The most common symptom of gastroesophageal reflux disease (GERD) is heartburn. It is something about 40 million Americans experience on a weekly basis.
Background: The most common symptom of gastroesophageal reflux disease (GERD) is heartburn. It is something about 40 million Americans experience on a weekly basis. Heartburn is caused when acidic stomach juices flow backward into the esophagus. This typically occurs when the lower esophageal sphincter, which is the natural valve that keeps stomach acid in the stomach and out of the esophagus, relaxes inappropriately. That relaxation exposes the esophagus to the harsh acid from the stomach. In some GERD patients, heartburn may be accompanied by other GERD symptoms, such as regurgitation of gastric contents into the mouth, chest pain and difficulty swallowing. Pulmonary manifestations, such as asthma, coughing or intermittent wheezing and vocal cord inflammation with hoarseness, occur in some GERD patients.
Treatment: Heartburn patients often take antacids to relieve symptoms. Liquid antacids tend to work better because they coat the esophagus and immediately neutralize the acid. Patients with constant heartburn who want the most effective medicine to suppress acid production should take a type of medicine called a proton pump inhibitor. There’s an over-the-counter version as well as about that other prescription medicines. These medicines are very effective at suppressing gastric acid so eliminate gastric acid but don’t’ keep people from refluxing gastric contents. Surgery can help patients, but many do not want to undergo such a drastic measure.
New treatment: There is a new option for patients that lies somewhere between medication and surgery. It actually replicates what is done in surgery and can be done on an outpatient basis in 30 minutes. It’s an endoscope procedure called the Plicator. The first step fo the procedure is to insert a guide wire. Then, doctors make dilation of the esophagus. An implant is released between the stomach and esophagus with a suture. The effects can be reversed if the patient so desires in the future.
Candidacy: Alfonso Torquati, M.D., an abdominal surgeon at Vanderbilt University Medical Center in Nashville, says any patient who suffers from GERD can have the procedure. Patients, however, who are in the early stages of the disease and seem to be doing well on medication should not be considered for the procedure.
Under Study: The procedure is being studied in an international trial. Dr. Torquati says researches need to prove that the device is a good treatment for GERD and that it is something insurance companies would want to cover.
(info from http://abclocal.go.com/wls/story?section=health&id=3656542)
Esophagus cancer associated with gastroesophageal reflux disease (GERD) is increasing at a rapid rate, says a review article published in the November/December issue of CA: A Cancer Journal for Clinicians, published by the American Cancer Society .
The article says that esophagus cancer is increasing at a faster rate than melanoma and prostate cancer. The rapid progress of the condition can be gauged from the fact that the incidence of esophageal adenocarcinomas has jumped by a massive 600 percent as compared to the 1970s. In comparison, the incidence of gastric cancers in decreasing, the article says. However, despite the alarming increase, the actual cases of the cancer of esophagus is only 7,000 to 8,000 new cases per year in the United States. In contrast, the American Cancer Society says that 145,000 people are likely to develop colon cancer by the end of 2005. The problem here is that there are no screening techniques that can rapidly diagnose esophageal cancer. The main conditions responsible for the development of the cancer are GERD and Barrett’s esophagus. The latter is a condition where the lining of the esophagus changes to that of the intestine. This is a recognized a pre-cancerous condition. It is also theorized that obesity may play a role in the development of the cancer.
“People who get this cancer are those who have GERD and, in the U.S., probably 60 million people have reflux and about 20 percent of those have reflux on a weekly basis, and those are the ones who’d be most at risk to get this cancer,” said Dr. Rhonda F.
Souza, co-author of the report and associate professor of medicine at the Dallas VA Medical Center and University of Texas Southwestern Medical School. “If you have chronic reflux, you need to pay attention, and if you have reflux and you have trouble swallowing, weight loss or bleeding, you should see a doctor. Those are alarm or early-warning signs.” There have been studies, which say that aspirin and other nonsteroidal anti-inflammatory drugs (NSAIDs) could prevent the progression of Bartlett’s into esophagus cancer, but they have not been convincing enough. It is recommended that men in the age group of 65-74 get regular endoscopies so that any tumor can be detected early and treated aggressively.