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?

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.

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Related Tip: 10 Things You Must Correct to Fight Acidity And Heartburn

What Causes Acidity?  Understanding its Symptoms and Causes

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?

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)

Gastroesophageal reflux disease or GERD is a chronic condition that can cause discomfort and a burning sensation in the chest. This is caused by stomach acids or bile that flows backward into the food pipe. If this happens more than twice a week, the patient may be diagnosed with GERD. Mild cases of GERD may be treated with lifestyle changes, antacids, diet changes and proton pump inhibitors. In more serious cases, surgery may also be needed. This aims at repairing or replacing the lower esophageal sphincter (LES). This valve is responsible for the backward movement of acids from the stomach to the food pipe.

Types of Surgery for GERD
Surgery is usually the last option for doctors treating GERD. This relieves symptoms of GERD and eliminates the need for long-term medication. There are many different types of surgical treatments. Some of the factors that determine the best type of surgery suited to a patient include the patient s age, weight, overall health etc.

Fundoplication: This surgery focuses on tightening the LES. Fundoplication may be performed as an open surgery or as a laparoscopic surgery. In both cases, the stomach is wrapped around the lower esophagus to reinforce and strengthen the LES. Fundoplication is the most common surgical procedure used to treat GERD and has a high success rate.
Stretta Procedure: This is an outpatient procedure that is performed using an endoscope. The doctor will pass a thin tube with an electrode at one end down the patient s esophagus. The electrode heats the tissue in the esophagus and makes tiny cuts. These cuts will then form scar tissue that strengthens the muscles surrounding the esophagus and blocks acid reflux. This is a fairly new procedure and hence the long-term results are still not clear.
Bard EndoCinch System: This procedure is not very common. It involves the use of an endoscope that is used to make stitches in the esophagus so as to create pleats in the LES. This helps strengthen the valve and prevent acid reflux.
Linx Surgery: This is a minimally invasive surgery where a special device called a linx is wrapped around the LES. A linx can be described as a small ring of magnetic titanium beads. This ring allows food to pass through but otherwise keeps the opening between the esophagus and stomach closed. Linx surgery is a relatively new procedure that has shown good results.
Recovering from Surgery for GERD
Recovering from surgery for GERD depends largely on the type of surgery undergone. Laparoscopic procedures have a short recovery time and are associated with less pain as compared to traditional open surgeries. Open surgery usually takes 2 weeks for full recovery while a patient may recover from laparoscopic surgery within a week.

Surgery For GERD - Types, Results and Recovery

Read to know why choosing diet drinks over regular beverages is not good for your health. The diet contains aspartame which is reportedly 200 times sweeter than table sugar. It adversely effects the brain, increases belly fat, headache, abdominal pain etc. 

Diet Drinks vs. Regular Beverages: Which is Worse For Your Health?

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