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)

A bloated abdomen is very upsetting, both for cosmetic reasons and also because it makes one feel lousy and lethargic. Also, it can bring your energy levels down in a big way. However, the good news is that bloated belly can be managed by making some basic changes in the way you eat and/or drink.

Knowing what causes bloated belly is the first step towards managing it.

Using a straw: Whether you are drinking a smoothie or shakes, coffee or tea, drink it directly from the glass. When sipping through a straw, a lot of air is consumed along with it, and that leaves you with a bloated feeling. If it is coke or aerated drink that is being consumed, it makes it even worse.
Packaged foods: While packaged foods help you by saving cooking time and provide a quick fix for the hunger pangs, they also come packed with loads of sodium. This leaves you with a bloated feeling, and if you are someone who uses packaged foods at each meal, it is almost there to stay. Switch to fresh foods and see how your bloating disappears.
Low-calorie foods: As we all are busy watching calories, we have started using aspartame. Be it artificial sweeteners for the coffee or diet cokes, these contain substances which take much longer to digest and so they stay in your tummy for a longer period of time. They are not recognized as foods by the stomach and so it takes time to digest. Switching to a no-sugar diet (minus the aspartame) or using palm jaggery can instantly provide relief.
Legume/Bean family: While legumes are known as the best protein source, especially for vegetarians, they are also loaded with gas. Whether it is the regular beans, green peas, double beans, or kidney beans, they all have a great tendency to bloat you up. The carbohydrate in these are not easy to digest, giving the gassy bloated feeling. Taking an anti-gas agent when there are too many beans on your plate is very much recommended.
Excessive use of gums or candy: For those who are used to chewing on gums or candies, there is a lot of air that is swallowed during this process. An alternative is to keep taking small sips of water, which will not leave you feeling bloated. The water also helps reduce bloating by keeping a constant movement of the intestine.
Eating too fast: As we are all pressed for time, there is no time to sit down and eat. However, eating too fast leads to bloating in two ways. Firstly, by taking in a large amount of air along with the food. Secondly, by not chewing the food properly, bigger pieces of food reach the stomach and leave you feeling bloated. If you wish to discuss any specific problem, you can consult a General Physician.

Bloated Belly - 6 Possible Things That Can Cause It!

Acidity - gastritis: understanding the symptoms and causes

Gastritis/acidity is a group of diseases or symptoms where there is excess secretion of acid by the gastric glands of the stomach.

If you have upper abdominal discomfort or pain, stomach fullness, heartburn, nausea, vomiting, indigestion, belching, waterbrash or irregular bowel movement, then you must be suffering from acidity or gastritis. It is a problem which becomes worse when an individual has poor eating habits and improper lifestyle.

Gastritis: swelling of stomach lining

Various factors like spicy food, medicines, tobacco, alcohol etc. Can cause increase in gastric acid production and disturb, weaken or damage the normal stomach lining. Gastritis occurs when there is an imbalance between the acid production and damage to the stomach lining, resulting in swelling of the stomach lining.

Gastritis a very common disorder of all age groups

Gastritis is of two types - acute gastritis (which occur suddenly) and chronic gastritis (develops over a period of time). In India gastritis is a very common disorder which occurs at any age but is more widespread in the adolescent age group (12-17 years). Adolescence is a change from childhood to adulthood, the period in which a lot of physical and psychological changes occur increasing the risk of gastritis. 

Multiple factors cause gastritis

Various factors like spicy food, medicines (pain killers), tobacco, alcohol, emotional disturbance, psychological stress, smoking, alcohol intake and bacterial infection lead to gastritis.

Besides these, the three most important factors include helicobacter pylori infection (bacterial infection), use of painkiller medicines and autoimmunity (body loses its own immunity and attacks itself). These factors in the long term may even cause an ulcer (permanent breakage of the stomach lining), acid reflux disorder (food coming back to mouth after swallowing) and stomach cancer.

What does Ayurveda suggest?

In Ayurveda, agni refers to fire like activity in alimentary canal responsible for digestion of food which is influenced by the status of doshas. When samana-vata associates with kapha in turn produces weak digestive power (agni-mandya). Consuming food against the code of dietetics i. E. Ahara-vidhi vidhana and ahara-vidhi-visheshayatana (method of taking food) lead to a number of diseases related with food. Eating food before the previous food is digested, untimely food, eating too much of spicy or oily food, eating when not hungry, drinking too much water during food and at a time unless required, very hot high fatty-fried food, stale food, heavy diet, excess consumption of horse gram, vitiate all the three body humours (tridosha) also contribute to the symptoms of gastritis.

Due to the sourness of consumed food the liquidity of pitta increases further decreasing the capacity for digestion (agnimandya). Hence, rasadi-dhatu is not formed in a proper manner. This, after a certain period, manifests as amlapitta (hyperacidity).

Symptoms of gastritis vary among individuals

Symptoms of gastritis vary among individuals, and in many people even there are no symptoms. It also depends on the duration of disease, whether it is of acute (coming on suddenly) or chronic (causing symptoms over a long period of time) type.

The most common symptoms of acute gastritis include:

Abdominal bloating or stomach fullness,

Belching (expelling air from the stomach through the mouth)

Waterbrashes (sour fluid or tasteless saliva into the mouth)

Upper abdominal pain or discomfort

Nausea/vomiting feeling

Irregular bowel movement

Recurrent indigestion,

Chest burn or gnawing feeling between meals (heartburn)

Hiccups etc.

In addition to this, symptoms of chronic gastritis may include weight loss, continuous flatulence, black stool, loss of appetite and even anemia.

How to diagnose gastritis?

To diagnose gastritis, performs a thorough physical evaluation, and may recommend a blood test for h. Pylori screening, stool test for blood in the stool. Abdominal x-rays or barium studies (upper or lower) may demonstrate the presence of thickened stomach lining and folds that are signs of inflammation in the stomach.

Sometimes, an endoscope, a thin tube containing a tiny camera, is inserted through the mouth and down into the stomach to look at the stomach lining (endoscopy). The doctor will check for inflammation and may perform a biopsy, in which a tiny sample of tissue is removed and sent for analysis of gastric lining.

If you would like to consult with me privately, please click on 'consult'.
Related Tip: 10 Things You Must Correct to Fight Acidity And Heartburn

What Causes Acidity?  Understanding its Symptoms and Causes

Cumin, also known as 'jeera' in the Indian subcontinent, is an ancient seed that has been prized for more than 3000 years. Ayurveda holds this spice in high regards and uses it for treating a host of health disorders including burning of excess fat.

Why are cumin seeds considered to aid in weight loss?

An effective detoxifier: Ayurveda considers the accumulation of toxins to cause weight gain and other medical conditions. While certain toxins are easily removed with water, fatty toxins stick to cells and disrupt cell metabolism resulting in weight gain. To detox such hard-to-remove toxins, cumin seeds are predominantly used in Ayurveda. The seeds remove excess kapha from the intestines and detox liver effectively.
Lowers cholesterol that aids in burning fat effectively: Black cumin is rich in phytosterols which are plant fats resembling cholesterol present in animal fats. When consumed, they limit the amount of cholesterol absorbed by the body. Taking a tablespoon of cumin seeds every day has been medically proven to lower the amount of cholesterol up to 10 percent and bad cholesterol up to 14 percent. This reduction in addition to the cholesterol-lowering measures that you may have adopted would be helpful in burning fat much faster. Taking about 2 grams of cumin seeds combined with light freehand or aerobic exercises can lead to subsequent weight loss in people who lead a sedentary lifestyle.
Lowers blood sugar levels and regulates metabolism: Any person with high blood sugar levels is aware that low insulin levels tend to create a craving for sweets and carbs while high insulin levels can cause extreme thirst and fatigue. Cumin seeds have been proven to lower the blood sugar levels. It lowers blood sugar levels by increasing insulin and glucose sensitivity. In this way, black cumin seeds can aid you to shed off extra pounds by improving the blood glucose levels as well as glucose absorption. In addition to all these benefits, black cumin seeds contain high amounts of oleic acid which is a fatty acid causing acceleration in the way in which the body burns fat.
Other benefits from cumin seeds: Constipation and indigestion are other common reasons for weight gain. An excellent source of fiber, antioxidants, and that has anti-flatulent properties, the cumin seeds can cure constipation, bloating and heaviness, thus, aiding in weight loss. Lack of sleep may also be causing weight gain. Cumin seeds can cure you of insomnia, thus. regulating your sleep pattern and metabolism.
Hence, cumin seeds are a simple and effective ayurvedic remedy for weight loss. Cumin seeds are more potent, and you can take a spoon of roasted or plain cumin seeds every day. Obese or normal, irrespective of your weight, taking cumin seeds regularly have quite a few benefits.

1 Tablespoon Of Cumin - Know How It Can Work Wonders!

It is a known and proven fact that eating while consuming alcohol is necessary. One tends to grow hungrier, the more he or she drinks alcohol. This is because alcohol has the attribute to stimulate one s appetite in such a way that one would have you craving for food that is rich in salt and high in fibre. Consuming only alcohol ignoring the hunger would lead to several diseases like pancreatitis and issues with the liver.

Though the appetite of an individual during alcohol consumption tends to incline towards snacks like pizza, french fries, nuts and cheese cubes, it is wise to opt for healthier food choices. Salty food can worsen the dehydration effects of the body. And as the body tends to be dehydrated during drinking, it is better to avoid salty food. High-fibre food items are not good for the health either. It delays the digestion process, which is not a good sign for the body. Also, it is also not advisable to eat food in large portions before going to bed, especially after alcohol intake.

There is a variety of healthy food that one can eat along with alcohol

Soup: A clear soup, like chicken clear soup or vegetable clear soup, which has a broth-like texture, is a healthy choice. Creamy soup with cream of chicken or cream of mushroom should be avoided as it would make one heavy, thus delaying the digestion process.
Rice: Plain rice is said to be one of the best food that is easy to digest, paired up with a light vegetable dish. It is very nutritious as well.
Chicken sandwich: Grilled chicken sandwich without cheese and mayo is a healthy food tip as it contains sodium.
Popcorn: Popcorn does not contain fat, neither is it high-fibre. It is the best low-calorie food to go along with alcohol and it tastes really good too.
Wheat crackers: Wheat crackers contain whole grains. It is full of complex carbohydrates, which help the alcohol to absorb easily. It also consists of Vitamin B, which like potassium, gets reduced with the consumption of alcohol.
Banana: It is rich in potassium. Though an individual would never have a banana along with alcohol, it is healthy as the level of potassium should be taken care of while drinking alcohol.
Wheat bread: Wheat bread toast can be consumed with alcohol without butter or cheese. It is an alternative to wheat crackers for those who do not prefer it.
Oats: Cooked food is easy to digest with alcohol, so a pot of cooked oatmeal can be a healthy accompaniment. It can be spiced up a bit to add flavour.
Salad: Salad is refreshing and healthy at the same time. It can be bland, but it is better to have healthy salad as an accompaniment than having salty food with alcohol.
Milk cereal: Cereal, especially whole grain cooked with low-fat milk, is healthy.
By being aware of the right eatables, the ill effects of alcohol can be mitigated to a large extent.

Alcohol - 10 Healthy Foods that You Can Eat With It!

In this health-conscious era, more and more people want to stay fit. They constantly look for ways to maintain good health. Many have even developed a good habit of starting the day with a glass of lukewarm water as soon as they wake up in the morning. Yes, drinking water on an empty stomach offers the maximum health benefits. It not only stimulates the removal of toxins from the body but also benefits the overall digestive system. 

Although warm water isn t the most palatable, there are many reasons to start drinking it this way, either alone or with lemon. Below given are 6 reasons to start drinking lukewarm water on an empty stomach:

Digestive system: The food pipe, after having digested a variety of foods the previous day, would still be left with remnants. Starting the day with a glass of warm water acts as a good flush, which removes all these remnants. The warm or hot water also helps in removing greasiness, which is very helpful in people who eat a lot of junk food.
Helps in Weight loss: Drinking warm water on an empty stomach is perfect for those who are trying to lose weight as warm water raises body temperature and the metabolism. This, eventually, helps in burning more fat and boosting the weight loss efforts through diet and exercise changes. Ideally, you should add some drops of lemon in it. 
Strengthens Immune system: When a glass of hot water along with some lime is consumed early in the morning, it gives the required dose of vitamin C and potassium to the body, which strengthens your immunity system. Also, as the stomach is empty, the absorption is faster. 
Maintains body s pH balance: The body s pH turns alkaline as the ascorbic acid and the citric acid is easily digested and removed from the system. Drinking warm water helps in maintaining the required pH in the body.
Keeps you positive throughout the day: A nice juicy lime smells great, and this can be one of the best mood enhancers to begin your day with.
Skin and hair: For anybody with good skin, the key success factor is hydration, and a glass of warm water in the morning works like a cherry on the cake. When our body accumulates toxins, it becomes prone to illness and aging. A glass of hot water in the morning stimulates detoxification and helps in repairing skin cells and elasticity.
So, start your day with a glass of warm water and feel the difference. In case you have a concern or query you can always consult an expert & get answers to your questions!

Benefits of Drinking Lukewarm Water in Morning - Start Your Day With It?

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