What is acid reflux relief?

In medically oriented terms, antonyms of the word relief include pain, distress or damage. That links its meaning to both subjective and objective aspects. Subjective, denoting sensations experienced by the sufferer such as pain and objective, meaning physical findings detected by specialists which are either functional distress or organic damage. Actually relief is related to control measures and it quantitatively signifies removal of an unpleasant existence or reduction of its magnitude. The definition of relief, therefore encompasses alleviation of pain, relaxation of distress and healing of damage. Acid reflux on the other hand has two sides; the subjective side (symptoms) which reflects the symptom of heartburn and the objective side (signs) that reflects the functional and/or organic signs of esophageal changes. Acid reflux relief is therefore a broad term that covers all the measures used to control symptoms and signs of acid reflux disease. Normally, the lower esophageal sphincter remains closed except during swallowing. This prevents the passage of food and acid from the stomach into the esophagus. If the lower esophageal sphincter becomes weakened or relaxed, stomach acid may back up into the esophagus. Frequent acid reflux can irritate and inflame the lining of the esophagus, causing symptoms and signs of acid reflux. A better understanding of relief would thus entail knowledge of some aspects of normal structure and function, so that changes in the disease and its control could be easily considered. Actually acid reflux relief involves both preventive and curative measures, and in addition to treatment; orientation with the causes, symptoms and complications of acid reflux are essential for proper management. Acid reflux relief includes: dietary changes,lifestyle modifications, specific medications and surgical operations.Basic knowledge of the underlying causes and progression of acid reflux and answering frequently asked questions about its relief; add to the depth of understanding.

Friday, March 7, 2008

Acid Reflux Relief logoTwenty-four hour ambulatory pH monitoring

The most direct method of assessing the relationship between symptoms and GERD is to measure the esophageal exposure to gastric juice with an indwelling pH electrode. Miller first reported prolonged esophageal pH monitoring in 1964, although it was not until 1973 that its clinical applicability and advantages were demonstrated by Johnson and DeMeester. Ambulatory pH testing is considered by many to be the gold standard for the diagnosis of GERD, because it has the highest sensitivity and specificity of all tests currently available. Some experts have suggested that 24-hour pH monitoring be used selectively, limited to patients with atypical symptoms or no endoscopic evidence of GE reflux. Given present-day referral patterns, more than half of the patients referred for antireflux surgery will have no endoscopic evidence of mucosal injury. For these patients, 24-hour pH monitoring provides the only objective measure of the presence of pathologic esophageal acid exposure. Although it is true that most patients with typical symptoms and erosive esophagitis have a positive 24-hour pH result, the study provides other useful information. It quantifies the actual time that the esophageal mucosa is exposed to gastric juice, measures the ability of the esophagus to clear refluxed acid and correlates esophageal acid exposure with the patient's symptoms. It is the only way to quantitatively express the overall degree and pattern of esophageal acid exposure, both of which may impact the decision toward surgery. Patients with nocturnal or bipositional reflux have a higher prevalence of complications and failure of long-term medical control. For these reasons, we continue to advocate its routine use in clinical practice.
The units used to express esophageal exposure to gastric juice are (a) cumulative time the esophageal pH is below a chosen threshold, expressed as the percent of the total, upright, and supine monitored time; (b) frequency of reflux episodes below a chosen threshold, expressed as number of episodes per 24 hours; and (c) duration of the episodes, expressed as the number of episodes greater than 5 minutes per 24 hours and the time in minutes of the longest episode recorded. The upper limits of normal were established at the 95th percentile. Most centers use pH 4 as the threshold. Combining the result of the six components into one expression that reflects the overall esophageal acid exposure below a pH threshold, a pH score was calculated by using the standard deviation of the mean of each of the six components measured.