- Acid Reflux Disease.
- Ulcer disease ("peptic ulcer") Includes H. Pylori.
Acid Reflux Disease GERD
What is GERD?
Gastroesophageal reflux disease refers to the abnormal frequency of acid from the stomach washing up the swallowing tube (esophagus) which can lead to the feeling of heartburn or burning in the throat.
With time this can lead to erosion (or wearing away) of the swallowing tube (esophageal) lining.
How common is it?
Very common and getting more common. An estimated 15 million Americans have chronic GERD. An estimated 7% of the adult population have heartburn daily.
What are GERD risk factors?
Age, over 40, being overweight and use of alcohol and coffee add to the risk of GERD.
How is GERD different than heartburn?
Just about everyone has heartburn occasionally especially with certain foods like pepperoni pizza or garlicky foods.
GERD refers to a disorder where this occurs with abnormal frequency of at least 3 times per week or where there are esophageal erosions.
One does not have to have esophageal erosions to have GERD.
What should I do if I think I have GERD?
Avoid overeating and avoid those foods you know aggravate the symptoms typically greasy foods, spicy foods and alcohol.
See your doctor or GI doctor.
In many cases special testing with EGD endoscopy (a flexible thin scope to look into the esophagus stomach under sedation) is appropriate. Also, other disorders can mimic GERD.
Such disorders include stomach ulcers, heart disease and others.
Accurate diagnosis is important.
Why can't I just take Tums, Zantac or Prilosec OTC?
Those medicines will work for GERD, but it is important if symptoms are chronic that you know what your diagnosis is and that a proper evaluation be done.
GERD is a chronic condition and getting things right the first time in terms of a treatment plan is important. Simple heartburn can have short term treatment. GERD with erosions in the esophagus usually requires long term maintenance.
Can GERD be cured?
GERD can be managed so that patients have few if any symptoms.
Weight loss and diet changes can reduce GERD. A true cure is less common.
Surgery is needed in rare cases.
The outlook for GERD patients is good with medical therapy.
Ulcer disease ("peptic ulcer") Includes H. Pylori
What are ulcers of the intestinal tract?
Ulcers are sore or breaks in the intestinal lining.
They can occurs in various places of the GI tract but most commonly when the word "ulcer" is used regarding the GI tract it refers to the stomach (the organ that holds food after it exits the swallowing tube) or the duodenum (the intestine just after the stomach).
What are ulcer symptoms?
Ulcer symptoms can vary. They can be pain which may be dull or burning usually in the upper abdomen. Nausea, loss of appetite can also occur. Rarely vomiting of blood or passing blood that is dark near black in the stool or dark red if ulcer is bleeding heavily which is uncommon.
Minor red blood on wiping after bowel movement or small amts of red blood on the stool are usually NOT from a stomach ulcer from other sources. There may be no symptoms.
What causes ulcers? Includes discussion of H pylori.
Ulcers can be caused by a variety of causes. Those causes include the stomach or intestine being sensitive to acid injury. Aspirin like medication known as NSAID medication, including aspirin, Anacin, Bufferin, ibuprofen, Motrin, Aleve and other arthritis meds.
Alcohol can sometimes cause ulcers in the stomach. It used to be thought that stress causes ulcer and it may play a role, but other factors likely play a bigger role. Smoking can aggravate ulcers. Since the late 1980s it has been shown that a bacteria H pylori that lives in the stomach in some person has a strong association with ulcers.
This is a chronic infection that is often acquired in childhood and it is difficult tell one has this infection without testing. Usually there are no symptoms and most people who have H pylori do not get ulcers. A combination of antibiotics and acid blockers called PPIs are used to treat H. Pylori. Choice of antibiotics is important to avoid bacterial resistance.
How are ulcers diagnosed?
Ulcer are diagnosed by taking a physician taking a history and doing certain exams such as endoscopy or X-rays. H pylori can be diagnosed by special testing of the breath, blood or by endoscopic exam with tissue sample of the stomach.
How are ulcers treated?
Mediation that block acid are common ulcer treatment such as Prilosec, Zantac and others. Antacids like Maalox or Mylanta were used in the past but less often now. H pylori if present is treated with a series of medications in addition to the ulcer treatment with acid blockers.
What should you do if you think you have an ulcer?
If you think you may have an ulcer, see your doctor or a gastroenterologist. Not all people who think they have an ulcer actually have one. Other illness can mimic ulcers. Emotional stress can aggravate ulcers but rarely causes them.