Gastro-oesophageal reflux disease

Acid reflux is when the acid that is normally formed in your stomach backs up into the oesophagus.  When acid reflux causes bothersome symptoms or damage, doctors call it “gastroesophageal reflux disease” or “GORD.”

Common symptoms are Heartburn, which is a burning feeling in the chest, regurgitation, which is when acid and undigested food flows back into your throat or mouth, nausea or vomiting, stomach or chest pain, difficulty in swallowing, and having a raspy voice, a sore throat or unexplained cough.

Treatment includes lifestyle modifications such as weight loss (if you are overweight), regular exercises and raising the head end of the bed by 6 to 8 inches. It is also important to avoid foods that make symptoms worse (for some people these include coffee, chocolate, alcohol, peppermint, and fatty foods), stop smoking and avoid late meals. There are different classes of drugs such as proton pump inhibitors, histamine blockers and antacids available for symptom relief. 

Peptic ulcer disease

A peptic ulcer is a wound/sore that can form on the lining of the stomach or duodenum. (The duodenum is the first part of the small intestine .)

Different factors can cause peptic ulcer disease including Helicobacter pylori (H. pylori), a type of bacteria that can cause a stomach infection leading to inflammation, frequent use of NSAID-type painkillers (e.g. Ibuprofen, diclofenac) or steroids, smoking and drinking too much alcohol.

Some people with peptic ulcers have no symptoms. Other people can have symptoms that include pain in the upper belly, bloating or feeling full after eating a small amount of food, not feeling hungry, nausea or vomiting. Sometimes peptic ulcers can lead to serious problems such as bleeding or perforation –  A hole in the wall of the stomach or duodenum.

Treatment depends on the cause, but most peptic ulcers are treated with medicines. People with H. pylori infection are often treated with 3 or more medicines for 2 weeks to get rid of the infection. This treatment can include a tablet to reduce the amount of acid that is made in the stomach (proton-pump inhibitors) and different types of antibiotics. People without H pylori infection are treated with a course of proton pump inhibitors.

People who have serious problems from their peptic ulcers might also need to be treated with surgery.

Achalasia cardia

Achalasia is a condition that affects the oesophagus. At the lower end of the oesophagus, where it connects to the stomach, there is a muscle called the lower oesophagal sphincter(LES). When the LES tightens, food can’t move from the oesophagus into the stomach. When the LES relaxes, food can move from the oesophagus into the stomach. When people have achalasia, the lower part of the oesophagus does not work normally, The LES doesn’t relax, so food can’t move into the stomach.

The common symptoms of achalasia is trouble swallowing foods and drinks, chest pain, vomiting, heartburn, feeling like you have a lump in your throat and unintentional weight loss.

There are various modalities for the diagnosis of achalasia which includes upper gastrointestinal endoscopy, barium swallow and oesophagal manometry.

Most achalasia treatments involve the LES. Several types of treatment can either temporarily reduce your symptoms or permanently alter the function of the valve. As first-line therapy, doctors can either dilate the sphincter or alter it. Pneumatic dilation typically involves inserting a balloon into your oesophagus and inflating it. This stretches out the sphincter and helps your oesophagus function better. An alternative to this is giving an injection to relax the sphincter. Surgical treatment is the other treatment option. Surgery can be done through a camera which may be inserted through the mouth (endoscopic) or through the abdominal wall (laparoscopic).

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