Gastroesophageal Reflux

Gastroesophageal reflux disease, commonly referred to as GERD or acid reflux is a chronic condition in which the liquid content of the stomach backs-up or refluxes into the esophagus. The liquid usually contains acid, bile and/or pepsin (a stomach digestive enzyme) which inflames and can damage the esophagus lining. Heartburn and acid reflux are common digestive conditions, but when they occur more than twice a week or interfere with daily life, the term is GERD. Reflux commonly occurs when a person is in the upright position allowing gravity to play a helpful role in pulling the liquid back into the stomach. But, while a person sleeps gravity does not play a role, so reflux at night is likely to result in damage to the esophagus.

Signs and symptoms include a burning sensation in the chest (heartburn) and sometimes in the throat. Also, chest pains, difficulty swallowing, dry cough and sore throat are common symptoms. Some may have a sensation of a lump in the throat as well.

Conditions that increase a person’s risk of GERD are obesity, pregnancy, smoking, asthma, diabetes and having a chronic dry mouth. Chronic inflammation/irritation of the esophagus can lead to other serious conditions such as esophageal stricture, esophageal ulcer and Barrett’s esophagus.

Often time’s doctors are able to diagnose GERD by the symptoms given, but sometimes other measures are used to be certain. A x-ray of the upper digestive system is sometimes used to allow the doctor to see the shape and condition of the esophagus, stomach and upper intestine. Also, an endoscopy can be used. This procedure calls for passing a flexible tube down the throat with a camera attached to the end, allowing the doctor to examine the esophagus and stomach. A test to monitor the amount of acid in the esophagus may also be performed as well as a test to measure the movement of the esophagus.

Initial treatment is generally done with over-the-counter pills to control acid such as antacids, medications to reduce acid production or to heal the esophagus. After a few weeks, if these medications do not work, then the doctor will prescribe other treatments to help. Most symptoms of GERD can be controlled with medications, but in situations where they are not helpful, surgery and other procedures may be recommended.

Although medications commonly work, a person can reduce the frequency of heartburn by changing certain aspects of their lifestyle. Maintaining a healthy weight will help relieve abdominal pressure against the stomach that would cause a back-flow into the esophagus. Avoiding tight fitting clothing also helps alleviate abdominal pressure. Avoiding fatty foods, alcohol, caffeine and other known foods to cause heartburn would greatly help. It is also recommended that you don’t lie down within two hours after finishing a meal, as well as avoiding smoking.

There are natural remedies as well. Herbal remedies used to help alleviate GERD symptoms include eating/drinking licorice, chamomile and marshmallow. Relaxation therapies to help calm stress and anxiety that bring on GERD symptoms can help. Relaxation therapy such as progressive muscle relaxation and guided imagery are used as well. Acupuncture has also been known to help with heartburn.

Anthony McClanahan
April Green
41 Sports Intern

For Further Information:
http://www.medicinenet.com/gastroesophageal_reflux_disease_gerd/page2.htm
http://www.mayoclinic.com/health/gerd/DS00967/DSECTION=symptoms

Lymphedema

The lymphatic system is one of the main systems that keeps your body healthy. It circulates protein-rich lymph fluid, collects bacteria, viruses and waste products. The wastes are filtered and flushed from the body via the lymph system. Lymphedema refers to swelling that occurs often in the legs and arms from a blockage in the lymphatic system, preventing the fluid in the arms and legs from moving freely (the more fluid that builds up, the more swelling that occurs). Lymphedema has no cure, but can be controlled with care.

Symptoms include having the affected limbs feel tight or heavy and having a restricted range of motion (limitation of movement). Other symptoms include discomfort and aching in the limbs and hardening/thickening of the skin on the affected arms/legs. Chronic infections in the affected limb is also very likely.

Lymphedema is either primary or secondary; primary meaning that it occurs on its own and secondary indicating that it was caused by another condition. Primary lymphedema is inherited, caused by developmental problems with the lymph vessels. It occurs mostly in women and usually affects the legs. Specific causes of primary lymphedema include, Milroy disease, meige disease and late-onset lymphedema. Secondary lymphedema can be caused by any condition or procedure that damages the lymph nodes or vessels; things such as, surgery, radiation treatment, cancer, infection or a serious injury affecting the lymphatic system can all cause secondary lymphedema.

The causes of lymphedema are not always obvious, so imaging tests are performed to properly diagnose. To look at the lymphatic system, imaging systems such as an MRI, CT, radionuclide imaging or a doppler ultrasound may be used.

Lymphedema can lead to other serious complications such as infections, elephantiasis and lymphangiosarcoma, that is why treatment is vital. Treatment focuses on minimizing swelling and controlling pain. Light exercise can significantly improve limb movement by aiding in pumping lymph fluid. Massaging your affected limb(s) encourages the flow of lymph fluid. Wrapping your arm or leg completely (similar to pneumatic compression or other compression garments) aids in lymph fluid movement.

In cases of severe lymphedema, surgery may be considered to remove excess tissue in your arm or leg. Reducing severe swelling, but not curing lymphedema.

Anthony McClanahan
April Green

41 Sports Intern

For more information see:
http://www.mayoclinic.com/health/lymphedema/DS00609