Heartburn, Regurgitation, Dyspepsia, And More

Heartburn is a burning feeling in the chest caused by stomach acid travelling up towards the throat (acid reflux). PPIs are used when H2 antagonists do not relieve symptoms adequately or when complications of GERD such as erosions or ulcers, strictures, or Barrett’s esophagus exist. Five different PPIs are approved for the treatment of GERD, including omeprazole (Prilosec, Dexilant), lansoprazole ( Prevacid ), rabeprazole ( Aciphex ), pantoprazole ( Protonix ), and esomeprazole ( Nexium ), and dexlansoprazole (Dexilant). A sixth PPI product consists of a combination of omeprazole and sodium bicarbonate ( Zegerid ). PPIs (except for Zegarid) are best taken an hour before meals. The reason for this timing is that the PPIs work best when the stomach is most actively producing acid, which occurs after meals. If the PPI is taken before the meal, it is at peak levels in the body after the meal when the acid is being made.

When asked about the best medicine for acid reflux, we can only respond by saying that the goal is to use the least powerful drug taken as infrequently as possible to control these symptoms in a satisfactory way. PPIs, in particular, carry significant long-term side effects , so it is desirable to get off of them, if possible. There is nothing magical about taking a PPI once a day when your symptoms can be controlled with an H2 blocker or antacid taken when needed. In addition, many people are able to control their symptoms and either discontinue or dramatically reduce their drug requirement by making smart dietary and lifestyle modifications.

Gastroesophageal reflux disease, commonly referred to as GERD or acid reflux, is a condition in which the liquid content of the stomach regurgitates (backs up or refluxes) into the esophagus. The liquid can inflame and damage the lining (esophagitis) although visible signs of inflammation occur in a minority of patients. The regurgitated liquid usually contains acid and pepsin that are produced by the stomach. (Pepsin is an enzyme that begins you could try this out the digestion of proteins in the stomach.) The refluxed liquid also may contain bile that has backed-up into the stomach from the duodenum. The first part of the small intestine attached to the stomach. Acid is believed to be the most injurious component of the refluxed liquid. Pepsin and bile also may injure the esophagus, but their role in the production of esophageal inflammation and damage is not as clear as the role of acid.

Ulcers of the esophagus heal with the formation of scars (fibrosis). Over time, the scar tissue shrinks and narrows the lumen (inner cavity) of the esophagus. This scarred narrowing is called a stricture. Swallowed food may get stuck in the esophagus once the narrowing becomes severe enough (usually when it restricts the esophageal lumen to a diameter of one centimeter). This situation may necessitate endoscopic removal of the stuck food. Then, to prevent food from sticking, the narrowing must be stretched (widened). Moreover, to prevent a recurrence of the stricture, reflux also must be prevented.

Acid reflux, also known as gastroesophageal reflux (GER) is the backing up of stomach contents into the throat. It isn’t just an adult illness. Infants can experience it, too. An infant with GER will spit up frequently or vomit. If your infant has those symptoms plus irritability, feeding difficulties , inadequate weight gain, coughing, choking, or wheezing after feeding, it may be a sign of a more serious condition known as GERD (gastroesophageal reflux disease). GERD is a complication of GER. In infants, GER is much more common than GERD.

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