GERD (gastroesophageal reflux disease, or chronic acid reflux) is a condition in which acid-containing contents in your stomach persistently leak back up into your esophagus, the tube from your throat to your stomach. Acid reflux happens to nearly everyone at some point in life. Having acid reflux and heartburn now and then is totally normal. But, if you have acid reflux/heartburn more than twice a week over a period of several weeks, constantly take heartburn medications and antacids yet your symptoms keep returning, you may have developed GERD. Your GERD should be treated by your healthcare provider. Not just to relieve your symptoms, but because GERD can lead to more serious problems.
Acid reflux happens because a valve at the end of your esophagus, the lower esophageal sphincter, doesn’t close properly when food arrives at your stomach. Acid backwash then flows back up through your esophagus into your throat and mouth, giving you a sour taste.
Acid Reflux is treated with medications which decrease acid secretion and improve the movement of the stomach.
Laparoscopic antireflux surgery (or Nissen fundoplication) is the standard surgical treatment. It’s a minimally invasive procedure that fixes your acid reflux by creating a new valve mechanism at the bottom of your esophagus. The surgeon wraps the upper part of the stomach (the fundus) around the lower portion of the esophagus. This reinforces the lower esophageal sphincter so food won’t reflux back into the esophagus
What is Achalasia Cardia ? Achalasia is a rare disorder in which your esophagus is unable to move food and liquids down into your stomach. Your esophagus is the muscular tube that transports food from your mouth to your stomach. At the area where your esophagus meets your stomach is a ring of muscle called the lower esophageal sphincter (LES). This muscle relaxes (opens) to allow food to enter your stomach and contracts (tightens to close) to prevent stomach content from backing up into your esophagus. If you have achalasia, the LES doesn’t relax, which prevents food from moving into your stomach.
Why your esophageal muscles fail to contract and relax normally is unknown. One theory is that achalasia is an autoimmune disease (your body attacks itself) that is triggered by a virus. Your immune system attacks the nerve cells in the muscle layers of the walls of your esophagus and at the LES. Your nerve cells, which control muscle function, slowly degenerate for reasons that are not currently understood. This results in excessive contractions in the LES. If you have achalasia, the LES fails to relax and food and liquids can’t pass through your esophagus into your stomach.
Achalasia symptoms generally appear gradually and worsen over time. Signs and symptoms may include:
The goal of treatment is to relieve your symptoms by relaxing your lower esophageal sphincter (LES). Several treatments are available for achalasia including balloon dilation, medications, and botulinum toxin injection. The gold standard treatment for Achalasia is the Surgical procedure, Heller’s Myotomy
Heller’s Myotomy is the surgery used to treat Achalasia. The surgeon cuts the muscle at the lower end of the esophageal sphincter to allow food to pass more easily into the stomach. The procedure can be done non-invasively (Laparoscopic Heller Myotomy). Some people who have a Heller myotomy may later develop gastroesophageal reflux disease (GERD).
To avoid future problems with GERD, a procedure known as fundoplication might be performed at the same time as a Heller myotomy. In fundoplication, the surgeon wraps the top of your stomach around the lower esophagus to create an anti-reflux valve, preventing acid from coming back (GERD) into the esophagus. Fundoplication is usually done with a minimally invasive (laparoscopic) procedure.
Ulcer disease is a condition in which painful sores or ulcers develop in the lining of the stomach or the first part of the small intestine (the duodenum). Normally, a thick layer of mucus protects the stomach lining from the effect of its digestive juices. But many things can reduce this protective layer, allowing stomach acid to damage the tissue.
There are two main causes of ulcers:
H. pylori commonly infects the stomach. About 50% of the world’s population has an H. pylori infection, often without any symptoms. The H. pylori bacteria stick to the layer of mucus in the digestive tract and cause inflammation (irritation), which can cause this protective lining to break down. This breakdown is a problem because your stomach contains strong acid intended to digest food. Without the mucus layer to protect it, the acid can eat into stomach tissue.
Another major cause of peptic ulcer disease is the use of NSAIDs, a group of medications used to relieve pain. NSAIDS can wear away at the mucus layer in the digestive tract. These medications have the potential to cause peptic ulcers to form
Taking certain other medications along with NSAIDs, such as steroids, anticoagulants, low-dose aspirin, selective serotonin reuptake inhibitors (SSRIs), alendronate and risedronate can greatly increase the chance of developing ulcers
Infrequently, other situations cause peptic ulcer disease. People may develop ulcers after:
Peptic ulcer disease can also occur if you have a rare condition called Zollinger-Ellison syndrome.This condition forms a tumor of acid-producing cells in the digestive tract. These tumors can be cancerous or noncancerous. The cells produce excessive amounts of acid that damages stomach tissue.
Some people with ulcers don’t experience any symptoms. But signs of an ulcer can include:
In severe cases, symptoms can include:
Once a peptic ulcer is diagnosed majority of the patients respond very well to medications. In patients who have been diagnosed to have H.Pylori infection, a course of antibiotics is useful to prevent recurrence of ulcers.In a small group of patients who have complicated ulcers there may be a need for surgery to decrease the acid secretion
In very rare cases, complicated ulcer disease will require surgery. This may be the case for ulcers that: