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GERD

GERD. Lauren Dorsey Brown- Nutrition. What is GERD?. Stands for Gastroesophageal Reflux Disease Other “nicknames” include: acid reflux, acid regurgitation, acid indigestion or heartburn. When the acidic juices from the stomach rise up into the esophagus, it causes a burning sensation.

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GERD

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  1. GERD Lauren Dorsey Brown- Nutrition

  2. What is GERD? • Stands for Gastroesophageal Reflux Disease • Other “nicknames” include: • acid reflux, acid regurgitation, acid indigestion or heartburn. • When the acidic juices from the stomach rise up into the esophagus, it causes a burning sensation

  3. When the food rises back up into the esophagus, the burning sensation is felt near the heart, hence the feeling of “heartburn”.

  4. Symptoms • “Burning” feeling • A burning sensation that seems centralized in the area of the heart, lower esophagus, upper stomach, chest or throat • Excessive salvation • The body may increase salvia concentration to counteract the acid in the esophagus • Painful swallowing • Acid taste in the mouth • A strong bitter/sour taste in the back of the throat, sometimes even pieces of food can resurface • Bad breath • Dental erosion • The stomach acid is strong enough to begin the erosion of the tooth enamel

  5. Symptoms • Trouble swallowing • Dysphasia: feels like food is stuck in the throat, choking sensation, pressure and burning sensation in chest after eating • Nausea and vomiting • Chronic cough • Acid can reflux into the lungs, or just irritate the esophagus • Asthma

  6. Causes of GERD: LES • The lower esophageal sphincter (LES) is a muscular value that allows passage of nutrients from the esophagus to the stomach, and prevents the return of them back into the esophagus • Weak muscles surrounding the LES could result in weak closing pressure of the values • The process of Transient LES Relaxation (burping) could be uncoordinated • If peristalsis is impaired, stomach acid that has returned into the esophagus will not be pushed back into the stomach

  7. Causes of GERD: Impaired digestion • If there are not enough digestion enzymes or stomach acid, food will not be digested properly in the stomach • Production of these decrease with age, illness, food allergies or overuse of medications • Food that cannot be digested and passed out of the stomach will sit there and attempt to return back up the esophagus

  8. Causes of GERD: Hiatus Hernia • The upper portion of the stomach can protrude though the hole in the diaphragm (esophageal hiatus) meant only for the esophagus • Food can be entrapped in The enlarged section, and Upward passage can happen • Hiatal hernia can occur from an injury to the area or pressure in abdomen from coughing or even pregnancy and delivery • 32% of people over 50 years old • 89% of people over 90 years old

  9. Causes of GERD: Bacterial & Fungi • Helicobacter Pylori: Infects mucosal lining in esophagus, stomach, and intestines • 70-90% of all ulcers are caused by this bacteria • Symptoms of this bacterial infection could be bad breath, stomach pain, nausea and vomiting • 70% of people do not show symptoms, and a blood or stool test may need to be done.

  10. Candida: A type of yeast that found in the gastrointestinal system • The population of these microbes can grow due to an immune problem or antibiotics • Problems arise when the population increases

  11. Causes of GERD: diet and lifestyles • Eating foods that are chocolate, citrus, fatty or fried, garlic, mint, spicy, or tomato based foods such as chili or pizza • Eating a lot of food

  12. Eating fast or under stress • Not chewing thoroughly • Eating right before sleeping • Gravity cannot help the food Make its passage down to the stomach easily • Smoking • Pregnancy • Obesity • Pregnancy and obesity increase your risk for a hiatus hernia

  13. Treatment: medical • Antacids: Maalox, Mylanta, Rolaids and Tums • Neutralize stomach acid • Provide quick relief but do not heal the esophagus or the LES • H-2 receptor blockers: Pepcid AC, Zantac, Axid • Reduce acid production • Provide longer relief than antacids but don’t work as quickly • Also in prescription strength • Proton pump inhibitors: Prevacidand Prilosec • block acid production and heal the esophagus • Also in prescription strength • Prokinetic agents: Benzamide and Domperidone and more • medications that help the stomach empty faster, and help the LES close tighter

  14. Treatment: surgical • Nissen fundoplication: tightening the LES by wrapping the top of the stomach over the esophagus • laparoscopic surgery is used more and involves small incisions with small instruments and a camera

  15. Stretta Procedure • Electrode energy is used to heat the esophageal tissue • Creates scar tissue and damages nerves that respond to the acid reflux • Strengthens muscles around the LES and in the esophagus • EndoCinch endoluminal gastroplication • stiches are placed near the weakened LES and then strung together to create barriers to prevent acid from enter the esophagus

  16. Changes in your life to relieve heart burn • Eat meals 3 to 4 hours before going to bed • Eat smaller meals • Avoid being over weight • Limit the consumptions of fatty foods, chocolates, minty foods, spicy foods, coffee, cola, alcohol • Eat a high fiber diet • People with a high fiber diet are 20% less likely to have acid reflux symptoms • Quit smoking • Avoid tight clothes and belts which may cause pressure to the abdomen

  17. GERD untreated • The inflammation in the lining of the esophagus can cause ulcers and bleeding which is esophagitis • Scars from the tissue damage can lead to narrowing of the esophagus which can make is hard to swallow • Barrett’s esophagus • The cells in the lining of the esophagus changes shape and color • Can change to cancer—which is fatal when untreated

  18. Questions • What type of medicine neutralizes stomach acid and provides quick relief -Antacids 2. What is the Lower esophageal sphincter (LES)? -Valve that allows passage of nutrients from the esophagus to the stomach, and prevents the return of them back into the esophagus 3. People are 20% less likely to have GERD if they eat a diet high in _____? -Fiber

  19. References • "Reflux Defense: Natural GERD and Heartburn Relief." Reflux Defense: Natural GERD and Heartburn Relief. Web. 29 Feb. 2012. <http://refluxdefense.com/>. http://refluxdefense.com/heartburn_GERD_articles/introduction-causes-and-symptoms.html • “GERD." - Medpedia. Web. 01 Mar. 2012. <http://wiki.medpedia.com/Special%3GERD>. http://wiki.medpedia.com/Gastroesophageal_Reflux_Disease_(GERD) • "WebMD - Better Information. Better Health." WebMD. WebMD. Web. 01 Mar. 2012. <http://www.webmd.com/>. http://www.webmd.com/heartburn-gerd/heartbrun-and-gerd • Food Composition Table; McGraw-Hill 2009 • Contemporary Nutrition 8th Ed. Wardlaw & Smith, New York

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