Gastro-oesophageal reflux (acid reflux)
What is gastro-oesophageal reflux?If heartburn begins to occur on a daily basis you need to see your Physician for advise.
Gastro-oesophageal reflux is a condition where the lower oesophageal sphincter (the muscular ring at the lower end of the oesophagus) is abnormally relaxed and allows the stomach's acidic contents to flow back or 'reflux' into the gullet (oesophagus). It can also cause heartburn and pain in the chest. Gastro-oesophageal reflux is a common condition and the most frequent cause of indigestion in the world.
Oesophagitis is inflammation of the inner lining of the oesophagus caused by repeated episodes of gastro-oesophageal reflux.
The symptoms of gastro-esophageal reflux oesophagitis?
A painful or burning sensation in the upper
abdomen or chest, sometimes radiating to the back (heartburn).
The acid reflux may reach the pharynx (throat) and mouth. It is sour and may burn.
A small number of patients have difficulties breathing and suffer from hoarseness because the refluxed fluid irritates the larynx and respiratory tract.
Excess belching is common.
When does gastro-oesophageal reflux occur?
Symptoms typically occur after over eating a
large or fatty meal or drinking alcohol.
Lying down, bending over or bending and lifting can all cause reflux.
It is made worse by smoking.
The frequency with which the symptoms occur varies. For most people, they are rare but weekly and daily episodes of refluxes are not uncommon sometimes even 10 times a day.
Does gastro-oesophageal reflux affect your health?
It is an unpleasant condition that
can have a big influence on your lifestyle.
Many people feel that their quality of life is lowered by the symptoms.
Prolonged exposure to refluxed acid leads to oesophagitis (inflammation of the oesophagus). Long-standing oesophagitis may be complicated by the formation of scar tissue that contracts and results in a narrowing (stricture) in the affected part of the oesophagus. This can make it difficult or even impossible to swallow. It is a serious condition that requires urgent assessment and treatment, but, fortunately, this complication is relatively rare. It can cause ulceration leading to bleeding and an iron deficiency, which may develop into anaemia due to a chronic blood loss.
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How does stomach acid travel up the oesophagus?
The trouble is caused by the faulty oesophageal
sphincter, the muscular ring at the lower end of the oesophagus, near the
diaphragm. The sphincter is designed to prevent the stomach contents from
flowing upward - it functions as one-way valve.
If the sphincter does not work properly, stomach acid flows into the oesophagus. The reflux tendency increases when the stomach contains a lot of gastric juice or food and when there is increased pressure in or on the stomach.
This is a small problem and not to worry a few of Chinese herbal medicine could help it.
Which conditions can cause gastro-oesophageal reflux?
In many cases, the disorder cannot be attributed to any specific cause but the following conditions can contribute to the problem.
The stomach pokes through the diaphragm, preventing the muscle fibres of the diaphragm from closing the lower end of the oesophagus. The oesophagus remains wide open which allows stomach acid to get into the oesophagus.
If the person is overweight the excessive fat in the abdominal cavity increases the pressure inside it. This causes the contents of the stomach to travel up into the gullet. Loss of weight reduces stomach acid reflux.
Because the uterus increases in size during pregnancy, it presses on the stomach, creating higher pressure inside it, which increases the tendency to reflux. In addition, hormonal changes lead to relaxation of the oesophageal sphincter during pregnancy.
The more the stomach is stretched by food, the higher the tendency to reflux. The tendency is also increased by eating fatty meals as fat delays gastric emptying. Try to avoid large rich meals, particularly in the evening and this will reduce the tendency to reflux.
Chocolate, peppermint, coffee, fruit juices, sour, hot spicy food and alcohol and over eating prevent the oesophageal sphincter from working properly.
Tobacco prevents the oesophageal sphincter from working in order, reduces the rate at which the stomach empties and increases stomach acid production.
Constipation increases the tendency to reflux by raising pressure inside the stomach cavity.
The tendency to reflux increases when you are lying down. This is just due to gravity. A simple way to change that is to use a pillow under the mattress or to raise the head of your bed by 3 inches with blocks or a house brick under the bed frame.
Gastro-oesophageal reflux disorders diagnosed?
The symptoms of Gastro-oesophageal reflux may be so obvious that no tests are needed. There are others scary test as well but we dont advise to do.
If the doctor is in doubt, or if the symptoms are very troublesome, a gastroscopy will be considered. During the procedure oesophagitis, hiatus hernias, peptic ulcers and other conditions can be either found or ruled out.
Another possibility is to measure the acidity in the lower end of the oesophagus during a 24-hour period. This will give an indication of how often and how long the reflux episodes last.
Gastro-oesophageal reflux can resemble those of a peptic ulcer, chest pains (angina pectoris), muscle pains, back problems, constipation, irritable bowel syndrome, gallstones, pancreatic disease etc. These conditions will sometimes have to be ruled out before the diagnosis can be made.
How to prevent gastro-oesophageal reflux?
The following changes in lifestyle can reduce the
risk of developing reflux: try to reduce strees, try to lose weight if you
are overweight avoid large, high-fat meals and bedtime snacks limit coffee
intake reduce alcohol consumption stop smoking. When should you take some
If the heartburn is frequent or the symptoms very unpleasant
How are gastro-oesophageal reflux disorders treated?
Gastro-oesophageal reflux disorders are mainly treated by herbal medicines. In most cases, herbs can successfully control the symptoms. The herbal medicine is to reduce acid secretion . A class of herbal medicines have to be prescript by Chinese Master. These are very effective and will also prevent the complications of gastro-oesophageal reflux. It should also strengten your stomach's Qi.
No surgical procedure is require.
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Irritable bowel syndrome (IBS)
Irritable bowel syndrome (IBS) is a condition characterised by a mixture of symptoms which are believed to be due to a disorder of intestinal motor function or the in-ability of the Qi in the Large Intestine. It is the commonest condition seen by gastroenterologists. The normal gut moves contents along the gut through muscular contractions (propulsion), but also has areas of hold-up (segmentation). The combination of propulsion and segmentation is called peristalsis, and when it is working normally, one is completely unaware of it. The control of peristalsis is complex and the best way to regard irritable bowel is as a loss of co-ordination of these muscular contractions.
Further more, psychological factors are commonly involved (associated with Qi ). This is not to say that the symptoms are not real (they are), but irritable bowel syndrome is often the outcome of a complex interaction between psychological and physical factors.
Some old-fashioned names for irritable bowel syndrome are still in common usage. These include irritable colon, spastic colon and mucous colitis. These are misleading since, the condition not only affects the colon, but also the remainder of the gut.
Although irritable bowel syndrome can be a distressing condition with many unpleasant symptoms, it never causes bowel cancer or other damage to the bowel.
In the UK about 13 per cent of women and 5 per cent of men suffer from IBS.
What causes irritable bowel syndrome? Although the cause is unknown, about half of all patients will date the onset of their symptoms to a major life event such as change of house or job, or bereavement. This suggests that there may be a psychological trigger in susceptible patients. Approximately 10 to 20 per cent of patients will date the onset of their symptoms to an acute gastroenteritis. In the remainder, the trigger factor remains unidentified. The abnormalities in peristalsis mentioned above can often be seen in close relatives of patients (although without symptoms), suggesting that a trigger sets off the condition in susceptible people. Nerve-signaling chemicals, particularly serotonin, appear to have an important role.
What are the symptoms of irritable bowel syndrome?
Symptoms vary from patient to patient, and may occur at any age. However, they most commonly start in late teenage years or early adulthood. The symptoms will depend on which parts of the gut are involved and there is often overlap between areas of the gut. Some patients may have only one part of the gut involved, while others have several. Moreover, the symptoms may vary over time.
A sensation like a golf ball in the throat between meals which does not interfere with swallowing (globus).
Heartburn - burning pain often felt behind the breastbone.
Painful swallowing (odynophagia), but without hold-up of food.
Sticking of food (dysphagia) - this requires investigation.
Non-ulcer dyspepsia (symptoms suggestive of a stomach or duodenal ulcer, but which has not been confirmed on investigation).
Feeling full after small meals. This may reach the stage of not being able to finish a meal.
Abdominal bloating after meals.
Increased gurgling noises which may be loud enough to cause social embarrassment (borborygmi).
Abdominal bloating which may be so severe that women describe themselves as looking pregnant.
Generalised abdominal tenderness associated with bloating.
Abdominal bloating of both types usually subsides overnight and returns the following day.
Abdominal bloating of both types usually subsides overnight and returns the following day.
Right-sided abdominal pain, either low, or tucked up under the right ribs. Does not always get better on opening the bowels.
Pain tucked up under the left ribs (splenic flexure syndrome). When the pain is bad, it may enter the left armpit.
Variable and erratic bowel habits alternating from constipation to diarrhoea.
Increased gastro-colic reflex. This is an awakening of the childhood reflex where food in the stomach stimulates colonic activity, resulting in the need to open the bowels.
Severe, short stabbing pains in the rectum, called proctalgia fugax.
Headaches are common.
In women, left-sided abdominal pain on sexual intercourse is not uncommon.
Increased frequency of passing urine is common.
Fatigue and tiredness are very common.
Sleep disturbance is also frequent.
Loss of appetite is common, as is nausea.
Features of depression occur in about one third of patients.
Anxiety and stress-related symptoms are common and may interact with the gut symptoms.
Difficulty in swallowing when food gets stuck.
Indigestion-type pain which wakes the patient at night.
Abdominal bloating which does not get better overnight.
Significant and unexplained weight loss.
The presence of bleeding from the back passage.
Chronic, painless diarrhoea.
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