off, there is the sign which is considered to be rather obvious by many flatulence. If a person wants to get rid of flatulence for an extended period, he or she should consider this to be a warning.

Bloating itself can be a sign for other problems which are deeper. The prime example of this happens to be coeliac disease. A bloating of the stomach which is accompanied by pain and a puzzling loss of weight could be signs of this disease.

If a fever seems to keep recurring without a cause which is explainable, it could be a sign of bloating. As a matter of fact, this sign along with bloating also does signal some infection, which should be looked at immediately by a medical professional. Also, too much stress on a person could be a sign of impending bloating issues.

Getting Rid of Bloating: In order to cure bloating which is caused by flatulence, an easy and elementary solution is to eat your food slowly and to chew properly. In serious case, seeking adequate medical help is important.

When a person finds that he or she seems to be suffering from bloating very often, it is a good idea to maintain a food diary. This will help find whether there are certain trigger foods which cause bloating. The pattern can be discussed with your doctor and concrete steps can be taken towards a complete solution.

Simple lifestyle changes beyond the diet can also make a difference. These include correction of sleeping and eating habits of a person. You are also required to be very regular with this.

Bloating always has some signs which are associated with its causes so it makes good sense to be aware of the same as the saying goes, 'a stitch in time saves nine'!

Warning Signs of Bloating? How to Treat It?

Foods that make your stomach bloat

Do you feel your stomach bloat after meals? if you notice, this doesn't happen after every meal? only at times. And at other times when you eat specific foods. Well, there are foods cause your stomach to bloat, so the wise thing to do is to know about them and avoid them! 

Here are a few of the biggest criminals:

1. Cold drinks: yes, these carbonated drinks have numerous side effects on your health. One of them is that they bloat your tummy. Beer happens to fall in this category too.

2. Dairy products: for the lactose intolerant, dairy products are almost like poison. The intolerance can be mild, moderate of severe, but one of the symptoms is gas. You can try to limit your consumption of dairy products.

3. Apples: apples and pears are known to contain high percentage of fiber. While they are important for us and should be eaten, if is good to know that they can affect sensitive tummies. Eat bit by bit, and if it helps, peel the skin and then eat.

4. Few veggies: while they are excellent health foods, asparagus, cabbage and broccoli are vegetable which cause gas in the stomach, which in turn leads to bloating of the tummy.

5. Sodium: sodium is also another reason for bloated tummies, so it is advised to limit salt intake.
6. Fast foods: fast foods like sausages, fried foods, ice cream, sweetened products, etc are known to cause the belly to bloat.

7. Rice preparations: rice is known to swell up inside the stomach once it gets water, hence making the stomach feel bloated.

8. Hard drinks: alcohol is also said to add on weight near the stomach and make it feel bloated.


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The 8 Foods That Bloat Your Belly!

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