Reflux heartburns

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    ‘While the pandemic can cause severe stress and increase stomach acid production, there is no medical evidence that coronavirus could cause reflux.’

    REFLUX Heartburns is a milder stage of Reflux Esophagitis, which is an inflammatory condition where Hydrocholoric Acid, normally produced by the stomach to aid in the digestion of food, regurgitates (goes back up) to the lower end of the esophagus (food pipe) which is connected to the stomach. In majority cases of reflux, the lower esophageal sphincter (“valve”) is incompetent (loose) and allows stomach acid and food to back up to the esophagus, a disease medically known as Gastro-Esophageal Reflux Disease (GERD). In some cases, acid reflux is not necessary for heartburns to occur.

    Can reflux mimic COVID-19?

    COVID-19 and GERD can have similar initial symptoms, like cough and chest pains, but the similarity ends there. While the pandemic can cause severe stress and increase stomach acid production, there is no medical evidence that coronavirus could cause reflux.

    Statistically, there could be aggravation of GERD symptoms during this global corona viral disease.

    Why is acid reflux bad?

    The stomach mucosa (lining) normally produces the digestive acid and tolerates it much better than the esophagus, which has a different cell lining that is less resistant to the acid.

    Reflux of stomach acid into the lower end of the esophagus, therefore, causes esophagitis (irritation, inflammation and swelling), which, if allowed to continue untreated, could cause esophageal stricture (scarring) and narrowing, making the channel connecting the food pipe to the stomach too small for food to pass through. Constant acid fumes could also be inhaled for years, decades, ultimately causing (non-smoker’s) Chronic Obstructive Pulmonary Disease (COPD).

    Is this condition common?

    Yes, very common. Sixty percent of the adult population has some type of GI reflux. About seven million Americans have GERD. Most patients complain of burning discomfort in the pit of the stomach after meals or at night, while lying down, allowing stomach acid to flow back to the esophagus. Many times, the burning disappears when the person gets up. The symptom could also be that of indigestion or “sour stomach.” People who take antacids, like Alka Seltzer, Maalox, Tums, etc. could have GERD.

    Is Hiatal Hernia present in Reflux Esophagitis?

    The food pipe, which is in the chest, goes down through a hole in the diaphragm (the tent-like flat muscle that separates the abdomen from the chest) to connect with the stomach in the abdomen. This hole is called a hiatus. If this hole becomes too large, the stomach, which is normally in the abdomen, could move up to the chest through the hole. If this happens, it is called Hiatus Hernia. Hiatus Hernia is found in only 20-30 percent of those with reflux esophagitis. The majority do not have accompanying Hiatus Hernia.

    Any other possible cause of esophagitis and stricture?

    Caustic acids, or alkali (the chemical in Liquid Plumber, Sosa, etc.) when swallowed (as in suicides), cause massive burns, swelling, sometimes esophageal perforation (hole through the damaged food pipe) and leads to severe esophagitis and esophageal stricture. The perforation could also result in Mediastinitis, a serious and overwhelming infection inside the chest, which has a high fatality or mortality rate. Chest surgery is usually carried out immediately the moment the diagnosis is made.

    What are the possible complications of GERD?

    Uncomplicated gastroesophageal reflux responds well to medical therapy and may be tolerated for many years. However, some people on treatment may still develop complications, like esophagitis, esophageal ulcer, hemorrhage, esophageal stricture, and Barrett’s metaplasia (cell changes in the esophagus that could transform to cancer).

    How is the diagnosis of GERD confirmed?

    A careful history and thorough physical examination, coupled with X-Ray Barium Swallow (done with the patient on his back and the head lower than the feet to check for reflux of barium), esophageal manometry (pressure measurement), pH (acidity) monitoring, Bernstein acid test, and endoscopy (looking inside and down the food pipe by passing a lighted “telescope” to see the condition of the lower food pipe and stomach). Through this same scope, tiny biopsies could be performed, to see the tissue reaction, Helicobacter pylori, Barrett’s, and to check for cancer.

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    Philip S. Chua, MD, FACS, FPCS, a Cardiac Surgeon Emeritus based in Northwest Indiana and Las Vegas, Nevada, is an international medical lecturer/author, a Health Public Advocate, and Chairman of the Filipino United Network-USA, a 501(c)3 humanitarian and anti-graft foundation in the United States. Visit our websites: philipSchua.com and FUN8888.com Email: [email protected]