GERD or acid reflux is caused by the regurgitation of acidic liquid stomach contents back up into the esophagus. It is a long-term condition where stomach contents come back upwards from the gastro-intestinal tract resulting in either symptoms or complications. It is a commonly occurring digestion condition. A burning sensation in the chest is usually caused by acid reflux which radiates up from the stomach to the mid-chest or throat. This condition is also known as the heartburn. A sour taste in the back of the mouth is a common experience amongst the patients. Long term reflux of gastric contents causes the condition to become chronic which can lead to difficulty in swallowing. In some cases the erosion of the tract lining can also cause breathing problems.

Symptoms:

Heartburn is a burning sensation felt in the retrosternal area. Most commonly it occurs post-prandial or nocturnally. Consumption of fatty foods, spicy foods, acidic foods aggravates the condition. Burning sensation is relieved with antacids, water or milk.
Perception of gastric content reflux in the mouth or hypopharynx is termed as acid regurgitation. It is also known as water brash. A bitter or acidic taste is felt in the mouth.
Other symptoms include dysphagia, odynophagia, nausea, chest pain, dyspepsia, epigastric fullness, bloating, frequent belching
Extra-esophageal symptoms like chronic cough, hoarseness, laryngitis, dysfunction of the vocal cords, bronchospasm can also be observed.
Complications:

Peptic stricture
Ulcers of the esophagus
Metaplastic disease (Barrett s esophagus)
Dysplastic disease (Adenocarcinoma)
Laryngitis or bronchitis
Pulmonary disease
Fluid in the sinuses and the middle ear
Diagnosis:
The diagnosis of GERD is made by its most commonly presenting symptom- heartburn. To confirm the diagnosis of GERD, the physicians treat patients with medications for suppression of the production of acid by stomach. If heartburn diminishes to a large extent by the medications, diagnosis of GERD is considered confirmed.

Conditions like an ulcer caused by bacterial infection, mimic the symptoms of GERD. To get a clearer diagnosis, an endoscopy is then performed. The common diagnostic modality for GERD is Upper intestinal gastro-endoscopy. A tube containing an optical system for visualization is swallowed, the tube progresses down the gastrointestinal tract, and then the lining of the esophagus, stomach, and duodenum can be examined. A normal esophagus is observed in most patients with symptoms of reflux. 

However, sometimes the lining of the esophagus appears inflamed. If erosions (superficial breaks in the esophageal lining) or ulcers (deeper breaks in the lining) are seen, a diagnosis of GERD can be made definitely. Other complications of GERD like ulcers, strictures, and Barrett's esophagus are also identified. Biopsies also may be obtained. Other common problems that may be causing GERD like symptoms can be diagnosed (for example ulcers, inflammation, or cancers of the stomach or duodenum) with EGD. Previously, barium meal x-ray was undertaken to diagnose GERD. It is now discontinued.

Other tests that are carried out are esophageal acid testing, esophageal motility testing, gastric emptying studies and acid perfusion test.

Treatment:

Lifestyle modifications   Avoiding acidic foods, quitting smoking, weight loss, abstaining from alcohol consumption improves symptoms in people with GERD.
Medications   Proton pump inhibitors (Pantoprazole, Omeprazole, Rabeprazole), H2 receptor blockers (Ranitidine, Cimetidine) and antacids.
Surgery   In cases where the proton pump inhibitors are unsuccessful in relieving symptoms of GERD, a surgical procedure called Nissen fundo-plication is done.

GERD - Complications Associated With It!

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!

Bloating and gas are most commonly caused due to indigestion as well as excessive accumulation of gas in the abdomen region. This can lead to a feeling of tightness and swelling, along with debilitating pain and discomfort, in some extreme cases. The other causes for bloating and gas may include wheat or gluten allergy, irritable bowel syndrome, food that gives rise to flatulence, lactose intolerance as well as severe conditions like acid reflux.

Homeopathy is an age old medical science that seeks to treat these and many other kinds of ailments with the help of its natural medication. However, in order to get the right treatment, it's important to visit the doctor and allow him to examine you properly and prescribe the right combination of medicines. The better the doctor understands your condition and symptoms, the better treatment he can offer.

Bloated abdomen refers to a feeling of fullness, tightness and distension of abdomen. There is also an excessive accumulation of gas in abdomen. Bloated abdomen can be painful, with cramping as well. 

The main causes behind bloated abdomen are constipation, Irritable Bowel Syndrome, wheat allergy, taking flatulent (gas-forming) food, overeating, food intolerance like lactose intolerance, and acid reflux (Dyspepsia). 

Over-the-counter instant gas-relieving pills and tonics can only provide very temporary relief, the causative agents remain firmly in place. Homeopathic medicines can completely cure bloatedness or bloated abdomen. Made from natural substances and free from any side effects, Homeopathic remedies for bloated abdomen can provide complete recovery by striking at the root of the problem, while ensuring there is no recurrence.

Homeopathic Treatment for Bloating and Gas-

Homeopathic medicines are very efficient in treating bloated abdomen. Sourced from natural substances, Homeopathic remedies are very beneficial in treating cases of bloatedness. Homeopathy provides complete recovery from bloatedness. The Homeopathic treatment for bloated abdomen is also of great help in releasing the wind from abdomen, thereby providing relief to the patient. The pain in the abdomen, burning and other associated symptoms also disappear with the use of natural Homeopathic medicines. Here is a list of some medicines that your homeopath might use to treat gas and bloating-

Graphites: This is one of the most commonly used and most efficient elements in Homeopathy. Graphites can help in treat abdomen bloating, which is accompanied by constipation on a prolonged basis. When this gas gets obstructed, instead of being allowed to see itself out of the body, the gas gets accumulated and causes a lot of discomfort and pain within the abdomen. Also, when there is an offensive odour in the gas that manages to pass through, one can use this medication.
Carbo Veg: This is one of the best homeopathic ways of resolving bloating and gas. This medicine is most commonly prescribed when there is belching along with the gas accumulation and bloating. The wind that accumulates in the abdomen may also give rise to breathing difficulties for many patients, in which case such a medicine is known to work wonders.
Abies Can: This is a natural Homeopathic cure for painful bloating which also comes with heart palpitations. In such cases, the doctor may prescribe this medicine to fight the gas that is busy burning in the abdomen. Other symptoms treated by this medicine include a sudden spike in the appetite as well.
Magnesium Phos: This medicine can help in treating gas and bloating that becomes colicky and gives rise to a lot of unbearable pain eventually. Also, it can be used for treating a feeling of fullness in the stomach due to the accumulation of gas. Further, the other symptoms treated by this medication include belching and hiccups.
Raphanus: When the gas obstructs the normal digestive process of the abdomen. This medicine can also be prescribed for successful treatment. It can also be used when the abdomen becomes hard due to the gas, which does not escape as flatulence or even as burps.
China: This is a Homeopathic medicine that can help in relieving symptoms like fullness, tightness, pain and even heaviness in the abdomen. It helps the patient in passing better motions so that the symptoms may be eliminated.
Homeopathy is an age old medical science that seeks to treat these and many other kinds of ailments with the help of its natural medication. However, in order to get the right treatment, it's important to visit the doctor and allow him to examine you properly and prescribe the right combination of medicines. The better the doctor understands your condition and symptoms, the better treatment he can offer.

Homeopathic Remedies for Bloating and Gas

Over the past several years, the prevalence of GERD (Gastro-oesophageal reflux disease) has increased in our communities due to unhealthy lifestyle and that can potentially lead to serious medical complications if left untreated. 

GERD is characterized by symptoms and/or tissue damage that results from repeated or prolonged exposure of the lining of the esophagus to acidic contents from the stomach and occurs when the lower esophageal sphincter (LES) does not seal off the esophagus from the stomach.

The two most frequently reported symptoms of GERD are heartburn, which can be described as a burning discomfort that begins behind the breastbone and radiates to the neck and throat, and acid regurgitation, which is characterized as a bitter, sour tasting fluid. One out of five people experience heartburn or acid regurgitation on a weekly basis and two out of five people experience heartburn or acid regurgitation at least once a month.

However, some patients may present with atypical symptoms such as a cough, asthma, laryngitis, or chest pain, and other patients with GERD experience no symptoms at all. 

Causes

1) Eating food while not feeling hungry
2) Eating in haste and in indigestion
3) Eating stale food
4) Eating spicy, hot  & tangy, fermented, stale food on a regular basis.
5) Excess consumption of tea, coffee
6) Sleeping immediately after meals
7) Drinking alcohol & smoking in excess
8) Mental stress
9) Staying awake at night, disturbed
sleep
10) Eating late at night.

Signs and symptoms:

Difficulty in swallowing
Regurgitation of food
Belching
Bitter taste in mouth
Discomfort or pain in upper abdomen
Dry cough
Anorexia ( loss of appetite )
Excessive thirst
Heartburn especially after meals and at night
Loss of taste
Nausea & vomitting
Bloating
Giddiness
Treatment in Ayurveda focuses on:

1) Improving appetite
2) Help nourishment of body
3) Regulating the acid metabolism in the body
4) Improve the ability of digestion & absorption
5) Treat inflammation and cause healing of the digestive tracts
6) Protecting the intestinal layers from ill effects of acid 

Do's & Don'ts for GERD:

Do's

1) Eat light to digest food
2) Eat only when one is hungry
3) Gap between two meals should not be more than 6 hrs
4) Eat fruits  daily 
5) Food good for GERD - Old caged rice, Jowar roti, Moongdal, Bittergourd, pumpkin, dates, pomegranate, Indian gooseberry,  Lemon, mint, mangosteen, turmeric, coriander, cumin, asafoetida, coconut, cowghee, cow milk, fresh buttermilk .
6) Drink lukewarm water half hour after meals
7) Walk after every meal
8) Daily exercise for atleast 45 min

Dont's
1) Very spicy & hot, excessive consumption of chillies & curd
2) Excess tea, coffee & fermented food
3) Excess stress & negative thinking
4) Sedentary lifestyle
5) Excess smoking & drinking
6) Drinking excessive water 
7) Sleeping immediately after meals
8) Sleeping in the afternoon
9) Staying awake late night

Symptoms of GERD are very commonly found in the population. If it is not taken care of, it can lead to complications like Barrett's oesophagus, oesophagitis, ulcers, Ca oesophagus, bleeding, scarring and difficulty in swallowing. Ayurveda has a complete holistic approach in treating GERD. Treating on time helps in avoiding complications in future.

Gastroesophageal Reflux Disease And Ayurveda!

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

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)

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