This section comprises energetically oriented treatments that have to do with intention, energy healing, prayer, and in some cases god.
Acupuncture can help to mitigate some of the symptoms of GERD and may also help correct the underlying imbalance that is causing the condition.
There are no clinical studies linking stress directly to GERD. However, many people with GERD say that psychological issues including stress, tension, and feelings of anxiety make their symptoms worse. Fortunately, stress can be effectively managed to prevent some of its harmful effects on health.
The body’s natural relaxation response is effective against stress. This is the reason why relaxation therapy can be helpful in managing strress. Relaxation therapy is a broad term which describes a number of techniques that help reduce stress, relieve the body from tension, and promote a calm and peaceful state of mind.
There are many forms of relaxation techniques, they generally involve refocusing one's attention to something calming and increasing awareness of the body. Relaxation techniques counteract the unpleasant effects of stress and promotes your sense of well being. These techniques also have protective benefits especially if practiced regularly. If you are aware of what a stress response feels like, you will make an effort to practice a relaxation technique as soon as you start to feel stress symptoms. As a result, you are able to prevent stress from getting out of control. Yoga and Biofeedback Training are some of the relaxation techniques that may help people with GERD.
There are no clinical studies linking stress directly to GERD. However, many people with GERD say that psychological issues including stress, tension, and feelings of anxiety make their symptoms worse. Fortunately, stress can be effectively managed to prevent some of its harmful effects on health.
The body’s natural relaxation response is effective against stress. This is the reason why relaxation therapy can be helpful in managing strress. Relaxation therapy is a broad term which describes a number of techniques that help reduce stress, relieve the body from tension, and promote a calm and peaceful state of mind.
There are many forms of relaxation techniques, they generally involve refocusing one's attention to something calming and increasing awareness of the body. Relaxation techniques counteract the unpleasant effects of stress and promotes your sense of well being. These techniques also have protective benefits especially if practiced regularly. If you are aware of what a stress response feels like, you will make an effort to practice a relaxation technique as soon as you start to feel stress symptoms. As a result, you are able to prevent stress from getting out of control. Below Yoga and Biofeedback Training are some of the relaxation techniques that may help people with GERD.
Yoga
Yoga promotes relaxation, reduce anxiety, and help you cope with stress. Some yoga poses are thought to improve gastrointestinal symptoms. Although it has many health benefits, it is still important to remember that yoga is should not replace conventional therapies for any disorder. Always check with your doctor before starting any exercise.
Easy pose or Sukhasana
This basic yoga pose is a good meditation pose for beginners. Sukhasana opens the hips, lengthens the spine, relieves tiredness and and promotes inner calm.
Lighning bolt pose or Uktasana
Utkatasana means“raised posture.” This pose relieves shoulder stiffness, strengthens the legs and ankles, lifts the diaphragm, tones the back and stomach, and develops your chest. It also warms up the body.
Biofeedback Training
Biofeedback is a technique which involves training people to improve their health by using the mind to control bodily functions. In biofeedback session, you are connected to electrical sensors that allow you to measure and receive feedback or information about your body. With the help of these sensors, you will be trained how to make changes in your body to get the desired results. Biofeedback often helps with some health conditions or physical performance. It is often used as a relaxation technique.
Uses
Biofeedback is used in treating a number of physical and mental health issues, including:
How to use
There is no special preparation needed for biofeedback. If you think you might benefit from this technique, discuss it first with your doctor to make sure that it is a good treatment option for you. Your doctor may recommend a biofeedback therapist who has enough experience treating the same conditions you have. Many biofeedback therapists are also licensed in another area of health care, such as nursing or physical therapy.
Biofeedback training is done in specialized labs. During the session, the therapist applies electrical sensors on different areas of the patient's body, such as the abdomen, head or other body parts, and will be hooked to the biofeedback machine. These sensors monitors body functions such as heart rate, body temperature and blood pressure. The information is fed back to the patient as cues, such as a beeping sound or a flashing light. The therapist gives instruction on different ways, both mental and physical, to help control the body's physiological reactions.
A biofeedback session can last for 30 to 60 minutes. The length and number of sessions will depend on your condition and how quickly you learn to control your body's responses. After weeks of practice, the biofeedback machines are no longer needed, and you can practice the techniques on your own. [
Lifestyle changes
Dietary and lifestyle modifications play a significant part in GERD therapy. The recommendations for making lifestyle changes are based on physiologic data that certain body positions, tobacco and alcohol use, and body mass index contribute to the lower esophageal sphincter relaxation, reflux, or both. Although there are little data to support the effectiveness of lifestyle intervention on relieving symptoms, the American College of Gastroenterology continue to recommend these measures as adjuncts to drug therapy.
Below are some tips to significantly reduce the frequency and severity of acid reflux symptoms.
Don't lie down after eating
Wait for least two to three hours after eating before lying on your back going to bed. Gravity helps to keep the stomach content from backing up into the esophagus. Lying down puts the stomach at the same level, or even above the level of the esophagus and this can increase the likelihood for reflux.
Elevate your head a few inches while you sleep.
This is a standard lifestyle modification for GERD. Lying flat presses the gastric contents against the lower esophageal sphincter and may result in reflux. An elevation of about 6 to 9 inches will allow gravity to assist in preventing reflux while you sleep. You can elevate your head by placing wood or cement blocks under the the feet of your bed. If this is not possible, you use a foam wedge. Insert the wedge between your mattress and box spring to elevate the upper half of your body. Wedges are available in medical supply stores.
Maintain a healthy weight.
Obesity can aggravate the symptoms of GERD. Having extra weight increases abdominal pressure which can push stomach contents up into the esophagus. The frequency and severity of GERD seems to be worse in obese patients. A National Health and Nutrition Examination Survey (NHANES) study shows that a significantly higher number of GERD-related hospitalizations occurred among the obese.
If you are overweight or obese, talk to your doctor to find out about weight-loss programs that would work best for you.
Don't smoke.
Patients with GERD are advised to quit smoking because it is thought to decrease the lower esophageal sphincter's ability to function properly. It is also known to stimulate the production of stomach acid and reduce salivary secretion rate. Both of these effects will compromise the body's natural defenses against GERD.
Avoid tight-fitting clothing.
Clothes that fit tightly around your waist, such as snug jeans or a tight belt, can increase pressure on your abdomen and the lower esophageal sphincter.
Keep a diary of GERD symptoms
Write down your symptoms and see if there's a pattern. This is a good way to find out when heartburn occurs and the specific activities that trigger the symptoms.
References:.
Katz, P.,Curbside Consultation in GERD: 49 Clinical Questions. 2008. Slack
Mauk, K., Gerontological Nursing: Competencies for Care. 2006. Jones & Bartlett
http://www.medicinenet.com/script/main/art.asp?articlekey=42494
Lifestyle changes
Dietary and lifestyle modifications play a significant part in GERD therapy. The recommendations for making lifestyle changes are based on physiologic data that certain body positions, tobacco and alcohol use, and body mass index contribute to the lower esophageal sphincter relaxation, reflux, or both. Although there are little data to support the effectiveness of lifestyle intervention on relieving symptoms, the American College of Gastroenterology continue to recommend these measures as adjuncts to drug therapy.
Below are some tips to significantly reduce the frequency and severity of acid reflux symptoms.
Don't lie down after eating
Wait for least two to three hours after eating before lying on your back going to bed. Gravity helps to keep the stomach content from backing up into the esophagus. Lying down puts the stomach at the same level, or even above the level of the esophagus and this can increase the likelihood for reflux.
Elevate your head a few inches while you sleep
This is a standard lifestyle modification for GERD. Lying flat presses the gastric contents against the lower esophageal sphincter and may result in reflux. An elevation of about 6 to 9 inches will allow gravity to assist in preventing reflux while you sleep. You can elevate your head by placing wood or cement blocks under the the feet of your bed. If this is not possible, you use a foam wedge. Insert the wedge between your mattress and box spring to elevate the upper half of your body. Wedges are available in medical supply stores.
Maintain a healthy weight.
Obesity can aggravate the symptoms of GERD. Having extra weight increases abdominal pressure which can push stomach contents up into the esophagus. The frequency and severity of GERD seems to be worse in obese patients. A National Health and Nutrition Examination Survey (NHANES) study shows that a significantly higher number of GERD-related hospitalizations occurred among the obese.
If you are overweight or obese, talk to your doctor to find out about weight-loss programs that would work best for you.
Don't smoke.
Patients with GERD are advised to quit smoking because it is thought to decrease the lower esophageal sphincter's ability to function properly. It is also known to stimulate the production of stomach acid and reduce salivary secretion rate. Both of these effects will compromise the body's natural defenses against GERD.
Avoid tight-fitting clothing.
Clothes that fit tightly around your waist, such as snug jeans or a tight belt, can increase pressure on your abdomen and the lower esophageal sphincter.
Keep a diary of GERD symptoms
Write down your symptoms and see if there's a pattern. This is a good way to find out when heartburn occurs and the specific activities that trigger the symptoms.
In addition to drug therapy, patients with GERD are encouraged to make lifestyle changes. Many people are able to control their symptoms by making simple changes in the diet and eating habits. Controlling severity and frequency of acid reflux can be done by avoiding foods that may trigger heartburn, proper meal timing and watching your meal sizes.
In addition to drug therapy, patients with GERD are encouraged to make lifestyle changes. Many people are able to control their symptoms by making simple changes in the diet and eating habits. Controlling severity and frequency of acid reflux can be done by avoiding foods that may trigger heartburn, proper meal timing and watching your meal sizes.
In addition to drug therapy, patients with GERD are encouraged to make lifestyle changes. Many people are able to control their symptoms by making simple changes in the diet and eating habits. Controlling severity and frequency of acid reflux can be done by avoiding foods that may trigger heartburn, proper meal timing and watching your meal sizes.
In addition to drug therapy, patients with GERD are encouraged to make lifestyle changes. Many people are able to control their symptoms by making simple changes in the diet and eating habits. Controlling severity and frequency of acid reflux can be done by avoiding foods that may trigger heartburn, proper meal timing and watching your meal sizes.
In addition to drug therapy, patients with GERD are encouraged to make lifestyle changes. Many people are able to control their symptoms by making simple changes in the diet and eating habits. Controlling severity and frequency of acid reflux can be done by avoiding foods that may trigger heartburn, proper meal timing and watching your meal sizes.
Many herbs are used as natural remedies for digestive disorders including heartburn. Herbs are available in different forms. They may be used as dried extracts (capsules, powder, teas), glycerine extracts or tinctures. It is important to tell your doctor if you plan to use herbs for treating your symptoms.
Many herbs are used as natural remedies for digestive disorders including heartburn. Herbs are available in different forms. They may be used as dried extracts (capsules, powder, teas), glycerine extracts or tinctures. It is important to tell your doctor if you plan to use herbs for treating your symptoms.
Barberry (Berberis vulgaris, Mahonia aquifolium)
This herb is also known as Oregon grape, Oregon barberry, Oregon grapeholly, trailing mahonia, berberis, jaundice berry, woodsour, sowberry, pepperidge bush, and sour-spine. Barberry grows wild throughout Europe but has been naturalized to many regions of the eastern US. Barberry has spiny, leaves and is widely grown as an ornamental plant. Its bright yellow flowers bloom between the months of April and June and become dark, red berries in the fall. The bark, roots and berries are used for medicinal purposes. Read more about [Barberry and stomach problems
More on [Barberry and Stomach Problems][3]
Many herbs are used as natural remedies for digestive disorders including heartburn. Herbs are available in different forms. They may be used as dried extracts (capsules, powder, teas), glycerine extracts or tinctures. It is important to tell your doctor if you plan to use herbs for treating your symptoms.
GERD is usually treated with a combination of diet and lifestyle changes, medications, and in some cases, surgery. Most doctors would first consider the least expensive and least invasive options such as over-the-counter medicines, then they work their way to more intensive forms of treatment.
Medications for GERD
There are various medications that can help relieve symptoms of GERD. They are available as over-the counter and prescription drugs. The most common over the counter-the-counter products are antacids. These drugs chemically react with stomach acids by forming salt and water.
Read more about GERD and antacids
GERD and H2 Blockers
Stomach acid production is a normal part of the digestive process. If stomach acid are produced excessively, this can cause the pain and discomfort in the abdomen commonly known as indigestion. The excess acid may also reflux into the esophagus, causing pain and a burning sensation known as heartburn. Conditions that cause excessive acid production may be treated with H2 blockers or H2 receptor antagonists.
Read more about H2 Blockers and GERD
GERD and Proton Pump Inhibitors
Another way to reduce stomach acid is to shut down the "pumps" in the acid-secreting cells. This is how proton pump inhibitors — a class of potent acid-suppressing drugs— stop cells in the lining of the stomach from making too much acid. Doctors usually these drugs to promote the healing of peptic ulcers.
Read more about Proton Pump Inhibitors and GERD
References:
Anthony, P.,Delmar's Pharmacy Technician Certification Exam Review. 2nd Edition. 2003. Delmar Cengage Learning.
Rosenthal. M. 50 Ways to Relieve Heartburn, Reflux and Ulcers. 2001.
McGraw-Hill
GERD is usually treated with a combination of diet and lifestyle changes, medications, and in some cases, surgery. Most doctors would first consider the least expensive and least invasive options such as over-the-counter medicines, then they work their way to more intensive forms of treatment.
Medications for GERD
There are various medications that can help relieve symptoms of GERD. They are available as over-the counter and prescription drugs. The most common over the counter-the-counter products are antacids. These drugs chemically react with stomach acids by forming salt and water.
Read more about GERD and antacids
GERD and H2 Blockers
Stomach acid production is a normal part of the digestive process. If stomach acid are produced excessively, this can cause the pain and discomfort in the abdomen commonly known as indigestion. The excess acid may also reflux into the esophagus, causing pain and a burning sensation known as heartburn. Conditions that cause excessive acid production may be treated with H2 blockers or H2 receptor antagonists.
Read more about H2 Blockers and GERD
GERD and Proton Pump Inhibitors
Another way to reduce stomach acid is to shut down the "pumps" in the acid-secreting cells. This is how proton pump inhibitors — a class of potent acid-suppressing drugs— stop cells in the lining of the stomach from making too much acid. Doctors usually these drugs to promote the healing of peptic ulcers.
Read more about Proton Pump Inhibitors and GERD
Most cases of GERD can be diagnosed and treated by primary care doctors. However some patients may require referral to gastroenterologists, the doctors who specialize in the diseases of the digestive system.
Many cases of GERD can be diagnosed on the basis of medical history and physical exam results. Your doctor will ask you a number of questions pertaining to the symptoms, such as their onset, frequency, and severity. It is also important for the doctor to find out what you do to relieve you from your symptoms and what seems to make them worse.
Physical examination is also an important diagnostic tool. During this procedure your doctor will:
Sometimes further testing may be needed to diagnose GERD and to find out the extent of damage it has caused. Below are the diagnostic tests for GERD:
Upper GI series or barium swallow is one of the common tests to diagnose problems in the esophagus, stomach, and duodenum. The stomach and small intestine must be empty for this procedure to be accurate. Before the scheduled upper GI series, the patient will be advised not to eat or drink anything after midnight. Other specific instructions will be given by the doctor.
For this test, the patient will be asked to drink barium, a thick, white, chalky liquid that will coat the digestive tract. Then X-rays of the upper digestive tract will be taken. The barium coating makes the esophagus, stomach and upper intestine to show up more clearly on X-ray. The upper GI series is useful in detecting problems such as ulcers, scar tissue, abnormal growths or hernia.
The upper GI series test usually takes 1 to 2 hours. It is a painless procedure, but the barium may cause constipation and white colored stool for a few days. The doctor may recommend drinking plenty of water to flush the barium from in about 2 to 3 days. Remedies for constipation may also be suggested.
Endoscopic examinationallows direct visualization of the esophagus and the stomach. In preparation for the procedure, the patient is advised not to eat anything for at least six hours before the scheduled endoscopy. A local anesthetic will be sprayed into the patient's throat to suppress the gag reflex, and a mild intravenous sedative will also be given to help the patient relax. Then a thin, flexible tube is inserted into the esophagus. The tube (endoscope) is equipped with a tiny camera and light, this device will give an accurate picture of what is happening in the upper gastrointestinal tract. The images from the esophagus and stomach will be seen on a video monitor. Still images can also be captured for for further diagnosis and hospital records. During endoscopy, the doctor also may collect tissue sample for further testing.
Ambulatory acid (pH) probe tests is currently the best method available for quantifying the exposure of the esophagus to acid. Ambulatory acid (pH) probe test records when, and for how long, stomach acid regurgitates into your esophagus. This test can also detect whether the reflux triggers respiratory symptoms, such as wheezing and coughing. In addition, the pH probe test can be used for evaluating the effectiveness of medical or surgical treatments.
In preparation for the ambulatory acid probe test, the patient will be instructed not eat or drink anything for six hours before the scheduled procedure. If you're taking GERD medications, your doctor may may also ask you to stop taking them to prepare for the test. Ambulatory acid (pH) probe tests involves placing an acid-measuring device in the esophagus. The doctor will first apply a local anesthetic to the nasal lining to numb the nose. Then a thin, flexible tube is passed through your nose into the esophagus. During the test, the tube stays in place and connects to a small computer that you wear around your waist or with a strap over your shoulder. After the probe is placed, the patient may leave the hospital and encouraged to continue normal activities. Resuming normal tasks will allow the doctor to get a realistic picture of what is happening in the esophagus. Patients will be asked to return in about 24 hours, the pH probe will be removed and the data will be transferred to a computer for analysis.
Esophageal impedance is a relatively new test for GERD. Impedance technology gives accurate information on the occurrence of reflux episode regardless of its chemical composition. Its basic principle is similar to the the 24-hour ambulatory acid testing: recording esophageal events with a probed placed through the nose. Unlike the pH probe, this test can detect episodes of low acid a or non-acid reflux, the height to which the regurgitation extends, and the clearing of the refluxed stomach contents from the esophagus. Impedance technology works by measuring changes in electrical current as substances pass through the esophagus.
Impedance monitoring is particularly helpful in assessing reflux in patients who are on acid suppression therapy. This group of patients may continue to have episodes of reflux even when their symptoms are controlled. In cases of adequate acid suppression, the reflux episodes may not be detected by the 24-hour acid probe test because the ph of the refluxed substance is not acidic enough.
.
References:
http://health.usnews.com/usnews/health/digestive-diseases/gerd/gerd.test.impedance.htm
Fischer,J., Bland, K.I. Mastery of surgery, Volume 1. 2007. Wolters Kluwer Health/Lippincott Williams & Wilkins
Most cases of GERD can be diagnosed and treated by primary care doctors. However some patients may require referral to gastroenterologists, the doctors who specialize in the diseases of the digestive system.
Many cases of GERD can be diagnosed on the basis of medical history and physical exam results. Your doctor will ask you a number of questions pertaining to the symptoms, such as their onset, frequency, and severity. It is also important for the doctor to find out what you do to relieve you from your symptoms and what seems to make them worse.
Physical examination is also an important diagnostic tool. During this procedure your doctor will:
Sometimes further testing may be needed to diagnose GERD and to find out the extent of damage it has caused. Below are the diagnostic tests for GERD:
Upper GI series or barium swallow is one of the common tests to diagnose problems in the esophagus, stomach, and duodenum. The stomach and small intestine must be empty for this procedure to be accurate. Before the scheduled upper GI series, the patient will be advised not to eat or drink anything after midnight. Other specific instructions will be given by the doctor.
For this test, the patient will be asked to drink barium, a thick, white, chalky liquid that will coat the digestive tract. Then X-rays of the upper digestive tract will be taken. The barium coating makes the esophagus, stomach and upper intestine to show up more clearly on X-ray. The upper GI series is useful in detecting problems such as ulcers, scar tissue, abnormal growths or hernia.
The upper GI series test usually takes 1 to 2 hours. It is a painless procedure, but the barium may cause constipation and white colored stool for a few days. The doctor may recommend drinking plenty of water to flush the barium from in about 2 to 3 days. Remedies for constipation may also be suggested.
Endoscopic examinationallows direct visualization of the esophagus and the stomach. In preparation for the procedure, the patient is advised not to eat anything for at least six hours before the scheduled endoscopy. A local anesthetic will be sprayed into the patient's throat to suppress the gag reflex, and a mild intravenous sedative will also be given to help the patient relax. Then a thin, flexible tube is inserted into the esophagus. The tube (endoscope) is equipped with a tiny camera and light, this device will give an accurate picture of what is happening in the upper gastrointestinal tract. The images from the esophagus and stomach will be seen on a video monitor. Still images can also be captured for for further diagnosis and hospital records. During endoscopy, the doctor also may collect tissue sample for further testing.
Ambulatory acid (pH) probe tests is currently the best method available for quantifying the exposure of the esophagus to acid. Ambulatory acid (pH) probe test records when, and for how long, stomach acid regurgitates into your esophagus. This test can also detect whether the reflux triggers respiratory symptoms, such as wheezing and coughing. In addition, the pH probe test can be used for evaluating the effectiveness of medical or surgical treatments.
In preparation for the ambulatory acid probe test, the patient will be instructed not eat or drink anything for six hours before the scheduled procedure. If you're taking GERD medications, your doctor may may also ask you to stop taking them to prepare for the test. Ambulatory acid (pH) probe tests involves placing an acid-measuring device in the esophagus. The doctor will first apply a local anesthetic to the nasal lining to numb the nose. Then a thin, flexible tube is passed through your nose into the esophagus. During the test, the tube stays in place and connects to a small computer that you wear around your waist or with a strap over your shoulder. After the probe is placed, the patient may leave the hospital and encouraged to continue normal activities. Resuming normal tasks will allow the doctor to get a realistic picture of what is happening in the esophagus. Patients will be asked to return in about 24 hours, the pH probe will be removed and the data will be transferred to a computer for analysis.
Esophageal impedance is a relatively new test for GERD. Impedance technology gives accurate information on the occurrence of reflux episode regardless of its chemical composition. Its basic principle is similar to the the 24-hour ambulatory acid testing: recording esophageal events with a probed placed through the nose. Unlike the pH probe, this test can detect episodes of low acid a or non-acid reflux, the height to which the regurgitation extends, and the clearing of the refluxed stomach contents from the esophagus. Impedance technology works by measuring changes in electrical current as substances pass through the esophagus.
Impedance monitoring is particularly helpful in assessing reflux in patients who are on acid suppression therapy. This group of patients may continue to have episodes of reflux even when their symptoms are controlled. In cases of adequate acid suppression, the reflux episodes may not be detected by the 24-hour acid probe test because the ph of the refluxed substance is not acidic enough.
Heartburn and regurgitation are classic symptoms of GERD. The back flow of acid stimulates the nerve fibers in the esophagus, and this commonly results in heartburn. The episodes of heartburn can last up to a couple of hours. It is usually described as burning pain behind the breast bone. The discomfort may start in the epigastric area or the upper abdomen and may spread into the neck. In some cases, the pain may be sharp or pressure-like, rather than burning. It may even be mistaken as a heart attack. Some patients report that the pain may extend to the back. Acid reflux is more common after meals, hence many people who have GERD notice that their heartburn is worse after eating.
Heartburn is also more common when on supine position or flat on the back. Without the effects of gravity, the stomach contents may easily move backwards into the esophagus and return to the stomach at a slower rate. Many people with GERD are awakened from sleep by the discomfort caused by heartburn
Acid regurgitation is the unpleasant return of sour and bitter stomach contents in the pharynx. At the upper end of the esophagus is a valve known as upper esophageal sphincter (UES) which prevents esophageal contents from backing up into the throat. When small amounts of refluxed substance get through the UES and enter the throat, there may be an acid taste in the mouth. Frequent regurgitation can lead to acid-induced erosions of the teeth.
Painful or difficult swallowingis also a common symptom of GERD. Frequent regurgitation of stomach contents can irritate the lining of the esophagus, this can result in inflammation or ulcers. Pain occurs when swallowed food passes the inflamed areas of the esophagus. When the irritated areas heal, its damaged cells are replaced, but the scarring may cause narrowing of the esophagus. This can result in difficulty swallowing or feeling that food is stuck in the throat.
Other signs and symptoms include:
It is very important to contact your doctor if symptoms occur frequently, and if they interfere with your daily activities. Some symptoms of GERD also occur in other health problems, the doctor's evaluation will help in determining whether the signs and symptoms are caused by GERD or other conditions.
