Gastroesophageal reflux disease and heartburn. Description. An in- depth report on the causes, diagnosis, treatment, and prevention of GERD. If it weakens and loses tone, the LES cannot close completely, and acid from the stomach backs up into the esophagus. Risk Factors for GERDObesity contributes to GERD, and it may increase the risk for erosive esophagitis (severe inflammation in the esophagus) in GERD patients. Increasing evidence indicates that smoking raises the risk for GERD. Risk Factors for Barrett’s Esophagus. Genetic factors may play an especially strong role in susceptibility to Barrett's esophagus, a precancerous condition caused by very severe GERD. Medication Warnings. Long- term use of proton pump inhibitors (PPIs) has been linked to an increased risk of hip, wrist, and spine fractures. Studies have found that taking PPIs with the blood thinner clopidogrel (Plavix) reduces the effectiveness of this blood thinner by nearly 5. A warning added in May 2. PPIs with methotrexate, a drug commonly used to treat certain cancers and autoimmune conditions, can lead to elevated levels of methotrexate in the blood, causing toxic side effects. Introduction. Gastroesophageal reflux disease (GERD) is a condition in which acid from the stomach flows back up into the esophagus (the food pipe), a situation called reflux. Reflux occurs if the muscular actions of the lower esophagus or other protective mechanisms fail. Heartburn is a condition in which the acidic stomach contents back up into the esophagus, causing pain in the chest area. This reflux usually occurs because the sphincter muscle between the esophagus and stomach is weakened. Remaining upright by standing or sitting up after eating a meal can help reduce the reflux that causes heartburn. Continuous irritation of the esophagus lining, as in severe gastroesophageal reflux disease, is a risk factor for developing esophageal cancer. Information about types of esophagitis and esophagitis symptoms like heartburn, acid reflux, sore throat, hoarseness, indigestion, bad breath, belching, chest pain.Learn about gastroesophageal reflux disease (GERD, acid reflux, heartburn) symptoms like heartburn, chest pain, regurgitation, and nausea. Diet, causes, diagnosis. It begins below the tongue and ends at the stomach. The esophagus is narrowest at the top and bottom; it also narrows slightly in the middle. The esophagus consists of three basic layers: An outer layer of fibrous tissue. Special Considerations; The lower esophageal muscle can be weakened by factors other than food. The following recommendations may be helpful in reducing symptoms. Introduction. Gastroesophageal reflux disease (GERD) is a condition in which acid from the stomach flows back up into the esophagus (the food pipe), a situation. Gastroesophageal reflux disease (GERD) is a condition in which the stomach contents (food or liquid) leak backwards from the stomach into the esophagus (the tube from. A middle layer containing smoother muscle. An inner membrane, which contains many tiny glands. Click the icon to see an image of the esophagus. In the stomach, acid and various enzymes break down the starch, fat, and protein in food. The lining of the stomach has a thin layer of mucus that protects it from these fluids. If acid and enzymes back up into the esophagus, however, its lining offers only a weak defense against these substances. Instead, several other factors protect the esophagus. The most important structure protecting the esophagus may be the lower esophageal sphincter (LES). The LES is a band of muscle around the bottom of the esophagus, where it meets the stomach. After a person swallows, the LES opens to let food enter the stomach. It then closes immediately to prevent regurgitation of the stomach contents, including gastric acid. The LES maintains this pressure barrier until food is swallowed again. This is especially true when lifting, bending over, or lying down after eating a large meal high in fatty, acidic foods. Persistent GERD, however, may be due to various conditions, including biological or structural problems. Malfunction of the Lower Esophageal Sphincter Muscles. The band of muscle tissue called the LES is responsible for closing and opening the lower end of the esophagus, and is essential for maintaining a pressure barrier against contents from the stomach. For it to function properly, there needs to be interaction between smooth muscles and various hormones. If it weakens and loses tone, the LES cannot close completely after food empties into the stomach, and acid from the stomach backs up into the esophagus. Dietary substances, drugs, and nervous system factors can weaken the LES and impair its function. Impaired Stomach Function. Patients with GERD have abnormal nerve or muscle function in the stomach. These abnormalities prevent the stomach muscles from contracting normally, which causes delays in stomach emptying, increasing the risk for acid back- up. Abnormalities in the Esophagus. Some studies suggest that most people with atypical GERD symptoms (such as hoarseness, chronic cough, or the feeling of having a lump in the throat) may have specific abnormalities in the esophagus. Motility Abnormalities. Problems in spontaneous muscle action (peristalsis) in the esophagus commonly occur in GERD, although it is not clear whether such problems cause the condition, or are the result of long- term GERD. Adult- Ringed Esophagus. People with this condition have many rings on the esophagus and persistent trouble swallowing (including getting food stuck in the esophagus). Adult- ringed esophagus occurs mostly in men. Hiatal Hernia. The hiatus is a small opening in the diaphragm through which the esophagus passes into the stomach. It's normally small and tight, but it may weaken and enlarge. When this happens, part of the stomach muscles may protrude into it, producing a condition called hiatal hernia. It is very common, occurring in more than half of people over 6. It was once believed that most cases of persistent heartburn were caused by a hiatal hernia. Indeed, a hiatal hernia may impair LES muscle function. However, studies have failed to confirm that it is a common cause of GERD, although its presence may increase GERD symptoms in patients who have both conditions. A hiatal hernia occurs when part of the stomach protrudes up into the chest through the sheet of muscle called the diaphragm. This may result from a weakening of the surrounding tissues and may be aggravated by obesity or smoking. An inherited risk exists in many cases of GERD, possibly because of inherited muscular or structural problems in the stomach or esophagus. Genetic factors may play an especially strong role in susceptibility to Barrett's esophagus, a precancerous condition caused by very severe GERD. Other Conditions Associated with GERDCrohn's disease is a chronic ailment that causes inflammation and injury in the small intestine, colon, and other parts of the gastrointestinal tract, sometimes including the esophagus. Other disorders that may contribute to GERD include diabetes, any gastrointestinal disorder (including peptic ulcers), lymphomas, and other types of cancer. It is now known to be a major cause of peptic ulcers. Antibiotics that eradicate H. Of some concern, however, are studies indicating that H. Curing ulcers by eliminating the bacteria might trigger GERD in some people. Studies are mixed, however, on whether curing H. Still, the bacteria should be eradicated in infected patients with existing GERD who are taking acid suppressing medications. There is some evidence that the combination of H. Nonsteroidal anti- inflammatory drugs (NSAIDs), common causes of peptic ulcers, may also cause GERD or increase its severity in people who already have it. There are dozens of NSAIDs, including over- the- counter aspirin, ibuprofen (Motrin, Advil, Nuprin), and naproxen (Aleve), as well as prescription anti- inflammatory medicines. People with GERD who take the occasional aspirin or other NSAID will not necessarily experience adverse effects, especially if they have no risk factors or evidence of ulcers. Acetaminophen (Tylenol), which is NOT an NSAID, is a good alternative for those who want to relieve mild pain without increasing GERD risk. Tylenol does not relieve inflammation, however. Other Drugs. Many other drugs can cause GERD, including: Calcium channel blockers (used to treat high blood pressure and angina)Anticholinergics (used to treat urinary tract disorders, allergies, and glaucoma)Beta adrenergic agonists (used to treat asthma and obstructive lung diseases)Dopamine agonists (used in Parkinson's disease)Bisphosphonates (used to treat osteoporosis)Sedatives. Antibiotics. Potassium. Iron pills. Click the icon to see an image of peristalsis. People of all ages are susceptible to GERD. Elderly people with GERD tend to have a more serious condition than younger people. Risk Factors for Heartburn and GERDEating Pattern. People who eat a heavy meal and then lie on their back or bend over from the waist are at risk for an attack of heartburn. Anyone who snacks at bedtime is also at high risk for heartburn. Pregnancy. Pregnant women are particularly vulnerable to GERD in their third trimester, as the growing uterus puts increasing pressure on the stomach. Heartburn in such cases is often resistant to dietary interventions and even to antacids. Obesity. A number of studies suggest that obesity contributes to GERD, and it may increase the risk for erosive esophagitis (severe inflammation in the esophagus) in GERD patients. Studies indicate that having excess abdominal fat may be the most important risk factor for the development of acid reflux and associated complications, such as Barrett's esophagus and cancer of the esophagus. Researchers have also reported that increased BMI is associated with more severe GERD symptoms. Losing weight appears to help reduce GERD symptoms. However, gastric banding surgery to combat obesity may actually increase the risk for, or worsen symptoms of GERD. Respiratory Diseases. People with asthma are at very high risk for GERD. Between 5. 0% and 9. GERD. People with chronic obstructive pulmonary disease (COPD) are also at increased risk for GERD, and having GERD may worsen pre- existing COPD. Smoking. Increasing evidence indicates that smoking raises the risk for GERD. Studies suggest that smoking reduces LES muscle function, increases acid secretion, impairs muscle reflexes in the throat, and damages protective mucus membranes. Smoking reduces salivation, and saliva helps neutralize acid. It is unknown whether the smoke, nicotine, or both trigger GERD. Some people who use nicotine patches to quit smoking, for example, have heartburn, but it is not clear whether the nicotine or stress produces the acid backup. Heartburn Causes, Tips, & FAQs. Get answers to your questions about heartburn causes, frequency, symptoms, and long- term effects. What is heartburn? What is the difference between heartburn and frequent heartburn? Why do stomach juices irritate the esophagus? What causes heartburn? What is GERD? What is the difference between heartburn and acid reflux? What is esophagitis? Are heartburn at day and heartburn at night different conditions? What are some common treatments for heartburn? Are there certain foods that cause heartburn? Are there steps I can take to fight frequent heartburn? Do I have to give up everything I love to control my heartburn? What does heartburn have to do with heat? How does stress contribute to heartburn? What is heartburn? Heartburn occurs when stomach acids reflux, or flow up, into the esophagus. Prilosec OTC. If you think you may have any of the symptoms described below, please talk to your doctor or healthcare provider. What is the difference between heartburn and frequent heartburn? Frequent heartburn is defined as heartburn occurring two or more days a week. Prilosec OTC is formulated for frequent heartburn. Why do stomach juices irritate the esophagus? These juices, which are produced by the stomach to help the body break down food, contain a powerful acid called hydrochloric acid. While the stomach is naturally protected from this potent acid, the esophagus does not share the same protective qualities as the stomach. So, if acidic stomach contents come into contact with the esophagus, the esophagus’ skin- like lining can be irritated or injured and result in the sensation known as heartburn. What causes heartburn? Heartburn is caused when stomach acid enters the esophagus. When functioning normally, the LES . However, at times the LES relaxes and allows stomach juices to flow upward into the esophagus. This relaxation exposes the esophagus to harsh acid from the stomach. Physicians refer to this as gastroesophageal reflux. What is GERD? GERD, or gastroesophageal reflux disease, is chronic, persistent heartburn, and results from the improper working of the ring of muscle that normally keeps food and acids inside the stomach. When this muscle doesn't work correctly, it allows acids to back up into the esophagus. Other signs of GERD include: regurgitation, difficulty swallowing, coughing, hoarseness, and a lump feeling in your throat. In some instances, these ailments surface even when heartburn's usual symptoms are absent. This can lead patients to misunderstand these conditions because people with ear, nose, and throat (ENT) complaints often do not have heartburn symptoms. Prilosec OTC is only indicated for the treatment of frequent heartburn. If you think you may have GERD, please talk to your doctor or healthcare provider about having a diagnostic screening test. What is the difference between heartburn and acid reflux? Acid reflux, or gastroesophageal reflux disease (GERD), is a chronic condition that causes a person’s liquid stomach contents—stomach acids, pepsin, and bile—to back up into the esophagus. Heartburn is the result of this action, but heartburn may also be a sign that some other trigger is at work. Just because you have heartburn, it does not necessarily mean that you have acid reflux. Acid reflux is a chronic condition characterized by irritation or inflammation of the esophagus. Some of the common symptoms of acid reflux include: chronic, persistent heartburn; regurgitation; drastic weight loss; discomfort and difficulty swallowing; coughing often; severe hoarseness or wheezing; a feeling of a lump in the throat; and interference with lifestyle or daily activities. If you think you may have this condition, speak with your healthcare professional about a diagnostic screening test. If left untreated, acid reflux can cause or contribute to a range of more serious health issues, such as ulcers of the esophagus and chronic coughing. What is esophagitis? When stomach acids repeatedly back up into the esophagus, they can injure the esophagus’ sensitive lining. That injury can lead to uncomfortable inflammation called esophagitis. Eventually, the acid wears away at the esophagus, causing bleeding. If the bleeding is heavy enough, blood can pass into the digestive tract and show up as dark, tarry stools. Esophagitis can cause ulcers—sensitive, open sores on the lining of the esophagus. In a small percentage of people, long- term acid exposure from GERD leads to a condition called Barrett's esophagus (BE). In BE, new cells form to take the place of those damaged by acid reflux. Are heartburn at day and heartburn at night different conditions? Both heartburn at day and heartburn at night result from stomach acid reflux. However, lying horizontally to sleep at night makes it more likely you will experience more stomach acid reflux than when sitting up or standing. What are some common treatments for heartburn? Antacids: Antacids neutralize the acid in your stomach. Antacids are commonly taken after you eat or when pain begins. Antacids provide immediate, temporary relief. H2 Blockers: H2 blockers relieve heartburn symptoms by reducing acid production. They begin working within an hour and can last for 1. H2 blockers begin working relatively quickly, but may not block heartburn as long with a single pill when compared to PPIs. Proton Pump Inhibitors: When you eat, millions of tiny pumps in your stomach produce acid to break down food. Heartburn occurs when these excess acids reflux into your esophagus. PPIs (such as Prilosec OTC) work by directly blocking many of these pumps. A PPI may take one to four days for full effect, but it can effectively block frequent heartburn for 2. Are there certain foods that cause heartburn? Yes, there are common foods and lifestyle factors that cause heartburn to flare up, and these are known as heartburn triggers. Paying attention to your body and how it reacts to these triggers helps you make smart choices: Citrus fruits. Spicy foods. Chocolate. Garlic. Onions. Fatty foods. Tomatoes or tomato- based products. Peppermints. Black pepper. Vinegar. Caffeinated or carbonated beverages. Alcoholic beverages. Are there steps I can take to fight frequent heartburn? Yes. There are several lifestyle choices, all of which contribute to reduce the chance of frequent heartburn. Reduce stress: Stress can contribute to heartburn and make you more likely to overeat. Make time for yourself, prioritize responsibilities, and try to keep things in perspective to reduce stress in your life. Exercise regularly: It will help you manage stress and keep you healthier overall. Exercising also helps you sleep better. Talk to your doctor before you start any exercise program. Control portions: Decrease the size of portions at mealtimes. Your stomach won't need to produce as much acid as with a big meal, and less acid means less chance of acid reflux. Stop smoking: Smoking relaxes the valve at the top of your stomach, allowing excess stomach acid to reflux into your esophagus. Do I have to give up everything I love to control my heartburn? With good advice from your healthcare professional, you should be able to develop a healthy plan to help control your heartburn. A healthy plan will let you keep eating the foods you love and continue doing your usual activities. Given the many recent advancements in our understanding and treatment of heartburn, even the most severe heartburn sufferers generally find that they can control their heartburn through heartburn medications and some simple lifestyle changes. What does heartburn have to do with heat? Many heartburn sufferers experience the burning sensation known as heartburn and associate the discomfort with intense heat. However, the discomfort is not caused by temperature but by the irritation resulting from the presence of acid in the esophagus. How does stress contribute to heartburn? Gastrointestinal symptoms have long been associated with stress, fear, and anxiety. The perception of heartburn can increase during stress. Numerous clinical studies confirm the correlation between stress and heartburn. Stress also can contribute to reflux by causing heartburn sufferers to engage in behaviors that trigger acid production (i. Stressful life events (anxiety, tension, and stress) can increase sensitivity to refluxed acid, reducing the threshold for pain and increasing the frequency and/or severity of heartburn symptoms. In addition, stress may increase a person's sensitivity to the pain caused by a heartburn episode.
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