Terra Pharmaceuticals
Reflux, Gastritis and Ulcer
Reflux
Acid reflux is a very common condition. It is characterized by a burning pain, known as heartburn, felt internally around the lower chest area. It is caused by stomach acid flowing back up into the food pipe.
Acid reflux is considered chronic when you've had it at least twice a week for several weeks.
The stomach contains a strong acid- hydrochloric acid - to help break down food and protect against pathogens such as bacteria.
The lining of the stomach is specially adapted to protect it from the powerful acid.
A ring of muscle - the gastroesophageal sphincter - normally acts as a valve that lets food into the stomach but not back up into the esophagus. When this valve fails, and stomach contents are regurgitated into the esophagus, the symptoms of acid reflux are felt, such as heartburn.
Causes of acid reflux
We all may experience acid reflux occasionally, often associated with certain food and drink. Recurrent acid reflux that leads to disease has other causes and risk factors and is termed gastroesophageal reflux disease (GERD).
Gastroesophageal reflux disease is seen in people of all ages, sometimes for unknown reasons (idiopathic). Often, the cause is attributable to a lifestyle factor, but it can also be due to causes that cannot always be prevented.
One such cause of GERD is a hiatal (or hiatus) hernia. This is an anatomical abnormality where a hole in the diaphragm allows the upper part of the stomach to enter the chest cavity, sometimes leading to GERD. Pregnancy can also cause acid reflux due to extra pressure being placed on the internal organs.
Other risk factors are more easily controlled:
- Obesity
- Smoking (active or passive)
- High intake of table salt
- Low dietary fiber intake
- Low levels of physical exercise
- Medications, including drugs for asthma, calcium-channel blockers, antihistamines, painkillers, sedatives, and antidepressants
- Alcohol or caffeine intake
Ulcer and Gastritis
What Is Ulcer and Gastritis?
Gastritis and ulcer are conditions that affect the stomach and small intestine, and they share many symptoms, such as abdominal pain, nausea, vomiting, loss of appetite and weight loss. There are many differences, though. Gastritis and ulcer both inflame the stomach lining, but gastritis is a general inflammation, and ulcer is a patch of eroded stomach lining. Though gastritis and ulcer share symptoms, an intense, localized pain is much more common with ulcer, and ulcer also carries the risk of bleeding, cancer and eventual stomach perforation. Doctors use a variety of techniques to diagnose each specific ailment, and the methods of treatment vary as well.
Causes Gastritis
Gastritis can be caused by a variety of reasons irritation due to chronic vomiting, excessive alcohol use, stress, or the use of certain medications or other anti-inflammatory drugs. It may also be caused by any of the following bacterias and infections:
- Bile reflux: A backflow of bile into the stomach from the bile tract (that connects to the liver and gallbladder).
- Helicobacter pylori (H. pylori): A bacteria that lives in the mucous lining of the stomach.
- Infections caused by bacteria and viruses
- Pernicious anemia: A form of anemia that occurs when the stomach lacks a naturally occurring substance needed to properly absorb and digest
If gastritis is left untreated, it can lead to a severe loss in blood, or in some cases increase the risk of developing stomach cancer.
Causes Ulcer
- A bacterium. A common cause of ulcers is the bacterium Helicobacter pylori. H. pylori bacteria commonly live and multiply within the mucous layer that covers and protects tissues that line the stomach and small intestine.
- Regular use of pain relievers. Certain over-the-counter and prescription pain medications can irritate or inflame the lining of your stomach and small intestine. These medications include ASA, ibuprofen, naproxen, ketoprofen and others. Peptic ulcers are more common in older adults who take pain medications frequently, such as might be common in people with osteoarthritis.
- Other medications. Other prescription medications that can also lead to ulcers include medications used to treat osteoporosis called bisphosphonates.
Risk Factors Gastritis
- Bacterial infection
- Regular use of pain relievers
- Older age
- Excessive alcohol use
- Stress
- Bile reflux disease
- Your own body attacking cells in your stomach
- Other diseases and conditions. Gastritis may be associated with other medical conditions, including HIV/AIDS, Crohn's disease and parasitic infections.
Risk Factors Ulcer
- Smoking
- Drinking alcohol
- Having uncontrolled stress. Although stress alone isn't a cause of peptic ulcers, it is a contributing factor.
Symptoms Gastritis
- Nausea or recurrent upset stomach
- Abdominal bloating
- Abdominal pain
- Vomiting
- Indigestion
- Burning or gnawing feeling in the stomach between meals or at night
- Hiccups
- Loss of appetite
- Vomiting blood or coffee ground-like material
- Black, tarry stools
Symptoms Ulcer
- Abdominal pain
- Dyspepsia or indigestion
- Bloating and fullness
- Mild nausea (may be relieved by vomiting)
- Belching and regurgitation
- Feeling very hungry 1 to 3 hours after eating
Treatment
GERD is a chronic disease that requires long-term management. Doctors often treat GERD with medications and by suggesting lifestyle changes. If symptoms do not improve, doctors may suggest surgery.
Lifestyle changes
Lifestyle modifications are the cornerstone of GERD treatment because they can help improve symptoms. These modifications may include:
- losing weight for people who are overweight or had a recent weight gain
- sleeping in an inclined position
- modifying diet and avoiding food triggers
- avoiding eating meals at least 3 hours before going to bed
Diet
Certain foods may trigger GERD symptoms in some people. These include:
- Greasy foods
- Spicy foods
- Chocolate
- Peppermint
- Caffeine
- Foods containing tomato products
- Alcoholic drinks
If a person avoids these types of foods and still experiences regular heartburn, it is important to visit a doctor, as there may be other underlying issues causing the symptoms.
Medications
Medications used to treat GERD suppress acid production. Of the available options, PPIs are considered the most effective in treating both erosive and nonerosive GERD. They can help heal the lining of the esophagus.
Other options include:H2 blockers, antacids, prokinetics: These help the stomach empty faster. Side effects include diarrhea, nausea, and anxiety.
Surgical Options : If lifestyle changes and medications do not significantly improve the symptoms of GERD, a gastroenterologist may recommend surgery.
Complications of GERD
GERD can worsen and result in other conditions if left untreated. These may include:
Esophagitis: This is inflammation of the esophagus. It can also lead to gastrointestinal (GI) bleeding.
Esophageal stricture: Repeated irritation can cause scarring in the esophagus, making it narrow. This can cause difficulty swallowing.
Barrett’s esophagus: The cells lining the esophagus can change into cells similar to the lining of the intestine. This can develop into esophageal cancer.
Respiratory problems: It is possible to breathe stomach acid into the lungs, which can cause a range of problems, such as chest congestion, hoarseness, asthma, laryngitis, and pneumonia.
A 2021 study found that GERD can contribute to the development of idiopathic pulmonary fibrosis. Another study in the same year found that GERD is common in people with asthma and may cause lung transplant complications.
Prevention
Aside from the lifestyle changes mentioned above, adopting the following changes may help prevent the onset of GERD:
- Eat small meals frequently
- Avoid eating very large meals
- Stay upright after eating
- Finish eating 2–3 hours before going to bed
- Quit or avoid smoking
- Avoid strenuous activities after eating
- Lose weight if overweight
- Minimize wearing tight clothing around the abdomen
- Sleep at a slight angle with the head slightly elevated
References:
1. http://www.medicalnewstoday.com
2.http://www.tmphysiciannetwork.org/Services/Medical-Services/Ulcer-and-Gastritis.aspx
3. https://my.clevelandclinic.org/
