Archive for 2011

pH study for GERD

Esophageal pH studies are conducted to diagnose gastroesophageal reflux disease (GERD) and its accompanying symptoms such as heartburn, acid reflux, cough, sore throat, and hoarseness. This pH test measures the amount of acidity that is being refluxed (i.e. regurgitated or back washed) from the stomach into the esophagus. The test is also performed to measure the effectiveness of acid reflux medications as well as to find out if symptoms of chest pain are the result of gastroesophageal reflux disease (GERD).

How esophageal pH studies are done

In an esophageal pH study, a slim plastic catheter, sized about a sixteenth of an inch round, is inserted into a nostril, through the throat and then into the esophagus, as the individual swallows to move the thin tube along. The end of the catheter contains a sensor, which can sense acid. The sensor is situated just above the lower esophageal sphincter, which is the muscle that prevents acids from back washing up from the stomach.

The patients are then allowed to go home, but must keep the catheter in place for 24 hours. During this monitoring time, the patient is supposed to follow their normal routine. That is, they should eat when they normally do, eat what they typically eat and lie down when they generally lie down. The monitoring will be measuring the pH levels during all of these activities.

After 24 hours, the patient returns to their Dallas, Fort Worth clinic, where the catheter is removed. The data recorded on the monitor is downloaded to a computer, where the results can be viewed and evaluated.

New Method

A recent device used to monitor gastroesophageal reflux disease (GERD) through pH monitor is through a capsule. The capsule is attached to the esophageal lining by inserting it through the nose (or mouth) and down the throat, similar to the catheter method. Once the capsule is in place, the catheter is removed. This method provides more comfort, since there is no catheter in the back of the throat. The thought is that more people will perform their normal activities, whether it is eating or going to work, without the catheter in place. The capsule transmits data for two to three days, before the battery dies. Within a week’s time, the capsule will detach from the esophageal lining on its own, only to be passed in the stool.

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Upper endoscopy

An upper endoscopy is an exam often performed in a physician’s office or clinic or hospital setting as an outpatient procedure. This diagnostic exam can often determine the cause of heartburn or gastroesophageal reflux disease. A small camera is inserted into the esophagus and is directed through the upper digestive tract through the stomach to the duodenum. The dynamic or live action images relayed by the camera to a full size monitor can show the physician if you have ulcers, bleeding, abnormal growths or other abnormalities that may be causing gastroesophageal reflux disease symptoms.

Preparing for this short procedure is simple. Most patients are asked to restrain from eating for six to twelve hours prior to the exam to assure that the stomach is empty. This not only allows the clinician to see the structures of the digestive system more easily, but limits the digested food that could reflux into the esophagus during the procedure.

Most medicines, including those for heart disease, blood pressure and thyroid conditions can still be taken prior to the study, but it is recommended to use only a sip of water to get the pills down. Those taking medicine for diabetes, such as insulin, may be asked to adjust their dosage prior to the study.

Some people may have conditions such as rheumatic heart disease, artificial heart valves, allergies to medications or lung disorders that the doctor and medical staff should be notified of prior to having the procedure performed so that precautions may be taken to prevent complications.

After arriving at the clinic to have your procedure performed, a physician will explain what will be done and answer any questions you may have. You will be given a sedative and possibly a pain reliever or local anesthetic to relax you and prevent any pain during the exam. Once on the table you will also be fitted with a mouthpiece to assist in holding your mouth open. After lying on your left side the doctor will insert the endoscope in your mouth and down into your esophagus.

Before you know it, thirty minutes or so, the procedure will be completed and the doctor will have a good idea of what may be causing your gastroesophageal reflux disease. Following the procedure you will be recovered by licensed medical staff and advised on post procedure throat discomfort. You will need a driver to bring you home due to the pain relievers and anesthetics used during the procedure. If pain, nausea or abnormal chills or fever occur within seventy two hours of the procedure you should contact your physician or go to your local emergency room for treatment.

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Control Heartburn by Changing Your Habits

You may be surprised to find that more than 35% of Americans suffer from Gastroesophageal Reflux Disease (GERD). Statistics indicate that the risk of having GERD increases after the age of forty, but it can affect people of all ages.

In people with gastroesophageal reflux disease, stomach acids and digestive juices flow backward into the tube that leads from the throat to the stomach, called the esophagus. GERD occurs when the valve between the esophagus and stomach doesn’t close tightly, which allows the contents of the stomach to move backwards into the esophagus.

This causes irritation of the esophagus and many uncomfortable symptoms that can lead to complications including cancer if left untreated. The main complaint of GERD is heartburn, a burning sensation or pain located behind the breast bone. Other symptoms include sore throat, regurgitation or acid taste in the mouth, chronic cough, laryngitis, discomfort in the ears and nose, and even asthma like symptoms.

You can control GERD and the symptoms of heartburn by making a few changes in your habits. The first is to change the way you eat. Try eating several smaller meals instead of three large meals each day. Also try to avoid lying down for at least 3 hours after you eat and stay away from midnight snacks, spicy foods, coffee, chocolate and mint, which can make symptoms worse.

If you are overweight, losing just five to ten pounds can provide some relief. Also wearing clothing that is a little looser around your stomach may make you feel better. If you have symptoms at night, you can try raising the head of your bed by six to eight inches by using a wedge under your mattress and you should also try to avoid smoking or chewing tobacco, as this worsens the symptoms as well.

If the symptoms prevent you from continuing with your daily activities, you have noticeable sharp pain when you swallow or in your chest, or have repeated occurrences of heartburn, you should see a doctor in the Dallas, Fort Worth area immediately to ensure that you receive a correct diagnosis and treatment.

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Causes and Treatments of Reflux Laryngitis

Gastroesophageal Reflux Disease, or GERD, occurs when stomach contents move backwards up into the esophagus. Patients that are obese or have a hiatal hernia have an increased risk of GERD. In instances where the stomach acid backs up into the larynx, or voicebox, the condition is known as reflux laryngitis.

The most common symptom of reflux laryngitis is heartburn. Severe reflux laryngitis can also cause hoarseness and asthma. In other cases, the patient may feel as though they have something caught in their throat, which is referred to as globus phenomenon.

There are a number of medications, both over the counter and prescription that are used to treat gastroesophageal reflux disease including heartburn. These include acid-blocking drugs such as Pepcid, Tagmet, Axid and Zantac (rantidine). These classes of drugs are available without a doctor’s prescription and are known as H2-blockers. Protein pump inhibitors, such as Prilosec and Prevacid are also available without a prescription. Reglan is a prescription medication that is sometimes prescribed to help with stomach emptying.

In cases where medication therapy is ineffective, surgery may be advised. Surgery includes strengthening the lower esophageal sphincter (or muscular valve), which is known as the fundoplication procedure. Fundoplication can be performed either as a minimally invasive laparoscopic surgery or transorally. The transoral approach uses a procedure called TIF Esophyx and is performed through the mouth without abdominal incisions.

Heartburn and hoarseness are typically present in a diagnosis of reflux laryngitis. When conservative treatment or drug therapy are not effective, Dallas and Fort Worth patients may be advised to obtain certain diagnostic tests. These tests include espohagram, laryngoscopy, endoscopy and esophageal pH monitoring.

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Do Acid Reflux Drugs Carry Fracture Risk?

You may want to explore options other than medication to relieve your heartburn. While a certain class of drugs aimed at relieving gastroesophageal reflux disease may go a long way in reducing the acid produced in your stomach, they may also be harming your body’s ability to absorb bone supporting minerals.

PPI’s or proton pump inhibitors such a Nexium, Prevacid and Prilosec have been used for years to counter the effects of heartburn, but studies show that these drugs inhibit the absorption of calcium especially in those who have taken the prescription medications for a year or more. The FDA has confirmed these findings and adds that people taking a high dose of PPI’s are also at increased risk for fracture in the wrist, hips, and spine.

The general public has not been aware of these findings and the proliferation of these types of drugs on the market puts many at risk. For this reason the FDA is instructing PPI manufacturers to include fracture risk information on the labels of both prescription and over-the-counter versions of these drugs.

Heartburn occurs when the lower esophageal sphincter, a small flap located at the top of the stomach weakens and allows food and stomach acid to reflux into the esophagus.

Researchers suggest that some alternatives to PPI drugs may be altering your diet to include probiotics and vitamin D. Reduce foods that trigger heartburn such as sugars, processed foods and alcohol, and implementing an exercise regimen to improve your body’s immune system.

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PH Testing for Chronic Acid Reflux

Acid reflux disease, also known as GERD (gastroesophageal reflux disease) causes unpleasant to painful symptoms ranging from minor cough or chest pain to severe heartburn. If you suspect you are suffering from chronic acid reflux, and lifestyle changes or over-the-counter heartburn medications aren’t working for you, it is important to have a medical professional perform outpatient pH testing for GERD. This testing will determine the amount of stomach acid released into your esophagus (acid reflux) on a daily basis.

To complete the testing, you will be given a small probe to wear for 24 hours. The probe will extend from your nostril down into your esophagus, where acid reflux occurs and causes symptoms. The monitor will keep track of when you eat, lie down, and when symptoms otherwise occur. You will need to refrain from eating or drinking up to 6 hours before the test. In addition, your doctor or nurse can tell you which medications may affect test results and therefore are prohibited during testing. For accurate test results, stick to your normal daily routine and activities during the testing period; however, it is important to keep the monitor clean and dry. Be sure to ask any questions you may have and have any concerns addressed before the testing period begins.

When testing is complete, Dr. Ihde will analyze your results. You will then receive a diagnosis and further options for treatments to control your acid reflux disease or acid reflux symptoms.

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