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.

Saturday, June 7, 2008

Acid Reflux Relief logoHeartburn Relief : Acid Reflux Treatment

The management of frequent heartburn entails certain measures to confirm the diagnosis of GERD. Following these diagnostic procedures, treatment of acid reflux disease should be considered.
Acid Reflux Treatment

The aim of treatment are to reduce refluxing, render the refluxate harmless, improve esophageal clearance, and protect the esophageal mucosa. The management of non-complicated cases generally includes weight reduction, sleeping with the head of the bed elevated by about 4 to 6 in. with blocks, and elimination of factors that increase abdominal pressure. Patients should not smoke and should avoid consuming fatty foods, coffee, chocolate, alcohol, mint, orange juice, and certain medications (such as anticholinergic drugs, calcium channel blockers, and other smooth-muscle relaxants). They should also avoid ingesting large quantities of fluids with meals. In mild cases, life-style changes and over-the-counter antisecretory agents may be adequate. In moderate cases, H2receptor blocking agents (cimetidine, 300 mg; ranitidine, 150 mg bid; famotidine, 20 mg bid; nizatidine 150 mg bid) for 6 to 12 weeks are effective in symptom relief. Higher doses are necessary for healing erosive esophagitis, but proton pump inhibitors (PPIs) are more effective in this setting.

In cases resistant to H2receptor blockers and severe cases, rigorous acid suppression with aPPI is recommended. The PPIs are comparably effective: omeprazole (40 mg/d), lansoprazole (30 mg/d), pantoprazole (40 mg/d), and rabeprazole (20 mg/d) for 8 weeks can heal erosive esophagitis in up to 90% of patients. Reflux esophagitis requires prolonged therapy, for 3 to 6 months or longer if the disease recurs quickly. After initial therapy, a lower maintenance dose of PPI is used. Side effects are minimal. Aggressive acid suppression causes hypergastrinemia but does not increase the risk for carcinoid tumors or gastrinomas. Vitamin B12 absorption is compromised by the treatment. Patients with reflux esophagitis who have complications, such as Barrett's esophagus with concomitant esophagitis, should be treated vigorously. Patients who have an associated peptic stricture are treated with dilators to relieve dysphagia as well as provided with vigorous treatment for reflux.

Antireflux surgery, in which the gastric fundus is wrapped around the esophagus (fundoplication), increases theLESpressure and should be considered for patients with resistant and complicated reflux esophagitis that does not respond fully to medical therapy or for patients for whom long-term medical therapy is not desirable. Laparoscopic fundoplication is the surgery of choice. Ideal candidates for fundoplication are those in whom motility studies show persistently inadequate LES pressure but normal peristaltic contractions in the esophageal body.

Patients with alkaline esophagitis are treated with general antireflux measures and neutralization of bile salts with cholestyramine, aluminum hydroxide, or sucralfate. Sucralfate is particularly useful in these cases, as it also serves as a mucosal protector.