‘Heartburn’

The Heartburn and Feeding

Monday, July 19th, 2010

The heartburn and diet are closely linked. There are several recommendations that can be observed to decrease or relieve your heartburn.

It is necessary to avoid prolonged fasting especially since an empty stomach will be much more vulnerable to acidity. If heartburn appear between meals, making a comparison can often relieve in some people. Contrary to what one might think, the milk can relieve stomach pain as very short term. However, it can also worsen the long-term heartburn because it contains casein and calcium, which increases gastric secretion and the resulting heartburn.

The citrine or acid fruits such as orange, grapefruit or apples can also be as responsible for gastric discomfort. From the point of view of the drinks, coffee, tea, chocolate, cocoa and cola contain methylxanthines that can cause severe pain to the stomach. (more…)

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Reflux Disease Gastroesophageal

Monday, July 12th, 2010

What is gastroesophageal reflux?

The burning, heartburn, retrosternal heartburn is a burning sensation in the center of the chest that often occurs after eating, bending over, exercising, and sometimes, when lying down. It is a common problem, nearly one in every 10 adults have these symptoms at least once a week, and one in three monthly. Some pregnant women have it almost daily. These symptoms indicate a disease called gastroesophageal reflux or GERD.

When you swallow, food passes through your throat and esophagus into the stomach. A muscle called the lower esophageal sphincter controls (more…)

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Burn Stomach and Digestion

Thursday, July 8th, 2010

Heartburn, pain in the sternum, regurgitation … These symptoms are the sign awkward sometimes cause indigestion.

The heartburn is linked to dysfunction of digestion. Chewing and saliva on the food are the first stage of digestion. You then divide the stomach work and food for it, it helps extremely acidic gastric juices. It is when these juices back into the esophagus we experience the unpleasant sensation of heartburn.

Indeed, while the stomach wall resists this acidity, the wall of the esophagus is much more fragile, which makes us feel more or less accentuated this acid reflux from the stomach. Then understand the importance of chewing food thoroughly, allowing the stomach and therefore less work to use less acidic gastric juices. (more…)

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Diet for People with Acid Reflux

Monday, July 5th, 2010

No matter what type of acid reflux suffers, regardless of the underlying factors to your own particular struggle with heartburn, a change in diet can have remarkable effects on the way to control the reflux acid.Hay some foods that seem to encourage heartburn in many people. These are general categories such as spicy foods, foods high in fat and dairy. We also know that chocolate, tomatoes and herbal supplements causing heartburn like symptoms, particularly if they are ingested shortly before bedtime.

Do you suffer from reflux?

If you recognize particular foods that seem to cause heartburn, you will see that eating in the morning rather than just before bedtime will alleviate your symptoms of heartburn. When you eat during the period of wakefulness and activity, the body is more able to contain stomach acids used to digest food. (more…)

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The Peptic Ulcer Disease Treatment

Monday, June 28th, 2010

peptic Ulcer DiseaseThe treatment of gastric and duodenal ulcers had until recently concentrated on neutralizing and reducing gastric acidity. However, attention has now shifted to the eradication of H. pylori. Therefore, antibiotic treatment must be considered in all patients infected with H. pylori with acute ulcers and those who have had gastric or duodenal ulcer in the past diagnosed by endoscopy or barium radiography, even if they are asymptomatic or receiving prolonged treatment for acid suppression. This is particularly important in patients with a history of complications (eg., Bleeding, perforation), because eradication of H. pylori can prevent future complications.

Antibiotic treatment for H. pylori is in development. Simple agents should not be used because no single antibiotic can cure in a predictable way most infections H. pylori. At first it was recommended triple therapy based on bismuth. This approach has been tested with simple patterns of two drugs, which include the use of drugs blocking acid secretion. Whatever treatment is used, antibiotic resistance, the advice of the physician and patient compliance determines its success.
(more…)

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Symptoms and Diagnosis of PUD

Thursday, June 24th, 2010

Symptoms and signs

Symptoms depend on the location of the ulcer and the patient’s age, many patients, especially seniors, have few symptoms or none. Pain is the most common symptom, usually located in the epigastrium and is relieved by food or antacids. The pain is described as burning, burning or hunger. The course is usually chronic or recurrent. Only about half of the patients presented the characteristic pattern of symptoms.

PUD symptoms and diagnoseThe symptoms of gastric ulcers do not usually follow a uniform pattern (eg., Eating often exacerbates the pain instead of alleviating it.) This is especially true in ulcers of the pyloric canal, which are often associated with obstructive symptoms (eg., Fullness, nausea, vomiting) caused by edema and scarring.

PUD diagnosisIn duodenal ulcer, the pain tends to be more uniform. The pain is absent when the patient awake, but appears at mid-morning, is relieved by food but recurs 2-3 h after the meal. The pain wakes the patient at night is common and highly suggestive of duodenal ulcer.

Diagnosis

The diagnosis of peptic ulcer is suggested mainly by history and confirmed by the studies described below. Stomach cancer may present with similar and must be discarded, especially in older patients who have weight loss or refer particularly severe or refractory symptoms. Endoscopy, cytology and multiple biopsies are reliable means of distinguishing the malignant gastric ulcers benign. (more…)

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Peptic Ulcer Disease: Etiology and Pathogenesis

Monday, June 21st, 2010

Peptic Ulcer Disease
Excoriated segment of the GI mucosa, typically in the stomach (gastric ulcer) or in the first centimeters of the duodenum (duodenal ulcer), which penetrates through the muscle layer of the mucosa.

Ulcers can range in size from several millimeters to several centimeters. The sores are different from erosion by the depth of penetration, the erosions are superficial and do not affect the muscle layer of the mucosa.

Because the knowledge of the central role of H. pylori in the pathogenesis of peptic disease is increasing, diagnosis and treatment of peptic ulcer disease has changed dramatically.
Is an erosion in the lining of the stomach or the first part of the small intestine, an area called the duodenum.
If the ulcer is located in the stomach is called gastric ulcer. (more…)

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Positional Therapy Treatment

Thursday, June 17th, 2010

Treatment

Doctors refer to “lifestyle change” as the first treatment for reflux. A 2006 study suggested that most of the dietary changes were anecdotal, and only weight loss and elevation of the head of the bed were tested as effective. A randomized study of transition had the advantage of avoiding meals two hours before going to bed.

Therapy treatmentPositional therapy, sleeping on the left side, has proven to drastically reduce nighttime reflux episodes. The elevation of the head of the bed is also an effective measure. Combining drug therapy, meals just before bedtime, and elevation of the head of the bed, over 95% of patients have complete relief. If not fully improved, additional measures may be considered.

The elevation of the head of the bed can be done using various items: plastic or wooden props to support the legs of the bed, pillows, wedges, lifts, inflatable or a spring mattress. The lift height is very important and should be at least 15 to 20 inches to be minimally effective in preventing the rise in gastric fluids. Some mattresses are not suitable when inclined and tend to cause back pain, and are therefore preferred foam mattresses. Some people tip the bed more than 20 cm, and argue that the efficiency is higher.

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Risks and Results Surgical Treatment

Monday, June 14th, 2010

The most common complications include bleeding or injury to properties in the spleen, stomach or esophagus (<5%). These rare but potentially serious complications can occur after a laparoscopic or open procedure. Respiratory complications such as atelectasis or pneumonia are less common after laparoscopic surgery than after open.

Surgical TreatmentUp to 2 / 3 of patients experience some degree of difficulty swallowing after surgery, especially with solid foods. This dysphagia is usually temporary and most patients can eat and swallow normally after six weeks. Another potential problem is the gastric distension associated with the inability to burp. Many patients with reflux esophagitis swallow as unconscious in an effort to acid reflux with alkaline saliva. This may bring with it the swallowing of large amounts of air. If the fundoplication is adjusted, it is very difficult to remove the gas belching. This usually disappears over time.

In most patients without surgical risk, the fundoplication requires a short hospital stay of approximately 3 days after laparoscopic surgery and 5 after the open. The hospitalization may be longer in patients with high surgical risk due to the presence of associated pathologies or if you have some postoperative complications.

The limited results so far suggest that long-term results are equivalent independent traveler type of surgery chosen (laparoscopic or open). Recurrence of reflux is uncommon after fundoplication, and if it happens means that the same is very floppy, has disappeared (dehiscence), or has slipped into the stomach. In these cases over diagnostic studies are needed to diagnose the cause of the recurrence of symptoms and plan the best solution posuble, both medical and surgical.

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Surgical Treatment of Gastro-esophageal Reflux part II

Thursday, June 10th, 2010

Surgical treatments are usually effective in controlling severe gastroesophageal reflux. The fundoplication was found to be more effective than ranitidine + metoclorpropamida in a study with 2 years of follow-up. The surgery for gastroesophageal reflux disease is indicated for patients who do not respond to tto. medical (H-2 blocker) with complications due to reflux or will not take the medication (inhibitors of proton pump), or who can not stop tto. medical (inhibitors of proton pump, H-2 blockers) without recurrence of symptoms. Tto costs. long term, the uncertainty of the consequences of tto. inhibitors with chronic proton pump, are also indications for surgery. Surgical treatment may be using the techniques reliza Hill, Belsey Nissen or Toupet. Fundoplication can be performed through open surgery or laparoscopy.

GERD

The surgery is best known Nissen fundoplication or modifications of this technique. The technique includes the mobilization and fondus fundoplication of the stomach around the ISS. As the pressure increases in the stomach, creating a pressure aumneto fundolicatura in closing the EEI, preventing reflux. The procedure is performed after the placement of a candle in the esophagus as a measure to prevent a too tight fundoplication. Fundoplication can be performed through open surgery or laparoscopy. The advantage of open surgery include the possibility palpation. Laparoscopy allows a clear view of the anatomical structure exist, less pain and faster recovery.

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