Regurgitation in Patients with Gastroesophageal Reflux Disease

Transient LES relaxations also occur in individuals without GERD, but they are infrequent. In fact, reflux of the stomach’s liquid contents into the esophagus occurs in most normal individuals.

Treatment

During laparoscopy, a small viewing device and surgical instruments are passed through several small puncture sites in the abdomen. This procedure avoids the need for a major abdominal incision. H2 antagonists are very good for relieving the symptoms of GERD, particularly heartburn. However, they are not very good for healing the inflammation (esophagitis) that may accompany GERD. In fact, they are used primarily for the treatment of heartburn in GERD that is not associated with inflammation or complications, such as erosions or ulcers, strictures, or Barrett’s esophagus.

It requires something other than the pH test to confirm the presence of GERD, for example, typical symptoms, response to treatment, or the presence of complications of GERD. GERD also may be confidently diagnosed when episodes of heartburn correlate with acid reflux as shown by acid testing. Esophageal acid testing is considered a “gold standard” for diagnosing GERD. As discussed previously, the reflux of acid is common in the general population.

GERD and Sleep

Visit our Acid Reflux / GERD category page for the latest news on this subject, or sign up to our newsletter to receive the latest updates on Acid Reflux / GERD. If an infant presents symptoms of GERD, it is important to get advice from a doctor or pediatrician as other, more severe, conditions share some of the symptoms of reflux in infants. There is a muscle at the lower end of the food pipe called the lower esophageal sphincter. This muscle relaxes to let food into the stomach and contracts to stop food and acid passing back up into the food pipe.

For more severe cases, other medications known as proton pump inhibitors like lansoprazole (Prevacid) can often be used. Always check with your doctor before taking any over-the-counter medications during pregnancy. Doctors usually avoid prescribing too many medications while a woman is pregnant because the medicine can be passed along to the fetus. Instead, doctors usually recommend making lifestyle changes, such as avoiding foods known to cause acid reflux and sleeping with the head slightly elevated.

It has also been found that liquid refluxes to a higher level in the esophagus in patients with GERD than normal individuals. Dr. Charles “Pat” Davis, MD, PhD, is a board certified Emergency Medicine doctor who currently practices as a consultant and staff member for hospitals.

Perhaps 10 to 20 percent of patients will not have their symptoms substantially improved by treatment for GERD. This lack of response to treatment could be caused by ineffective treatment.

Regurgitation means backwards flow of a fluid. In the case of the GI tract, regurgitation is the forceful expulsion of stomach contents backwards through the esophagus and out the mouth. Regurgitation is an important body defense against noxious substances, but can be complicated by aspiration of stomach contents into the lungs, causing inflammation of the lungs. Repeated regurgitation is damaging to the tooth enamel, and can lead to disturbances of fluid, electrolyte and acid-base status.

The reflux of liquid into the lungs (called aspiration) often results in coughing and choking. Aspiration, however, also can occur without producing these symptoms. With or without these symptoms, aspiration may lead to infection of the lungs and result in pneumonia. This type of pneumonia is a serious problem requiring immediate treatment.

Elevation of the upper body at night generally is recommended for all patients with GERD. Nevertheless, most patients with GERD have reflux only during the day and elevation at night is of little benefit for them. It is not possible to know for certain which patients will benefit from elevation at night unless acid testing clearly demonstrates night reflux. However, patients who have heartburn, regurgitation, or other symptoms of GERD at night are probably experiencing reflux at night and definitely should elevate their upper body when sleeping. Reflux also occurs less frequently when patients lie on their left rather than their right sides.

Quit smoking. Some studies have found that nicotine can relax the muscles of the LES and can also interfere with your saliva’s ability to clear acid out of the esophagus. 5. Elevate your bed.

Although acid reflux is extremely common and rarely serious, don’t ignore your acid reflux symptoms. Making a few lifestyle changes and using over-the-counter antacids are often all you need to control acid reflux symptoms.

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- December 1, 2015

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