GERD Cure Diet
Acid indigestion and 'heartburn' often come from eating too much heavy or greasy food or from drinking too much alcohol or coffee. These make the stomach produce extra acid, which causes discomfort or a 'burning' feeling in the stomach or mid-chest. Some people mistake the chest pain, called 'heartburn', for a heart problem rather than indigestion. If the pain gets worse when lying down, it is probably heartburn. Frequent or lasting acid indigestion is a warning sign of an ulcer.
HPI When questioned, the patient is dismissive and prefers instead to discuss his beautiful girlfriend, new sports car, and widespread influence. He denies having had a heart attack and claims that it was just minor heartburn. He loudly belittles the staff for being inattentive and claims that the consulting physician is the only one here who can appreciate me.
The polymodal nociceptor properties of TRPV1 make these ion channel an intriguing target for novel therapies of abdominal pain and inflammation. From a therapeutic perspective it would appear, therefore, that TRPV1 channel blockers may be of substantial value in suppressing GI hyperalgesia related to inflammation and other circumstances where there is activation (sensitization) or up-regulation of TRPV1 (Fig. 1). That such an approach is worth pursuing is emphasized by the beneficial effect of chronic capsaicin desensitization in functional dyspepsia and over-active bladder 82, 104 . However, a disadvantage of this approach is the initial pungency that capsaicin and related TRPV1 agonists bring about. Early attempts to circumvent this problem led to the use and development of vanilloid-related compounds with reduced pungency but preserved ability to desensitize. Various cap-saicin analogs differ in the relative ratio of initial excitation to subsequent refrac
A 64-year-old woman with a longstanding diagnosis of mixed connective tissue disorder and pulmonary fibrosis is admitted with symptoms of recent increase in postprandrial retrosternal distress, heartburn, and nocturnal cough. Her ECG shows nonspecific T-wave changes and she finds minimal relief of her symptoms with sublingual NTG. On examination, she is not in any acute distress and is afebrile. Chest exam reveals bilateral crackles. CXR is shown in Fig. 74. The cause of this patient's acute symptoms may be
The symptoms described are due to an acid reflux disorder, and the chest x-ray shows a large hiatal hernia. Hiatal hernia represents herniation of the stomach through the esophageal hiatus and is frequently found in adults. It occurs as an oval retrocardiac mass, most often with an air-fluid level, and is due to laxity, stretching, and widening of the hiatus. Obesity and increased intraabdominal pressures are contributing factors. The majority of hernias spontaneously reduce and are called sliding hernias. A paraesophageal hernia occurs when the stomach herniates next to the distal esophagus. Patients may be asymptomatic or may have symptoms of reflux.
The history of wine has been documented as far back as 2000 bc. In Babylon, salves were mixed with wine to treat various skin conditions. The Ancient Egyptians are also recorded to have used it for the treatment of other ailments, including asthma, constipation, epilepsy, indigestion, jaundice and depression. Perhaps as a deterrent to self-medication, various bizarre and somewhat unlikely ingredients were added, including pigs' eyes, bats' blood, dogs' urine and crocodile dung (Pickleman 1990).
The answer is a Fauci 14e pp 14511455 Massive lifethreatening hemoptysis is 100 cc of blood in 24 h The most common
The answer is d. (Fauci, 14 e, pp 194-197.) The most common cause of chronic cough in adults is postnasal drip due to sinusitis or rhinitis (allergic, vasomotor, irritant, perennial nonallergic). Patients typically complain of having to clear their throats or a feeling of something dripping in the back of their throats. Physical examination reveals muco-purulent secretions and a cobblestone appearance to the mucosa. Asthma is more of an episodic disease with wheezing, but occasionally patients complain of only cough. Gastroesophageal reflux disease (GERD) must be considered in patients who complain of heartburn or regurgitation. Other causes of chronic cough include bronchitis, congestive heart failure, and use of angiotensin converting enzyme (ACE) inhibitors.
GERD (gastroesophageal reflux disease) a. GERD (gastroesophageal reflux disease) 300. The presence of gastroesophageal reflux is best diagnosed by 308. A 72-year-old woman complains of fatigue, dyspepsia, and shortness of breath. Her daughter tells you that her mother also has some slight memory loss and occasionally complains of numbness in her legs. The laboratory tests you ordered show a hemoglobin of 10.2 g dL and an MCV of 110. The most likely cause is 309. A 45-year-old man complains of frequent heartburn and a mild chronic cough. On examination, he has gastroesophageal reflux disease (GERD). In addition to prescribing medications, which one of the following dietary recommendations would you make
Red pepper has been used since ancient times as both a spice and a treatment for GI disease. However, the biological actions of its pungent ingredient were not understood before capsaicin was found to be a selective stimulant of primary afferent neurons. The immediate but transient excitation is followed by a long-lasting desensitization of sensory neurons to capsaicin and other stimuli 27, 28 . Following this discovery, capsaicin became an important tool to probe sensory neuron functions in many organs, including the gut 27-30 . The collective outcome of these studies attests to the important role which afferent neurons play in the control of GI blood flow, mucosal ion transport, mucosal inflammation, mucosal protection, mucosal repair, motor activity and nociception 29, 30 . There is now increasing awareness that hypersensitivity of sensory neurons and a disturbed gut-brain axis contribute to functional bowel disorders such as functional dyspepsia and IBS 2 . into the alimentary...
Esophageal radiography is used to identify hiatal hernia, varices, strictures, esophageal reflux, and peptic ulcer of the esophagus. Diverticula, chalasia, achalasia, and congenital abnormalities can be diagnosed using barium swallow. This examination can also help in the diagnosis of tumors that put pressure on the esophagus, causing esophageal narrowing and filling defects.
A 24-year-old HIV-positive patient who has had AIDS for 3 years presents with painful swallowing and dysphagia to solids and liquids. He has no previous history of heartburn or reflux disease. His CD4 count is 41 L and he recently required 3 wk of antibiotics for Pneumocystis carinii pneumonia. Examination of the pharynx reveals no oral thrush. Barium swallow demonstrates multiple nodular filling defects of various sizes that resemble a cluster of grapes. Which of the following is the most likely diagnosis
It may cause a chronic, dull (sometimes sharp) pain in the pit of the stomach. As with acid indigestion, often the pain lessens when the person eats food or drinks a lot of water. The pain usually gets worse an hour or more after eating, if the person misses a meal, or after he drinks alcohol or eats fatty or spicy foods. Pain is often worse at night. Without a special examination (endoscopy) it is often hard to know whether a person with frequent stomach pain has an ulcer or not. Whether stomach or chest pain is caused by heartburn, acid indigestion, or an ulcer, a few basic recommendations will probably help calm the pain and prevent it from coming back. If the heartburn is worse at night when lying flat, try sleeping with the upper body somewhat raised. 2. Like milk, some antacids such as sodium bicarbonate (baking soda) and Alka-Seltzer may quickly calm acid indigestion, but soon cause more acid. They should be used only for occasional indigestion, never for ulcers. This is also...
Stable exertional angina, occurring predictably with a given level of exercise, is the most common initial presentation of ischemic heart disease. Discomfort appears with a fairly predictable and reproducible level of exercise, such as walking briskly for half a block, and just as predictably fades within several minutes with rest or nitroglycerin. The discomfort is variously described as a pressure, tightness, weight, band around the chest, indigestion, or gas. It may be felt in the epigastrium, retrosternally, in the arms, shoulders, neck, jaws, or even the back.
Both A. tsaoko and A. vilosum are used in the treatment of abdominal pain and congestion, lack of appetite, nausea, and vomiting. A. tsaoko has also been used to treat malarial patients (Li, 1593 Yao et al., 1995). A. vilosum was used in classical Chinese medicine to treat nausea and vomiting, abdominal pain, diarrhoea, indigestion, gas, loss of appetite, morning sickness, pain and discomfort during pregnancy, and involuntary urination (Time-Life, 1997). Clearly there are a range of options open to researchers seeking a traditional source for the management of nausea associated with D. febrifuga and its derivatives.
Some diseases that should be included in the differential diagnosis of laryngotracheobronchitis are spasmodic croup, bacterial tracheitis, diphtheritic croup, measles croup, and epiglottitis. Spasmodic croup has a presentation similar to laryngotracheobronchitis however, there is usually no history of infection in the patient or their family. Although viruses may cause spasmodic croup, it is more often associated with triggers, such as gastroesophageal reflux, or allergic and psychological factors. Bacterial tracheitis usually begins as a viral laryngotracheobronchitis, which becomes a bacterial complication of a viral disease. The patient usually has thick, purulent airway secretions. Staphylococcus aureus is the primary cause, although parainfluenza virus type 1, Moraxella (Branhamella) catarrhalis, nontypable Haemophilus influenzae, and anaerobic organisms may also cause this entity. Diphtheritic croup is rare in North America but like...
Recurrent abdominal j ain iRAP) occurs in about 10-15 of children between 5 and 15 years of age. Organic causes include diseases of the GI tract such as constipation, lactose intolerance, parasites (Giardia sp), inflammatory bowel disease, and peptic ulcer disease. Pancreatitis and cholelithiasis are pancreatic causes of RAP. Urinary tract infections, abdominal epilepsy, porphyria, sickle cell anemia, and lead poisoning are non-GI causes. In contrast to younger children (
A common idea expressed in some ancient through contemporary writings is that dreams are generated by internal sensations, such as indigestion after eating an anchovy, onion, and green pepper pizza right before bedtime, or by illness. Some Greek as well as other writers even maintained that dream content could be used to help diagnose physical illnesses. Yet, of the many studies that have tried to relate physiological changes in the body to dream content, the results have been disappointing.
Figure 9.13 is the tracing of a 48-year-old white male who presented in the early morning hours with retrosternal pain that he described as feeling like his usual pain of esophageal reflux, but slightly more intense and lasting longer. By now you have the skills to conclude that his initial ECG was, indeed, perfectly normal.
Ray Stoneham is typical of a group of stoic patients who endure symptoms of cardiac disease and convince themselves that their symptoms represent something less serious. The first hint that this is not a GI problem comes when Ray relates that his indigestion is in the high retrosternal area. Aggravation of the pain with exercise sets off further alarm bells. Vomiting and diaphoresis the first night of the pain complete the transition to a focus on a possible cardiac etiology. Ray's symptoms, indeed, are sufficiently worrisome to warrant hospitalization regardless of our findings on physical examination or laboratory investigation.
FIGURE 24-4 Disease associations with Helicobacter pylori (HP). The large circle represents a typical population in a developed country where 60 of persons are not infected with H. pylori. The darker circle represents the 40 of persons who are infected with H. pylori. Even so, nearly all the duodenal ulcers and gastric ulcers occur in the H. pylori-positive group. Each year, 1 of infected patients undergo transition from asymptomatic gastritis to symptomatic peptic ulcer. Note that most gastric adenocarcinomas and gastric mucosa-associated lymphoid tissue (B-cell) lymphomas also occur in the H. pylori-positive persons. Controversy reigns as to the role of H. pylori in persons with dyspepsia but in whom ulcers are not found Should H. pylori be treated in these persons, or ignored FIGURE 24-4 Disease associations with Helicobacter pylori (HP). The large circle represents a typical population in a developed country where 60 of persons are not infected with H. pylori. The darker circle...
Cardiovascular disease remains the major cause of morbidity and mortality for all patients with diabetes. Women with diabetes are five times more likely to develop coronary artery disease than women without diabetes.33 The protective effect of female gender against cardiovascular disease before menopause is not true for any woman with diabetes. Presentation of heart disease may be atypical in the woman with diabetes. Fatigue, decreased exercise tolerance, or dyspepsia may be anginal equivalent symptoms in the woman with diabetes.34 Routine evaluation with exercise stress testing may have up to a 54 false-positive rate in women, so other cardiac evaluations, such as a stress nuclear perfusion study or stress echo, may be necessary. Small-vessel disease is common in diabetes therefore, revascularization procedures may be more difficult in women with diabetes. Risk-factor modification, including smoking cessation, aspirin use, blood pressure control (with consideration of an...
The gastrointestinal reflux scan, also called the gastroesophageal reflux scan, is a radionuclide study of the esophagus and stomach. Indications for this scan are symptoms associated with gastric reflux, which may include heartburn, vomiting, aspiration, regurgitation, or dysphagia. The gastrointestinal reflux scan may encompass scanning the lungs when aspiration of gastric contents presents a concern. In cases of suspected aspiration, the radionuclide is administered with the evening meal. The patient remains in the supine position until scanning is performed the following day. A gastric emptying scan may be performed at the same time as the reflux scan.
The general treatment is similar to the treatment for infectious hepatitis. The patient should have sufficient fluids, good nutrition, and bed rest. If the patient exhibits dyspepsia and malaise, he may be administrated alkalies, belladonna, and antimetics. A newly available gamma globulin seems to reduce the severity of hepatitis type B following needle-stick or contact exposure. This can be administered following exposure by ingestion, inoculation, or splash on involved exposure surface. This gamma globulin seems to lessen the severity of the disease. Since recovery and convalescence is slow and prolonged, psychosocial stimulation should be provided.
A myocardial infarction can happen to either males or females, old or young, and not necessarily during physical or emotional stress. A person experiencing the early signs and symptoms of a heart attack may not know that he is having a heart attack. He may state that he feels like having bad indigestion.
Burning or pain in the pit of the stomach or chest (acid indigestion and heartburn, see p. 128) Eat only small amounts of food at one time and drink water often. Antacids can help, especially those with calcium carbonate (see p. 382). It may also help to suck hard candy. Try to sleep with the chest and head lifted up some with pillows or blankets.
Know from personal experience that it helps the digestive juices, stimulating them as an aperitif, while some dishes would be unthinkable without a glass of wine to aid the digestion. I could not envisage a plate of pasta accompanied by water, nor a delicious roast chicken. Indigestion would be sure to follow.
For indigestion, for example, Celsus recommended 'Those who have a slow digestion and for that reason get a distended abdomen, or because of some kind of fever feel thirst during the night, they should, before going to bed, drink three or four cups of wine through a thin straw' (Skovenborg 1990, p. 14).
Many roundworms in the intestines may cause discomfort, indigestion, and weakness. Children with many roundworms often have very large, swollen bellies. Rarely, roundworms may cause asthma, or a dangerous obstruction or blockage in the gut (see p. 94). Especially when the child has a fever, the worms sometimes come out in the stools or crawl out through the mouth or nose. Occasionally they crawl into the airway and cause gagging.
Inhibitor of TRPV1 and to this end much work is being carried out to develop novel inhibitors 104 . Interestingly, capsaicin-sensitive nerve stimulation in subjects with active allergic rhinitis produces reproducible and dose-dependent leucocyte influx, albumin leakage and glandular secretion. These results provide in vivo evidence for the occurrence of neurogenic inflammation in the human upper airway with active allergic disease and may therefore suggest the therapeutic utility of TRPV1 antagonists in the management of this disease 105 . In addition, the treatment of persistent cough is a facet of airway diseases that is sorely in need of effective treatments and a TRPV1 inhibitor may prove extremely effective against cough induced by, for example, gastroesophageal acid reflux 106 , as well as that associated with asthma and other airways diseases as described.
Weight loss, possibly in association with changes in the gastrointestinal hormonal milieu, results in dramatic effects on the comorbid conditions of severe obesity (1). Reversal or improvement have been seen for the following comorbidities type 2 diabetes (11), hyperlipidemia, hypertension, obstructive sleep apnea, weight-bearing osteoar-thritis, gastroesophageal reflux disease, and depression. Reversal or improvement are reasonable and presumed for other comorbidities, including cardiac and peripheral vascular disease, and carcinomas of the breast, uterus, ovary, prostate, colon, pancreas, and liver (10). There are also improvements in quality-of-life factors related to body image, personal hygiene, sexual activity, employment opportunities, and socioeconomic status (1). Finally, growing epidemiological evidence suggests that weight-loss surgery may increase longevity (41).
His wife preempts your attempt to take a history by announcing that Ray has had indigestion for three days, has been taking Tums by the bucketload, and just picks at his food. She is sure that he has an ulcer. Ray seems content with his wife running this show, and makes no effort to offer further clarification. The office chart in your hand is thin. Ray normally comes in only when coerced by his wife. He has never been in a hospital, has no chronic illnesses, no allergies, and is on no meds. But tonight, his wife says, he himself suggested going to the doctor's office. Gradually you are able to coax more information out of Ray and you learn that his indigestion is high in the retrosternal area, has been constant for almost three days, and seems worse when he is carrying feed to the calves. In fact, he felt badly enough that he did not milk the cows tonight, but left that task to his son-in-law. He vomited once the first night of the indigestion and was sweaty most of the night. Tums...
A 38-year-old banker with a history of heartburn suddenly experiences excruciating pain in the epigastric region of the abdomen. Surgery is performed immediately upon admission to the emergency room. There is evidence of a ruptured ulcer in the posterior wall of the stomach. Where will a surgeon first find the stomach contents
A 35-year-old male chronic smoker presents with heartburn. His heartburn worsens when bending and lying down at night, preventing him from sleeping it is promptly relieved with antacids. Chronic untreated GERD can lead to columnar metaplasia of distal esophagus epithelium ( BARRETT'S ESOPHAGUS), which predisposes to esophageal adenocarcinoma. GASTROESOPHAGEAL REFLUX DISEASE (GERD)
And eradicated throughout adulthood (Brenner et al. 1997). Because of the chronic inflammation caused by H. pylori, and the relationship between chronic gastritis and cancer of the stomach, H. pylori is considered carcinogenic. A Japanese study (Uemura et al. 2001) looked at more than 1500 patients who had ulcers of the duodenum or stomach or polyps or hypertrophy of the stomach or dyspepsia (heartburn) without an ulcer. Approximately 80 had evidence of H. pylori infection, and 20 did not. Gastric cancers developed in 36 (2.9 ) of the infected patients and in none of those uninfected. When looked at by specific categories, 21 (4.7 ) patients with non-ulcer dyspepsia developed cancer, as well as 10 (3.4 ) patients with previous gastric ulcers, and 5 (2.2 ) with gastric hypertrophy or polyps. No gastric cancers were found in patients with duodenal ulcers alone (Uemura et al. 2001).
Stances that tend to break the barrier (such as aspirin or vinegar) may lead to gastric irritation, from mild to severe. Vagal activity also stimulates acid secretion from the stomach cells. This perhaps explains the rather common and so-called heartburns (upper gastric burning sensation) reported by worried or overstressed persons who may show an increased tone of the vagi. As many as 33 to 44 of Americans experience heartburn at least once a month and up to 13 have heartburn each day. The likelihood of having heartburn increases with age and among women who are pregnant. Having heartburn every once in a while is something almost everyone experiences, but if it occurs 2 or more days per week, it can be a sign of a more serious problem called gastroesophageal reflux disease. The small intestine secretes two hormones, secretin and cholecystokinin-pancreozymin (CCK-PZ). They both act on the exocrine pancreatic function stimulating the secretion of pancreatic juice (1,200 mL day, pH 8.0...
Reflux), but they may also be paraesophageal (the gastroesophageal junction remains fixed below the diaphragm with no reflux symptoms are due to pressure). Complications associated with paraesophageal hiatal hernias are strangulation, obstruction, incarceration, and hemorrhage. Chronic untreated gastroesophageal reflux disease secondary to a sliding hiatal hernia may lead to Barrett's esophagus (columnar metaplasia of the distal esophagus), which is associated with an increased risk of esophageal adenocarcinoma.
A 38-year-old female patient presented to the rheumatology clinic with a 3-week history of a painful fingertip ulcer. The pain was so severe that it was keeping her awake at night. For 20 years (since her teens) her hands had been turning white then purple in the cold weather, going red (with tingling) when rewarming. Her feet also felt cold. Her family doctor had told her that this was Raynaud's phenomenon, which was very common. However, each winter her symptoms seemed to be worsening, and even a slight temperature change would bring on an attack. The previous winter she had had some finger ulcers which had, however, been less painful than the current one and which had healed spontaneously. Also of concern to her was that for 6 months the skin of her fingers had felt tight, and she had recently been experiencing some difficulty swallowing, with heartburn. There was no past medical history of note. She had smoked five cigarettes a day for 2 years. There was no history of chemical...
IBS can present as abdominal pain of variable intensity and position, although often it is in the lower abdomen or left lower quadrant and often it is crampy. Usually there is a change or alteration in bowel habits - diarrhea, constipation, or a combination. Other symptoms may include nausea, vomiting, and gas. Weight loss is usually not a symptom and suggests other causes. Women with IBS may have other chronic pain syndromes, including headaches, dyspepsia,
A 57-year-old white male complains of deep, burning retrosternal pain ( HEARTBURN) that worsens when he lies down. Most hiatal hernias are sliding (the stomach herniates into the thorax together with the gastroesophageal junction, producing reflux), but they may also be paraesophageal (the gastroesophageal junction remains fixed below the diaphragm with no reflux symptoms are due to pressure). Complications associated with paraesophageal hiatal hernias are strangulation, obstruction, incarceration, and hemorrhage. Chronic untreated gastroesophageal reflux disease secondary to a sliding hiatal hernia may lead to Barrett's esophagus (columnar metaplasia of the distal esophagus), which is associated with an increased risk of esophageal adenocarcinoma.
Reasons, Remedies And Treatments For Heartburns
Find Out The Causes, Signs, Symptoms And All Possible Treatments For Heartburns!