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!

GERD or gastroesophageal reflux disease is a chronic digestive disease which occurs when the stomach acid and at times the contents in your stomach flows backwards into the food pipe. The backwash or reflux irritates the esophagus's lining and hence causes GERD. Individuals may manage GERD's discomfort by changing their lifestyle and by taking over-the-counter or OTC medications. But, certain people might also require stronger medications or surgery for reducing the symptoms.

Some of the basic signs include chest pain, burning sensation in the chest, dry cough, difficulty in swallowing, sore throat, etc. If you experience such symptoms at least twice a week or if your physician notices damage in your food pipe, then you might undergo diagnosis. Though drugs are the primary GERD treatment yet, an individual can manage it by following certain tips which may give relief.

Few ways to manage GERD- self-care tips:

One of the effective ways to help yourself is by consuming smaller meals. Instead of taking three big meals regularly, you may try having smaller meals frequently and avoid stuffing.
Almost all individuals tend to have dinner just half an hour before sleep, but this might affect GERD patients. It is best to eat 2 hours before going to bed as by doing so your stomach will get enough time to digest the food.
Due to a hectic schedule and fast paced lifestyle, people tend to eat as quickly as possible. To manage GERD, one must eat slowly and put down the spoon or fork in between each bite.
Changing the daily diet by striking off the trigger foods is beneficial in managing GERD symptoms. Though the food triggers vary from one person to another yet, it includes coffee, chocolate, peppermint, alcohol, tomato, citrus juices, onions, spicy and high- fat foods, etc.
Sleeping with the head end of the bed elevated by 6 inches is a very effective way of reducing night time reflux. It is also advisable to sleep on your left side . Never sleep on the right side as this position promotes reflux. Medications to reduce acid production are the mainstay of the medical treatment. 
One always has to ensure that they are following the various lifestyle changes along with the medication. Other medications include pro kinetic medicines which help the stomach empty. Surgery always remains the last resort in the treatment of GERD. Endoscopy is required for the diagnosis or GERD Prior to any surgery a Manometry and 24 hr ph merry test is compulsory.
If you are suffering from GERD symptoms frequently, then you may maintain a diary for figuring out which foods are giving you trouble.

When is a surgery required?
If lifestyle changing tips and other medications fail to provide any relief, then physicians recommend undergoing surgery.

Surgery is done for strengthening lower esophageal sphincter and also for reinforcing it. The surgery for reinforcing lower esophageal sphincter is performed by surgeons laparoscopically. The surgeon inserts instruments like a tiny camera and flexible tube by making 3-4 incisions in the abdomen. This surgery for managing GERD may be quite effective.
Experts state that candidates who undergo GERD surgery are those who are unwilling to take GERD drugs or are not getting relief from them. While choosing a surgeon, it is better to consider one who possesses huge experience of the particular operation which you need and also with a good track record.
So, you must visit a doctor if you experience frequent gastroesophageal reflux disease symptoms. It won't be a good decision to take OTC medications without your doctor's recommendation if you notice arm or jaw pain along with difficulty in breathing as these are signs of heart attack.

Gastroesophageal Reflux Disease - How Best Can You Manage It?

Like most things in life, the uterus also has both good and bad sides to it. It is a symbol of womanhood and also carries the developing baby. The bad side is that it brings with it (and its appendages) many problems including dysfunctional uterine bleeding, endometriosis, fibroids, pelvic inflammatory disease, uterovaginal prolapse, adenomyosis, a pelvic pain of unknown origin, cancer of the uterine cavity and other obstetric complications.

Hysterectomy is one of the most commonly performed procedures and ensures complete relief from these symptoms. There are however, multiple procedures, which can be used to manage these conditions without having to resort to removal of the uterus. This can help in preventing complications from hysterectomy including prolonged recovery, infertility in women of childbearing age and loss of womanhood.

Read on to know some of the emerging conservative alternatives to hysterectomy:

Myomectomy: Where there are fibroids, which are in the smooth muscles of the uterus and show symptoms like pain and discomfort. In these, it is advisable to go for a myomectomy. This removes only the fibroid, leaving the uterus in place. It can be done in one of the 3 ways traditional surgical process through an incision; laparoscopically through minute incisions; and then through vagina. In all these, only the fibroid is removed and sent for biopsy to confirm it is benign. It is less invasive, requires less recovery time and helps retain the uterus.

Uterine endometrial ablation: In cases of dysfunctional uterine bleeding or menorrhagia with no fibroids, the lining of the uterus could require removal. In these women, thermal balloon ablation, cryoablation, and radiofrequency ablation can be used. A small amount of extreme heat or cold or radio frequency waves are used to remove the uterine lining, thereby managing symptoms.

Uterine artery embolization: In women with fibroids, the feeding arteries could be cauterised to ensure blood supply is stopped so that fibroid growth is stopped. With very promising success rates, this is gaining popularity as a conservative method.

Laparoscopy and endometriosis excision: In endometriosis, where the uterine tissue is growing in areas outside the uterus, it could be removed laparoscopically after identifying the area of growth on ultrasound and laparoscopy.

Vaginal pessary: In women with uterine prolapse, the uterus drops from its normal position, pushing against the vaginal walls. This can be due to vaginal childbirth, age, smoking and obesity. Vaginal pessary is where a removable device is placed into the vagina to prevent it from falling down. It is a temporary solution, but very useful in holding the uterus in place and relieve symptoms partially or completely.

In all these, medical management (painkillers and hormone replacement), stress and weight management, quitting smoking, reducing alcohol are also essential.

Hysterectomy - Know the Emerging Conservative Alternatives to it?

Top 10 Everyday Skin Care Hacks

You skin needs just a little care daily. There are some very simple ways in which we can provide that much needed affection and get back radiance and softness. And all this without any extra effort!

Try these everyday regimes for the glow.

1. Adopt Hydration - The first thing your skin needs to stay beautiful is adequate 'hydration,' or what they call in plain terms as plenty of water. So bottoms up to at least two liters of water daily.

2. Avoid Dehydration  - While you are busy hydrating your skin, remember to be careful and not dehydrate by staying out under the harsh sun for longer than 10-15 mins at a stretch. Ditch the caffeine habit (Soda, coffee, tea) as it dehydrates your body on the cellular level, inviting the onset of those dreaded wrinkles early than anticipated. 

3. Apply Lesser Layers - Your skin is your body's largest organ and it needs to breathe. So try and not swathe it under layers of heavy makeup and pore clogging chemical body butters on a regular basis.

4. Give It Fresh Air - To get your skin breathing truly fresh, put on your exercise gear and head outdoors to spend some quality time with Mother Nature at the nearest park or maybe you can take that long pending weekend trip out of the city!

5. Don’t Stress - Do not be stressed all the time unnecessarily. Learning how to manage stress effectively can take away years from your skin. 

6. Exercise - Run. Jump. Dance. Get moving, in short. The more your skin sweats, the better will it look and the elasticity would improve dramatically too. 

7. Get Nutrition - Get in the habit of starting the day with plenty of fruits and a healthy breakfast with the right amount of protein, carbs and essential fats. Fats are required by your skin to lubricate and moisturize from the inside. But make sure you stick to good fats found in olive oil, eggs, yogurt (the ones without any additives or artificial sugars), and whole grain breads etc.

8. Go Smoke-free - Just stop smoking and you would see a dramatic improvement in your skin tone within a few weeks (yes, it takes time to reverse that kind of damage) 

9. Wear Sunscreen - Slather on the sunscreen before you leave the house but make sure it's SPF index must be 30 and above for it to be effective under the harsh Indian sun.

10. Exfoliate & Detox - Scrub-rub-a dub every week. NOT every day though.. Make sure you use organic scrubs made with rice granules or sugar grains instead. Use a natural face mask such as Banana mash or a Tomato-Cucumber-Honey paste every alternate day to detoxify, cleanse and moisturize your face and body. 

If you would like to consult with me privately, please click on 'Consult'.

From Lybrate: If you found this tip useful, please thank the doctor by clicking on the heart icon below. Also, spread good health by sharing this tip with your loved ones over WhatsApp, Facebook and other media.


10 Only Skin Care Hacks You Will Ever Need

The heart may sometimes face excessive fluttering or a throbbing sensation, which may make you feel uncomfortable. Such sudden throbbing sensations resulting in discomfort are called 'palpitations'. Homeopathy has some great remedies depending on the cause of these problems.

Let s have a look at these:

Palpitations caused by anxiety: This is one of the top causes for palpitations which occur before sitting for an exam, interview or before important events of your life. However, they may tend to stay longer and it is advisable that you control them with the use of Aconite or Arsenic Album.
Palpitations caused by Physical exertion: If you have a weakened heart or if you smoke and thus tend to feel a lot of exertion even with the slightest of physical efforts, then Spigelia, Iberis and Digitalis are good medications. Digitalis is especially good for palpitations caused by the slightest of movements, while spigelia is very good with palpitations that cause arm pain as well.
Anemia: Anemia or the lack of red blood cells can be very dangerous for your health as it can damage your vital organs. It can also cause palpitations along with other symptoms such as paleness, lack of strength and drowsiness. Natrum Mur and Ferrum Met are two of the most effective remedies in such cases.
Use of tobacco products: Another reason for palpitations developing is the use of tobacco products, such as cigarettes or chewing tobacco. In such cases, palpitations may occur even with the slightest of exertions or at rest. Medications effective in such situations are Kalmia, Tabacum and Convallaria. These variations may be required depending on the types of symptoms you may show such as a quick heart rate or a slow heart rate.
A palpitation caused by hyperthyroidism: Excessive secretion of thyroid is called hyperthyroidism and can cause a host of problems within the body including palpitation. Iodum and Spongia are two excellent medications in treating variations of palpitations caused by an over active thyroid gland.
Palpitations caused by acidity or gastric problems: This is possibly the most common cause for palpitations and Lycopodium as well as Abies Can are two very effective homeopathic medications, which can easily remedy the situation, depending on the type of problems you are having.

Palpitations - How Homeopathic Remedies Can Help You Manage Them?

An estimated of 10 percent or more children snore for more than 1 night. Snoring results from the obstruction of breath when the air makes its way through the mouth. The air passage of the throat through which the air goes in and out causes the tissue to vibrate causing snore. The sound of the snore totally depends on the amount of air passing through the mouth and the frequency at which the throat is vibrating. Children above the age of three years tend to snore when they are deep in sleep.

Primary and secondary snoring:
Children who are otherwise healthy should not have a snoring problem unless there is some health disorder. However, if loud snoring is observed in otherwise a perfectly healthy kid, seeking medical help is a wise thing to do. In general, primary snoring is defined as a condition which is not associated with other sleep-related disorders such as lung disorder, OASS, inability to sleep for a longer duration etc.

Other possibilities:
It is estimated that close to three percent of the children suffers from breathing problem while sleeping. OSAS is a condition which is characterised by pauses in breathing and gasps along with loud snores. There could be instances where a kids  muscle relaxes way too much obstructing the air to pass through. The body and the brain are both alerted at this stage. As soon as the brain sends a signal, the body wakes up. Thus, most kids suffering from this disorder are not able to sleep well and tend to feel tired throughout the day.

Common causes of sleep apnea:
Sleep apena is a major cause of snoring. It can be caused because of allergies, obesity, GERD etc. In children sleep, apnea can also be caused by tonsil. Since the tonsil size of children less than 7 years of age tends to be bigger than adult individuals, it causes snoring related problem. Swollen tonsils not only obstruct air but creates other health related problems as well.

Symptoms of sleep apnea during the day and night:

Loud snore
Snorts, gasps, pauses during sleep
Heavy sweat during sleep
Social and behavioural problems
Failure to get up in the morning
A nasal voice
Easily irritated, cranky and aggressive
Relief measure:
The first thing a that a doctor does is a physical exam followed by observing the symptoms of a kid. Primary snorting can be addressed by physical exercise, counselling and breathing exercise. Problems related to apnea are addressed through medicine, counselling, and exercise. Certain dietary restrictions also needed to be followed during this time. However, apena is completely treatable within a certain time frame.

Mouth Breathing - What Can Cause It?

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