GERD (Gastro Esophageal Reflux Disease) seems to becoming more prevalent. It is sometimes referred to as ACID REFLUX Although GERD may be present in a good percentage of the population, the symptoms do not manifest typically. A typical presentation could be just a "heartburn" feeling. You may have nausea, chest discomfort, and even shortness of breath. Several people may actually feel as if they are having a heart attack. The population already diagnosed with angina may have similar symptoms of their angina attacks; a common presentation.
Many patients that present to the Emergency Department (ED) with these symptoms are actually “worked up” for several cardiac problems. This presents a challenge for the ED team as well as the paramedics [who are trained to treat it the same way]. If you come to the ED or even your primary care physician he may do the following:
EKG (electrocardiogram)
Cardiac Blood Work (Troponin and Myoglobin)
Complete Blood Count (CBC)
X-Ray (swallow studies, Computerized Topography [CT]
Medication Administration (Reglan, Zantac, Pepcid, Prilosec)
Endoscopy
Physicians use something called the differential diagnosis to confirm or deny the presence of GERD. The differential diagnosis is the detective work. This is kind of like a game of logic for them. They will take all of the information and exclude or include possible diagnosis. Unfortunately many of them will overlap (several similar symptoms) and will require a further “CLINCIAL CORRELATION” [Get more tests]. You need to put all of the results together in order to formulate a game plan.
The cause of GERD is very simple; you are refluxing (backward flow) your stomach contents (digestive components) into your esophagus. Although this is the ACID reflux there is also a NON-ACID reflux. The NON-ACID reflux is the contents in the stomach that are not acidified; such as bile. This occurs because of anatomical (structure) or functional abnormalities; like:
Lower esophageal sphincter relaxation
Hiatal hernia
Abnormal esophageal contractions
Slow emptying of the stomach
The discomfort comes from the presence of the acids in your stomach and the irritation to the nerve endings in the esophageal lining. The acids are primarily pepsin (from Pepsinogen) and hydrochloric acid. Continual irritation to the esophageal lining will cause erosion. This erosion is called an ULCER. The following may be signs and symptoms of GERD:
Heartburn
Hoarseness (from exposure above the Upper Esophageal Sphincter)
Chest tightness
Shortness of Breath (usually from chronic GERD)
This results from the nerve endings in the esophagus being so close to the lungs
Nausea
Bleeding (Hemoptysis or Hematemesis)
The unfortunate item, in adults, is that this condition will most likely not go away. It can be treated and monitored. There are long term complications of GERD. You can develop something called Barrett’s esophagus (a pre-cancerous scenario). The lining of the esophagus, once damaged, will result in the formation of scar tissue (fibrosis). The development of asthma or even complications of Chronic Obstructive Pulmonary Disease (COPD) may occur.
Treatment for GERD is usually occurs through the use of medications; Proton Pump Inhibitor, Acid Neutralizers, histamine antagonists, pro-motility drugs, form barriers and possibly surgery. A major treatment is a lifestyle change to include activities, foods to be avoided or promoted, natural remedies, and positional changes.
Many patients that present to the Emergency Department (ED) with these symptoms are actually “worked up” for several cardiac problems. This presents a challenge for the ED team as well as the paramedics [who are trained to treat it the same way]. If you come to the ED or even your primary care physician he may do the following:
EKG (electrocardiogram)
Cardiac Blood Work (Troponin and Myoglobin)
Complete Blood Count (CBC)
X-Ray (swallow studies, Computerized Topography [CT]
Medication Administration (Reglan, Zantac, Pepcid, Prilosec)
Endoscopy
Physicians use something called the differential diagnosis to confirm or deny the presence of GERD. The differential diagnosis is the detective work. This is kind of like a game of logic for them. They will take all of the information and exclude or include possible diagnosis. Unfortunately many of them will overlap (several similar symptoms) and will require a further “CLINCIAL CORRELATION” [Get more tests]. You need to put all of the results together in order to formulate a game plan.
The cause of GERD is very simple; you are refluxing (backward flow) your stomach contents (digestive components) into your esophagus. Although this is the ACID reflux there is also a NON-ACID reflux. The NON-ACID reflux is the contents in the stomach that are not acidified; such as bile. This occurs because of anatomical (structure) or functional abnormalities; like:
Lower esophageal sphincter relaxation
Hiatal hernia
Abnormal esophageal contractions
Slow emptying of the stomach
The discomfort comes from the presence of the acids in your stomach and the irritation to the nerve endings in the esophageal lining. The acids are primarily pepsin (from Pepsinogen) and hydrochloric acid. Continual irritation to the esophageal lining will cause erosion. This erosion is called an ULCER. The following may be signs and symptoms of GERD:
Heartburn
Hoarseness (from exposure above the Upper Esophageal Sphincter)
Chest tightness
Shortness of Breath (usually from chronic GERD)
This results from the nerve endings in the esophagus being so close to the lungs
Nausea
Bleeding (Hemoptysis or Hematemesis)
The unfortunate item, in adults, is that this condition will most likely not go away. It can be treated and monitored. There are long term complications of GERD. You can develop something called Barrett’s esophagus (a pre-cancerous scenario). The lining of the esophagus, once damaged, will result in the formation of scar tissue (fibrosis). The development of asthma or even complications of Chronic Obstructive Pulmonary Disease (COPD) may occur.
Treatment for GERD is usually occurs through the use of medications; Proton Pump Inhibitor, Acid Neutralizers, histamine antagonists, pro-motility drugs, form barriers and possibly surgery. A major treatment is a lifestyle change to include activities, foods to be avoided or promoted, natural remedies, and positional changes.
