Heartburn is a burning feeling in the chest caused by stomach acid travelling up towards the throat (acid reflux). If you find a new, painful, tender, and irreducible lump, it’s possible you may have an irreducible hernia, and you should have it checked in an emergency setting. If you already have a hernia and it suddenly becomes painful, tender, and irreducible, you should also go to the emergency department. Strangulation more bonuses of intestine within the hernia sac can lead to gangrenous (dead) bowel in as little as six hours. Not all irreducible hernias are strangulated, but they need to be evaluated. Very recently, endoscopic techniques for the treatment of GERD have been developed and tested. One type of endoscopic treatment involves suturing (stitching) the area of the lower esophageal sphincter, which essentially tightens the sphincter.
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. These medications are generally safe and effective, but like any prescription drug, they are not appropriate for all people with reflux disease and can cause side effects. Your GP will often be able to diagnose gastro-oesophageal reflux disease (GORD) based on your symptoms. Capsule pH testing is expensive. Sometimes the capsule does not attach to the esophagus or falls off prematurely. For periods of time the receiver may not receive signals from the capsule, and some of the information about reflux of acid may be lost. Occasionally there is pain with swallowing after the capsule has been placed, and the capsule may need to be removed endoscopically. Use of the capsule is an exciting use of new technology although it has its own specific problems.
The stomach produces hydrochloric acid after a meal to aid in the digestion of food. People who have frequent acid reflux symptoms most often experience them at night. Nighttime GERD also produces the most pain. However, the level of pain does not always indicate the degree of damage to your esophagus. The burning, pressure, or pain of heartburn can last as long as 2 hours and is often worse after eating. Lying down or bending over can also result in heartburn. Many people obtain relief by standing upright or by taking an antacid that clears acid out of the esophagus.
One unresolved issue in GERD is the inconsistent relationships among acid reflux, heartburn, and damage to the lining of the esophagus (esophagitis and the complications). Symptoms of nausea, vomiting, and regurgitation may be due either to abnormal gastric emptying or GERD. An evaluation of gastric emptying, therefore, may be useful in identifying patients whose symptoms are due to abnormal emptying of the stomach rather than to GERD. It’s estimated that 1 in every 10-20 people with Barrett’s oesophagus will develop oesophageal cancer within 10-20 years.