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!

In recent years, there has been the emerging trend of resorting to customized treatment for different types of cancer. These treatments vary from individual to individual, depending on the severity of their condition. PSMA PET scan and DOTA scan are two such procedures used in the treatment of prostate cancer.

Before identifying the benefits of these scans, let us have a look at the risks of prostate cancer.

Prostate Cancer- What is it?

Prostate cancer shows up in the prostate gland of men, which produces the fluid that transfers and nourishes the sperm. It is a very commonly occurring condition in men and early treatment can cure it completely.

Symptoms of Prostate Cancer:

Prostate cancer starts showing its symptoms from the middle stages. One should seek medical help if he observes the following warning signs-

  Pain while urinating
  Bone pain
  Reduction in force of urine
  Erectile Dysfunction
  Presence of blood in semen

With increasing age and obesity, there remains a high chance of developing prostate cancer.

What is PSMA PET scan?

It is an effective and reliable mode of diagnosis to identify the extent of prostate cancer. It is also known as Prostascint scan. This scan is recommended for patients in the early stage of cancer and to determine whether the disease has spread to the pelvic lymph nodes.

In this process, the patient is injected with an antibody and a radioactive material that can be detected by cameras. The doctor then sees a three-dimensional picture of the affected area on the monitor. The complete process takes three days to finish.

Benefits of PSMA PET scan:

  Helps to determine the position and range of a tumour
  Helps the doctor to plan effective methods of treatment to eradicate a tumour completely
  Helps to predict the result of treatment up to a certain extent, unlike other imaging tests

What is DOTA scan?

It is a highly advanced scan used to detect the spread and sensitivity of tumours concerning prostate cancer. The molecules injected during the scan attaches itself to the neuroendocrine tumours known as carcinoids.

Benefits of DOTA scan:

  Helps to detect the exact location of a tumour
  Helps the doctor to plan for effective radioactive therapies
  Helps to identify the exact stage of a cancerous tumour

Both PSMA and DOTA scans are the fruits of modern scientific research and go a long way in eradicating cancerous cells from the body. Early detection of the disease with these scans increases the chance of being cured of the disease.

Prostate Cancer - Knowing The Importance Of PSMA PET Scan & Dota Scan!

Oily skin and summers: what is the ideal way to handle it?

Oily skin is a condition that can be characterized by shine on the skin and a large number of pores. The oil in question is a result of overactive sebaceous glands that produce excessive sebum. This can result in acne and blackheads. Summer is a time of the year where skin problems due to oily skin are worsened by factors such as sweat and dust. So proper skin care is necessary in order to negate the effects of oily skin.

There are multiple ways to handle this condition in summers:

1. Using cleansers - Proper cleaning of skin is a very important step in lessening the effects of oily skin. Harsh cleansers have an opposing effect as they facilitate secretion of oil, so a mild cleanser is usually the best option. Some cleansers may contain ingredients that irritate the skin, so care is advised in selecting a proper one.

2. Hydration and food - Keeping the body well hydrated in summers combined with a diet free of greasy, oily food and less fats can help in reducing the effects of oily skin.

3. Using masks to clear the face - Masks such as clay masks, yogurt, and baking soda can help in cleansing the skin by clearing the oil. It should be noted that these treatments should not be overdone as they can cause the skin to dry up too much and over secrete oil.

4. Skin moisturizers - People often have this notion that oily skin does not require moisturizer application. Selecting a moisturizer that is fit for oily skin and using it will help moisturize the skin and keep it healthy.

5. Sunscreen - Sunscreen is a necessity during summers, and the sunscreen you choose should be specifically for oily skin in order for it to work effectively. Application of sunscreen can help prevent the UV rays of the sun from penetrating the skin and cause complications.

6. Dermatological treatment - In case of severe oiliness, treatments such as chemical peels and creams laced with tretinoin can help.



Oily skin and summers: what is the ideal way to handle it?

A polyp is a cauliflower-like growth on the skin or the mucosal surface. Colon is the medical term for the larger intestine and the rectum. A growth on the mucosal surface of this part of the intestine is known as a colon polyp. Although not visible, colon polyps is present with symptoms, which can lead to their diagnosis. The main cause for concern is that some colon polyps can turn into colorectal cancer, which is the third largest cancer in America.

Types: There are two main types of polyps

Hyperplastic or inflammatory: These are benign growths and do not carry the risk of developing into cancer.
Adenomas: These carry the risk of turning into cancer, and so early detection and intervention is essential.
Though not all polyps develop into tumors, yet all tumors develop from a polyp. There is a strong genetic component, which makes it worse. Someone with inflammatory bowel disease or Crohn s disease is also at a higher risk of mucosal inflammation, which can induce dysplasia and then polyps.

Risk factors:

Family history
Inflammatory bowel disease
Obesity
Diet rich in processed meat and red meat
Smoking
Lack of physical activity
Type 2 diabetes
Being male, being African American
Symptoms: Though often silent, some symptoms which also appear only after the polyp has grown considerably include:

Bleeding with stools   often small amounts intermittently, which is occult bleeding, not visible though
Altered bowel habits (constipation, diarrhea)
Abdominal pain and discomfort
Unexplained weight loss
Anemia (due to blood loss)
Diagnosis: If a person is at risk from medical history and has the above symptoms, then the following are done:

Sigmoidoscopy Viewing the colon and rectum to see if there are any polyps. A biopsy may also be taken to confirm cancerous growth.
Colonoscopy The entire colon is viewed to rule out polyps in other areas of the colon.
CT scan of the abdomen which is non-invasive and can be used as the first step.
Treatment:

If a polyp is diagnosed, then it needs to be removed.
If it turns out cancerous, then detailed evaluation should be done to rule out spread to other areas. Additionally, chemotherapy and radiotherapy may be required to completely eliminate the tumor and contain it.
The surgical removal of the tumor would be planned depending on the stage of the tumor.
Adapting a healthy lifestyle is very essential to managing polyps and preventing cancer. Quitting smoking, managing weight, eating healthy, and being physically active are some ways to prevent colorectal cancer.
Repeat colonoscopy needs to be done to ensure these are not recurrent.

Colon Polyps - What Are The Available Treatment Options?

When dieting and exercising fail to help an obese person manage their weight, bariatric surgery may be suggested. One of the most popular types of bariatric surgery is a gastric sleeve surgery or sleeve gastrectomy. The main aim of this surgery is to reduce the amount of food that can be consumed in one sitting. It does not affect the amount of nutrients and fats absorbed from the food that has been eaten. A majority of the weight loss resulting from this surgery happens within 12-18 months.

A gastric sleeve surgery is a relatively safe, straightforward and short surgery. Prior to surgery, few patients would have been given a special diet.  This surgery is always  performed laparoscopically popularly known as keyhole route. More than half the outer side of the stomach is removed. The remaining part of the stomach takes the form of a tube. 

Though recovery from any surgery varies from person to person, most patients are able to walk and allowed sips of water by evening. Though certain amount of pain and discomfort is expected, this remains in bearable range with pain killers. Usually liquid diet is advised for 2 weeks followed by soft foods for 4 weeks.

You will notice that you feel fuller much faster and are able to consume a very limited portion of your normal food intake. It is essential to drink plenty of water to remain adequately hydrated and to prevent constipation.

On an average, this surgery can help people lose up to 70% - 100%% of their excess body weight. However, this depends largely on your understanding and compliance of post operative dietary changes. A dietician can also help you make right food choices, decide meal portions and address the right number of meals needed by your body. For long term weight maintenance it is important not to fall back to your earlier lifestyle and to maintain a positive attitude.

Gastric Sleeve Surgery - What Is The Process Of It?

GERD is a digestive disorder that affects the lower esophageal sphincter, which is the ring of muscle between the esophagus and stomach. Gastroesophageal reflux is the backward flow of acids from the stomach into the esophagus. Doctors believe that some people usually suffer due to a condition called hiatal hernia. Pregnant women usually suffer from heartburn or acid indigestion caused by Gastroesophageal Reflux Disease.

The primary goals in the treatment of this disease are relief from symptoms, healing of erosive esophagitis and prevention of complications of esophagitis. The symptoms include heartburn and regurgitation. The setting includes a proton pump inhibitor (PPI). Patients suspected due to GERD with non-cardiac chest pain are recommended to have diagnostic evaluation before institution of therapy. For diagnosing GERD, barium radiographs should not be used.

The other points that must be remembered to diagnose GERD are
1. Endoscopy is recommended only in case of alarming symptoms. Even in typical symptoms, the upper endoscopy is not recommended.
2. For preoperative evaluation, esophageal manometry is recommended, but it has no role in diagnosing GERD.
3. Ambulatory reflux monitoring is a test that can assess association of reflux symptoms.

Management:
The suggested lifestyle modifications for the patients with GERD are

    Weight loss is recommended for patients who are overweight. So, avoid large meals and decrease dietary fat intake.
    Avoid alcohol, chocolate, onions, garlic, acidic foods and peppermint.
    Do not lie down within 3 to 4 hours after meal (recommended for nocturnal GERD patients).
    For symptom relief and to heal erosive esophagitis, a 8-week course of PPIs is the therapy of choice.
    Medications that help in potentiating GERD symptoms, including alpha-adrenergic agonists, nitrates, calcium channel blockers and theophylline should be avoided.
    For patients without diagnostic evaluation, therapy for GERD other than acid suppression, including prokinetic therapy should not be used.
    For patients with partial response to PPI therapy, additional symptom relief can be achieved by increasing the dose twice daily or switching to a different PPI.
    It is recommended to elevate the head of the bed 10 to 20 cm.
    Avoid wearing clothes which are tight around the waist.
    If patients experience heartburn relief, Histamine-receptor antagonists (H2RA) therapy can be used as a maintenance option in patients without erosive disease.

Some surgical options
1. For long-term therapy for patients suffering with GERD, surgical therapy is the best treatment option.
2. In patients who have no evidence of erosive esophagitis, preoperative ambulatory pH monitoring in mandatory.
3. Gastric bypass is the preferred operation for patients who are suffering with obesity and are contemplating surgical therapy for GERD.

Apart from these, there are potential risks that are associated with PPIs such as switching them can be considered in setting of side effects and the therapy can be a risk factor for Clostridium difficile infection.

Management of Gastroesphageal Reflux Disease (GERD)

Don't wait any longer, manage your Venous Ulcer online with a Lybrate doctor today

Consult for Venous Ulcer - Online and Easy!

FilterClear All

COMMON SPECIALITIES

COMMON ISSUES