Indraprastha Apollo Hospitals

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:

1. 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.
2. 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.
3. Other symptoms include dysphagia, odynophagia, nausea, chest pain, dyspepsia, epigastric fullness, bloating, frequent belching
4. Extra-esophageal symptoms like chronic cough, hoarseness, laryngitis, dysfunction of the vocal cords, bronchospasm can also be observed.

Complications:

1. Peptic stricture
2. Ulcers of the esophagus
3. Metaplastic disease (Barrett’s esophagus)
4. Dysplastic disease (Adenocarcinoma)
5. Laryngitis or bronchitis
6. Pulmonary disease
7. 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:

1. Lifestyle modifications – Avoiding acidic foods, quitting smoking, weight loss, abstaining from alcohol consumption improves symptoms in people with GERD.
2. Medications – Proton pump inhibitors (Pantoprazole, Omeprazole, Rabeprazole), H2 receptor blockers (Ranitidine, Cimetidine) and antacids.
3. Surgery – In cases where the proton pump inhibitors are unsuccessful in relieving symptoms of GERD, a surgical procedure called Nissen fundo-plication is done.

In case you have a concern or query you can always consult an expert & get answers to your questions!

People very often tend to feel uneasy, right after taking your lunch or for that matter any meal. At that point of time, neither do you feel like doing anything nor do you understand what has gone wrong with your health. This is quite common after-effect of eating, which is mainly related to the digestive process.

There are always certain symptoms, which if you carefully notice, you can pinpoint right before the completeion of any meal. 

• You can feel stuffy pretty easily even after having something in moderate quantity
• A sense of tiredness might creep in, just when you are about to finish your meal
• You might go through a feeling of nausea, which might be the result of indigestion due to the problem of ulcer or gallbladder disease.

What leads to people feeling sick after having a meal?

Food poisoning is one of the foremost problems, due to which you might all of a sudden start feeling unwell after having your food.

• There are food items like curd, which if kept in the open for too long, can easily get contaminated and cause food poisoning.
• Consuming too much of spicy items as well as those containing fat, can have ill effect on your health, thereby resulting in uneasiness.
• Too much eating at a time can also result in people having discomfort due to the time taken for digestion.
• Allergy from any particular food item might also result in you feeling restless or sick after having your meal.

What can you do to avoid having this problem?

There are certain ways through which you can prevent yourself from getting affected adversely after taking your meal. It is often said prevention is better than cure, so little bit of prevention might save you from having digestive pills or any related medicine, which you usually take as and when any sort of uneasiness creeps into your system. As the age old saying goes, ‘eat breakfast like a king, lunch like a prince and dinner like a pauper.’ Of course, this doesn’t mean that you would gobble up anything which comes your way during breakfast and lunch hours.

• Try not to have foods which are spicy or fried, especially during dinner time as most of the problems occur at night.
• It’s always preferable to have smaller meals on a frequent basis, rather than having three large meals in a day.
• Allow your food time to digest, so relax and sit still after eating.

So, we have discussed about the reasons for which you might feel sick right after having your meal, where now you are aware of the symptoms, what causes this problem and how can you prevent this problem from happening.

In case you have a concern or query you can always consult an expert & get answers to your questions!

Obstruction of the bile duct is characterized by the blockage of the bile duct. The function of the bile ducts is to transport bile to your small intestine. The bile is excreted in order to digest fats from the food. 

There are two types of bile ducts in the body

1. Intrahepatic ducts: These ducts are small tube like structures that carry the bile to extrahepatic ducts
2. Extrahepatic ducts: Extrahepatic ducts are two ducts that descend from the liver into the body's small intestine

Causes
The bile comprises of waste products, bile salts and cholesterol. The liver excretes bile which flows through the bile ducts and is stored in the gallbladder. If the bile ducts are blocked then the bile accumulates in the liver and can lead to jaundice.

Certain causes of this particular condition are mentioned below
1. Bile duct obstruction may result from gallstones
2. If you have inflammation in your bile ducts
3. Narrowing of the bile ducts
4. Enlargement of the lymph nodes
5. Bile duct tumors
6. Tumors in the pancreas
7. Various infections such as hepatitis
8. Liver complications such as cirrhosis

The symptoms are
1. You may experience yellowish skin
2. You may have symptoms of fever and vomiting
3. Abdominal pain especially in the upper part
4. Stools may be light colored
5. You may pass urine that is dark in color

Treatment
The various treatment options for obstruction of the bile duct are surgeries that remove the blockage. Other treatment options are an ERCP (Endoscopic retrograde cholangiopancreatography) and a cholecystectomy which is the process of removal of the gallbladder. ERCP is another procedure that is used to get rid of gallstones from the gallbladder. You may prevent it by consuming a lot of fiber in your diet. Make lifestyle changes such as exercising on a regular basis and eating healthy. If you wish to discuss about any specific problem, you can consult a gastroenterologist.