Paisley Prescriptions - November 2020

Anxiety & Depression

PYRx1120

November 2020 Issue - Paisley Prescriptions
Acid Reflux & Heartburn
 

If something is named heartburn, reflux or GERD (gastroesophageal reflux disease), it can’t be good. While usually not life-threatening, acid reflux, and all it’s monikers, definitely can threaten your quality of life. GERD has no respect for decadence on the dinner table, and no one wants to enjoy a delicious filet minion paired with a big,
full-bodied glass of cabernet only to have to follow it up with plop, plop fizz, fizz as dessert. So what is GERD and how can you manage it? Read on to comfortably digest what our local medical experts have to say about this
uncomfortable condition.



PYRx1120 docby Vincent K. Arlauskas, M.D.


Is acid reflux triggered more by the quantity
of food or the type of food?

Both. Quantity of foods and weight gain can lead to worsening of acid reflux. There are trigger foods for reflux, such as caffeine, peppermint, chocolate, spicy foods and alcohol. These trigger foods can worsen reflux no matter the quantity.


Are there longterm effects of acid reflux if I don’t seek treatment?

Yes. Long-term reflux, if left untreated, can scar the esophagus, which may cause food to get stuck. It can also potentially lead to esophageal cancer.

Vincent K. Arlauskas, M.D., Southeast Georgia Physician Associates-General & Vascular Surgery and Chief, Department of Surgery, Southeast Georgia Health System Brunswick Campus.



PYRx HaroldKentby Harold L. Kent, MD


Can I manage acid reflux
without medication?

Managing acid reflux without medication can be done in some cases through lifestyle changes. For patients who are overweight, getting down to a healthy weight can help to decrease the pressure on the stomach, which can lead to acid reflux. Other measures include avoiding trigger foods such as tomatoes, chocolate, coffee, and foods that the patient knows will produce heartburn. A standard recommendation for acid reflux includes elevating the head of one's bed on blocks in order to have gravity help with keeping gastric secretions away from the esophagus while sleeping. Discontinuing tobacco and alcohol will also help control acid reflux. For patients found to have acid reflux and a hiatal hernia, there are surgical anti-reflux procedures, most of which are now done laparoscopically, as well as endoscopic procedures which can control acid reflux in a majority of patients. These procedures surgically rebuild the anti-reflux mechanism of the lower esophagus.

How can I distinguish between heartburn and a heart attack?
Patients over the age of 50 who have risk factors for a heart attack such as pain in the arms, neck, chest and shoulder which are associated with shortness of breath, and anxiety or a feeling of impending doom—and even heartburn—should be evaluated immediately. The diagnosis of a heart attack can be confirmed by checking a blood test for troponin level. The results of this test can be obtained fairly rapidly in most centers. Obtaining an EKG is part of the process of evaluating a patient for a heart attack. However, there are heart conditions where an EKG may not reveal whether the patient has had a heart attack. If a patient experiencing heartburn alone as a symptom has a normal troponin level and EKG, the odds are they have not had a heart attack.

How do I know the difference between heartburn and acid reflux?
Acid reflux is the condition of having gastric acid and contents enter the esophagus due to a poorly functioning anti-reflux valve in the lower esophagus and/or the presence of a hiatal hernia. When the opening in the diaphragm where the esophagus joins with the stomach becomes enlarged, allowing the stomach and esophagus to slide through the hiatus, the condition is known as a hiatal hernia. When many people experience acid reflux, they describe the symptoms as a burning sensation behind their lower breastbone. This is frequently referred to as heartburn. Acid reflux is the condition that causes the symptoms of heartburn just like pain is the symptom of having a cut or burn. In extreme cases, patients can experience regurgitation where food passes from the stomach and up the esophagus.
My infant spits up a lot.

Can children have acid reflux?
Some infants are born with a poorly functioning esophageal valve and experience acid reflux, as well as aspiration (gastric secretions going into the windpipe). Infants born prematurely can be at increased risk for this. If standard non-operative treatments for reflux are unsuccessful, such as feeding in the upright position, thickened feeds etc., or if the infant has aspiration, then surgery may be required. Pediatric surgeons (fully trained general surgeons with additional training in performing operations in children) refined the laparoscopic technique of doing a Nissen fundoplication (and other variations) over 30 years ago to help fix acid reflux in children. In this procedure, the upper stomach is wrapped around the lower esophagus and sutured in place to form an anti-reflux valve. Sometimes a tube is also placed into the stomach through an incision in the abdominal wall during this procedure. Some episodes of infants spitting up are due to an enlarged, thickened muscle at the outlet of the stomach, a condition called hypertrophic pyloric stenosis. This usually causes vomiting and is also corrected surgically, either laparoscopically, or through a very small abdominal incision.

Dr. Harold L. Kent, specializing in Bariatric & General Surgery, is owner of Georgia Coast Surgical Med Spa & More, 3226-F Hampton Avenue, Brunswick; 912-264-9724. Website: Georgiacoastsurgical.com, Facebook: Georgia Coast Surgical & Med Spa.

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