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

Our heart is one of the most important organs that must be kept healthy and fit so that we can lead a good lifestyle, however, unfortunately many people still suffer from heart problems. And, one such heart problem is Cardiomyopathy.

What is Cardiomyopathy?

Cardiomyopathy is a disease of the heart muscles that makes it very difficult for the heart muscles to pump blood to the rest of the body. Since the muscles are unable to pump blood effectively, it can lead to heart failure. It is a very serious condition and may require extensive treatment to fully recover from the disorder. 

Different types of Cardiomyopathy

Now we will be discussing about the different types of Cardiomyopathy that can affect an individual.

Hypertrophic Cardiomyopathy - In this case, the heart muscles becomes abnormally thickened, particularly affecting the muscle of your heart's main pumping chamber (left ventricle). The thickened heart muscle can make it harder for the heart to work properly. Most affected people have a family history of the disease.
Dilated Cardiomyopathy - In this case, the muscles enlarge and become weak, therefore they cannot pump the blood. These weak muscles over a period of time become absolutely ineffective and can cause heart failure.
Restrictive Cardiomyopathy - In this type, the heart muscle becomes rigid and less elastic, so it is unable to relax and can't expand and fill with blood between heartbeats.Which eventually does not allow the blood to flow properly.
Arrhythmogenic Right Ventricular Dysplasia - In this rare type of cardiomyopathy, the muscle in the lower right heart chamber (right ventricle) is replaced by scar tissue, which can lead to heart rhythm problems. It's often caused by genetic mutations. This condition can cause a sudden cardiac arrest or heart failure as well.
Symptoms 

Patient may be asymptomatic in the early stages of cardiomyopathy. But as the condition advances, signs and symptoms usually appear, including:

Breathlessness with exertion or even at rest
Swelling of the legs, ankles and feet
Bloating of the abdomen due to fluid buildup
Cough while lying down
Fatigue
Heartbeats that feel rapid, pounding or fluttering
Chest discomfort or pressuretreated
Dizziness, lightheadedness and fainting
Signs and symptoms tend to get worse unless treated.

Complications 

Cardiomyopathy can lead to other heart conditions, including:

Heart failure. Untreated, heart failure can be life-threatening.
Blood clots. Blood clots might form in your heart and may enter your bloodstream, then they can block the blood flow to other organs, including your heart and brain.
Valve problems. The heart valves might not close properly. This can lead to a backward flow of blood.
Cardiac arrest and sudden death.Cardiomyopathy can lead to abnormal heart rhythms which can result in fainting or, in some cases, sudden death.
Treatment 

It can include medications, surgically implanted devices or, in severe cases, a heart transplant, depends on which type of cardiomyopathy you have and how serious it is.

Prevention

You can help reduce your chance of cardiomyopathy and other types of heart disease by living a heart-healthy lifestyle and making lifestyle choices such as:

Avoiding the use of alcohol or cocaine
Controlling high blood pressure, high cholesterol and diabetes
Eating a healthy diet
Getting regular exercise
Getting enough sleep
Reducing your stress
So here are some of the most common types of Cardiomyopathy. These types can affect people of any age group if they lead an unhealthy lifestyle. Cardiomyopathy is a very serious condition and any person  suffering from it should be diagnosed early and given medical treatment as soon as possible.

Patient With Shortness Of Breath - Types Of Cardiomyopathy And Management!

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?

Somebody in the world suffers a stroke every two seconds. Stroke affects physical as well as mental health gravely. It can be a life- altering situation leading to new limitations overnight. Such limitations can be physical or mental, affecting mobility and cognition. According to psychologists, cognitive functions of the brain encompass speech, language, functional memory, spatial- motor systems, ability to switch between tasks, executive functions like task organization, attention, and being able to employ tools and symbols.

When the stroke strikes, it irreversibly damages a part of the brain. It happens due to hemorrhage or blocked supply of blood. However, the brain can be trained and taught compensatory strategies. These compensatory strategies consist of attention increasing activities that require neurological utilities. These activities and exercises are formed in a way to improve the memory. Both pictorial and hearing skills are engaged in these activities.

Memory, attention span, and executive activities are dependent on each other and any problem regarding these affects an individual s daily life. That is why to improve the complete mental capacity, exercises are required. These exercises help to improve memory and attention span. In cognitive rehabilitation, goals are set as per the requirements of the patient and treatment is then followed. This requires some plans and strategies to carry out daily activities. These plans may consist of planning and analysis of the task.

The recovery varies from individual to individual depending upon the restoration of the damaged neurological functions supporting specific cognitive area. However, there are very limited types of treatments for cognitive rehabilitation, mostly generic treatments which depends on doctor s experience.

Evidence is found by researchers which supports the cognitive rehabilitation after stroke, in which the areas discussed are smaller than the issues faced by the stroke survivors. The studies fail to talk about the long-term results and common treatments for daily tasks. It is now really important for us to have a serious innovation in the field of cognitive rehabilitation with the amount of stroke patients increasing day by day.

Before one going for rehabilitation, he/ she should ensure that why they need it and what are their needs that are to be fulfilled through rehabilitation. Experts recommend rehabilitation so that patients are able to lead as normal lifestyle as possible post stroke strikes them.

Who are more prone to stroke?

Old age people, alcoholics, people with high cholesterol levels, active smokers, Diabetic patients, people who consume drugs, people suffering from Hypertension, patients going through transient ischemic attack (TIA) are all very much prone to a stroke.

It is also very important to consult a doctor after stroke. He will advise you the best possible way to treat the problem. 

Take away

Stroke these days can happen to anyone which although largely depends upon the age factor, but one's lifestyle can also make him/her the target of stroke. There is cognitive rehabilitation which can help a person to recover post stroke through activities and exercises and change in lifestyle. It is important for an individual to consult a doctor if he/she finds any difficulty in carrying out daily activities with one side of the body.

Cognitive Rehabilitation Post Brain Stroke!

Cystic fibrosis is a genetic condition, which primarily affects the lungs and persistence of this condition might lead to severe breathing problems and loss of lung function. If you have inherited two copies of the defective gene from your parents, you are likely to suffer from this disease. Cystic Fibrosis causes a buildup of thick mucus in your lungs and affects other organs such as the kidneys, pancreas and the intestines in your body.

It isn't very uncommon as one out of fifty people in Asia is a carrier of this disease. The disease gets its name from the cysts formed in the pancreas of the sufferer. However, this disease can be detected by testing the quantity of salt present in your sweat. Prenatal testing for Fibrosis is another method to test if your newborn is likely to contract a lung infection.

Complications faced due to cystic fibrosis include:
1. Serious sinus infections
2. Serious damage in lungs due to inflammation and incessant infection
3. Malnutrition
4. Complication in breaking down protein
5. Respiratory tract contamination

If you observe one or more of the following symptoms, you might be suffering from Cystic Fibrosis:
1. Salty-tasting skin
2. Bowel obstruction caused due to meconium ileus (obstruction of the bowels)
3. Mucus amiss in your alveoli
4. Persistent coughing with phlegm discharge
5. Shortness of breath while engaging in a physical task
6. Stunted or measly growth despite healthy lifestyle habits
7. Infertility in males

If you're suffering from cystic fibrosis, there isn't any particular treatment which is recommended due to the varying degrees of it found in people. However, consultation with a medical practitioner and an individualised treatment plan can help you minimise the risks and lead a better life.

Some therapies you can opt for are:
a) Airway clearance: This therapy helps sift the thick layer of mucus around your organs. Some people have also chosen to use the inflatable vest which vibrates around your chest, thereby, thinning and loosening the layer of mucus.

b) Inhaled medicines: Another breakthrough in the field of respiratory medicine, this method requires the patient to sniff a liquid consisting of mist, which is inhaled with the aid of a nebuliser. This method is known to be beneficial for opening airways.

c) Pancreatic enzyme supplements: Along with multivitamins, these specially designed supplements are known to cater to your pancreas with the much-needed nutrients and they need to be consumed with every meal.

Cystic Fibrosis: All You Need to Know

Bradycardia is a condition which in basic terms means slow beating of the heart. In most cases, the typical rate is 60 to 100 beats in a minute when the person is at rest. In case your heart beats less than 60 times in a minute, then it is slower than normal. But a slow heart rate is not always a health concern even though sometimes it could indicate issues with of the heart.

What could bradycardia mean?
Some people with slow heart rate or bradycardia tend to be very fit, and they have no underlying health issues. Athletes and healthy young adults often have a heart rate lower than 60. But in others, bradycardia indicates that the natural pacemaker of the heart is not working well, or the electrical pathways have been disrupted. In severe forms of the problem, the heart may beat so slowly that it fails to pump adequate blood for meeting the needs of the body. This may show some symptoms and could be fatally dangerous.

What are the causes of bradycardia?
There are various causes of bradycardia, and some of them include:

Alterations in the heart which results from aging
Health conditions that slow down the electrical impulse through the heart. This may include electrolyte imbalance, low thyroid levels, and others.
Diseases which may disrupt the electrical system of the heart including heart attack, coronary artery disease, and myocarditis.
Certain medications that are used for treating heart problems like high blood pressure or hypertension, arrhythmia, and beta-blockers, and digoxin.
What are the symptoms of bradycardia?
When a person has very slow heart rate, he or she may experience lightheadedness or dizziness, feeling short of breath, having difficulties in doing normal activities or exercising, having chest pain, feeling tired and fatigued. In some cases, it is seen that the person may have palpitations, feeling confused, trouble in concentrating and fainting.

What s worse, some people don t have any symptoms at all, or their symptoms are so negligible that they think they are caused just because of aging. The best way to understand whether you have this problem is to take the pulse, and in case, it is slow or uneven, you must talk to a doctor.

How is bradycardia diagnosed and treated?
Bradycardia tends to come and go from time to time, and therefore, a standard EKG is not always able to detect it. A standard ambulatory electrocardiogram is used for detecting the condition, and sometimes, blood tests are also necessary.

The treatment of bradycardia is entirely dependent on the cause of the problem and its symptoms. It is worthy of mention here that in case the problem is not causing any symptoms, then they would not be treated under usual circumstances.

An Effective Guide To Bradycardia!

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