Acid Reflux Disease
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Acid Reflux Disease
Gastroesophageal reflux disease (GERD) or gastro-oesophageal reflux disease (GORD) is one of the upper gastrointestinal chronic diseases where stomach content persistently and regularly flows up into the esophagus, resulting in symptoms and/or complications. Symptoms include dental corrosion, dysphagia, heartburn, odynophagia, regurgitation, non-cardiac chest pain, extraesophageal symptoms such as chronic cough, hoarseness, reflux-induced laryngitis, or asthma. On the long term, and when not treated, complications such as esophagitis, esophageal stricture, and Barrett's esophagus may arise. Risk factors include obesity, pregnancy, smoking, hiatal hernia, and taking certain medications. Medications that may cause or worsen the disease include benzodiazepines, calcium channel blockers, tricyclic antidepressants, NSAIDs, and certain asthma medicines. Acid reflux is due to poor closure of the lower esophageal sphincter, which is at the junction between the stomach and the esopha ...
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X-ray
An X-ray, or, much less commonly, X-radiation, is a penetrating form of high-energy electromagnetic radiation. Most X-rays have a wavelength ranging from 10  picometers to 10  nanometers, corresponding to frequencies in the range 30  petahertz to 30  exahertz ( to ) and energies in the range 145  eV to 124 keV. X-ray wavelengths are shorter than those of UV rays and typically longer than those of gamma rays. In many languages, X-radiation is referred to as Röntgen radiation, after the German scientist Wilhelm Conrad Röntgen, who discovered it on November 8, 1895. He named it ''X-radiation'' to signify an unknown type of radiation.Novelline, Robert (1997). ''Squire's Fundamentals of Radiology''. Harvard University Press. 5th edition. . Spellings of ''X-ray(s)'' in English include the variants ''x-ray(s)'', ''xray(s)'', and ''X ray(s)''. The most familiar use of X-rays is checking for fractures (broken bones), but X-rays are also used in other ways. ...
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Esophageal PH Monitoring
Esophageal pH monitoring is the current gold standard for diagnosis of gastroesophageal reflux disease (GERD). It provides direct physiologic measurement of acid in the esophagus and is the most objective method to document reflux disease, assess the severity of the disease and monitor the response of the disease to medical or surgical treatment. It can also be used in diagnosing laryngopharyngeal reflux. Background The importance of refluxed gastric contents in the pathogenesis of GERD was emphasized by Winkelstein who introduced the term " peptic esophagitis" and by Bernstein and Baker who reported the symptom of heartburn following instillation of hydrochloric acid in the distal esophagus in what was then became known as the acid perfusion test. Formal measurement of acid in the esophagus was first described in 1960 by Tuttle. He used a glass pH probe to map the gastroesophageal pH gradient, and demonstrated a sharp gradient in normal subjects and a gradual, sloping gradien ...
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Obesity
Obesity is a medical condition, sometimes considered a disease, in which excess body fat has accumulated to such an extent that it may negatively affect health. People are classified as obese when their body mass index (BMI)—a person's weight divided by the square of the person's height—is over ; the range is defined as overweight. Some East Asian countries use lower values to calculate obesity. Obesity is a major cause of disability and is correlated with various diseases and conditions, particularly cardiovascular diseases, type 2 diabetes, obstructive sleep apnea, certain types of cancer, and osteoarthritis. Obesity has individual, socioeconomic, and environmental causes. Some known causes are diet, physical activity, automation, urbanization, genetic susceptibility, medications, mental disorders, economic policies, endocrine disorders, and exposure to endocrine-disrupting chemicals. While a majority of obese individuals at any given time are attempting to ...
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Esophagitis
Esophagitis, also spelled oesophagitis, is a disease characterized by inflammation of the esophagus. The esophagus is a tube composed of a mucosal lining, and longitudinal and circular smooth muscle fibers. It connects the pharynx to the stomach; swallowed food and liquids normally pass through it. Esophagitis can be asymptomatic; or can cause epigastric and/or substernal burning pain, especially when lying down or straining; and can make swallowing difficult (dysphagia). The most common cause of esophagitis is the reverse flow of acid from the stomach into the lower esophagus: gastroesophageal reflux disease (GERD). __TOC__ Signs and symptoms The symptoms of esophagitis include: * Heartburn – a burning sensation in the lower mid-chest * Nausea * Dysphagia – swallowing is painful, with difficulty passing or inability to pass food through the esophagus * Vomiting (emesis) * Abdominal pain * Cough Complications If the disease remains untreated, it can cause scarring and disco ...
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Odynophagia
Odynophagia is pain when swallowing. The pain may be felt in the mouth or throat and can occur with or without difficulty swallowing. The pain may be described as an ache, burning sensation, or occasionally a stabbing pain that radiates to the back. Odynophagia often results in inadvertent weight loss. The term is from ''-'' 'pain' and ' 'to eat'. Causes Odynophagia may have environmental or behavioral causes, such as: * Very hot or cold food and drinks (termed cryodynophagia when associated with cold drinks, classically in the setting of cryoglobulinaemia). * Taking certain medications * Using drugs, tobacco, or alcohol * Trauma or injury to the mouth, throat, or tongue It can also be caused by certain medical conditions, such as: * Ulcers * Abscesses * Upper respiratory tract infections * Inflammation or infection of the mouth, tongue, or throat (esophagitis, pharyngitis, tonsillitis, epiglottitis) * Immune disorders * Oral or throat cancer See also * Phagophobia Phagophobia ...
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Dysphagia
Dysphagia is difficulty in swallowing. Although classified under "symptoms and signs" in ICD-10, in some contexts it is classified as a disease#Terminology, condition in its own right. It may be a sensation that suggests difficulty in the passage of solids or liquids from the mouth to the stomach, a lack of Pharynx, pharyngeal sensation or various other inadequacies of the swallowing mechanism. Dysphagia is distinguished from other symptoms including odynophagia, which is defined as painful swallowing, and Globus Pharyngis, globus, which is the sensation of a lump in the throat. A person can have dysphagia without odynophagia (dysfunction without pain), odynophagia without dysphagia (pain without dysfunction) or both together. A psychogenic disease, psychogenic dysphagia is known as phagophobia. Classification Dysphagia is classified into the following major types: # Oropharyngeal dysphagia # Esophageal dysphagia, Esophageal and obstructive dysphagia # Neuromuscular symptom comp ...
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Prokinetics
A prokinetic agent (also gastroprokinetic agent, gastrokinetic agent or propulsive) is a type of drug which enhances gastrointestinal motility by increasing the frequency or strength of contractions, but without disrupting their rhythm. They are used to treat certain gastrointestinal symptoms, including abdominal discomfort, bloating, constipation, heart burn, nausea, and vomiting; and certain gastrointestinal disorders, including irritable bowel syndrome, gastritis, gastroparesis, and functional dyspepsia. Most prokinetic agents are grouped under the Anatomical Therapeutic Chemical Classification System (a World Health Organization drug classification system), as ATC code A03F. Pharmacodynamics Activation of a wide range of serotonin receptors by serotonin itself or by certain prokinetic drugs results in enhanced gastrointestinal motility. Other prokinetic drugs may increase acetylcholine concentrations by stimulating the M1 receptor which causes acetylcholine release, or by ...
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Proton Pump Inhibitor
Proton-pump inhibitors (PPIs) are a class of medications that cause a profound and prolonged reduction of stomach acid production. They do so by irreversibly inhibiting the stomach's H+/K+ ATPase proton pump. They are the most potent inhibitors of acid secretion available. Proton-pump inhibitors have largely superseded the H2-receptor antagonists, a group of medications with similar effects but a different mode of action, and antacids. PPIs are among the most widely sold medications in the world. The class of proton-pump inhibitor medications is on the World Health Organization's List of Essential Medicines. Omeprazole is the specific listed example. Medical uses These medications are used in the treatment of many conditions, such as: * Dyspepsia * Peptic ulcer disease including after endoscopic treatment for bleeding * As part of ''Helicobacter pylori'' eradication therapy * Gastroesophageal reflux disease (GERD or GORD) including symptomatic endoscopy-negative reflux disea ...
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H2 Antagonist
H2 antagonists, sometimes referred to as H2RAs and also called H2 blockers, are a class of pharmaceutical drug, medications that block the action of histamine at the histamine H2 receptor, histamine H2 receptors of the parietal cells in the stomach. This decreases the production of gastric acid, stomach acid. H2 antagonists can be used in the treatment of dyspepsia, peptic ulcers and gastroesophageal reflux disease. They have been surpassed by proton pump inhibitors (PPIs); the PPI omeprazole was found to be more effective at both healing and alleviating symptoms of ulcers and reflux oesophagitis than the H2 blockers ranitidine and cimetidine. H2 antagonists are a type of antihistamine, although in common use the term "antihistamine" is often reserved for H1 antagonist, H1 antagonists, which relieve Allergy, allergic reactions. Like the H1 antagonists, some H2 antagonists function as inverse agonists rather than receptor antagonists, due to the constitutive activity of these re ...
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Antacid
An antacid is a substance which neutralizes stomach acidity and is used to relieve heartburn, indigestion or an upset stomach. Some antacids have been used in the treatment of constipation and diarrhea. Marketed antacids contain salts of aluminum, calcium, magnesium, or sodium. Some preparations contain a combination of two salts, such as magnesium carbonate and aluminium hydroxide (e.g. hydrotalcite). Medical uses Antacids are available over the counter and are taken by mouth to quickly relieve occasional heartburn, the major symptom of gastroesophageal reflux disease and indigestion. Treatment with antacids alone is symptomatic and only justified for minor symptoms.U.S. Department of Health & Human Services. Agency for Healthcare Research and Quality 23 September 201Consumer Summary – Treatment Options for GERD or Acid Reflux Disease: A Review of the Research for Adults Alternative uses for antacids include constipation, diarrhea, hyperphosphatemia, and urinary alkalizatio ...
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Angina
Angina, also known as angina pectoris, is chest pain or pressure, usually caused by ischemia, insufficient blood flow to the Cardiac muscle, heart muscle (myocardium). It is most commonly a symptom of coronary artery disease. Angina is typically the result of vascular occlusion, obstruction or vasospasm, spasm of the coronary arteries, arteries that supply blood to the heart muscle. The main mechanism of coronary artery obstruction is atherosclerosis as part of coronary artery disease. Other causes of angina include cardiac arrhythmia, abnormal heart rhythms, heart failure and, less commonly, anemia. The term derives from the Latin ''angere'' ("to strangle") and ''pectus'' ("chest"), and can therefore be translated as "a strangling feeling in the chest". There is a weak relationship between severity of angina and degree of oxygen deprivation in the heart muscle, however, the severity of angina does not always match the degree of oxygen deprivation to the heart or the risk of a ...
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Esophageal Spasm
Esophageal spasm is a disorder of motility of the esophagus. There are two types of esophageal spasm: * Diffuse or distal esophageal spasm (DES), where there is uncoordinated esophageal contractions * Nutcracker esophagus (NE) also known as hypertensive peristalsis, where the contractions are coordinated but with an excessive amplitude. Both conditions are linked to gastroesophageal reflux disease (GERD). DES and nutcracker esophagus present similarly and can may require esophageal manometry for differentiation. When the coordinated muscle contraction are irregular or uncoordinated, this condition may be called diffuse esophageal spasm. These spasms can prevent food from reaching the stomach where food gets stuck in the esophagus. At other times the coordinated muscle contraction is very powerful, which is called nutcracker esophagus. These contractions move food through the esophagus but can cause severe pain. Signs and symptoms The symptoms may include trouble swallowing, ...
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