Acid Reflux

A tube (esophagus) carries food from the throat to the stomach. Along the way a ring of muscle (lower esophageal sphincter) opens to allow food to pass. When weakened, this doesn’t close all the way and stomach acids seep back into the esophagus, causing acid reflux.

Symptoms

• Bitter taste from bile & stomach acids

The symptoms of heartburn can include:

• Burning pain behind the breastbone area.
• Burning pain or reflux symptoms that is worse when one is lying down or bending over.

Some people have reflux that damages the lining of the esophagus, but they have no symptoms to alert them that acid injury is occurring.

• Avoid food, beverages and medicines that affect the lower esophageal sphincter muscle action or irritate the lining of the esophagus.
• Aspirin, anti-inflamatory and pain medications other than acetaminophen.
• Decrease the size of portions at mealtimes. Don’t overeat!
• Eat meals two to three hours before lying down.
• Elevate the head of the bed four to six inches using blocks or telephone books.
• If you are overweight, lose weight.
• Avoid situations that can increase the pressure on the abdomen, as they will cause more reflux. Try simple things like avoiding tight clothing or control top hosiery and body shapers. Stop smoking, as cigarettes decrease the ability of the lower esophageal sphincter muscle to work properly.

There are usually no early symptoms of colorectal cancer. That’s why so many people who do not get screenings die. By the time it is discovered, it is often too late.

Symptoms include:

• Rectal bleeding
• Cramping
• Weight loss
• Constant fatigue

If Symptoms Persist Long Term

For occasional heartburn, over-the-counter medicines taken as directed can be helpful in reducing symptoms. If prolonged or frequent use of nonprescription medicines (more than directed on the product) becomes necessary, or if they do not completely control symptoms, a gastroenterologist should be consulted. People with severe esophageal reflux or heartburn symptoms unresponsive to the measures described above may need a more complete diagnostic evaluation. A variety of tests and procedures are currently used to further evaluate the patient with heartburn.

It can lead to very serious problems including cancer.

Causes of Acid Reflux

• Large Meals
• Fried, Fatty Foods
• Smoking
• Chocolate
• Alcohol
• Caffeine
• Citrus Fruits & Juices
• Peppermint & Spearmint
• Carbonated beverages
• Ketchup & Mustard
• Vinegar
• Tomato Sauce
• Citrus Fruits & Juices

Treatment for Acid Reflux

• Avoid causes
• Eat smaller & more frequent meals, slowly
• Don’t eat at least 2 hours before bedtime
• Elevate head of bed by 4-10 inches
• Lose weight
• Moderate exercise
• Wear lose fitting clothes
• Antacids (liquids)
• Medications, and if this fails, surgery is an option
• Avoid food, beverages and medicines that affect the lower esophageal sphincter muscle action or irritate the lining of the esophagus, such as:
  • Fried or fatty foods
  • Chocolate
  • Peppermint
  • Alcohol
  • Coffee (decaf too)
  • Carbonated beverages
  • Ketchup and mustard
  • Vinegar
  • Tomato sauce
  • Citrus fruits or juices
• Aspirin, anti-inflamatory and pain medications other than acetaminophen.
• Decrease the size of portions at mealtimes. Donʼt overeat!
• Eat meals two to three hours before lying down.
• Elevate the head of the bed four to six inches using blocks or telephone books.
• If you are overweight, lose weight.
• Avoid situations that can increase the pressure on the abdomen, as they will cause more reflux. Try simple things like avoiding tight clothing or control top hosiery and body shapers. Less obvious causes include sit-ups, leg-lifts or abdominal crunches.
• Stop smoking, as cigarettes decrease the ability of the lower esophageal sphincter muscle to work properly.

When to See a Doctor

After 2 weeks ask your doctor to consult a gastroenterologist for additional tests to rule out more serious conditions.

Treatment & Questions

Talk to your gastroenterologist to make an informed decision about what is right for you.

The muscle (lower esophageal sphincter) located between the esophagus and stomach normally opens after swallowing. This allows food to pass into the stomach. This lower esophageal sphincter muscle then closes quickly to prevent the return (reflux) of food and stomach juices back into the esophagus.

When the lower esophageal sphincter muscle either relaxes inappropriately or is very weak, the acid contents of the stomach can back up, or reflux, into the esophagus. This is called gastro-esophageal reflux and typically produces heartburn, a burning sensation below the sternum where your ribs come together. In addition to heartburn, symptoms may include a persistent sore throat, hoarseness, chronic cough, asthma, heart-like chest pain and a feeling of a lump in the throat. When the acid contents from the stomach regularly back up into the esophagus, chronic GERD can occur.

Several factors influence the occurrence and severity of gastroesophageal reflux and heartburn, including:

• The ability of the lower gastroesophageal sphincter muscle to open and close properly.
• The type and amount of stomach juices that are backed up into the esophagus.
• The clearing action of the esophagus.
• The neutralizing effect of saliva and other factors.

People experience GERD and heartburn in a variety of ways. Heartburn usually begins as a burning pain that starts behind the breastbone and radiates upward to the neck. Often there is a sensation of food coming back into the mouth, accompanied by an acid or bitter taste. Heartburn is sometimes called acid indigestion and usually occurs after meals.

If Acid Reflux Symptoms Persist

• Endoscopy
• Biopsy
• Esophageal Manometric Studies
• Impedance Monitoring
• pH (acid) Monitoring
• Surgery

Some may need surgery because of severe reflux and poor response to medical treatment plans. Fundoplication is a surgical procedure that reduces reflux. Patients not wanting to take medication to control their symptoms are also candidates for surgery.

When stomach acid backs up (refluxes) contents of the stomach can back up, or reflux, into the esophagus. This is called gastroesophageal reflux and typically produces heartburn, a burning sensation below the sternum where your ribs come together. In addition to heartburn, symptoms may include a persistent sore throat, hoarseness, chronic cough, asthma, heart-like chest pain and a feeling of a lump in the throat.

Acid Reflux typically produces heartburn, a burning sensation below the sternum where your ribs come together. In addition to heartburn, symptoms may include a persistent sore throat, hoarseness, chronic cough, asthma, heart-like chest pain and a feeling of a lump in the throat.

Printable Acid Reflex Fact Sheet

The region’s largest gastroenterology physician practice, Gastroenterology Professional Association, announces today that they have changed their name to Atlantic Digestive Specialists, effective immediately.

“We’ve learned that there is confusion in regard to the word ‘gastroenterology’ but that people more clearly understand the term ‘digestive’,” says Dr. Sean Lynch. “Gastroenterologists treat diseases associated with the entire digestive system, from the esophagus to the stomach, intestines and other digestive organs, and we hope our new name will help to make us as accessible and relatable as possible to our patients and the communities that we serve.”

A new logo has been created to accompany the name. It is a human form with an outline of the digestive tract.

“Our new name and logo best illustrates the services we provide,” says Dr. Lynch.

Because a healthy digestive system is essential to overall health, a new tagline has been developed — “Helping people inside & out”.

With offices in Somersworth, Portsmouth, and Hampton, Atlantic Digestive Specialists is dedicated to providing the most comprehensive services related to the digestive system and are the trusted colonoscopy and endoscopy providers.

Drs. Baquero, Damianos, Epstein, Flavin, Grondin, Hyett, Lynch, Maher, and Ruben are the most experienced board certified gastroenterologists in seacoast New Hampshire.

The physicians at Atlantic Digestive Specialists donate screening colonoscopies to eligible patients at Families First Health and Support Center in Portsmouth each spring during national colonoscopy awareness month.

Nurse Jane Cummings writes…

For the past three years, Atlantic Digestive Specialists has provided free colonoscopies for uninsured patients from Families First and other medical practices in the Seacoast area. Over 85 patients have been screened and received appropriate follow-up. Some have been diagnosed and referred for treatment. Portsmouth Regional Hospital donates the facility, and all laboratory fees are waived.

This occurs during three Saturdays during March, which is Colon Cancer Awareness month. The feedback from patients is extremely positive. They are given expert care and treated warmly and respectfully by all of the staff involved. They understand the benefit of screenings for colon cancer. Many have a family history and are advised to have screenings more frequently.

Dr. Epstein developed this program and oversees the entire medical process. Ana Drexler, RN, schedules the appointments and the nursing staffing at the Short Stay Unit. Janelle handles all the patient records. Everyone responds to my many questions with efficiency and good humor.

Most of us think of a colonoscopy as unpleasant and approach it with dread and fear. Our patients view it as a positive experience and appreciate the opportunity to receive a health screening that they are not able to afford. This is a great collaboration of the public and private sector resulting in preventive health services to the uninjured in the Seacoast community. It has been an honor for Families First to participate in this program

MT from Rochester writes…
It was a relief to have the colonoscopy done and know everything was ok. I was treated very well by everyone. The staff was amazing and relaxed me so I never worried. It would have been impossible for me to afford on my own. Thank you.

RH from Hampton writes…
All the staff and doctors were very nice to me. I do not have insurance so it really saved me a lot of money. I did not feel any pain. My father and grandfather died from colon cancer. I know I have to have more frequent procedures and am grateful to have this available for me.

Confusion about nitrate consumption persists

Preservative found in hot dogs, bacon, pepperoni

By Suzanne Laurent      [email protected]      June 02, 2013 2:00 AM

Many folks dusted off the grill last weekend and are ready for a summer of preparing meals outdoors.

A staple of the summer season for many is hot dogs and hamburgers. It’s also time to head out on vacations and indulge a little in sumptuous buffets that include other American favorites — bacon and sausages.

Over the last several years, there have been confusing messages to consumers about eating processed meats that have nitrites and nitrates.

Sodium nitrate and sodium nitrite are two food preservatives with very similar chemical formulas, but different properties in the body. Sodium nitrate helps prevent bacterial colonization of foods. Sodium nitrite is a strong oxidizing agent used as meat preservative.

While these compounds are added to meats like sausage, bacon and hot dogs, they are also found in natural sources. Nitrates are found in green vegetables and nitrites are also found in humans as a powerful antimicrobial agent. Nitrates are also found in some water supplies.

In the 1970s, there were studies that found, when cooked at high temperatures, nitrites and nitrates could form nitrosamines, which are cancer causing compounds.

“In the late 1970s, the USDA tried to ban sodium nitrite but was overridden by the meat industry,” said Dr. Angela Lambert, a naturopath and owner of Ancient Traditions in Portsmouth.

Lambert also pointed to a University of Hawaii study in 2005 that found processed meats increased the risk of pancreatic cancer by 67 percent.

“Colorectal cancer risk has been increased when linked to consumption of processed meats, particularly those containing sodium nitrite,” she said.

But, Dr. Aris Damianos, a gasterenterologist at Portsmouth Regional Hospital, said, “The studies are all over the map. … Of course, the less processed meats you eat, the better.”

Damainos said to really have any effect, dietary changes need to be made at a younger age.

“If you’re 60, say, the die has been cast,” he said. “The risk for gastric or colon cancer also includes hereditary and genetic factors. It also depends on other things like if the person is also a smoker.”

Damainos recommends a diet high in fruits and vegetables and high in fiber, with limited red meat and processed meats for optimum health.

“In general processed meats are fatty and this puts the heart at risk as well,” he said.

Alyssa Lavoie, a clinical registered dietitian at Portsmouth Regional Hospital, said she advises “moderation with everything.”

“I would advise against eating foods with nitrites and nitrates for pregnant women and very young children,” she said. “Nitrates may also cause a blood disorder in infants called methemoglobinemia. But, this would be found from nitrates in drinking water, not from eating processed meats.”

There are nitrite-free and nitrate-free products on the market. But, these products typically contain high amounts of nitrates obtained from ingredients like celery juice, which means they could contain as much as if not more than their traditional counterparts.

“A young child who never had a hot dog with nitrates added wouldn’t even know the difference in taste,” Lavoie said. “High-nitrate foods, in particular the processed meats like hot dogs, pepperoni, and sausage, are not healthy in general and limiting the intake of these items is important for heart health.”