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 laryngitis
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 Should You Know

5 Ways to protect your skin this summer

Staying out in the sun too long can cause you to suffer from a host of skin problems such as age spots, wrinkles and even increase your risk of developing skin cancer. During the summer months, you need to take extra care of yourself as the sun is at its peak at that time. Here's what you can do in this summer to ensure that your skin remains protected:

1. Avoid the rays of the sun between 10 am and 2 pm

The strength of the UV rays depends on a number of factors such as reflective surfaces, height, and time of day. The sun's UV rays are at their strongest between 10 am and 2 pm. If you're outdoors, seek a cool area to protect yourself from the damaging rays of the sun. You could stand under a tree or use an umbrella to shield yourself from its ultraviolet rays.

2. Don't use tanning beds

Several studies reveal that tanning beds can cause skin cancer. According to these studies, individuals under 30 who use tanning beds increase their risk of melanoma (the most deadly of all skin cancers) by about 75%.

3. Increase your fluid intake

One of the ways in which you can beat the sun and protect your skin is by increasing your fluid intake during this time. On an average, one should have about 3 liters of fluids every day, which is about 1.5-2 liters of water and 1 liter of fluid from solid foods. From summer foods like watermelon and berries to beverages like fruit juice, milk, etc and liquid-based meals - all these avenues should be considered.

4. Have a proper cleansing regimen

To help your skin look fresh even during the summer months, you should exfoliate regularly. When you do this, all the dead skin cells are removed, giving your face a youthful and fresh appeal.

5. Use a sunscreen all the time

To protect yourself from the damaging ultraviolet rays of the sun, you should never forget to apply sunscreen when going out. Ideally, a sunscreen that has an SPF of 30 should be applied thoroughly to your skin 30 minutes before leaving your house. More importantly, it should be applied again every 2 hours.



5 Ways to protect your skin this summer

The kidneys are primarily responsible for filtering blood and removing waste from the body. They also regulate the fluid and electrolyte balance. If the kidneys stop functioning, a patient may need to undergo dialysis or have a renal transplant. Many patients prefer undergoing a transplant as it offers a better quality of life in the long run.

A kidney transplant can be described as a procedure to replace one s own kidneys with a donor's kidney. In case of kidney transplant, there are two types of donors. The human body can function with one healthy kidney and hence family members and friends of the patient may choose to donate a kidney. Else, a kidney may be sourced from recently deceased donors who have chosen to donate their organs after death. In both cases, it is important that the donor kidney match the patient s blood and tissue type.

A renal transplant surgery usually takes about 3 hours. The donor kidney is placed in the abdominal cavity and connected to the patient s arteries, veins and bladder. Usually, the donor kidney begins functioning immediately. The patient s own damaged or diseased kidneys may not be removed unless there is a severe infection, cancer or a diagnosis of large polycystic kidneys.

The patient will need to be hospitalized for a few days after the surgery. In some cases, dialysis may be needed if the kidneys are unable to produce urine. In addition diuretics and other medication may be needed to remove excess water and salt from the body. Medication will also be prescribed to suppress the immune system so that the patient s body does not reject the donor kidney. These medications typically need to be taken for the rest of the patient s life.

A renal transplant is considered a relatively safe procedure. Less than 20 out of 100 people reject a donor kidney. However, there are a few other risks involved. These include:
  Bleeding
  Severe infection
  Failure of the donor kidney
  Reaction to anesthesia
  Increased risk of infections due to suppressed immune system

Kidney transplant is not advised for people suffering from diseases such as cancer or any significant lung or heart disease. If the patient is suffering from an infection, he or she may be advised to wait until the infection subsides before undergoing a renal transplant. A renal transplant may seem to be an expensive procedure but in the long run, this can work out to be more budget friendly than dialysis.

Renal Transplant - What Should You Know About It?

Obesity is a serious, chronic disease that can have a negative effect on many systems in your body. People who are overweight or obese have a much greater risk of developing serious conditions, including:

Heart disease
Type 2 diabetes
Bone and joint disease
The prevalence of childhood obesity has increased dramatically over the past few decades, and obesity during adolescence is associated with significant medical morbidity during adulthood. Eating disorders and obesity are usually seen as very different problems but actually share many similarities. Eating disorders (EDs) are the third most common chronic condition in adolescents, after obesity and asthma.

In fact, eating disorders, obesity, and other weight-related disorders may overlap as girls move from one problem, such as unhealthy dieting, to another, such as obesity. Understand the links between eating disorders and obesity and promote healthy attitudes and behaviors related to weight and eating.

What is an Eating Disorder?

Eating Disorders describe illnesses that are characterized by irregular eating habits and severe distress or concern about body weight or shape. Eating disturbances may include inadequate or excessive food intake which can ultimately damage an individual s well-being. The most common forms of eating disorders include Anorexia Nervosa, Bulimia Nervosa, and Binge Eating Disorder and affect both females and males.

Signs & Symptoms of an Eating Disorder:

A man or woman suffering from an eating disorder may reveal several signs and symptoms, some which are:

Chronic dieting despite being hazardously underweight
Constant weight fluctuations
Obsession with calories and fat contents of food
Engaging in ritualistic eating patterns, such as cutting food into tiny pieces, eating alone, and/or hiding food
Continued fixation with food, recipes, or cooking; the individual may cook intricate meals for others but refrain from partaking
Depression or lethargic stage
Avoidance of social functions, family and friends. May become isolated and withdrawn
Switching between periods of overeating and fasting
What are the health risks associated with these disorders?

Stunted growth.
Delayed menstruation.
Damage to vital organs such as the heart and brain.
Nutritional deficiencies, including starvation.
Cardiac arrest.
Emotional problems such as depression and anxiety.
What is Obesity?

Obesity means being overweight by the accumulation of excess fat within the body. Obesity is defined to some extent by measuring Body Mass Index (BMI). People become obese by consumption of excess calories, imbalance between calories intake and calories outgoing, leading a sedentary life, lack of sleep , disturbances in lipid metabolism and intake of medications that put on obese.

What are the risks associated with obesity?

Obesity increases the risk for:

High blood pressure
Stroke
Cardiovascular disease
Gallbladder disease
Diabetes
Respiratory problems
Arthritis
Cancer
Emotional problems such as depression and anxiety
How eating disorder and obesity are related?

Eating disorders and obesity are part of a range of weight-related problems.

Body dissatisfaction and unhealthy dieting practices are linked to the development of eating disorders, obesity, and other problems.
Binge eating is common among people with eating disorders and people who are obese.
Depression, anxiety, and other mood disorders are associated with both eating disorders and obesity.
The environment may contribute to both eating disorders and obesity.
Help adolescents develop healthy eating habits:

Help children learn to control their own eating.
Offer children a variety of healthy foods at meal and snack times.
Eat dinner together as a family most days of the week.
Be aware of your child's emotional health or else consult a psychologist
Encourage children to participate in sports, dance, swimming and other physical activities.
Counteract harmful media messages about body image. 
The splendid approach:

The approach should be quite simple. A proper diet plan, nutritious foods and fruits with proper exercise can do a world of good to you. 

Obesity Due To Eating Disorders!

What is the ovary and what are ovarian cysts?  

Ovarian cysts are fluid-filled sacs or pockets within or on the surface of an ovary. Women have two ovaries - each about the size and shape of an almond - located on each side of the uterus. Eggs (ova) develop and mature in the ovaries and are released in monthly cycles during your childbearing years.

Many women have ovarian cysts at some time during their lives. Most ovarian cysts present little or no discomfort and are harmless. The majority of ovarian cysts disappear without treatment within a few months.

However, ovarian cysts - especially those that have ruptured - sometimes produce serious symptoms. The best ways to protect your health are to know the symptoms that may signal a more significant problem, and to schedule regular pelvic examinations.

What causes ovarian cysts?
Most ovarian cysts start during the normal function of your menstrual cycle. These are known as functional cysts. Other types of cysts are much less common.

Functional cysts

Your ovaries normally grow cyst-like structures called follicles each month. Follicles produce the hormones estrogen and progesterone and release an egg when you ovulate. Sometimes a normal monthly follicle just keeps growing. When that happens, it becomes known as a functional cyst. There are two types of functional cysts:

Follicular cyst. Around the midpoint of your menstrual cycle, an egg bursts out of its follicle and begins its journey down the fallopian tube in search of sperm and fertilization. A follicular cyst begins when something goes wrong and the follicle doesn't rupture or release its egg. Instead it grows and turns into a cyst.
Corpus luteum cyst. When a follicle does release its egg, the ruptured follicle begins producing large quantities of estrogen and progesterone in preparation for conception. This changed follicle is now called the corpus luteum. Sometimes, however, the escape opening of the egg seals off and fluid accumulates inside the follicle, causing the corpus luteum to expand into a cyst.
The fertility drug clomiphene (Clomid, Serophene), which is used to induce ovulation, increases the risk of a corpus luteum cyst developing after ovulation. These cysts don't prevent or threaten a resulting pregnancy.

Functional cysts are usually harmless, rarely cause pain, and often disappear on their own within two or three menstrual cycles.

Other cysts

Some types of cysts are not related to the normal function of your menstrual cycle. These cysts include:

Dermoid cysts. These cysts may contain tissue such as hair, skin or teeth because they form from cells that produce human eggs. They are rarely cancerous.
Cystadenomas. These cysts develop from ovarian tissue and may be filled with a watery liquid or a mucous material.
Endometriomas. These cysts develop as a result of endometriosis, a condition in which uterine endometrial cells grow outside your uterus. Some of that tissue may attach to your ovary and form a growth.
Dermoid cysts and cystadenomas can become large, causing the ovary to move out of its usual position in the pelvis. This increases the chance of painful twisting of your ovary, called ovarian torsion.

 SYMPTOMS:

Menstrual irregularities
Pelvic pain - a constant or intermittent dull ache that may radiate to your lower back and thighs
Pelvic pain shortly before your period begins or just before it ends
Pelvic pain during intercourse (dyspareunia)
Pain during bowel movements or pressure on your bowels
Nausea, vomiting or breast tenderness similar to that experienced during pregnancy
Fullness or heaviness in your abdomen
Pressure on your rectum or bladder that causes a need to urinate more frequently or difficulty emptying your bladder completely.

Ovarian Cysts - Knowing The Types & Symptoms!

Many people know that smoking causes several problems including cancer, heart disease, and respiratory disease. However, there are other diseases occur because of smoking and chewing tobacco. Buerger's Disease is one such disease in which the blood vessels in legs and arms get blocked. This blockage will interfere in blood flow and results in forming blood clots. These clots will affect both legs and
hands.
Buerger's Disease is also known as Thromboangitis Obliterans. It is a type of vasculitis which causes inflammation in the blood vessels including thickening, narrowing, weakening, or scarring.
Buerger's Disease cannot be cured easily. However, by quitting the use of tobacco and smoking, one can limit the symptoms from getting worse. If a person is not able to quit smoking, he/she might end up
suffering from severe tissue damage. One can also even lose toes, fingers, or other parts of the limbs. This is why quitting all type of tobacco or smoking is the only way to treat Buerger's Disease.

What Causes Buerger's Disease?
As discussed earlier, smoking cigarettes or cigars and chewing any form of tobacco is one of the main causes of Buerger's Disease. Still, the exact cause of this disease is unknown, but in most cases of Buerger's Disease, the sufferer has consumed tobacco products. It is an assumption that chemicals present in tobacco, cigarettes, and cigars may affect the lining of blood vessels, causing them to swell. According to experts, the genes in the body may also cause this disease. It is suspected that this disease is caused by an autoimmune response in which the immune system of the body attacks healthy tissues mistakenly. According to this theory, some people are prone to this disease.

Symptoms of Buerger's Disease-
Some of the most common symptoms of Buerger's Disease are:
  Pain in the hands and feet while exercising
  Stiffness due to reduced blood flow
  Pain at Rest
  Skin ulcerations
  Gangrene of the fingers and toes in severe cases
  Numbness, coldness, or tingling of the feet and hand
  Pale, reddish, or blue-tinted hands or feet.

Diagnosis of Buerger s Disease-
There is a set of tests that can diagnose Buerger s disease. Doctors first ask a person about his/her lifestyle, use of tobacco, and symptoms. After seeing a few symptoms, doctors may perform a test to check the blood flow. He may also look for other diseases that cause similar symptoms. Some of the common test to diagnose Buerger s Disease are:


  Allen Test: The Allen test is a blood flow test. In this type of test, patients squeeze their hand into a firm fist, which pushes out blood from hand. The doctor presses the arteries to slow down the
blood flow of the hand. At this stage, the normal color of the skin gets pale. After that, patients open his/her hand and doctors release the pressure from both sides of the wrist one by one. If it takes a longer time to go back to the normal skin color, it may be an indication of Buerger s disease

  Angiogram: It is a type of X-ray that will help to check the blockage of the blood vessels in the legs and arms. In this test, doctor place catheter (thin tube) into an artery to pump the dye. After
that, he takes X-ray images. Doctors may also perform tomography (CT) or MRI scan for clear results.

  Blood Tests: The blood tests will help the doctor to check if there is any other disease that causes the same symptoms as most of the vascular diseases mimics the symptoms of Buerger s
Disease. The doctor may also perform tests to check for diseases like lupus, diabetes, and those that cause blood clots.

Treatment of Buerger' Disease-
Quitting smoking and use of tobacco will help a person to lower the symptoms of this disease. Doctors may also prescribe for pain killers or antibiotics to get rid of the pain in affected areas. If a person finds it difficult to quit smoking, doctors help him/her with the right program and rehabilitation techniques.

Take Away-
Buerger's Disease is one of the rare illness caused by intake of tobacco products, this is why quitting smoking is most important to treat this disease. It is also advisable to consult a doctor as soon as a person identify any of the above symptoms.

All You Need To Know About Peripheral Vascular Injuries!

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