Gastroesophageal reflux disease is a chronic disorder that involves weakness and inappropriate relaxation of the lower esophageal sphincter allowing the contents of the stomach to flow up into the esophagus.
Gastroesophageal reflux disease is a chronic disorder that involves weakness and inappropriate relaxation of the lower esophageal sphincter allowing the contents of the stomach to flow up into the esophagus.
GERD is most common gastric problem in community affecting large number of people. Diagnosis and management is very simple with understanding.
http://www.youtube.com/c/DrDhavalMangukiyaGastrosurgeonSurat
https://gastrosurgerysurat.blogspot.com/
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This presentation is to help readers to be equipped with knowledge on predisposing factor to peptic ulcer disease and how it can be managed in the clinical/hospital setup.
GERD is most common gastric problem in community affecting large number of people. Diagnosis and management is very simple with understanding.
http://www.youtube.com/c/DrDhavalMangukiyaGastrosurgeonSurat
https://gastrosurgerysurat.blogspot.com/
https://drdhavalmangukiya.com/
This presentation is to help readers to be equipped with knowledge on predisposing factor to peptic ulcer disease and how it can be managed in the clinical/hospital setup.
Acid Reflux -Cause Remedy Cure https://bit.ly/3H92t5i Every day, the digestive system is always being used due to regular food and liquid intake. When food and drinks are induced, it goes through a passage called the esophagus that helps breakdown the food. When food reaches its destination or the stomach, acid and pepsin is released to help aid in the process of digestion.
If and ever a problem in the digestive system occur, many people often neglect these possible problem by using home remedial treatment to aid with digestive problems. However, a common digestive disease that most people have neglected and encountered is the acid reflux or heartburn. This digestive disease or disorder occurs when the esophagus is irritated by the acid regurgitating to the stomach while acid is being seeped back through the esophagus and throat.
There are different kinds of digestive disease but the most common of all is acid reflux or gastro- esophageal reflux disease known also as heartburn. There are symptoms to indicate if you have acid reflux. These symptoms will likely help an individual indicate whether they have acid reflux. T
he most common symptoms that acid reflux is associated with is the searing sensation in the digestive tract, usually the chest or throat, that individuals will encounter. Even symptoms of hoarseness, acid in the mouth, sour or bitter taste, wheezing and coughing are also symptoms of acid reflux.
Gastroesophageal reflux disease (GERD) happens when a muscle at the end of your esophagus does not close properly. This allows stomach contents to leak back, or reflux, into the esophagus and irritate it.
You may feel a burning in the chest or throat called heartburn. Sometimes, you can taste stomach fluid in the back of the mouth. This is acid indigestion. If you have these symptoms more than twice a week, you may have GERD.
Anyone, including infants and children, can have GERD. If not treated, it can lead to more serious health problems. In some cases, you might need medicines or surgery. However, many people can improve their symptoms by:
-- Avoiding alcohol and spicy, fatty or acidic foods that trigger heartburn
-- Eating smaller meals
-- Not eating close to bedtime
-- Losing weight if needed
-- Wearing loose-fitting clothes
Global Medical Cures™ | Indigestion
DISCLAIMER-
Global Medical Cures™ does not offer any medical advice, diagnosis, treatment or recommendations. Only your healthcare provider/physician can offer you information and recommendations for you to decide about your healthcare choices.
Intestinal obstruction is blockage of the intestine with help of a foreign body or any other causes like cancer it will obstruct the intestine. signs and symptoms of obstruction nausea, vomiting, pain, and etc.managemt like medical ad surgical are there. see any infection in the ostomy .advice life eat a bland diet, change the pouch, avoid smell food like cabbage, etc, eat as chew and eat should bd advised
Global Medical Cures™ | Gastroesphageal Reflux in Infants
DISCLAIMER-
Global Medical Cures™ does not offer any medical advice, diagnosis, treatment or recommendations. Only your healthcare provider/physician can offer you information and recommendations for you to decide about your healthcare choices.
GERD | Gastro esophageal reflux disease-a brief medical study martinshaji
Gastro esophageal reflux disease (GERD) is a chronic digestive disease. GERD occurs when stomach acid or, occasionally, stomach content, flows back into your food pipe (esophagus). The backwash (reflux) irritates the lining of your esophagus and causes GERD. This is a very common condition observed
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Has food become your enemy? Here's a natural remedy you should try for fast relief of acid indigestion. Since our acid indigestion relief is all natural and drug-free, it is safe for pregnant women.
Gastroparesis is a condition in which a human stomach cannot empty itself of food in a normal manner. Gastroparesis disorder is also known as delayed gastric emptying.
GERD Symptoms Causes, Treatment, and How to Manage Them.pptxMediEND
GERD, or gastroesophageal reflux disease, is a common digestive disorder that affects millions of people worldwide. It can have a significant impact on daily life, causing discomfort and disrupting daily activities. This presentation aims to provide valuable information on the causes, treatment, and management of GERD symptoms. By understanding the symptoms and triggers of GERD, you can take steps to manage and prevent them, leading to a better quality of life. Whether you have been recently diagnosed with GERD or are experiencing occasional heartburn, this Presentation will provide you with the essential knowledge to take control of your symptoms. Let's dive in.
Gasto Symptoms is your health guide to GI related issues: colonoscopy screening, abdominal pain, heartburn, acid reflux, and other gastrointestinal symptoms
Acidity is said to have occurred when a person suffers from heartburn, and also when formation of gas takes place in the stomach. It is a common problem which many suffer from, and occurs mainly due to excess secretion of hydrochloric acid in the stomach. To know more about Acidity visit here: www.lazoi.com
Is It Bloating or Something More Serious? When to See a Doctor- Dr. Vikrant KaleDr. Kale's Gastro Clinic
Feeling bloated? While occasional bloating is common, persistent or severe bloating can be a sign of an underlying medical condition. Learn from Dr. Vikrant Kale, a leading gastroenterologist, when to seek medical attention for your bloating and how to manage this digestive issue effectively.
Report Back from SGO 2024: What’s the Latest in Cervical Cancer?bkling
Are you curious about what’s new in cervical cancer research or unsure what the findings mean? Join Dr. Emily Ko, a gynecologic oncologist at Penn Medicine, to learn about the latest updates from the Society of Gynecologic Oncology (SGO) 2024 Annual Meeting on Women’s Cancer. Dr. Ko will discuss what the research presented at the conference means for you and answer your questions about the new developments.
Title: Sense of Smell
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the primary categories of smells and the concept of odor blindness.
Explain the structure and location of the olfactory membrane and mucosa, including the types and roles of cells involved in olfaction.
Describe the pathway and mechanisms of olfactory signal transmission from the olfactory receptors to the brain.
Illustrate the biochemical cascade triggered by odorant binding to olfactory receptors, including the role of G-proteins and second messengers in generating an action potential.
Identify different types of olfactory disorders such as anosmia, hyposmia, hyperosmia, and dysosmia, including their potential causes.
Key Topics:
Olfactory Genes:
3% of the human genome accounts for olfactory genes.
400 genes for odorant receptors.
Olfactory Membrane:
Located in the superior part of the nasal cavity.
Medially: Folds downward along the superior septum.
Laterally: Folds over the superior turbinate and upper surface of the middle turbinate.
Total surface area: 5-10 square centimeters.
Olfactory Mucosa:
Olfactory Cells: Bipolar nerve cells derived from the CNS (100 million), with 4-25 olfactory cilia per cell.
Sustentacular Cells: Produce mucus and maintain ionic and molecular environment.
Basal Cells: Replace worn-out olfactory cells with an average lifespan of 1-2 months.
Bowman’s Gland: Secretes mucus.
Stimulation of Olfactory Cells:
Odorant dissolves in mucus and attaches to receptors on olfactory cilia.
Involves a cascade effect through G-proteins and second messengers, leading to depolarization and action potential generation in the olfactory nerve.
Quality of a Good Odorant:
Small (3-20 Carbon atoms), volatile, water-soluble, and lipid-soluble.
Facilitated by odorant-binding proteins in mucus.
Membrane Potential and Action Potential:
Resting membrane potential: -55mV.
Action potential frequency in the olfactory nerve increases with odorant strength.
Adaptation Towards the Sense of Smell:
Rapid adaptation within the first second, with further slow adaptation.
Psychological adaptation greater than receptor adaptation, involving feedback inhibition from the central nervous system.
Primary Sensations of Smell:
Camphoraceous, Musky, Floral, Pepperminty, Ethereal, Pungent, Putrid.
Odor Detection Threshold:
Examples: Hydrogen sulfide (0.0005 ppm), Methyl-mercaptan (0.002 ppm).
Some toxic substances are odorless at lethal concentrations.
Characteristics of Smell:
Odor blindness for single substances due to lack of appropriate receptor protein.
Behavioral and emotional influences of smell.
Transmission of Olfactory Signals:
From olfactory cells to glomeruli in the olfactory bulb, involving lateral inhibition.
Primitive, less old, and new olfactory systems with different path
Lung Cancer: Artificial Intelligence, Synergetics, Complex System Analysis, S...Oleg Kshivets
RESULTS: Overall life span (LS) was 2252.1±1742.5 days and cumulative 5-year survival (5YS) reached 73.2%, 10 years – 64.8%, 20 years – 42.5%. 513 LCP lived more than 5 years (LS=3124.6±1525.6 days), 148 LCP – more than 10 years (LS=5054.4±1504.1 days).199 LCP died because of LC (LS=562.7±374.5 days). 5YS of LCP after bi/lobectomies was significantly superior in comparison with LCP after pneumonectomies (78.1% vs.63.7%, P=0.00001 by log-rank test). AT significantly improved 5YS (66.3% vs. 34.8%) (P=0.00000 by log-rank test) only for LCP with N1-2. Cox modeling displayed that 5YS of LCP significantly depended on: phase transition (PT) early-invasive LC in terms of synergetics, PT N0—N12, cell ratio factors (ratio between cancer cells- CC and blood cells subpopulations), G1-3, histology, glucose, AT, blood cell circuit, prothrombin index, heparin tolerance, recalcification time (P=0.000-0.038). Neural networks, genetic algorithm selection and bootstrap simulation revealed relationships between 5YS and PT early-invasive LC (rank=1), PT N0—N12 (rank=2), thrombocytes/CC (3), erythrocytes/CC (4), eosinophils/CC (5), healthy cells/CC (6), lymphocytes/CC (7), segmented neutrophils/CC (8), stick neutrophils/CC (9), monocytes/CC (10); leucocytes/CC (11). Correct prediction of 5YS was 100% by neural networks computing (area under ROC curve=1.0; error=0.0).
CONCLUSIONS: 5YS of LCP after radical procedures significantly depended on: 1) PT early-invasive cancer; 2) PT N0--N12; 3) cell ratio factors; 4) blood cell circuit; 5) biochemical factors; 6) hemostasis system; 7) AT; 8) LC characteristics; 9) LC cell dynamics; 10) surgery type: lobectomy/pneumonectomy; 11) anthropometric data. Optimal diagnosis and treatment strategies for LC are: 1) screening and early detection of LC; 2) availability of experienced thoracic surgeons because of complexity of radical procedures; 3) aggressive en block surgery and adequate lymph node dissection for completeness; 4) precise prediction; 5) adjuvant chemoimmunoradiotherapy for LCP with unfavorable prognosis.
The prostate is an exocrine gland of the male mammalian reproductive system
It is a walnut-sized gland that forms part of the male reproductive system and is located in front of the rectum and just below the urinary bladder
Function is to store and secrete a clear, slightly alkaline fluid that constitutes 10-30% of the volume of the seminal fluid that along with the spermatozoa, constitutes semen
A healthy human prostate measures (4cm-vertical, by 3cm-horizontal, 2cm ant-post ).
It surrounds the urethra just below the urinary bladder. It has anterior, median, posterior and two lateral lobes
It’s work is regulated by androgens which are responsible for male sex characteristics
Generalised disease of the prostate due to hormonal derangement which leads to non malignant enlargement of the gland (increase in the number of epithelial cells and stromal tissue)to cause compression of the urethra leading to symptoms (LUTS
263778731218 Abortion Clinic /Pills In Harare ,sisternakatoto
263778731218 Abortion Clinic /Pills In Harare ,ABORTION WOMEN’S CLINIC +27730423979 IN women clinic we believe that every woman should be able to make choices in her pregnancy. Our job is to provide compassionate care, safety,affordable and confidential services. That’s why we have won the trust from all generations of women all over the world. we use non surgical method(Abortion pills) to terminate…Dr.LISA +27730423979women Clinic is committed to providing the highest quality of obstetrical and gynecological care to women of all ages. Our dedicated staff aim to treat each patient and her health concerns with compassion and respect.Our dedicated group ABORTION WOMEN’S CLINIC +27730423979 IN women clinic we believe that every woman should be able to make choices in her pregnancy. Our job is to provide compassionate care, safety,affordable and confidential services. That’s why we have won the trust from all generations of women all over the world. we use non surgical method(Abortion pills) to terminate…Dr.LISA +27730423979women Clinic is committed to providing the highest quality of obstetrical and gynecological care to women of all ages. Our dedicated staff aim to treat each patient and her health concerns with compassion and respect.Our dedicated group of receptionists, nurses, and physicians have worked together as a teamof receptionists, nurses, and physicians have worked together as a team wwww.lisywomensclinic.co.za/
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Ve...kevinkariuki227
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
Acute scrotum is a general term referring to an emergency condition affecting the contents or the wall of the scrotum.
There are a number of conditions that present acutely, predominantly with pain and/or swelling
A careful and detailed history and examination, and in some cases, investigations allow differentiation between these diagnoses. A prompt diagnosis is essential as the patient may require urgent surgical intervention
Testicular torsion refers to twisting of the spermatic cord, causing ischaemia of the testicle.
Testicular torsion results from inadequate fixation of the testis to the tunica vaginalis producing ischemia from reduced arterial inflow and venous outflow obstruction.
The prevalence of testicular torsion in adult patients hospitalized with acute scrotal pain is approximately 25 to 50 percent
Knee anatomy and clinical tests 2024.pdfvimalpl1234
This includes all relevant anatomy and clinical tests compiled from standard textbooks, Campbell,netter etc..It is comprehensive and best suited for orthopaedicians and orthopaedic residents.
Tom Selleck Health: A Comprehensive Look at the Iconic Actor’s Wellness Journeygreendigital
Tom Selleck, an enduring figure in Hollywood. has captivated audiences for decades with his rugged charm, iconic moustache. and memorable roles in television and film. From his breakout role as Thomas Magnum in Magnum P.I. to his current portrayal of Frank Reagan in Blue Bloods. Selleck's career has spanned over 50 years. But beyond his professional achievements. fans have often been curious about Tom Selleck Health. especially as he has aged in the public eye.
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Introduction
Many have been interested in Tom Selleck health. not only because of his enduring presence on screen but also because of the challenges. and lifestyle choices he has faced and made over the years. This article delves into the various aspects of Tom Selleck health. exploring his fitness regimen, diet, mental health. and the challenges he has encountered as he ages. We'll look at how he maintains his well-being. the health issues he has faced, and his approach to ageing .
Early Life and Career
Childhood and Athletic Beginnings
Tom Selleck was born on January 29, 1945, in Detroit, Michigan, and grew up in Sherman Oaks, California. From an early age, he was involved in sports, particularly basketball. which played a significant role in his physical development. His athletic pursuits continued into college. where he attended the University of Southern California (USC) on a basketball scholarship. This early involvement in sports laid a strong foundation for his physical health and disciplined lifestyle.
Transition to Acting
Selleck's transition from an athlete to an actor came with its physical demands. His first significant role in "Magnum P.I." required him to perform various stunts and maintain a fit appearance. This role, which he played from 1980 to 1988. necessitated a rigorous fitness routine to meet the show's demands. setting the stage for his long-term commitment to health and wellness.
Fitness Regimen
Workout Routine
Tom Selleck health and fitness regimen has evolved. adapting to his changing roles and age. During his "Magnum, P.I." days. Selleck's workouts were intense and focused on building and maintaining muscle mass. His routine included weightlifting, cardiovascular exercises. and specific training for the stunts he performed on the show.
Selleck adjusted his fitness routine as he aged to suit his body's needs. Today, his workouts focus on maintaining flexibility, strength, and cardiovascular health. He incorporates low-impact exercises such as swimming, walking, and light weightlifting. This balanced approach helps him stay fit without putting undue strain on his joints and muscles.
Importance of Flexibility and Mobility
In recent years, Selleck has emphasized the importance of flexibility and mobility in his fitness regimen. Understanding the natural decline in muscle mass and joint flexibility with age. he includes stretching and yoga in his routine. These practices help prevent injuries, improve posture, and maintain mobilit
Pulmonary Thromboembolism - etilogy, types, medical- Surgical and nursing man...VarunMahajani
Disruption of blood supply to lung alveoli due to blockage of one or more pulmonary blood vessels is called as Pulmonary thromboembolism. In this presentation we will discuss its causes, types and its management in depth.
Explore natural remedies for syphilis treatment in Singapore. Discover alternative therapies, herbal remedies, and lifestyle changes that may complement conventional treatments. Learn about holistic approaches to managing syphilis symptoms and supporting overall health.
These lecture slides, by Dr Sidra Arshad, offer a quick overview of physiological basis of a normal electrocardiogram.
Learning objectives:
1. Define an electrocardiogram (ECG) and electrocardiography
2. Describe how dipoles generated by the heart produce the waveforms of the ECG
3. Describe the components of a normal electrocardiogram of a typical bipolar leads (limb II)
4. Differentiate between intervals and segments
5. Enlist some common indications for obtaining an ECG
Study Resources:
1. Chapter 11, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 9, Human Physiology - From Cells to Systems, Lauralee Sherwood, 9th edition
3. Chapter 29, Ganong’s Review of Medical Physiology, 26th edition
4. Electrocardiogram, StatPearls - https://www.ncbi.nlm.nih.gov/books/NBK549803/
5. ECG in Medical Practice by ABM Abdullah, 4th edition
6. ECG Basics, http://www.nataliescasebook.com/tag/e-c-g-basics
4. 76
What is Gastroesophageal
Reflux Disease?
When you eat, food travels down the tube (esophagus)
connecting your mouth to your stomach. Your stomach makes
acid that helps break down the food so your body can use it.
The acid normally stays in your stomach where it belongs.
But sometimes the valve at the base of the esophagus, where it
connects to the stomach, doesn’t work right. If the valve
relaxes or opens when it shouldn’t, stomach acid can rise up
into the esophagus, which creates a burning feeling called
“heartburn.” If a large amount of stomach fluid rises up the
esophagus and enters the back of the throat, this is called
regurgitation. Heartburn and regurgitation are the two most
common symptoms of gastroesophageal reflux disease, a
common problem that is better known simply as GERD.
Most people have heartburn or regurgitation once in awhile.
That’s normal. But if you have frequent, persistent heartburn
and regurgitation, acid may be hurting your esophagus. And
the pain or discomfort caused by the heartburn may disrupt
your sleep, work, or general well-being. GERD can be serious
because without treatment it may get worse and could end up
badly damaging your esophagus.
GERD is very common. More than 60 million Americans
experience heartburn at least once a month and more than 15
million Americans experience heartburn symptoms every day!
Here’s the important point:
GERD is a long-term condition that
doesn’t usually go away by itself. It is
a chronic disease. That’s why it’s vital
that you talk with your doctor and, if
a treatment is recommended, that
you stick to the treatment as
prescribed by your doctor.
Sometimes the
valve at the base
of the esophagus,
where it connects
to the stomach,
doesn’t work right,
allowing stomach
acid to rise up into
the esophagus.
Esophagus
Valve
Stomach
5. Other factors may make it more likely
you will experience acid reflux:
• Alcohol use
• Smoking
• Pregnancy
Eating certain types of foods also raises
the risk of acid reflux:
• Citrus fruits such as oranges,
grapefruit, or lemons
• Chocolate
• Caffeine-containing drinks such as
coffee or tea
• Fatty and fried foods
• Garlic and onions
• Mint flavorings
• Spicy foods
• Tomato-based foods,
like spaghetti sauce, chili, and pizza
98
What Causes GERD?
In some people, the valve between their esophagus and
stomach is simply weaker than normal for unknown reasons.
Other factors can make the situation worse, such as pressure
on the stomach from tight clothing or extra body fat. Eating
fatty or oily foods causes the stomach to empty more slowly,
which can also make acid reflux more likely. And certain
medications can cause the valve to relax, allowing acid up
into the esophagus.
6. 1110
What’s the Danger?
If you don’t treat GERD, stomach acid can cause a number
of problems in the lower region of your esophagus. The
lining of the esophagus in this area can become red and
irritated. This is
called esophagitis.
If damage
continues, the
lining of the
esophagus can
form erosions
and bleed. Scars
formed when this
type of damage
heals can narrow
the esophagus,
making it hard for food to go all the way down to the
stomach. This feels as if food is getting “stuck” on the way
down. And if the stomach acid repeatedly rises high enough,
you may have a chronic sore throat or voice hoarseness.
Sometimes the lining of the lower esophagus changes
because of the constant irritation. This change is called
Barrett’s esophagus and it may increase your risk for getting
cancer of the esophagus.
What Does Acid Reflux
Feel Like?
Acid reflux usually begins with a rising, burning
sensation in the chest or throat. Sometimes
with regurgitation, stomach contents rise to
the back of the mouth and you can taste a
sour or bitter flavor. Symptoms most
commonly occur after meals. People
report that symptoms get worse
when they bend over, lie down, or
exert themselves physically.
Be careful!
Sometimes the chest pain
of an impending heart
attack can feel like GERD
or indigestion. If you have
any doubt, call your doctor
or 911 immediately!
Esophagus
Irritation
7. 12 13
For some patients with typical GERD
symptoms who do not respond to
medication, additional tests are
needed. Two types of tests can be
used to confirm the presence of
GERD. In one method, the
monitor is attached to a thin tube
that passes through your nose
down to the esophagus. The
other method uses a wireless
capsule, placed during
endoscopy, that transmits
results to a recorder.
How Can My Doctor Tell if I
Have GERD?
Unless you have developed complications from GERD such
as difficulty swallowing or bleeding, your doctor may
recommend diet changes, weight loss, quitting smoking,
and/or medication. If this approach works, the diagnosis of
GERD is confirmed. If not, then more tests may be ordered.
If your doctor suspects that your esophagus may be
damaged, it is important to take a look. You will be sent to
see a specialist called a gastroenterologist, who may do a test
called endoscopy. A thin, flexible tube with a tiny lens at the
tip (called an endoscope) is used to look at the inside of the
esophagus. You’ll be given a relaxing medication and asked
to lie on your side. Then the endoscope will be passed
through your mouth, past your throat and down the
esophagus. The doctor will be able to clearly see what your
esophagus looks like and can check for damage that might
signal a risk of cancer. The doctor may also remove a small
sample of tissue to look at with a microscope. This is
painless.
If you have difficulty swallowing, and food seems to be
getting stuck on the way down, your doctor may suggest an
x-ray exam. In this procedure you’ll be asked to swallow a
liquid that clearly shows up on an x-ray. The doctor will
watch as the liquid goes down your esophagus and will be
able to see if there are problems with swallowing, or if there
are any obstructions.
Unless
you have
developed
complications
from GERD
such as difficulty
swallowing or
bleeding, your doctor
may recommend diet
changes, weight loss,
quitting smoking,
and/or medication.
8. 1514
Treatments for GERD
If lifestyle changes don’t relieve your symptoms and your
doctor suspects or confirms that you have GERD, there are
several possible ways to treat the problem. First, there are
different types of medication:
H2 blockers
H2 blockers reduce the amount of acid that the stomach
makes. This reduction in the amount of acid often prevents
the symptoms of GERD. Several brands of H2 blockers are
available, both by prescription and over-the-counter. H2
blockers are usually taken at least twice a day. They are fairly
inexpensive, readily available, have a long safety record, few
side effects, and usually work well for mild or moderate
cases. However, they don’t work as well as some newer
medications in serious cases. They are also not as good at
promoting actual healing of the esophagus if irritation or
ulcers are present.
Proton-pump inhibitors
Proton-pump inhibitors (PPIs) are medications used to treat
GERD. They stop acid production more completely because
they more effectively block the stomach from making acid.
PPIs are the most effective medicines to heal ulcers and
irritation of the esophagus. Proton pump inhibitors are
usually taken once a day.
What Can I Do to Reduce
Acid Reflux?
The old saying “An ounce of prevention is worth a pound of
cure” applies to GERD. Depending on the severity of your
symptoms, you may find that making one or more of the
following changes can bring relief:
• Eat dinner at least three hours before you go to bed.
• Avoid, or eat sparingly, high-fat foods such as cream sauces
and fried foods.
• Avoid the “trigger” foods
listed earlier.
• If you are overweight, try losing
some of those pounds.
• Don’t wear tight-fitting clothing.
• Stop smoking.
• Reduce or stop drinking alcohol.
• Raise the head of your bed
4-6 inches.
When making significant lifestyle changes
such as quitting smoking or losing weight,
you should consult with your doctor.
Also consider enlisting the support
and encouragement of friends and
family members.
9. 17
When You See Your Doctor
To get the most out of a doctor’s visit, it helps to be
prepared. Take a pen and a notebook. Consider bringing
along a trusted friend or family member. Here are some
other tips:
• Before your visit, write down all your questions.
• Learn more about acid reflux before your visit
at the library or on the Internet.
• Be as specific as possible when describing
how you feel and what usually occurs
when you feel pain.
• Be persistent if you are confused.
16
At the moment, most proton pump inhibitors are only
available by prescription and are more expensive than H2
blockers. One disadvantage is that they don’t work immedi-
ately. Several doses are required for acid to be reduced. Your
doctor may prescribe an over-the-counter antacid or fast-
acting medication such as an H2 blocker to use at first.
Surgery
If long-term treatment with medications is undesirable,
surgery to tighten the valve is an option. Note that surgery is
not more effective than medicines and it does not prevent
Barrett’s esophagus. In addition, surgery always has some
risk of complications or unwanted side effects. With the help
of your doctor, you will need to weigh the risks of surgery
against its possible benefits.
The Key to
Success:
Whatever medication
your doctor prescribes
for you, be sure to
keep taking it as your
doctor directed even
though you may be
feeling better!
GERD usually won’t
disappear…but it may
be successfully
managed.
10. 1918
The Good News
The pain, discomfort,
and potential harm
caused by GERD can
almost always be avoided
these days. By staying clear of
known “trigger” foods, making
some of the suggested lifestyle
changes, and consistently using
your medications, you can reduce
GERD, and avoid its painful or
uncomfortable symptoms.
Questions to Ask the Doctor
11. 2120
RECIPE
RECIPE
Asparagus Topped with
Shrimp or Scallops
Serves 4 to 6
The pale green thin asparagus I've seen growing
in Georgia and South Carolina seem the essence of
Southern to me. They bend gracefully with the coastal
winds, and are plucky enough to grow in our sandy soil. They have an
affinity for shrimp and scallops, and are available around the same times
of the year. No acid (lemon juice, vinegar) is needed as the lemon peel
adds enough zing, and the acid changes the color of the asparagus. If you
are fortunate enough to have lemon grass, add it to the asparagus water
before you bring the water to the boil. Remove when the asparagus are
cooked and discard.
2 pounds asparagus, preferably thin
4 tablespoons light olive oil
1 medium onion or 2 or 3 shallots, chopped *possible trigger
1 pound medium peeled uncooked shrimp or scallops
4 tablespoons freshly grated lemon or orange peel (no white attached)
Salt
Freshly ground black pepper *possible trigger
1 tablespoon chopped herbs, preferably fresh
Cut off any woody ends of the asparagus. Peel any thick stalks or
tough skin, beginning at the little offshoots near the tips. Add to a
large pot or frying pan with enough boiling water to cover until just
done and still crisp, about 3 to 5 minutes, drain, rinse in cold water to
stop the cooking and set the color. Top with half the grated peel, salt
and pepper and leave at room temperature, or refrigerate if done more
than an hour or two in advance.
If using bay scallops, slice horizontally into 2 or 3 thinner slices. Heat
the 2 tablespoons oil in a large saucepan, add the scallops or shrimp
and cook 1 to 2 minutes, then turn and cook quickly until done. When
ready to serve, arrange some of the room temperature asparagus on
each plate, and top with the seafood, grated peel, oil, salt and pepper
as needed to render flavorful and pretty.
Cream of Carrot
Soup
Serves 6 to 8
2 tablespoons butter
5 to 6 medium carrots, sliced
1 onion, thinly sliced *may be excluded if onion is a trigger
4 cups fresh or canned chicken stock or broth
3/4 cup plain yogurt (optional)
1 1/2 tablespoons sugar, or to taste
Freshly ground white pepper to taste *possible trigger
1 small garlic clove crushed with salt *possible trigger
Finely chopped cilantro, chives, parsley, or thyme (optional)
Melt the butter in a large pot. Add the carrots and onion, cover, and
cook over low heat until soft, but not brown, about 10 minutes. Stir in
the stock, cover, and simmer until the vegetables are very soft, about
30 minutes. Remove the solids with a slotted spoon and puree in
batches in a food processor or blender until very smooth. (You may
need to add a little of the cooking liquid to the food processor.) If you
want a really smooth soup, force the puree through a fine-mesh sieve.
Stir the puree into the cooking liquid and whisk in the yogurt. If serving
hot, bring just to a boil and remove from heat. Season to taste with
sugar, white pepper, and garlic. Pour into a soup tureen or individual
bowls and sprinkle on some chopped herbs.
Serve hot or cold.
GERD-friendly recipes from:
Chef Nathalie Dupree
Author, nine cookbooks (two James Beard Awards)
Host, more than 300 programs for The Food
Network, PBS and The Learning Channel
12. 2322
For More Information
To learn more about GERD and how you can manage it,
contact the following organizations or find them on the Internet:
American College of Physicians
Philadelphia, PA
www.doctorsforadults.com
American College of Gastroenterology
Bethesda, MD
301-263-9000
www.acg.gi.org
American Gastroenterological Association
Bethesda, MD
301–654–2055
www.gastro.org
International Foundation for Functional
Gastrointestinal Disorders Inc.
Milwaukee, WI
888–964–2001
www.aboutgerd.org
National Digestive Diseases Information Clearinghouse
Bethesda, MD
http://digestive.niddk.nih.gov/ddiseases/pubs/gerd/#4
MedlinePlus
http://www.nlm.nih.gov/medlineplus/gerd.html
Notes
13. 24
Partner
American College of Physicians (ACP)
Established in 1915, the American College of Physicians
(ACP) is the nation’s largest medical specialty organization
and second largest physician group. Its mission is to enhance
the quality and effectiveness of health care by fostering
excellence and professionalism in the practice of medicine.
ACP membership includes about 119,000 members including
medical students. Members are physicians in general internal
medicine and related subspecialties, including cardiology,
gastroenterology, nephrology, endocrinology, hematology,
rheumatology, neurology, pulmonary disease, oncology,
infectious diseases, allergy and immunology, and geriatrics.
Internists treat the majority of adults in the United States.
For more information about
internal medicine physicians,
please visit:
www.doctorsforadults.com.
25
Sponsor
AstraZeneca LP
AstraZeneca is a major international health care business
engaged in the research, development, manufacture, and
marketing of prescription pharmaceuticals and the supply
of health care services. It is one of the world's leading
pharmaceutical companies focusing in gastrointestinal,
cardiovascular, neuroscience, respiratory, oncology, and
infection products.
14. 26
Credits
Sponsor
AstraZeneca LP
Partner
American College of Physicians
Patrick C. Alguire, M.D., F.A.C.P.
Director, Education and Career Development
Contributors to the Video
Harvey Licht, M.D., F.A.C.P.
Associate Professor of Medicine
Division of Gastroenterology
Temple University School of Medicine
Philadelphia, PA
Minhhuyen T. Nguyen, M.D.
Director, Clinical Gastroenterology
Fox Chase Cancer Center
Philadelphia, PA
Special Thanks to:
Nathalie Dupree
Honorary Doctorate, Johnson and Wales University
Advanced Certificate, Cordon Bleu
Author, nine cookbooks (two James Beard Awards)
Host, more than 300 programs for The Food Network,
PBS and The Learning Channel
Project Manager
Carol Brandenburg
Executive Producer
Conrad Productions
Guidebook Author
Stephen R. Braun
Medical Writer
Amherst, MA
Guidebook Designer
Cinda Debbink
Design Partners
www.dgdesignpartners.com