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What is GERD Reflux Disease?

gerdAlmost everyone has had heartburn from time to time. It’s fairly uncomfortable, but usually goes away on its own after a while or faster with the help of over the counter acid reducing medication. The burning sensation in your chest can just about drive you crazy while it’s there though. Many people have even been known to rush to the emergency room, fearing they are having a heart attack, while suffering from the sometimes sharp pains of heartburn.

Now, imagine having that burning feeling every single day, maybe even all day, every day. That, my friends, could be GERD reflux disease, not just heartburn. GERD stands for Gastroesphageal Reflux Disease, and it occurs when the lower esophageal sphincter (LES), the ring of muscle between the esophagus and the stomach, is damaged or weak. The LES is basically the gate that closes the door to the stomach. If it doesn’t relax properly, stomach acid can travel past it and into the esophagus on a regular basis.

Symptoms for GERD vary, and not everyone will experience the disease the same way, but almost all will have trouble with heartburn. Other symptoms could include a persistent dry cough (usually at night), sore throat, hoarseness, laryngitis, feeling like there is a lump in the throat, earaches, bad breath, sudden increases in saliva, and nausea. Also, GERD can irritate the airways and cause asthma symptoms to worsen. Unfortunately, medication used to treat asthma can actually cause GERD to worsen as well. Children can also suffer with the disease and usually experience symptoms like coughing, reoccurring nausea and vomiting, and breathing problems.
Luckily, there are treatments available for GERD. Sometimes a lifestyle change is enough to dramatically reduce the symptoms, but in most cases, medication and a lifestyle change combine to give the best results. Those with severe weakening of the LES may need a fairly simple surgery to correct the problem. The important thing is that you don’t have to just live with it. See a reflux doctor in your area to get started with a treatment plan.

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If You Suffer From Reflux

If you suffer from reflux, despite taking medications, there is good news in the news!  Procedures for reflux have become refined over the years, and there is now reason to believe that a simple procedure can rid you of reflux disease.

Now, most of you are familiar with the symptoms of reflux, mainly the heartburn that you feel after a meal or drink.  In simple cases an over the counter antacid will immediately improve your symptoms.  But, as reflux gets worse, there are other signs and symptoms that you may not realize is reflux disease.  For instance, having food or fluid come up when you lean over to pick something up or when you lie down to rest.  Many people have throat and sinus symptoms such as hoarseness, sore throat, what feels like a lump or pressure in the throat and persistent mucus and sinus drainage.  A persistent cough or clearing of the throat may be reflux, and it’s estimated that up to 80% of adults with asthma have reflux induced asthma.

If antacids are not treating the problem adequately, or if your symptoms recur day after day, people look for stronger medicine.  The next line of treatment is what is called an H2 antagonist – like ranitidine, which is now an over the counter medicine.  This medicine reduces the acid production by about 60%.  The most powerful medications we have are called proton pump inhibitors.  You’ve seen TV ads about taking these pills.  They reduce acid production in the stomach by about 90%!  Very strong medicine indeed!

So if you have reduced the acid in the stomach so much, why do people still have symptoms?  Well, the first reason is that these medicines are designed to treat esophagitis, an irritation or erosion of the lining of the esophagus.  Normally, a valve between the esophagus and the stomach keeps acid and enzymes of digestion out.  Overeating, and foods that slow the stomach emptying can cause a full stomach to spill contents through the valve and injure the lining of the esophagus.  By reducing the acid content you allow these injuries to heal, because most of the time the esophagus is fairly well protected from the acid and enzymes in the stomach.  Typically 90% of cases are healed within 6 to 8 weeks.



So again, why do you still have to take medications?  Well, sometimes the valve deteriorates, allowing acid and enzymes to splash into the esophagus all the time.

In that case, even reducing acid by 90% still causes symptoms.  The fluid still has digestive enzymes, which injure the end of the esophagus, but can also move all the way up the esophagus to injure the throat, sinuses, and even the lung passageways.  Medicines can treat the acid, but they can’t fix a broken valve!  Up till now, surgery to repair the valve would be the next step.

So, in the past, surgery would use some of the stomach to recreate the valve, but over time we realized that patients were having good control of their reflux, but a lot of side effects to the surgery.  Bloating, gassiness, having difficulty swallowing….it’s like they traded one problem for another.  So the traditional surgery, called a “NIssen Fundoplication”, works well, but is reserved for only the worst cases of reflux.  This leaves a lot of patients with reflux symptoms despite being on the maximum medical treatment available.  What do they do?

Well, that’s the good news.  Since 2007, a new technique to recreate the natural valve has been gaining popularity in the United States.  It’s called “Transoral Incisionless Fundoplication” or TIF for short.  Like the Nissen, TIF controls reflux very well.  On average, 80% of patients control their symptoms without the use of daily medications.  Meaning they take no medication, but eat and drink like they did before they had reflux.  Also, in over 30 published studies, the incidence of the Nissen-type side effects has been practically zero!  Some patients even reduce the bloating and gassiness they had before surgery!

How does it work?  Well, a device is placed through the mouth and into the stomach.  It grabs the junction of the esophagus and stomach and folds the stomach back into place.  Then it places sutures to hold it in place until it heals.  When it heals, it becomes a permanent change.


How good does it work?  Recently, a head to head trial of medicine vs surgery showed that medicine controlled heartburn symptoms only 13% of the time, while TIF controlled heartburn 90% of the time.  Regurgitation was controlled by medicines 50% of the time, and TIF controlled regurgitation 97% of the time.  Atypical symptoms were eliminated 84 to 100% of the time with TIF.  Importantly, 100% of patients were daily acid medication before this study.  After TIF, only 8% were still on daily medication.  An amazing difference if you are tired of taking medications.

Finally, there is one more thing to consider.  Medicines are generally safe, but they have their own list of side effects.  We know that acid suppression in the stomach decreases the ability to absorb many important nutrients, especially iron, magnesium and calcium.  Calcium deficiency from chronic medicine use has been shown to increase fractures in



women.  Also, the acid helps defend against many bacteria, so the incidence of pneumonias and colon infection and diarrhea is higher with acid suppression.  There are studies

that indicate that acid medications increase the rate of heart attacks in susceptible patients, and interfere with the absorption of certain other medications
So if you are tired of reflux symptoms, or have symptoms of reflux and didn’t know it, get evaluated by an expert in TIF.  If you have been on medications for years, and are tired of taking them, now is a good time to look at this important new advance in reflux therapy.that patients may be on.



Glenn M. Ihde MD



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Common acid reflux drug could cause heart disease

By ANI | ANI – Sun 14 Jul, 2013

Washington, July 14 (ANI): A new study suggests that drugs that help millions of people cope with acid reflux may also cause cardiovascular disease.
It is the first time researchers have shown how proton pump inhibitors, or PPIs, might cause cardiovascular problems.

In human tissue and mouse models, the researchers from Houston Methodist Hospital found PPIs caused the constriction of blood vessels.
If taken regularly, PPIs could lead to a variety of cardiovascular problems over time, including hypertension and a weakened heart.
In the paper, the scientists call for a broad, large-scale study to determine whether PPIs are dangerous.

“The surprising effect that PPIs may impair vascular health needs further investigation,” John Cooke, M.D., Ph.D., the study’s principal investigator, said.
“Our work is consistent with previous reports that PPIs may increase the risk of a second heart attack in people that have been hospitalized with an acute coronary syndrome.
“Patients taking PPIs may wish to speak to their doctors about switching to another drug to protect their stomachs, if they are at risk for a heart attack,” he said.
The study is published in the journal Circulation. (ANI)


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Pregnant with Heartburn

Avoiding acid reflux and heartburn in Dallas during pregnancy

Heartburn bothers millions of people every year, but for many women the burning and indigestion doesn’t strike until pregnancy. For women who have already struggled with gastroesophageal reflux disease (GERD), pregnancy is often marked by increased discomfort from the already problematic symptoms of heartburn and acid reflux.

Unfortunately, pregnancy is a time when treatments like reflux surgery aren’t always an option. Still, even during pregnancy your GERD surgeon can help you develop strategies to reduce the experience of heartburn and improve your health.



Why So Much Heartburn during Pregnancy?

There are a few reasons why so many women experience severe heartburn while pregnant. The first is often the most obvious: excess weight.

A growing child means a growing uterus, which crowds out the stomach and adds pressure to the organ. During this time the waistline generally is growing too, adding further weight and pressure to the internal organs, namely the stomach, esophagus and lower esophageal sphincter (LES). Unfortunately, this pressure and constant exposure to stomach acid during pregnancy can lead some women to develop permanent damage to the esophagus and LES, which means that even after the baby is born, the frequent heartburn might not go away.

Other reasons associated with the development of heartburn during pregnancy include dietary changes and hormone fluctuations. Pregnancy hormones are recognized to relax the LES, which permits digestive juices to travel freely into the esophagus. Most women start experiencing heartburn during their second trimester of pregnancy.

Treating Heartburn during Pregnancy

Treatment options for heartburn are limited during pregnancy, but your GERD surgeon can still help you develop strong strategies to reduce heartburn.

Here are a few lifestyle changes that can help treat your heartburn during pregnancy:

  • Resist eating spicy and overly fatty foods
  • Chew food thoroughly and eat slowly
  • Wear loose fitting clothing
  • Eat at least two hours prior to lying down for bed
  • Sleep with your head elevated
  • Try walking briefly after a large meal

After following months of lifestyle changes and physician-approved home remedies, many women are able to safely undergo reflux surgery once their child is born to correct any permanent damage to the esophagus or LES that may have developed during the pregnancy.

Your GERD surgeon will provide you with some helpful strategies to reduce heartburn as much as possible. Here are a few suggestions you may discuss with your doctor:

  • Eating habits: Controlling your diet is difficult while pregnant, but eating right is essential for the health of you and your child. Do your best to refrain from cravings and have healthy, heartburn-friendly foods at hand to snack on.
  • Over the counter medications: Do not take any over the counter medications without the supervision of your GERD surgeon and obstetrician while you are pregnant. Certain over-the-counter medications could be harmful to your child’s development. Your physician will give you detailed instructions on what medications can potentially ease your heartburn.

For more advice about coping with GERD while pregnant contact your heartburn specialist.

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Try Tai Chi, Stay Reflux-Free

Try Tai Chi Before or After Reflux Surgery in DallasStress may be a fact of life, but it can be a pain for those who suffer from acid reflux. By making your esophagus more sensitive to acid backwash, stress can cause heartburn symptoms to worsen, sparking a cycle of acid reflux and anxiety that makes every day more difficult.

Though reflux surgery can provide a permanent solution to acid reflux, reducing stress before your procedure can be an asset in keeping symptoms under control. Even after reflux surgery, stress management techniques can help you quell anxieties and face each day with greater calm.

Progressive muscle relaxation is one useful activity, but fleshing out your stress management system with a variety of relaxing strategies will be even more beneficial. Tai chi is an ancient practice that can help you reduce stress with meditative movements and a focus on your breathing.

Meditation in Motion

Tai chi originated in ancient China and has since developed worldwide popularity largely due to its accessible nature. Tai chi is unlikely to spark acid reflux and is known as an activity that nearly anyone can do—it is often recommended for the elderly, patients recovering from surgery and even those confined to wheelchairs.

The movements of tai chi are slow and deliberate, flowing together without ever fully extending the joints or tensing the muscles. Focus is placed on breathing deeply, giving the practice a meditative and calming effect that can be powerful in reducing stress. As an added bonus, these gentle movements can help you build strength, balance and flexibility.

Getting Started with Tai Chi

Because tai chi is so low-impact, it is generally a safe choice both before and after reflux surgery. Still, it will be wise to speak with Dr. Ihde before trying tai chi to ensure that it is a healthy activity for you.

Once your GERD surgeon gives you the go-ahead, your first step should be taking a class. Though tai chi is highly accessible to beginners, its language and concepts can be intimidating to the uninitiated. A good instructor can help you get the basics down and answer any questions you have about the activity. You should also give tai chi a chance to prove its value—you may not notice any dramatic benefits until you’ve practiced the activity for several weeks, so give yourself some time to master it.

Has tai chi helped you control stress before or after reflux surgery? Tell us about your experiences with tai chi in the comments below!

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Rearrange Your Residence for Reflux Relief

Rearrange Your Residence before Reflux Surgery in DallasEach of our decisions is influenced by the world around us. Whether you realize it or not, your environment can have a strong impact on your behavior, especially when it comes to your diet and exercise habits. Because of this, surrounding yourself with a healthy environment can be a big help in controlling GERD and symptoms like acid reflux, and nowhere is this more possible than in your own home.

Though your GERD surgeon can help you put an end to your symptoms for good with reflux surgery, reassessing your household can be a tremendous help in staying pain-free in the meantime. To turn your home into a reflux-free place to be, start by:

Clearing Out Your Triggers

If you suffer from GERD, you’ve probably already identified many foods that spark your symptoms, but many common reflux triggers are staples of the American diet. Cheese, ice cream and other high-fat dairy products; soda, coffee and alcohol; chocolate, mint and citrus; tomatoes, peppers and onions—if these foods and others cause you problems, then they have no place in your kitchen, so get rid of them before you accidentally indulge.

Sort through every cabinet, drawer and shelf. Go through your fridge, pantry and freezer. Anything that may prompt your symptoms will be better off far away from you. Of course, your reflux triggers may also be favorite treats of other people who reside in your home, so if your spouse, roommate or children object to the removal of these items, simply ask that they be kept somewhere far from your view.

Making Healthy Habits Easier

Once all your triggers are gone, you can start filling your kitchen with foods that put you at no risk of reflux. Ask Dr. Ihde which foods will be best for your diet and make them easily accessible. Good choices may include high-fiber whole grains, low-acid fruits, fresh vegetables and low-fat proteins, while common reflux remedies like ginger, aloe vera and Tums may also be worth keeping around. Keep the best foods front and center in your fridge and pantry to make them the first things grabbed when you need a snack.

Exercise is also valuable in addressing GERD, but heavy weight lifting, abdominal exercises and high impact activities like running can trigger or worsen acid reflux for many people. You can arrange your home to make it easier to participate in gentle exercises with little risk of sparking GERD symptoms. Do your best to learn which activities are most likely to cause you acid reflux and consider investing in fitness DVDs and light resistance gear that help you stay active without the pain of heartburn.

There are many ways to help yourself avoid reflux at home, but reflux surgery is the only way to permanently rid yourself of symptoms. For more strategies on avoiding acid reflux and heartburn, talk to your GERD surgeon.

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Quick Solutions for Stress-Related Reflux

Reduce stress before reflux surgery with these quick tipsThough exercise and techniques like progressive muscle relaxation can help you keep stress at bay long-term, you won’t always have time for them in the midst of a hectic day. When stress threatens to spark your GERD symptoms at work, you may need to find another way to ease your anxieties quickly without even standing up from your desk.

Fortunately, there are as many ways to control stress as there are stressors. Whether you’re working with your GERD surgeon to control acid reflux or are preparing for reflux surgery, there are many ways to find fast-acting relief from stress-related reflux.


The next time you’re feeling overwhelmed by anxiety, calm down in a jiffy by:

  • Imagining a more peaceful place. If your current surroundings are stressing you out, take a few moments to picture yourself doing something more tranquil. Envision yourself kicking back on the beach of a desert island, taking a stroll through your favorite park, living it up in your dream house or cuddled in a cozy blanket by a roaring fire. Think through your fantasy in as much detail as time will allow, giving your mind a chance to settle into the comfort of your visualization.
  • Listening to some mood music. Music can relax us like few other things, but only if it’s the right music—death metal is probably not going to help you calm down. Though the soothing power of classical music has been documented by research, listening to any slow, gentle song can help you control your heart rate and unwind.
  • Changing your attitude. A pessimistic attitude can make stress far worse. Instead of worrying incessantly about your situation, it will help to find the good in your circumstances. A positive outlook will make any situation easier to cope with, but it can also slow your heart rate and reduce the tension in your muscles. If you’re having trouble staying optimistic, think of anything that brings a smile to your face—focusing your attention on your spouse, your dog or a party you’re planning can be a big help in feeling less stressed.

Tips like these can help you reduce stress quickly, but they may not always be enough. Remember: if stress and acid reflux are consistently disrupting your days, it may be best to speak with your GERD surgeon about a permanent solution with reflux surgery.

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Iberogast and Heartburn: Understanding Supplements

Iberogast and Heartburn: Understanding SupplementsUsing natural supplements to ease the pain of heartburn and acid reflux without the direct supervision of your GERD surgeon can be dangerous. Because supplements are not regulated by the FDA it is difficult to ensure what is in a product when you are taking it, and by using it you are exposing yourself to an increased risk of unfortunate side effects and even worsening the symptoms you are trying to resolve.

The best thing that you can do to overcome the incessant heartburn and acid reflux of gastroesophageal reflux disease (GERD) is to talk with your doctor about reflux surgery. However, with all the talk of supplements that provide reflux relief, it is best to know what is what when it comes to treating heartburn naturally.

What is Iberogast?

The majority of the research on treating heartburn with natural supplements has revolved around Iberogast. This is actually a concoction of nutrients that is associated with improvements in many different gastrointestinal concerns, including heartburn and acid reflux.

Exactly what is in Iberogast depends on who you get it from. The blend often includes the following herbs and nutrients:

  • Caraway seed
  • Clown’s mustard plant
  • Angelica
  • Chamomile
  • Celandine
  • Licorice
  • Lemon balm
  • Peppermint
  • Milk thistle

How much of each and which of these nutrients is in any given dosage of Iberogast is impossible to say, as the product is not regulated by the FDA. Unfortunately, some of the items generally added to Iberogast can cause heartburn and acid reflux to worsen when introduced on their own, leaving the possibility for Iberogast to actually exacerbate—not alleviate—your GERD symptoms.

Iberogast is the most commonly used supplement blend for acid reflux. There are hundreds of other natural remedies that are said to alleviate heartburn, but none have shown any substantial evidence of actually doing just that. Certain environmental and lifestyle changes can naturally decrease the severity of your heartburn, like drinking more water, eating less, eating slower, quitting smoking and avoiding spicy, fattening and carbonated foods and drinks.

The bottom line is that natural supplements can sometimes help alleviate heartburn and acid reflux symptoms, but they never work as a substitute for medical treatment and can cause more harm than good if used unsupervised. Talk with your GERD surgeon before turning to any natural supplements, including Iberogast.

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What Do You Mean It’s Heartburn?

Think you know all there is to know about acid reflux and heartburn in Ft. Worth and Dallas?

What do you mean it’s heartburn?

Heartburn: it is that lingering sensation in the back of your chest that something is burning. As stomach acid escapes into your esophagus your esophageal lining becomes irritated, inflamed and generally unhappy. The result is a couple of hours of pure misery for you, often accompanied by regurgitation and indigestion.

So that’s all there is to know about heartburn right? Wrong. While heartburn strikes the majority of people in the same unhappy ways following an oversized or overly spiced meal, there are a handful of other symptoms that don’t get nearly as much attention as standard acid reflux. In fact, there are many people in Dallas and Ft. Worth with heartburn who don’t even realize it; remaining completely unaware of the source of the symptoms causing them such misery.

Think your sore esophagus is all there is to it? Think again. Here are a few lesser-known symptoms that are associated with heartburn and acid reflux in Ft. Worth and Dallas:

  • Bad taste in your mouth. Your meal went down tasting great, but the aftertaste is just the pits. And come to think of it, this is the aftertaste you got after breakfast too—and dinner last night. That isn’t a coincidence; that is acid reflux. A bitter taste in your mouth after eating is a common sign of stomach acid making it into your throat.
  • Lost voice. Hoarseness of voice often develops when stomach acid refluxes out of the esophagus and into the larynx, or voice box. The hoarseness may develop quickly after eating a large meal, or could linger and become chronic if you are experiencing frequent heartburn.
  • Sore throat. Maybe the stomach acid isn’t causing too much of a burning in your chest, but if the stomach acid reaches your throat it could cause this common flu like symptom. If your sore throat commonly develops after eating and comes back frequently it could be due to acid reflux.
  • Respiratory problems. Chronic coughing, trouble breathing and wheezing are all common signs of acid reflux. If the stomach acid reaches the lungs then these problems often occur, and can grow severe if left untreated.

These problems will most commonly develop in conjunction with the typical signs of acid reflux, though they can sometimes develop in lieu of the general signs of the disease. If you are experiencing a collection of these symptoms and think they may be related to acid reflux, then contact your GERD surgeon for more information about treatment options.

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