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Your search term(s) "gastroesophageal-reflux-disease AND (heartburn OR hiatal-hernia)" returned 40 results.

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American Gastroenterological Association Medical Position Statement on the Management of Gastroesophageal Reflux. Disease. Gastroenterology. 135:1383-1391. 2008.

This position statement on the management of gastroesophageal reflux disease (GERD) addresses 12 issues: a definition of GERD and how it is differentiated from episodic heartburn; the use of lifestyle modifications for GERD; the use of antisecretory medications as empirical therapy and when esophagogastroduodenoscopy is indicated; the role and priority of diagnostic tests, including endoscopy, esophageal manometry, ambulatory pH monitoring, and impedance pH monitoring; management considerations in patients with suspected reflux chest pain syndrome; recommended initial management, including antisecretory therapy, for patients with suspected extraesophageal reflux syndromes including asthma, laryngitis, or cough; the progression of GERD and the development of esophagitis and/or Barrett’s esophagus; maintenance therapy for patients with typical esophageal reflux syndrome; maintenance therapy for patients with suspected extraesophageal reflux syndromes; the clinical consequences of chronic potent acid inhibition; the role of endoscopy in long-term management of patients with GERD; and the indications and anticipated benefits of antireflux surgery. For each topic, a comprehensive literature search was conducted, pertinent evidence reviewed, and the quality of relevant data evaluated. The recommendations are based on the best available evidence or, in the absence of quality evidence, expert opinion, and are all weighted based on the U.S. Preventive Services Task Force grades. 2 references.

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Another Complication of Reflux: Laryngeal Pharyngeal Reflux (LPR). Digestive Health Matters. 17(2): 4. Summer 2008.

This article briefly describes laryngeal pharyngeal reflux (LPR), a complication of gastroesophageal reflux disease (GERD). The author comments that reflux of gastric acid can cause several throat problems, but the symptoms and treatment of LPR are often different from typical GERD symptoms. Physicians are encouraged to consider LPR as a separate problem from GERD. Patients with LPR usually do not have heartburn, require larger doses of medications for weeks to months before seeing any improvement, usually do not require long-term treatment, and rarely develop complications. Individuals with persistent throat symptoms, such as hoarseness, frequent throat clearing, or coughing should seek medical attention. Once diagnosed, the first approach is to control the reflux. In addition, throat clearing should be minimized because it tends to aggravate the injury. The author suggests three strategies to help stop throat clearing behavior: try swallowing to clear the throat; exhale forcefully rather than cough; and gently tap the vocal cords together rather than use forceful effort to clear the throat. LPR will usually heal well with proper diagnosis and treatment.

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Gastroesophageal Reflux Disease. IN: Hauser, S., ed. Mayo Clinic Gastroenterology and Hepatology Board Review. 3rd ed. New York, NY: Informa Healthcare USA. 2008. pp 3-20.

This chapter on gastroesophageal reflux disease (GERD) is from a comprehensive textbook that provides an in-depth examination of essential knowledge in gastroenterology, hepatology, and the related areas of pathology, endoscopy, nutrition, and radiology. Gastroesophageal reflux is defined as the return of gastric contents other than air into or through the esophagus. GERD refers to reflux that produces frequent symptoms or that results in damage to the esophageal mucosa or organs of the upper aerodigestive system and, occasionally, the lower respiratory tract. The chapter covers etiology, factors contributing to GERD, epidemiology, presentation, symptoms, establishing a diagnosis, diagnostic tests that may be indicated, and treatment strategies. Factors contributing to the development of GERD can include problems with the barrier function of the lower esophageal sphincter, acid clearance, intrinsic mucosal factors, gastric factors, Helicobacter pylori infection, and connective tissue disease. The cardinal symptoms of GERD are heartburn and acid regurgitation. Diagnostic tests are unnecessary in most people with GERD. Investigations are needed in patients who have alarm symptoms, equivocal results on a treatment trial, or atypical symptoms. Patient-initiated or physician-initiated empirical treatment for presumed GERD has become commonplace. Potent acid suppression with proton pump inhibitors is effective in most patients and heals reflux esophagitis after only a few weeks of therapy. The chapter is illustrated with full-color drawings and photographs. 13 figures. 7 tables. 19 references.

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Guide to Eosinophilic Esophagitis in Children and Adults. Flourtown, PA: Children’s Digestive Health and Nutrition Foundation. 2008. 6 p.

This brochure describes eosinophilic esophagitis (EE), a disease characterized by an isolated inflammation of the esophagus by a specific white blood cell, the eosinophil. The brochure describes symptoms, incidence, diagnosis, and treatment of EE. Symptoms of EE can include difficulty swallowing, food becoming stuck in the esophagus, or symptoms of gastroesophageal reflux disease (GERD) such as vomiting, regurgitation, abdominal pain, or heartburn. EE is diagnosed by upper endoscopy and biopsy. Once EE is confirmed, patients are either treated with medications or referred to an allergist for dietary restriction. Children especially may be treated with dietary modifications. The brochure is illustrated with full-color photographs of adults and children, as well as endoscopic photographs of some of the esophageal changes seen in EE. The back cover of the brochure describes the work of the International Gastrointestinal Eosinophilic Researchers (TIGER), a group of pediatric and adult physicians and basic scientists interested in understanding the underlying science and clinical effects that eosinophils have on disease.

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Indigestion. Bethesda, MD: National Digestive Diseases Information Clearinghouse. 2008. 6 p.

This fact sheet familiarizes readers with indigestion, also known as dyspepsia, a term used to describe one or more symptoms including a feeling of fullness during a meal, uncomfortable fullness after a meal, and burning or pain in the upper abdomen. The fact sheet answers common questions about indigestion, including its causes, symptoms, diagnosis, and treatment. Indigestion can be caused by a condition in the digestive tract such as gastroesophageal reflux disease (GERD), peptic ulcer disease, cancer, or diseases of the pancreas or bile ducts. Sometimes a person has indigestion for which a cause cannot be found. This type of indigestion is called functional dyspepsia. Indigestion and heartburn are different conditions, but a person can have symptoms of both. The doctor may order x rays; blood, breath, and stool tests; and an upper endoscopy with biopsies to diagnose indigestion. Some people may experience relief from indigestion by making a few lifestyle changes and decreasing stress. The doctor may prescribe antacids, H2 receptor antagonists (H2RAs), proton pump inhibitors (PPIs), prokinetics, or antibiotics to treat the symptoms of indigestion. The fact sheet includes a brief description of current research in this area. Readers are referred to online publications and resource organizations, including the American Gastroenterological Association at 301–654–2055 or www.gastro.org and the International Foundation for Functional Gastrointestinal Disorders at 1–888–964–2001 or www.iffgd.org. The document concludes with a summary of the activities of the National Digestive Diseases Information Clearinghouse (NDDIC), a service of the National Institute of Diabetes and Digestive and Kidney Diseases. 1 figure.

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Heartburn, Gastroesophageal Reflux (GER), and Gastroesophageal Reflux Disease (GERD). Bethesda, MD: National Digestive Diseases Information Clearinghouse. 2007. 7 p.

Written in a question and answer format, this fact sheet reviews the causes, symptoms, risk factors, complications, diagnosis, treatment, and prevention of heartburn, gastroesophageal reflux (GER), and gastroesophageal reflux disease (GERD). GER occurs when the lower esophageal sphincter (LES) opens spontaneously, for varying periods of time, or does not close properly and stomach contents rise up into the esophagus. GER is also called acid reflux because stomach acid rises up with the food. Treatment options discussed include lifestyle changes, medications such as antacids, H2 blockers, proton pump inhibitors, and prokinetics. One sidebar considers the problem of GERD in children. The fact sheet concludes with contact information for five resource organizations, including government agencies and a brief description of the activities of the National Digestive Diseases Information Clearinghouse (NDDIC).

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Hiatal Hernia and Treatment of Acid-Related Disorders. Gastroenterology and Hepatology. 3(2): 92-94. February 2007.

This article answers common questions physicians may have about hiatal hernia and the treatment of acid-related disorders. The author first describes the varying manifestations of hiatal hernia, outlining the four types commonly considered. The author goes on to discuss the causes of hiatal hernia, a topic which remains somewhat controversial. Other topics include risk factors for hiatal hernia including obesity and pregnancy, how the presence of hiatal hernia can affect the development of gastroesophageal reflux disease (GERD), how the presence of a hiatal hernia changes the symptoms and disease severity of GERD, how hiatal hernia affects response to treatment, current surgical options for repair of hiatal hernia, and other treatment options. Patients with more severe forms of GERD, such as Barrett’s esophagus or severe erosive esophagitis, are more likely to have a hiatal hernia. Patients with severe reflux and hiatal hernia who are on high-dose acid suppression will often report that their heartburn is gone but that they can still taste gastric juice in their mouth; these patients may need to be sent for surgical treatment of their hernia. 5 references.

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Is it More Than Simple Heartburn? Digestive Health Matters. 16(3): 3-5. Fall 2007.

This article, designed to support GERD Awareness Week, describes gastroesophageal reflux disease (GERD), its symptoms and complications, and why it is important to have this condition diagnosed and treated. The article differentiates between heartburn and GERD, focusing on when to visit a physician and how to prepare for that appointment. One sidebar lists the numerous symptoms of GERD, stressing that heartburn is not the only symptom of the chronic condition. The article includes tips for controlling simple heartburn, such as maintaining an upright posture after a meal, raising the head of the bed, avoiding certain foods before lying down or exercising, learning about medication side effects, and losing weight if necessary. The article summarizes one patient’s experience living with long-term gastrointestinal pain and heartburn before she was diagnosed. Readers are referred to the organization’s website for more stories (www.aboutgerd.org).

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Management of Nighttime Gastroesophageal Reflux Disease. Gastroenterology and Hepatology. 3(8): 605-606. August 2007.

This article from a series on advances in gastroesophageal reflux disease (GERD) answers common clinical questions about emerging the management of nighttime GERD. The author reviews the prevalence of nighttime GERD among GERD patients in the United States and discusses the typical presenting symptoms of this condition, how the nighttime symptoms differ from those in individuals with only daytime GERD, how nighttime GERD heightens the risk of a more complicated disease course, studies that compared different options for the treatment of nighttime GERD, recommended follow-up for nighttime GERD patients, and current research, including that investigating nonacid reflux events during sleep. The author notes that if it has been established that a patient has nighttime heartburn and thus, nighttime reflux, treatment should be more aggressive, focusing on relief of nighttime reflux and nighttime symptoms. Likewise, because nighttime GERD is a more aggressive form of the disease, a clinician may be more likely to perform an endoscopy on a patient in whom significant nighttime heartburn is suspected. 7 references.

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Many Manifestation of Gastroesophageal Reflux Disease: Presentation, Evaluation, and Treatment. Gastroenterology Clinics of North America. 36(3): 577-600. September 2007.

This article on the presentation, evaluation, and treatment of the various manifestations of gastroesophageal reflux disease (GERD) is from a special issue of Gastroenterology Clinics of North America that focuses on gastrointestinal (GI) motility. The author notes that GERD is a common problem that is expensive to diagnose and treat and that is increasing in prevalence in the Western world. Important risk factors for GERD are obesity and the eradication of Helicobacter pylori. Classic symptoms of GERD include heartburn and acid regurgitation, but using those symptoms alone to diagnosis GERD is not adequate. Ambulatory esophageal pH testing is the most sensitive test for GERD, whereas endoscopy is the most specific test. Medical treatment with proton pump inhibitors (PPIs) has revolutionized the treatment of GERD and its complications, but long-term side effects of these drugs can be a concern. Laparoscopic anti-reflux surgery and PPIs have been found to have similar levels of effectiveness in the long term. 8 figures. 2 tables. 94 references.

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