1)Gastroesophageal reflux disease (GERD), also known as acid reflux, is a long-term condition where stomach contents come back up into the esophagus resulting in either symptoms or complications.^[5][6] Symptoms include the taste of acid in the back of the mouth, heartburn, bad breath, chest pain, vomiting, breathing problems, and wearing away of the teeth.^[5] Complications include esophagitis, esophageal strictures, and Barrett's esophagus.^[5]

Risk factors include obesity, pregnancy, smoking, hiatus hernia, and taking certain medicines.^[5] Medications involved include antihistamines, calcium channel blockers, antidepressants, and sleeping medication.^[5] It is due to poor closure of the lower esophageal sphincter (the junction between the stomach and the esophagus).^[5] Diagnosis among those who do not improve with simpler measures may involve gastroscopy, upper GI series, esophageal pH monitoring, or esophageal manometry.^[5]

Treatment is typically via lifestyle changes, medications, and sometimes surgery.^[5] Lifestyle changes may include not lying down for three hours after eating, losing weight, avoiding certain foods, and stopping smoking.^[5] Medications include antacids, H₂receptor blockers, proton pump inhibitors, and prokinetics.^[5][8] Surgery may be an option in those who do not improve with other measures.^[5]

In the Western world, between 10 and 20% of the population are affected by GERD.^[8] Gastroesophageal reflux (GER) once in a while, without significant symptoms or complications, is more common.^[5] The condition was first described in 1935 by the American gastroenterologist Asher Winkelstein.^[9] The classic symptoms had been described earlier in 1925.^[10]

2)Gastroesophagal Reflux Disease is caused by a failure of the lower esophageal sphincter. In healthy patients, the "Angle of His"—the angle at which the esophagus enters the stomach—creates a valve that prevents duodenal bile, enzymes, and stomach acid from traveling back into the esophagus where they can cause burning and inflammation of sensitive esophageal tissue.

Factors that can contribute to GERD:

GERD has been linked to a variety of respiratory and laryngeal complaints such as laryngitis, chronic cough, pulmonary fibrosis, earache, and asthma, even when not clinically apparent. These atypical manifestations of GERD are commonly referred to as laryngopharyngeal reflux (LPR) or as extraesophageal reflux disease (EERD).

Factors that have been linked with GERD, but not conclusively:

In 1999, a review of existing studies found that, on average, 40% of GERD patients also had H. pylori infection.^[26] The eradication of H. pylori can lead to an increase in acid secretion,^[27] leading to the question of whether H. pylori-infected GERD patients are any different than non-infected GERD patients. A double-blind study, reported in 2004, found no clinically significant difference between these two types of patients with regard to the subjective or objective measures of disease severity.^[28]

Diagnosis[edit]

Endoscopic image of peptic stricture, or narrowing of the esophagus near the junction with the stomach: This is a complication of chronic gastroesophageal reflux disease and can be a cause of dysphagia or difficulty swallowing.

The diagnosis of GERD is usually made when typical symptoms are present.^[29] Reflux can be present in people without symptoms and the diagnosis requires both symptoms or complications and reflux of stomach content.^[30]

Other investigations may include esophagogastroduodenoscopy (EGD). Barium swallow X-rays should not be used for diagnosis.^[29]Esophageal manometry is not recommended for use in diagnosis, being recommended only prior to surgery.^[29] Ambulatory esophageal pH monitoring may be useful in those who do not improve after PPIs and is not needed in those in whom Barrett's esophagus is seen.^[29]Investigation for H. pylori is not usually needed.^[29]

The current gold standard for diagnosis of GERD is esophageal pH monitoring. It is the most objective test to diagnose the reflux disease and allows monitoring GERD patients in their response to medical or surgical treatment. One practice for diagnosis of GERD is a short-term treatment with proton-pump inhibitors, with improvement in symptoms suggesting a positive diagnosis. Short-term treatment with proton-pump inhibitors may help predict abnormal 24-hr pH monitoring results among patients with symptoms suggestive of GERD.^[31]

Endoscopy[edit]

Endoscopy, the looking down into the stomach with a fibre-optic scope, is not routinely needed if the case is typical and responds to treatment.^[29] It is recommended when people either do not respond well to treatment or have alarm symptoms, including dysphagia, anemia, blood in the stool (detected chemically), wheezing, weight loss, or voice changes.^[29] Some physicians advocate either once-in-a-lifetime or 5- to 10-yearly endoscopy for people with longstanding GERD, to evaluate the possible presence of dysplasia or Barrett's esophagus.^[32]

Biopsies performed during gastroscopy may show:

Reflux changes may not be erosive in nature, leading to "nonerosive reflux disease".

Severity[edit]

Severity may be documented with the Johnson-DeMeester's scoring system:^[34] 0 - None 1 - Minimal - occasional episodes 2 - Moderate - medical therapy visits 3 - Severe - interfere with daily activities

 3)Solution: 

 

 

 

 

 experience sleep disruptions and have dietary restrictions. Almost half of them have night-time symptoms, which affect their day activities.

In more severe cases, continued oesophageal damage can lead to scarring, which may cause the oesophagus to narrow, making it difficult to swallow. In some cases, normal cells in the lining of the esophagus may be replaced by a different type of cell. This is called Barrett's esophagus, which can sometimes develop into cancer. 
 

Heartburn, also called acid indigestion, is a symptom of gastroesophageal reflux (GERD). It can occur when acid or other contents from your stomach"back up" into the esophagus. That’s the tube food passes through going from your mouth to your stomach.

The problem stems from a muscle that may be weak or may relax at inappropriate times. It’s called the lower esophageal sphincter or LES, and it’s located between your stomach and your esophagus. If it doesn't close quickly enough, it can’t prevent the acid backwash. That results in heartburn. 

3. 

  

Loosen clothing

Heartburn happens when the contents of your stomach rise up into your esophagus, where stomach acids can burn the tissue.

In some cases, you might be having an episode of heartburn because tight clothing is compressing your stomach.

If that’s the case, the first thing to do is loosen your belt — or your pants, dress, or whatever else is holding you tight.

Stand up straight.Your posture can also contribute to heartburn. If you’re sitting or lying down, try standing up. If you’re already standing, try standing up more straightly.An upright posture puts less pressure on your lower esophageal sphincter (LES). Your LES is a ring of muscle that helps stop stomach acid from rising into your esophagus.

Elevate your upper body.Lying down can make heartburn worse. When it comes time for bed, adjust your sleeping surface to raise your upper body.According to the Mayo Clinic, lifting your head with extra pillows isn’t usually enough. Instead, the goal is to elevate your body from the waist up.If you have an adjustable bed, set it at a suitable angle to provide relief. If your bed isn’t adjustable, you can change the angle of your sleeping surface by using a wedge pillow.

Mix baking soda with water.You might have a heartburn remedy at hand in your kitchen without even knowing it. Baking soda can calm some episodes of heartburn by neutralizing your stomach acid.To do this, dissolve a teaspoon of baking soda in a glass of water and drink it slowly. In fact, you should drink everything slowly when you have heartburn.

Try ginger.Ginger has been used as a folk remedy for heartburn for centuries. Ginger can help relieve nausea, so some believe it may be worth trying for heartburn, too.Consider adding grated or diced ginger root to your favorite stir-fry recipes, soups, and other foods. To make ginger tea, steep raw ginger root, dried ginger root, or ginger tea bags in boiling water.It’s probably best to avoid ginger ale, though. Carbonated beverages are a common heartburn trigger, and most brands of ginger ale are made with artificial flavoring rather than the real thing.

Take licorice supplements:Licorice root is another folk remedy that’s been used to treat heartburn. It’s believed that it might help increase the mucous coating of your esophageal lining, which may protect your esophagus from damage caused by stomach acid.Deglycyrrhizinated licorice (DGL) is a supplement that contains licorice that’s been processed to remove much of its glycyrrhizin, a compound that can cause adverse side effects.Eating too much licorice or DGL may raise your blood pressure, lower your potassium levels, and interfere with certain medications. Always talk to your doctor before taking licorice or DGL supplements.

Sip apple cider vinegar Apple cider vinegar is another home remedy that some people use to treat heartburn, believing that it may neutralize stomach acid.One researcher suggested that drinking diluted apple cider vinegar after a meal may help alleviate heartburn for some people. However, these effects didn’t reach the level of statistical significance so more research is needed.If you decide to try this remedy, dilute the apple cider vinegar with water and drink it after your meal.

Chew gum.According to 2014 research, chewing gum for half an hour after meals may also help reduce heartburn.Chewing gum stimulates saliva production and swallowing. This might help dilute and clear stomach acid from your esophagus.

Avoid cigarette smoke.You probably already know that smoking is bad for your health. But did you know that smoking can contribute to heartburn? If you’re a smoker and you get an attack of heartburn, don’t light up.Smoking might be a go-to coping strategy when you’re uncomfortable, but it’s not going to make that burning feeling go away.

Take over-the-counter heartburn medication.There are plenty of over-the-counter (OTC) heartburn medications that are available for use. These medicines come in three classes:

PPIs and H2 blockers reduce how much acid your stomach secretes, which can help prevent and reduce heartburn symptoms. Antacids neutralize stomach acid.

The takeaway when heartburn hits, many over-the-counter treatments, home remedies, and lifestyle adjustments may provide relief.Adjusting your daily habits can also help prevent heartburn symptoms from developing in the first place. For example, try to:

If you experience heartburn more than two or three times a week, talk to your doctor. In some cases, they might prescribe medications or other treatments.

When you swallow, a circular band of muscle around the bottom of your esophagus (lower esophageal sphincter) relaxes to allow food and liquid to flow into your stomach. Then the sphincter closes again.

If the sphincter relaxes abnormally or weakens, stomach acid can flow back up into your esophagus. This constant backwash of acid irritates the lining of your esophagus, often causing it to become inflamed.
Conditions that can increase  risk of GERD include:

  In very serious cases, untreated GERD (and subsequent Barrett's esophagus) can lead to cancer of the esophagus. ... The main risk factors are smoking, drinking alcohol, poor diet, and chronic reflux disease. Symptoms include weight loss, trouble swallowing, or gastrointestinal bleeding.                                                                                      Gerd diet!                           

A diet rich in whole grains and fruits and vegetables can help manage GERD symptoms. If  experiencing heartburn or other symptoms of gastroesophageal reflux disease (GERD), chances are good that diet is one of the first things the doctor will ask about.                                                                                                            Avoid these food when having                       Gerd

items that people with GERD are often advised to avoid include:

 Lifestyle changes usually allow the body to heal itself in the majority of cases, and it means there won't be long-term damage to the esophagus, throat, or teeth. However, sometimes lifestyle changes are not enough. More serious cases of GERD can often be treated with medications such as: antacids.  This is unfortunate because GERD is generally a treatable disease, though serious complications can result if it is not treated properly. ... GERD is a chronic disease. Treatment usually must be maintained on a long-term basis, even after symptoms have been brought under control.  Although occasional acid reflux won't kill you, it should still be taken seriously. If left untreated, chronic acid reflux can lead to conditions that increase your risk for developing esophageal cancer, which can in fact kill you.  

 

What is the best treatment for acid reflux?

Antacids. Popular over-the-counter medications like Tums, Maalox, Rolaids andMylanta neutralize stomach acid and provide fast-acting relief in mild or isolated cases of acid reflux. Some antacids come in liquid form to coat the lining of the esophagus and help reduce the amount of acid in the stomach 

Are bananas good for acid reflux?

Banana. Bananas make a great snack, and at pH 5.6, they're usually great for people with acid reflux. However, about 1% of acid refluxers find that their condition is worsened by bananas.  

What fruit is good for acid reflux?

4. Noncitrus fruits. Noncitrus fruits, including melons, bananas, apples, and pears, are less likely to trigger reflux symptoms than acidic fruits.  While it's true that milk can temporarily buffer stomach acid, nutrients in milk, particularly fat, may stimulate the stomach to produce more acid. Even though milkmight not be a great heartburn remedy, however, it's a rich source of bone-building calcium. Try fat-free skim milk and don't overdo it.  

What drinks are good for acid reflux?

Herbal tea. Herbal teas help improve digestion and soothe many stomach problems, such as gas and nausea. Try caffeine-free herbal tea for acid reflux but avoid spearmint or peppermint teas. ... Licorice helps increase the mucus coating of the esophageal lining, which helps calm the effects of stomach acid.  

Is honey good for heartburn?

Honey may work in several ways to help acid reflux symptoms. An article published by the Indian Journal of Medical Research points out several key benefits: ... Honeymay work to reduce inflammation in the esophagus. Honey's texture allows it to better coat the mucous membrane of the esophagus.  

. Heartburn and GERD may make you feel like it's difficult to swallow or you may feela tightness in the throat, as if food is stuck in your throat or esophagus. You may have chest pain when lying down, bending over, or after eating.Sometimes the tissue damage from acid reflux can lead to a condition called Barrett's esophagus. ... However, people who have both GERD and Barrett's esophagus are more likely to develop esophageal cancer than people who only have GERD.Foods to Avoid with GERD

 

 For most Americans, heartburn is just an occasional problem. Sixty million people get it at least once a month.

But for the 19 million people who have a chronic form of heartburn known as gastroesophageal reflux disease (GERD), untreated symptoms can lead to a variety of health complications. 

If esophagitis goes on too long, scar tissue can narrow the esophagus. Called a stricture, this can make it hard or painful to swallow.

Large pieces of food can get stuck and may require endoscopy to remove them. You may also be at risk of choking, and you can lose too much weight if you avoid food and drinks because of a stricture.

A stricture is treated with a dilation, or stretching, of the esophagus. This may need repeating, but acid-blocking meds such as proton pump inhibitors (PPIs) may prevent it from returning. 

p.s.   i used google

The inflammation caused by Crohn's disease often spreads deep into the layers of affected bowel tissue. Crohn's disease can be both painful and debilitating, and sometimes may lead to life-threatening complications.

While there's no known cure for Crohn's disease, therapies can greatly reduce its signs and symptoms and even bring about long-term remission.  

Treatment can control or reduce the symptoms and help stop them coming back. With treatment, many people with Crohn's disease are able to function well. 
 

Medicines are the main treatments, but sometimes surgery may be needed. 

Anti-inflammatory drugs are often the first step in the treatment of inflammatory bowel disease. Immune system suppressors is another drugs that not only helps to also reduce inflammation, but they target your immune system, which produces the substances that cause inflammation. For some people, a combination of these drugs works better than one drug alone. Antibiotics can reduce the amount of drainage and sometimes heal fistulas and abscesses in people with Crohn's disease. Some researchers also think antibiotics help reduce harmful intestinal bacteria that may play a role in activating the intestinal immune system, leading to inflammation.  

Nutrition therapy is another treatment. Doctor may recommend a special diet given via a feeding tube (enteral nutrition) or nutrients injected into a vein (parenteral nutrition) to treat Crohn's disease. This can improve the patient's  overall nutrition and allow the bowel to rest. Bowel rest can reduce inflammation in the short term.


The doctor may use nutrition therapy short term and combine it with medications, such as immune system suppressors. Enteral and parenteral nutrition are typically used to get people healthier prior to surgery or when other medications fail to control symptoms.

The doctor may also recommend a low residue or low-fiber diet to reduce the risk of intestinal blockage if the patient has a narrowed bowel (stricture). A low residue diet is designed to reduce the size and number of his stools.

If diet and lifestyle changes, drug therapy, or other treatments don't relieve the signs and symptoms, the doctor may recommend surgery. Nearly half of those with Crohn's disease will require at least one surgery. However, surgery does not cure Crohn's disease.

During surgery, the surgeon removes a damaged portion of your digestive tract and then reconnects the healthy sections. Surgery may also be used to close fistulas and drain abscesses.

The benefits of surgery for Crohn's disease are usually temporary. The disease often recurs, frequently near the reconnected tissue. The best approach is to follow surgery with medication to minimize the risk of recurrence. 

Signs and symptoms should not be ignored. Most of these symptoms may be caused by things other than stomach cancer. They may also occur with other types of cancer. People who have any of these symptoms, especially if they don’t go away or get worse, should see their doctor to determine the cause and be treated.

 
Diagnosis

A doctor will diagnose GERD and recommend a course of treatment when the above symptoms are observed. If the symptoms do not improve after following the doctor’s advice or receiving basic treatment, the following tests may be used to provide a more detailed diagnosis:

For most patients, the symptoms are not severe and can be reduced through the following simple lifestyle changes:

What causes gastroesophageal reflux disease?

Stomach abnormalities. One common cause of acid reflux disease is a stomach abnormality called a hiatal hernia, which can occur in people of any age. A hiatal hernia happens when the upper part of the stomach and LES (lower esophageal sphincter) move above the diaphragm.




What are the warning signs of esophageal cancer?

If you notice that your reflux only occurs with certain foods, try eliminating them from your diet. Some people also find that sitting up straight during and after eating improves their symptoms.

Gastroesophageal reflux disease, or GERD, is a digestive disorder that affects the lower esophageal sphincter (LES), the ring of muscle between the esophagus and stomach. Many people, including pregnant women, suffer from heartburn or acid indigestion caused by GERD. Doctors believe that some people suffer from GERD due to a condition called hiatal hernia. In most cases, GERD can be relieved through diet and lifestyle changes; however, some people may require medication or surgery.

What is gastroesophageal reflux
Gastroesophageal refers to the stomach and esophagus. Reflux means to flow back or return. Therefore, gastroesophageal reflux is the return of the stomach's contents back up into the esophagus.

Types of food you should not eat when you have GERD

This is unfortunate because GERD is generally a treatable disease, though serious complications can result if it is not treated properly. GERD is a chronic disease. Treatment usually must be maintained on a long-term basis, even after symptoms have been brought under control.

Common signs and symptoms of GERD include:

Doctors recommend lifestyle and dietary changes for most people needing treatment for GERD. Treatment aims at decreasing the amount of reflux or reducing damage to the lining of the esophagus from refluxed materials.

More information about heartburn
Heartburn is a painful burning feeling in your chest or throat. It happens when stomach acid backs up into your esophagus, the tube that carries food from your mouth to your stomach. If you have heartburn more than twice a week, you may have GERD. However, you can have GERD without having heartburn.

  Increase the amount of protein you have by
- adding a couple of teaspoons of dried milk powder to each pint of milk to use like ordinary milk for drinking and cooking
-adding protein powders and high energy powders to everyday foods

-lack of physical activity      

Your mother’s meal should consist of fresh fruits and vegetables. Other symptoms include discomfort or pain in the stomach area, nausea, vomiting, difficulty swallowing, weight loss, vomiting blood or having blood in the stool and feeling bloated or full after a small meal. If your mother has more than 2 of the symptoms, consult a doctor immediately.