MedlinePlus Medical Encyclopedia

Hoarseness. Long-term use of antacids, however, can result in side effects, including diarrhea , altered calcium metabolism (a change in the way the body breaks down and uses calcium ), and buildup of magnesium in the body. Too much magnesium can be serious for patients with kidney disease If antacids are needed for more than 2 weeks, a doctor should be consulted. Any reflux is then relatively harmless as it consists of alginic acid and not damaging stomach acid. In most people with GERD, however, the esophageal sphincter does not seal tightly. It remains relaxed between swallows. This allows digestive juices to enter the esophagus and irritate the esophageal lining.

The lining of the stomach is specially adapted to protect it from the powerful acid, but the esophagus is not protected. Hiatal hernias contribute to reflux, although the way in which they contribute is not clear. A majority of patients with GERD have hiatal hernias, but many do not. Therefore, it is not necessary to have a hiatal hernia in order to have GERD. Moreover, many people have hiatal hernias but do not have GERD. It is not known for certain how or why hiatal hernias develop. Richter JE, Friedenberg FK. Gastroesophageal reflux disease. In: Feldman M, Friedman LS, Brandt LJ, eds. Sleisenger and Fordtran’s Gastrointestinal and Liver Disease. 10th ed. Philadelphia, PA: Elsevier Saunders; 2016:chap 44.

Clearly, we have much to learn about the relationship between acid reflux and esophageal damage, and about the processes (mechanisms) responsible for heartburn. This issue is of more than passing interest. Knowledge of the mechanisms that produce heartburn and esophageal damage raises the possibility of new treatments that would target processes other than acid reflux. Acid reflux occurs when there is acid backflow from the stomach into the esophagus This happens commonly but can cause complications or troublesome symptoms, such as heartburn.

Townsend CM Jr, et al. Gastroesophageal reflux disease and hiatal hernia. In: Sabiston Textbook of Surgery: The Biological Basis of Modern Surgical Practice. 19th ed. Philadelphia, Pa.: Saunders Elsevier; 2012. Accessed Jan. 17, 2017. One cause that is not preventable is a hiatal (or hiatus) hernia A hole in the diaphragm allows the upper part of the stomach to enter the chest cavity, sometimes leading to GERD. Most people can manage the discomfort of GERD with lifestyle changes and over-the-counter medications. But some people with GERD may need stronger medications or surgery to ease symptoms.

Lastly, pH testing can be used to evaluate patients prior to endoscopic or surgical treatment for GERD. As discussed above, some 20% of patients will have a decrease in their symptoms even though they don’t have GERD (the placebo effect). Prior to endoscopic or surgical treatment, it is important to identify these patients because they are not likely to benefit from the treatments. The pH study can be used to identify these hop over to this site patients because they will have normal amounts of acid reflux. Hiatal hernias usually do not require treatment. However, treatment may be necessary if the hernia is in danger of becoming strangulated (twisted in a way that cuts off blood supply) or is complicated by severe GERD or esophagitis ( inflammation of the esophagus). The doctor may perform surgery to reduce the size of the hernia or to prevent strangulation.

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