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Heartburn/Acid Reflux/Indigestion/Dyspepsia/Pyrosis/GERD
Published in Charles Theisler, Adjuvant Medical Care, 2023
Diet: Losing weight helps lessen heartburn symptoms. It’s best to refrain from eating within three to four hours of going to bed. Eating large meals as well as foods that result in heartburn (e.g., spicy foods, tomatoes, coffee, caffeine, and citrus) or foods that decrease lower esophageal sphincter pressure (e.g., fatty or fried meals, garlic, onions, chili peppers, chocolate, peppermint, spearmint, coffee, cola, and tea) should be avoided.5 Include protein-rich meals to increase lower esophageal sphincter pressure.6
Digestive and Metabolic Actions of Dopamine
Published in Nira Ben-Jonathan, Dopamine, 2020
Gastroesophageal reflux disease (GERD), or acid reflux disease, is a recurrent condition where acidic gastric juices leak upward into the esophagus [8]. The most common symptoms are an acidic taste in the mouth, regurgitation, and heartburn. The pathogenesis of GERD is multifactorial, involving lower esophageal sphincter relaxation or pressure abnormalities. As a result, reflux of acid, bile, pepsin, and pancreatic enzymes occurs, leading to esophageal mucosal injury. Other factors contributing to the pathophysiology of this disease include hiatal hernia, impaired esophageal clearance, delayed gastric emptying, and impaired mucosal defensive factors. Treatments for GERD include changes in food choices, medications, and surgery in extreme cases. Initial treatment is commonly done with proton-pump inhibitors such as omeprazole to neutralize the acid. Metoclopramide, a peripheral D2R antagonist, has been used alone or in combination with antacids to treat GERD for some years. However, use of metoclopramide has declined in recent years because of concerns with adverse effects such as PD-like movement disorders.
Dietary Habits and Susceptibility to Various Cancers
Published in Sheeba Varghese Gupta, Yashwant V. Pathak, Advances in Nutraceutical Applications in Cancer, 2019
Kimberly Padawer, Yashwant V. Pathak
Heartburn is felt as a burning pain in the chest, which often is described in a similar manner as cardiac symptoms. Certain foods can trigger heartburn or acid-reflux including spicy or fatty foods, chocolate, alcohol, caffeine, or peppermint. Esophageal adenocarcinoma is an associated complication of gastroesophageal reflux disease, or GERD, which is when heartburn occurs on a regular basis over at least a 2-week period. In addition to heartburn, regurgitation of food can occur, or even vomiting and difficulty and pain when swallowing [35]. Barrett’s esophagus is when abnormal cellular growth (dysplasia) occurs in the lining of the esophagus due to chronic acid reflux from the stomach. Normal esophageal cells lining the lower esophagus are typically squamous epithelial cells. However, in Barrett’s esophagus, these squamous cells have differentiated into a more intestinal cell type capable of malignant transformation. Individuals with chronic heartburn symptoms or GERD may want to have an endoscopy in order to test for Barrett’s esophagus as directed by a healthcare provider. Endoscopy is a procedure when a small flexible tube is placed down the esophagus in order to view whether tissue is damaged. Additionally, a 24-hour pH study can be performed when endoscopy is inconclusive. However, patients should be made aware of the benefits or risks of the procedure, including cost. If left unmanaged, Barrett’s esophagus could potentially lead to esophageal cancer [36].
Improving clinical outcomes of Barrett’s esophagus with high dose proton pump inhibitors and cryoablation
Published in Annals of Medicine, 2023
BE recurred on endoscopic pathology in 9% (Table 2) in 53 ± 18mo from initial CRYO. BE recurred in 4/14 (29%) with initial LGD/IDD compared with 1/38 (3%) who initially had only non-dysplastic BE (relative risk 0.09 [95% CI, 0.01, 0.76]; p < .03). CE was again accomplished for all recurrent IM using focal ablations with CRYO in five combined with APC in one for IM. Advanced disease recurred in only 1 female who had discontinued her PPI-BID because of insurance issues. Heartburn/reflux increased. Thirty months after CE of her BE with LGD, a polypoid adenoma with mucosal (T1a-LMP,-M2) carcinoma and HGD developed in a hiatal hernia, all re-ablated with multiple endoscopic methods without recurrence over 44 months. No patient initially with HGD or superficial EAC developed a recurrence.
Relationship between body mass index, waist circumference, waist hip ratio and erosive gastroesophageal reflux disease in a tertiary centre in Nigeria: A case control study
Published in Alexandria Journal of Medicine, 2018
Olusegun Adekanle, Samuel Anu Olowookere, Oluwasegun Ijarotimi, Dennis Amajuoyi Ndububa, Akinwumi Oluwole Komolafe
Gastro-oesophageal reflux disease (GERD) is a condition that develops when the reflux of stomach content causes troublesome symptoms with or without mucosa damage and or complications. At upper gastro-intestinal endoscopy, GERD may be erosive (when there is visible erosions) or non-erosive (when there is no visible mucosa erosion). Heartburn and regurgitation are typical symptoms of reflux experienced by patients.1,2 GERD is one of the most prevalent clinical conditions affecting the gastro-intestinal tract. Associated conditions that have been established to occur with GERD include the Zollinger Ellison syndrome (ZES) and connective tissue disease like scleroderma.3 Central obesity has been fairly reasonably shown from studies outside Nigeria to be associated with GERD.4–8 Among patients with obesity, studies have shown that central deposition of fat relates more to reflux symptoms than peripheral deposition of fat.9 Other conditions that have been shown to be associated with GERD include pregnancy, cigarette smoking, and the use of drugs like the nitrates, calcium channel blockers, beta blockers and aminophylline.10 Surgical destruction of the lower oesophageal sphincter or balloon dilatation also renders the gastro-esophageal valve incompetent.10 Few studies have shown an association between GERD and central obesity in Nigeria and many of these are questionnaire based with only one or so that was based on diagnostic upper gastro-intestinal endoscopy.
The diagnostic value of GerdQ in subjects with atypical symptoms of gastro-esophageal reflux disease
Published in Scandinavian Journal of Gastroenterology, 2018
Elisabeth Norder Grusell, Ann-Christine Mjörnheim, Caterina Finizia, Magnus Ruth, Henrik Bergquist
Gastro-esophageal reflux disease (GERD) is common in the western world, with prevalence as high as 20–30% and increasing [1]. GERD has, according to the Montreal agreement, a symptomatic definition, that is, ‘a condition that develops when the reflux of stomach content causes troublesome symptoms and/or complications’ [2]. Typically, the diagnosis is based on the symptoms heartburn and regurgitation. However, many patients report symptoms that are atypical, overlap with other diagnoses or have an extra-esophageal origin such as chest pain, hoarseness, laryngitis, chronic cough and asthma [3–7]. In the clinical setting, it may therefore be difficult to distinguish GERD from conditions such as functional dyspepsia, irritable bowel syndrome and eosinophilic esophagitis (EoE) [8,9]. Furthermore, GERD and the aforementioned diagnoses may coexist.