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?

Heartburn is a common symptom experienced by many people, but is often overlooked as indigestion. Besides making you uncomfortable, this can be a sign of a much bigger health problem. While the occasional heartburn can be treated with antacids, chronic heartburn can be a sign of gastroesophageal reflux disease (GERD) or acid reflux. Here are three important reasons you should not ignore heartburn.

It can promote tooth decay:The acid regurgitated might not necessarily stop in the esophagus. It can often also make its way into your mouth. When this happens frequently it can promote tooth decay and wear out enamel. This can also leave your mouth with a sour taste. Acid reflux induced tooth erosion can easily be prevented by the early treatment of acid reflux,but in most cases is noticed only after the damage has been done.
It can cause cancer of the esophagus:Chronic acid reflux that persists for years can lead to changes in the cells of the esophagus. This can lead to a cancerous condition known as Barrett's esophagus. The condition has no other symptoms can if left untreated can develop into cancer of the esophagus. Women are at a higher risk of this form of cancer than men. Though esophageal cancer is relatively rare, it is not something to be trifled with. The survival rate of esophageal cancer is very low in comparison to other forms of cancer. Only 15-20% patients live longer than 5 years after this condition is diagnosed.
It can lead to breathing problems:Heartburn is caused by stomach acid flowing back into the esophagus. If it is inhaled after regurgitation, it can worsen asthmatic conditions and pneumonia. At the same time, treating acid reflux with medication like PPIs can also increase the risk of pneumonia as it can promote bacterial growth and suppress coughing. Thus, when consulting a doctor for acid reflux treatment ensure that you mention any existing asthmatic conditions so that you can be treated with your lung functioning in mind.
In addition, acid reflux can also impact a person's health and quality of life. To prevent heartburn people often find themselves avoiding certain foods. This can impact their social lives and in turn make them withdrawing into themselves. A person's sleep can also be affected by heartburn. Hence, it is important to treat heart burn as early as possible and not wait for it to become a chronic problem.

GERD / Heartburn - 3 Reasons Why You Should Not Ignore it 

Cover small intestine is very significant in maintaining proper digestive health by jogging nutrients are fluids that be eat or drink. Yourself in delivering the waste products in the large intestine. This surgery which is the small bowel resection is done to remove part or the entire small bowel. This is basically done when part of our small bowel as blockage or when the diseased.

Importance of intestinal surgery or small bowel resection
There are several conditions which may affect our small bowel. Generally your doctor might advise you to remove a portion of your small bowel but in some cases a portion of your small Bible might have to be removed to confirm that a disease have been ruled out if tissue diagnosis might be required. Some situations where you may require surgery involves:

Severe ulcers that develops in the small bowel leads to bleeding and in some cases infection also
A situation where there is either a congenital blockage in the intestine or maybe from a scar tissue
Cancer is an obvious option
Some injuries to the small bowel is an obvious situation
In some cases there may be a pocket of intestines present there since birth
Several diseases which cause inflammation in the small bowel
Risks Involving Small Bowel Resection
It is very obvious that any kind of surgery has some potential risks so does the small Bowel resection, which includes which includes:

There maybe some difficulty in breathing
Infections are very common
There might be some damage in the structures surrounding it
There maybe case a of heart attack
Abnormal bleeding
Bleeding resulting in blood clots
Pneumonia
Bleeding in the stomach area
The abdomen might start collecting pass which is known as intra abdominal abscess
If the intestinal blockage is formed by a scar tissue then it requires more surgery
They might be problems while absorbing the vitamins and nutrients which is commonly known as short bowel syndrome
Due to some infections diarrhoea is always a frequent risk.
A Long-term Outlook after small bowel resection A majority of people have recovered well from the surgery. You can definitely resume your normal day to day activities even if you had ileostomy and you are required to carry a drainage bag. Diarrhoea might still be a concern for you if you had a big section of your bowel removed and you still might have problem in digesting foods. Inflammatory diseases might still require for the medication.

Intestinal Surgery - Know The Risks Involved!

Ovarian cysts and fertility: Is there a connection?

Having a child is one of the most profound experiences in a woman s life. The joy of being a mother and welcoming a new life is unparalleled. In the midst of such expectation, an inability to conceive can take a serious toll on any woman s health. The mental scars from such an event can never be obliterated.

This does not mean you should give up. Consult a doctor to find the cause and rectify it. With advances in medical science and technologies like IVF in the market, no fertility challenge is insurmountable.

One of the most common cause of infertility is ovarian cysts. According to research conducted by the American Society For Reproductive Medicine, ovarian cysts resulting in ovulation abnormality and infertility has been recorded among 25% of women.

There are two types of cysts that are produced as byproducts of ovulation-

1. Follicular Cysts which does not break open to release the eggs. Rather the follicle stays as a whole while the cyst continues to grow.

2. Corpus Cysts or luteal cysts is a condition when after the egg has bronek free, the follicles seal itself rather than shrinking and the fluid builds up inside.

Causes-

Ovarian cysts are mainly caused due to hormonal imbalance, abnormal cell growth where the cells overgrow and develop into cysts, pelvic infections that spread to the ovaries and fallopian tubes and causes severe harm to them, and endometriosis when the tissue attaches to an ovary and forms cell growth.

Which ovarian cyst affects fertility?

Ovarian cysts that generate complications during pregnancy include-

1. Endometriomas - This is the condition when the tissues lining your uterus or endometrium grows outside the uterus or the fallopian tubes and is largely associated with fertility problems. Endometriomas can differ in sizes from the range of less than an inch to over 6 inches. They are filled with dark coloured blood.

Some studies have demonstrated that women suffering from mild endometriosis develop a lower (2%-4%) chance of getting pregnant each month when compared to women who are healthy and have a 15%-20% chance. Another research states that 40% of unexplained infertility results from endometriosis through anatomical distortion or inflammation.

2. Polycystic Ovary Syndrome - PCOS is the condition where small cysts form inside your ovaries which prompts irregular periods, excessive stomach cramps and large hormonal imbalance. Connected to immature ovaries, they do not assist in ovulation and thus produces complications infertility. The immature follicles with an immature egg cause the ovary to be politic.

This chronic lack of ovulation also alters the hormonal levels in your body that assists in ovulation. Women with PCOS develop high levels of androgen or male hormones in your body, which gets converted to estrogen. As a result, they do not ovulate.

Does the treatment of ovarian cysts also affect fertility?

This usually depends on the kind of treatment you receive. Hormonal birth control doesn t have a long-term effect on fertility. Although surgeries can invariably damage some healthy eggs inside your body, the doctors recommend that the ovaries be removed before you have more complications. However, in both the situations, the egg count in your body decreases significantly.

Ovarian Cysts & Fertility - Is There A Connection?

When blood clot blocks one or more arteries in your lungs the condition is known as pulmonary embolism. It can cause a decrease in the oxygen levels in your blood, damage to your lungs due to sudden restrictions in the flow of blood along with adverse effects on other parts of your body. Life threatening blockage can cause death if left untreated and you should immediately contact your health care provider to get proper diagnosis. Pulmonary embolism requires various lab tests and generally requires short time to resolve.

Symptoms:
The symptoms of pulmonary embolism mainly depend upon many factors pertaining to your previous medical history. Pulmonary embolism varies with the size of your lungs, the size of the clots formed in your blood, and any other underlying history of the heart or lungs. That said, pulmonary embolism has symptoms which are not similar to any two persons and will vary accordingly.

The common symptoms however may include the following and you are advised to opt for a health checkup if these are persistent in your body:
1. Cough along with bloody sputum is a common symptom.
2. Shortness of breath, which will become worse as the days passes by. They will appear suddenly and cause huge discomfort in breathing.
3. Chest pain which may give you the feeling of a heart attack. The pain will intensify when you sit to eat or cough. Deep breath will cause problems too and will not go away easily with exertion.
4. Some other symptoms include fever, excess sweat, irregular heartbeat and dizziness.

Pulmonary embolism can be diagnosed by the following methods:
1. Electrocardiography (also known popularly as ECG) to measure your heart's electrical activity and functioning.
2. CT plumonary angiography is gold standard for diagnosing pulmonary embolism.
3. Chest x ray, which is a common and non invasive test to check your heart and lungs as well as the problems with any bones surrounding them.
4. ECHO can detect secondary changes in heart due to pulmonary embolism.

Treatment of pulmonary embolism can be done with medicines if it is detected at an early stage or also if the clot is small. However, if the size of your clot is problematic and blocks the blood flow to your lungs or heart then surgery may be necessary. Open surgery and clot removal surgery are common in the treatment of pulmonary embolism and will require good regular follow up check ups. Regular leg exercises will also reduce the chances of any underlying disease and you should hence consult your doctor.

What Is Pulmonary Embolism?

Ovarian cysts are common and most women will have at least one during their life. In most cases they do not display any symptoms and are discovered only during routine physical exams and ultrasounds. In most cases, it is nothing to worry about but in rare cases it can lead to complications and hence it is best to get an ovarian cysts checked out by a doctor.

Ovarian cysts usually affect women in their child bearing years. They can be described as fluid-filled sacs that develop in either of the ovaries. In an ultrasound image, these can look like small bubbles. Problems usually arise when these cysts grow larger or rupture. 

In such cases, you may experience symptoms that include:

Pain in the lower abdomen
Painful intercourse
Irregular menstruation
Painful urination and bowel movement
Pelvic pain after exercising
Nausea and vomiting
Bloating
Spotting between periods
Heartburn and indigestion
If the doctor suspects ovarian cysts, an ultrasound is usually used to confirm the diagnosis. A pelvic ultrasound or a sonograph as it is also known is a non-invasive imaging technique that uses high-frequency sound waves to produce images of the body s internal structure. In some cases, an endovaginal ultrasound may also be required. This involves inserting a covered wand or probe into the vagina through which a clearer image of the ovaries can be seen.

If the cyst does not trigger any of the above symptoms, it usually does not require treatment. Instead a pelvic ultrasound may be scheduled after a month to check on the size of the cyst. In most cases, these cysts resolve themselves within a month or two. In the case of larger cysts, a biopsy may be required to rule out the chances of the cysts being cancerous. Birth control pills may be prescribed to address the pain associated with this condition. These pills are also used to stop ovulation and reduce the risk of developing further cysts.

Surgery is considered only if the cyst grows in size or continues to pain. In such cases, surgery can be of two kinds: laparoscopy or laparotomy. Laparoscopy involves the removal of cysts through a telescope like an instrument that is inserted through a small incision made in the abdomen. This is usually used to remove small cysts. Larger cysts and ovarian tumours are treated with a laparotomy. This involves making a bigger incision in the stomach and may also involve the removal of the ovaries, fallopian tubes and uterus depending on the tumour. 

Ovarian Cysts - 9 Symptoms About It!

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