Peritonitis Sign Symptoms, Causes, Diagnosis And Treatment Best Note For MBBS , Nursing, Pharmacy,DMLT Students Odisha Health Help Line No-9040733513

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DEFINITION

Peritonitis

Peritonitis is inflammation of the peritoneum — a silk-like membrane that lines your inner abdominal wall and covers the organs within your abdomen — that is usually due to a bacterial or fungal infection. Peritonitis can result from any rupture (perforation) in your abdomen, or as a complication of other medical conditions.

Peritonitis requires prompt medical attention to fight the infection and, if necessary, to treat any underlying medical conditions. Treatment of peritonitis usually involves antibiotics and, in some cases, surgery. Left untreated, peritonitis can lead to severe, potentially life-threatening infection throughout your body.

If you're receiving peritoneal dialysis therapy, you can help prevent peritonitis by following good hygiene before, during and after dialysis.

SYMPTOMS

Signs and symptoms of peritonitis include:

• Abdominal pain or tenderness
• Bloating or a feeling of fullness (distention) in your abdomen
• Fever
• Nausea and vomiting
• Loss of appetite
• Diarrhea
• Low urine output
• Thirst
• Inability to pass stool or gas
• Fatigue

If you're receiving peritoneal dialysis, peritonitis symptoms may also include:

• Cloudy dialysis fluid
• White flecks, strands or clumps (fibrin) in the dialysis fluid

When to see a doctor

Peritonitis can be life-threatening if it's not treated promptly. Contact your doctor immediately if you have severe pain or tenderness of your abdomen, abdominal bloating, or a feeling of fullness associated with:

• Fever
• Nausea and vomiting
• Low urine output
• Thirst
• Inability to pass stool or gas

If you're receiving peritoneal dialysis, contact your health care provider immediately if your dialysis fluid is cloudy, if it contains white flecks, or strands or clumps (fibrin), or if it has an unusual odor, especially if the area around your tube (catheter) is red or painful.

CAUSES

Infection of the peritoneum can happen for a variety of reasons. In most cases, the cause is a rupture (perforation) within the abdominal wall. Though it’s rare, the condition can develop without an abdominal rupture. This type of peritonitis is called spontaneous peritonitis.

Common causes of ruptures that lead to peritonitis include:

• Medical procedures, such as peritoneal dialysis. Peritoneal dialysis uses tubes (catheters) to remove waste products from your blood when your kidneys can no longer adequately do so. An infection may occur during peritoneal dialysis due to unclean surroundings, poor hygiene or contaminated equipment. Peritonitis also may develop as a complication of gastrointestinal surgery, the use of feeding tubes or a procedure to withdraw fluid from your abdomen (paracentesis) and rarely as a complication of colonoscopy or endoscopy.
• A ruptured appendix, stomach ulcer or perforated colon. Any of these conditions can allow bacteria to get into the peritoneum through a hole in your gastrointestinal tract.
• Pancreatitis. Inflammation of your pancreas (pancreatitis) complicated by infection may lead to peritonitis if the bacteria spread outside the pancreas.
• Diverticulitis. Infection of small, bulging pouches in your digestive tract (diverticulitis) may cause peritonitis if one of the pouches ruptures, spilling intestinal waste into your abdominal cavity.
• Trauma. Injury or trauma may cause peritonitis by allowing bacteria or chemicals from other parts of your body to enter the peritoneum.

Peritonitis that develops without an abdominal rupture (spontaneous peritonitis) is usually a complication of liver disease, such as cirrhosis. Advanced cirrhosis causes a large amount of fluid buildup in your abdominal cavity (ascites). That fluid buildup is susceptible to bacterial infection.

RISK FACTORS

Factors that increase your risk of peritonitis include:

• Peritoneal dialysis. Peritonitis is common among people undergoing peritoneal dialysis therapy.
• Other medical conditions. The following medical conditions increase your risk of developing peritonitis: cirrhosis, appendicitis, Crohn's disease, stomach ulcers, diverticulitis and pancreatitis.
• History of peritonitis. Once you've had peritonitis, your risk of developing it again is higher than it is for someone who has never had peritonitis.

COMPLICATIONS

Left untreated, peritonitis can extend beyond your peritoneum, where it may cause:

• A bloodstream infection (bacteremia).
• An infection throughout your body (sepsis). Sepsis is a rapidly progressing, life-threatening condition that can cause shock and organ failure.

TESTS AND DIAGNOSIS

To diagnose peritonitis, your doctor will talk with you about your medical history and perform a physical exam. When peritonitis is associated with peritoneal dialysis, your signs and symptoms, particularly cloudy dialysis fluid, may be enough for your doctor to diagnose the condition.

In cases of peritonitis in which the infection may be a result of other medical conditions (secondary peritonitis) or in which the infection arises from fluid buildup in your abdominal cavity (spontaneous peritonitis), your doctor may recommend the following tests to confirm a diagnosis:

• Blood tests. A sample of your blood may be drawn and sent to a lab to check for a high white blood cell count. A blood culture also may be performed to determine if there are bacteria in your blood.
• Imaging tests. Your doctor may want to use an X-ray to check for holes or other perforations in your gastrointestinal tract. Ultrasound may also be used. In some cases, your doctor may use a computerized tomography (CT) scan instead of an X-ray.
• Peritoneal fluid analysis.Using a thin needle, your doctor may take a sample of the fluid in your peritoneum (paracentesis), especially if you receive peritoneal dialysis or have fluid in your abdomen from liver disease. If you have peritonitis, examination of this fluid may show an increased white blood cell count, which typically indicates an infection or inflammation. A culture of the fluid may also reveal the presence of bacteria.

The above tests may also be necessary if you're receiving peritoneal dialysis and a diagnosis of peritonitis is uncertain after a physical exam and an examination of the dialysis fluid.

TREATMENTS AND DRUGS

You may need to be hospitalized for peritonitis that's caused by infection from other medical conditions (secondary peritonitis). Treatment may include:

• Antibiotics. You'll likely be given a course of antibiotic medication to fight the infection and prevent it from spreading. The type and duration of your antibiotic therapy depend on the severity of your condition and the kind of peritonitis you have.
• Surgery. Surgical treatment is often necessary to remove infected tissue, treat the underlying cause of the infection, and prevent the infection from spreading, especially if peritonitis is due to a ruptured appendix, stomach or colon.
• Other treatments. Depending on your signs and symptoms, your treatment while in the hospital may include pain medications, intravenous (IV) fluids, supplemental oxygen and, in some cases, a blood transfusion.

If you're undergoing peritoneal dialysis

If you have peritonitis, your doctor may recommend that you receive dialysis in another way for several days while your body heals from the infection. If peritonitis persists or recurs, you may need to stop having peritoneal dialysis entirely and switch to a different form of dialysis.

LIFESTYLE AND HOME REMEDIES

Often, peritonitis associated with peritoneal dialysis is caused by germs around the catheter. If you're receiving peritoneal dialysis, take the following steps to prevent peritonitis:

• Wash your hands, including underneath your fingernails and between your fingers, before touching the catheter.
• Clean the skin around the catheter with an antiseptic every day.
• Store your supplies in a sanitary area.
• Wear a surgical mask during your dialysis fluid exchanges.
• If you have pets, don't sleep with them.
• Talk with your dialysis care team about proper care for your peritoneal dialysis catheter.

If you've had spontaneous peritonitis before or if you have peritoneal fluid buildup due to a medical condition such as cirrhosis, your doctor may prescribe antibiotics to prevent peritonitis. If you’re taking a proton pump inhibitor, your doctor may ask you to stop taking it.

If you develop new abdominal pain or have a new injury

Peritonitis may result from a burst appendix or trauma-related abdominal injury.

• Seek immediate medical attention if you develop abdominal pain so severe that you're unable to sit still or find a comfortable position.
• Call 911 or emergency medical assistance if you have severe abdominal pain following an accident or injury.

What Is The Disease Parotitis-Mumps Odisha Health Help Line-9040733513

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Parotitis

Parotitis is the name given to inflammation and infection of the largest of the salivary glands known as the parotid glands. Inflammation results in swelling of the tissues that surround the salivary glands, redness, and soreness. Salivary glands are responsible for producing saliva in the mouth, which has the important function of cleansing the mouth. Inflammation of the salivary glands reduces their ability to function properly and may lead to infections within the mouth.

The inflammation of parotitis may result from many causes, including infection, drugs, radiation, and various diseases. Mumps was once the most common viral cause of parotitis, but vaccination has made mumps a rare disease today. Parotitis caused by bacterial infection is somewhat common in the United States.

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How Long Before Conception, Implantation, and Pregnancy Symptoms Occur

You know that sex leads to pregnancy, but how soon after sex could you actually get pregnant? The answer isn't exact. Instead, it's a range—it could be in minutes or take a few days.

Below, we explore how long it takes to get pregnant, how to maximize your chance of conceiving, and for pregnancy symptoms to begin.

#Overview

Conception may take place as soon as three minutes after sexual intercourse, or it may take up to five days. Implantation occurs five to 10 days after fertilization, which means anywhere from five to 15 days after you had sex.

Pregnancy symptoms may start as early as a week after you had sex or may take several weeks to start. Some women never get noticeable early pregnancy symptoms.1

Could lying down after sex help you conceive faster? It seems like it makes sense. Sperm need to swim through the reproductive system. Perhaps it's easier for them to make the journey if they don't have to swim up—and can just swim horizontally. However, things are slightly more complicated than that.

Fertilization can occur within minutes of sex...but it's also possible to have intercourse on Tuesday and not conceive until Friday!

#Conception

You might think that the time between sex and conception is just the amount of time it takes sperm to swim to the egg. However, how quickly sperm swim doesn’t fully answer the question.

Studies have found that sperm take between two and 10 minutes to travel from the cervix through to the fallopian tubes (where they hope to meet an egg).2 This is regardless of gravity. They will swim "up" through the uterus no matter what position your body is in. If there is an egg waiting, conception can occur as quickly as three minutes after sexual intercourse.

That said, sperm can survive inside the female reproductive system for up to five days.3 This means that the day you had sex doesn’t have to be the day you got pregnant. If you had sex on Monday, and you ovulate on Thursday, conception can occur days after you had sexual intercourse.

Sometimes, a doctor will estimate the day of conception based on how many weeks the fetus measures in an ultrasound, and this conception date doesn't match up with a day the couple had sex.4 This possible delay between intercourse and fertilization explains how that can happen.

While you're more likely to get pregnant if you have sex two to three days before ovulation, you can get pregnant from sex that occurs up to six days before an egg is released from the ovary.

#Implantation

Conception is when a sperm cell fertilizes an egg. Implantation is when the fertilized egg (which is now an embryo) implants itself into the uterine wall. You’re not technically pregnant until this happens. Implantation doesn’t happen right after fertilization.

Many people assume that fertilization happens in the uterus. This isn’t correct. The sperm cells meet the egg in the fallopian tubes, and this is where conception happens.5

After conception, the embryo needs to go through a number of development stages before it can implant itself into the uterine lining. It also needs to travel from inside the fallopian tubes down into the uterus. This takes a few days.

Implantation usually occurs between five and 10 days after fertilization.6 But as you read above, fertilization can occur as soon as a few minutes after sex or as many as five days after. This means that implantation can occur as soon as five days after you had sex or as late as 15 days after sexual intercourse.

#Pregnancy #Symptoms

Whether fertilization occurs within minutes of sex or days later, will you be able to feel you're pregnant when it happens? Unfortunately, no.

Some women claim to have "known" they conceived within minutes of sex. The truth is that it's scientifically impossible. Any potential pregnancy symptoms won't appear until embryo implantation (at the very, very earliest), and that doesn't happen for another seven to 10 days. It takes time for the fertilized egg to travel from the fallopian tubes and find a soft landing area in the uterus.

Having pregnancy signs at the time of implantation is also unlikely. Most women don't start to experience pregnancy symptoms until they are a few days past their expected period. Some women never "feel" pregnant.7

The earliest you might expect to “feel

 pregnant” after sex would be around seven days. More commonly, it takes between two to four weeks after sex before pregnancy symptoms are noticeable.

Does Lying on Your Back Help?

Just about every woman has received advice to remain on her back after sex, in hopes it'll make it easier to get pregnant. There’s no research specifically on lying still after sex to back up the claim.

However, there is research on the fertility treatment intrauterine insemination (or IUI). During IUI treatment, specially washed sperm are transferred directly to the woman’s uterus via the cervix through a thin catheter.

In one study, researchers wanted to know if IUI treatment would be more effective if the woman remained on her back for 15 minutes after the procedure.2

Researchers found that the women who remained on their backs for 15 minutes after the sperm transfer had a 27% pregnancy rate after three cycles. The women who were encouraged to get up right after the treatment had an 18% pregnancy rate after three cycles.

Remaining horizontal after IUI treatment did improve pregnancy rates. Whether that would translate to sexual intercourse, is unclear.

Aim for 10 to 20 Minutes

If you’re going to lie on your back, how long should you stay there to reap any benefits? Again, there’s no research on sexual intercourse to give us an answer. However, we have another study on IUI that may give us a clue.

In this study, 396 couples having IUI treatment for male factor infertility, cervical issues, or unexplained infertility were randomly assigned to a post-IUI “rest” group.8 Women were either asked to remain horizontal for 5 minutes, 10 minutes, or 20 minutes post-insemination.

In this particular study, the clinical pregnancy rates were dramatically different between the 5 and 10-minute groups. 

Clinical pregnancy rates per cycle:

4.5% for those who remained horizontal for 5 minutes

15.9% for those who remained horizontal for 10 minutes

19.7% for those who remained horizontal for 20 minutes

The difference between the 10 and 20-minute groups was not considered to be statistically significant. Therefore, the researchers suggest women remain lying down for at least 10 minutes after insemination. 

However, if you need to use the bathroom right after sex (especially if you get frequent urinary tract infections), get up and go ahead. You’re not going to ruin your chances of conception.

[Note: Don't compare these results to the first study referenced above. This study looked at the pregnancy rate per cycle, while the first study mentioned in this article was looking at cumulative pregnancy rates after three treatment cycles.]

You may conceive within minutes of sexual intercourse, but, more commonly, hours or days will pass between intercourse and the day of the egg is fertilized. Lying down after or during sex may help you get pregnant faster, but it probably won't make a big difference. Sperm cells will swim towards your ovaries whether you’re standing up or standing on your head! 

Remember that a pregnancy test can’t detect pregnancy at the moment of conception or even on your implantation day. There needs to be enough pregnancy hormone in the body for the test to come up positive. This takes time. In order not to waste pregnancy tests, wait until your period is at least one day late before peeing on a stick. Otherwise, you may get a false negative, even if you are pregnant.

ANKYLOGLOSSIA(TONGUE-TIE) Causes Sign Symptoms Treatment Odisha Health Help Line-+919040733513

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ANKYLOGLOSSIA (TONGUE-TIE) 

•  A congenital anomaly of variable severity characterised by an abnormally short lingual

frenulum, which may restrict movement of the tongue. 

In severe cases the tongue is joined to the bottom of the mouth .

Symptoms

•  Many tongue-ties are asymptomatic and cause no  problem but some cases may have :

    - Breastfeeding difficulties

    - sore nipples 

    - poor weight gain

Treatment :

Frenotomy ( surgical release  of the tongue-tie )

Complications of frenotomy

  Infrequent, but may include: 

            •  bleeding 

            •  infection 

            •  ulceration 

            •  pain 

            •  damage to tongue and surrounding area 

            •  recurrence of  tongue-tie   

N.B.      In an infant with tongue-tie  and feeding difficulties, surgical release  of the tongue-tie does not consistently improve infant feeding , but is  likely to improve maternal  nipple pain .

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Gastritis

Pic-1 Gastritis

Pic-2 Gastritis

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pic-4 Gastritis

pic-5 Gastritis

DEFINITION

Gastritis describes a group of conditions with one thing in common: inflammation of the lining of the stomach. The inflammation of gastritis is most often the result of infection with the same bacterium that causes most stomach ulcers. Injury, regular use of certain pain relievers and drinking too much alcohol also can contribute to gastritis.

Gastritis may occur suddenly (acute gastritis), or it can occur slowly over time (chronic gastritis). In some cases, gastritis can lead to ulcers and an increased risk of stomach cancer. For most people, however, gastritis isn't serious and improves quickly with treatment.

SYMPTOMS

The signs and symptoms of gastritis include:

• Gnawing or burning ache or pain (indigestion) in your upper abdomen that may become either worse or better with eating
• Nausea
• Vomiting
• A feeling of fullness in your upper abdomen after eating

Gastritis doesn't always cause signs and symptoms.

When to see a doctor

Nearly everyone has had indigestion and stomach irritation. Most cases of indigestion are short-lived and don't require medical care. See your doctor if you have signs and symptoms of gastritis for a week or longer. Tell your doctor if your stomach discomfort occurs after taking prescription or over-the-counter drugs, especially aspirin or other pain relievers.

If you are vomiting blood, have blood in your stools or have stools that appear black, see your doctor right away to determine the cause.

CAUSES

Gastritis is an inflammation of the stomach lining. Weaknesses in the mucus-lined barrier that protects your stomach wall allow your digestive juices to damage and inflame your stomach lining. A number of diseases and conditions can increase your risk of gastritis.

Gastritis can develop suddenly (acute gastritis) or gradually and last for an extended period (chronic gastritis).

RISK FACTORS

Factors that increase your risk of gastritis include:

• Bacterial infection. Although infection with Helicobacter pylori is among the most common worldwide human infections, only some infected people develop gastritis or a similar stomach disorder. Doctors believe vulnerability to the bacterium could be inherited or could be caused by lifestyle choices, such as smoking and high stress levels.
• Regular use of pain relievers.Common pain relievers — such as aspirin, ibuprofen (Advil, Motrin IB, others) and naproxen (Aleve, Anaprox) — can cause both acute gastritis and chronic gastritis. Using these pain relievers regularly or taking too much of these drugs may reduce a key substance that helps preserve the protective lining of your stomach. Stomach problems are less likely to develop if you take pain relievers only occasionally. Acetaminophen (Tylenol, others) does not lead to gastritis.
• Older age. Older adults have an increased risk of gastritis because the stomach lining tends to thin with age and because older adults are more likely to have H. pylori infectionor autoimmune disorders than younger people are.
• Excessive alcohol use. Alcohol can irritate your stomach lining, which makes your stomach more likely to be harmed by digestive juices. Excessive alcohol use is more likely to cause acute gastritis.
• Stress. Severe stress due to major surgery, injury, burns or severe infections can cause acute gastritis.
• Your own body attacking cells in your stomach. Called autoimmune gastritis, this type of gastritis occurs when your body attacks the cells that make up your stomach lining. This produces a reaction by your immune system that can wear away at your stomach's protective barrier. Autoimmune gastritis is more common in people with other autoimmune disorders, including Hashimoto's disease and type 1 diabetes. Autoimmune gastritis can also be associated with vitamin B-12 deficiency.
• Other diseases and conditions. Gastritis may be associated with other medical conditions, including HIV/AIDS, Crohn's disease and parasitic infections.

COMPLICATIONS

Left untreated, gastritis may lead to stomach ulcers and stomach bleeding. Rarely, some forms of chronic gastritis may increase your risk of stomach cancer, especially if you have extensive thinning of the stomach lining and changes in the lining's cells.

Tell your doctor if your signs and symptoms aren't improving despite treatment for gastritis.

PREPARING FOR YOUR APPOINTMENT

Start by making an appointment with your family doctor or a general practitioner. If your doctor suspects gastritis, you may be referred to a specialist in digestive disorders (gastroenterologist).

What you can do

• Be aware of pre-appointment restrictions. When you make the appointment, ask if there's anything you need to do in advance, such as restrict your diet.
• Write down symptoms you're experiencing, including any that may seem unrelated to the reason for which you scheduled the appointment.
• Write down key personal information, including major stresses or recent life changes.
• Make a list of all medications,vitamins or supplements you're taking.
• Consider taking someone along. Someone who accompanies you may remember something that you missed or forgot.
• Write down questions to askyour doctor.

Preparing a list of questions will help you make the most of your time with your doctor. For gastritis, some basic questions to ask your doctor include:

• What is likely causing my symptoms or condition?
• Could any of my medications be causing my condition?
• What are other possible causes for my symptoms or condition?
• What tests do I need?
• Is my condition likely temporary or chronic?
• What is the best course of action?
• What are alternatives to the primary approach you're suggesting?
• I have other health conditions. How can I best manage them together?
• Are there restrictions that I need to follow?
• Should I see a specialist?
• Is there a generic alternative to the medicine you're prescribing?
• Are there brochures or other printed material I can take? What websites do you recommend?
• What will determine whether I should schedule a follow-up visit?

Don't hesitate to ask other questions.

What to expect from your doctor

Your doctor is likely to ask you a number of questions, including:

• What are your symptoms?
• How severe are your symptoms? Would you describe your stomach pain as mildly uncomfortable or burning?
• Have your symptoms been constant or occasional?
• Does anything, such as eating certain foods, seem to worsen your symptoms?
• Does anything, such as eating certain foods or taking antacids, seem to improve your symptoms?
• Do you experience any nausea or vomiting?
• Have you recently lost weight?
• How often do you take pain relievers, such as aspirin, ibuprofen or naproxen?
• How often do you drink alcohol, and how much do you drink?
• How would you rate your stress level?
• Have you noticed any black stools or blood in your stool?
• Have you ever had an ulcer?

What you can do in the meantime

Before your appointment, avoid drinking alcohol and eating foods that seem to irritate your stomach, such as those that are spicy, acidic, fried or fatty. But talk to your doctor before stopping any prescription medications you're taking.

TESTS AND DIAGNOSIS

Although your doctor is likely to suspect gastritis after talking to you about your medical history and performing an exam, you may also have tests to pinpoint the exact cause. Tests may include:

• Tests for H. pylori. Your doctor may recommend tests to determine whether you have the bacterium H. pylori. Which type of test you undergo depends on your situation. H. pylori may be detected in a blood test, in a stool test or by a breath test. For the breath test, you drink a small glass of clear, tasteless liquid that contains radioactive carbon. H. pylori bacteria break down the test liquid in your stomach. Later, you blow into a bag, which is then sealed. If you're infected with H. pylori, your breath sample will contain the radioactive carbon.
• Using a scope to examine your upper digestive system (endoscopy). During endoscopy, your doctor passes a flexible tube equipped with a lens (endoscope) down your throat and into your esophagus, stomach and small intestine. Using the endoscope, your doctor looks for signs of inflammation. If a suspicious area is found, your doctor may remove small tissue samples (biopsy) for laboratory examination. A biopsy can also identify the presence of H. pylori in your stomach lining.
• X-ray of your upper digestive system. Sometimes called a barium swallow or upper gastrointestinal series, this series of X-rays creates images of your esophagus, stomach and small intestine to look for abnormalities. To make the ulcer more visible, you swallow a white, metallic liquid (containing barium) that coats your digestive tract.

TREATMENTS AND DRUGS

Treatment of gastritis depends on the specific cause. Acute gastritis caused by nonsteroidal anti-inflammatory drugs or alcohol may be relieved by stopping use of those substances. Chronic gastritis caused by H. pylori infection is treated with antibiotics.

In most cases, you also take medications that treat stomach acid to reduce your signs and symptoms and promote healing in your stomach.

Medications used to treat gastritis include:

• Antibiotic medications to kill H. pylori. For H. pylori in your digestive tract, your doctor may recommend a combination of antibiotics, such as clarithromycin (Biaxin) and amoxicillin or metronidazole (Flagyl), to kill the bacterium. Be sure to take the full antibiotic prescription, usually for 10 to 14 days.
• Medications that block acid production and promote healing. Proton pump inhibitors reduce acid by blocking the action of the parts of cells that produce acid. These drugs include the prescription and over-the-counter medications omeprazole (Prilosec), lansoprazole (Prevacid), rabeprazole (Aciphex), esomeprazole (Nexium), dexlansoprazole (Dexilant) and pantoprazole (Protonix). Long-term use of proton pump inhibitors, particularly at high doses, may increase your risk of hip, wrist and spine fractures. Ask your doctor whether a calcium supplement may reduce this risk.
• Medications to reduce acid production. Acid blockers — also called histamine (H-2) blockers — reduce the amount of acid released into your digestive tract, which relieves gastritis pain and promotes healing. Available by prescription or over-the-counter, acid blockers include ranitidine (Zantac), famotidine (Pepcid), cimetidine (Tagamet) and nizatidine (Axid).
• Antacids that neutralize stomach acid. Your doctor may include an antacid in your drug regimen. Antacids neutralize existing stomach acid and can provide rapid pain relief. Side effects can include constipation or diarrhea, depending on the main ingredients.

LIFESTYLE AND HOME REMEDIES

Preventing H. pylori infection

It's not clear how H. pylori spreads, but there's some evidence that it could be transmitted from person to person or through contaminated food and water. You can take steps to protect yourself from infections, such as H. pylori, by frequently washing your hands with soap and water and by eating foods that have been cooked completely.

Acid Reflux-Gastroesophageal reflux disease (GERD) Disease Means,Sign Symptoms, Causes, Diagnosis And Treatment Odisha Health Help Line-9040733513

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DEFINITION

Gastroesophageal reflux disease (GERD) is a chronic digestive disease. GERD occurs when stomach acid or, occasionally, stomach content, flows back into your food pipe (esophagus). The backwash (reflux) irritates the lining of your esophagus and causes GERD.

Both acid reflux and heartburn are common digestive conditions that many people experience from time to time. When these signs and symptoms occur at least twice each week or interfere with your daily life, or when your doctor can see damage to your esophagus, you may be diagnosed with GERD.

Most people can manage the discomfort of GERD with lifestyle changes and over-the-counter medications. But some people with GERD may need stronger medications, or even surgery, to reduce symptoms.

SYMPTOMS

GERD signs and symptoms include:

• A burning sensation in your chest (heartburn), sometimes spreading to your throat, along with a sour taste in your mouth
• Chest pain
• Difficulty swallowing (dysphagia)
• Dry cough
• Hoarseness or sore throat
• Regurgitation of food or sour liquid (acid reflux)
• Sensation of a lump in your throat

When to see a doctor

Seek immediate medical attention if you experience chest pain, especially if you have other signs and symptoms, such as shortness of breath or jaw or arm pain. These may be signs and symptoms of a heart attack.

Make an appointment with your doctor if you experience severe or frequent GERD symptoms. If you take over-the-counter medications for heartburn more than twice a week, see your doctor.

CAUSES

GERD is caused by frequent acid reflux — the backup of stomach acid or bile into the esophagus.

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

However, if this valve relaxes abnormally or weakens, stomach acid can flow back up into your esophagus, causing frequent heartburn. Sometimes this can disrupt your daily life.

This constant backwash of acid can irritate the lining of your esophagus, causing it to become inflamed (esophagitis). Over time, the inflammation can wear away the esophageal lining, causing complications such as bleeding, esophageal narrowing or Barrett's esophagus (a precancerous condition).

RISK FACTORS

Conditions that can increase your risk of GERD include:

• Obesity
• Bulging of top of stomach up into the diaphragm (hiatal hernia)
• Pregnancy
• Smoking
• Dry mouth
• Asthma
• Diabetes
• Delayed stomach emptying
• Connective tissue disorders, such as scleroderma

COMPLICATIONS

Over time, chronic inflammation in your esophagus can lead to complications, including:

• Narrowing of the esophagus (esophageal stricture).Damage to cells in the lower esophagus from acid exposure leads to formation of scar tissue. The scar tissue narrows the food pathway, causing difficulty swallowing.
• An open sore in the esophagus (esophageal ulcer). Stomach acid can severely erode tissues in the esophagus, causing an open sore to form. The esophageal ulcer may bleed, cause pain and make swallowing difficult.
• Precancerous changes to the esophagus (Barrett's esophagus). In Barrett's esophagus, the tissue lining the lower esophagus changes. These changes are associated with an increased risk of esophageal cancer. The risk of cancer is low, but your doctor will likely recommend regular endoscopy exams to look for early warning signs of esophageal cancer.

PREPARING FOR YOUR APPOINTMENT

If you think you have GERD, you're likely to start by first seeing your family doctor or a general practitioner. Your doctor may recommend you see a doctor who specializes in treating digestive diseases (gastroenterologist).

Because appointments can be brief, and because there's often a lot of ground to cover, it's a good idea to be well-prepared. Here's some information to help you get ready, and what to expect from your doctor.

What you can do

• Be aware of any pre-appointment restrictions. At the time you make the appointment, be sure to ask if there's anything you need to do in advance, such as restrict your diet.
• Write down any symptoms you're experiencing, including any that may seem unrelated to the reason for which you scheduled the appointment.
• Write down key personal information, including any major stresses or recent life changes.
• Make a list of all medications,vitamins or supplements that you're taking.
• Consider taking a family member or friend along.Sometimes it can be difficult to absorb all the information provided during an appointment. Someone who accompanies you may remember something that you missed or forgot.
• Write down questions to askyour doctor.

Your time with your doctor is limited, so preparing a list of questions can help you make the most of your time together. List your questions from most important to least important in case time runs out. For gastroesophageal reflux disease, some basic questions to ask your doctor include:

• What is likely causing my symptoms?
• What kinds of tests do I need?
• Do I need an endoscopy?
• Is my GERD likely temporary or chronic?
• What is the best course of action?
• What are the alternatives to the primary approach that you're suggesting?
• I have other health conditions. How can I best manage them while managing GERD?
• Are there any restrictions that I need to follow?
• Should I see a specialist? What will that cost, and will my insurance cover it?
• Is there a generic alternative to the medicine you're prescribing for me?
• Are there brochures or other printed material that I can take with me? What websites do you recommend?
• Should I schedule a follow-up visit?

In addition to the questions that you've prepared to ask your doctor, don't hesitate to ask questions during your appointment anytime you don't understand something.

What to expect from your doctor

Your doctor is likely to ask you a number of questions. Being ready to answer them may allow more time later to cover points you want to address. Your doctor may ask:

• What are your symptoms?
• When did you first notice these symptoms?
• Have your symptoms been continuous or occasional?
• How severe are your symptoms?
• What, if anything, seems to improve your symptoms?
• What, if anything, appears to worsen your symptoms?
• Do your symptoms wake you up at night?
• Are your symptoms worse after meals or after lying down?
• Do your symptoms include nausea or vomiting?
• Does food or sour material ever come up in the back of your throat?
• Do you have difficulty swallowing?
• Have you gained or lost weight?
• Do you experience nausea and vomiting?

What you can do in the meantime

Try lifestyle changes to control your symptoms until you see your doctor. For instance, avoid foods that trigger your heartburn and avoid eating at least two hours before bedtime.

TESTS AND DIAGNOSIS

Diagnosis of GERD is based on:

• Your symptoms. Your doctor may be able to diagnose GERD based on frequent heartburnand other symptoms.

• A test to monitor the amount of acid in your esophagus.Ambulatory acid (pH) probe tests use a device to measure acid for 24 hours. The device identifies when, and for how long, stomach acid regurgitates into your esophagus. One type of monitor is a thin, flexible tube (catheter) that's threaded through your nose into your esophagus. The tube connects to a small computer that you wear around your waist or with a strap over your shoulder.

  Another type is a clip that's placed in your esophagus during endoscopy. The probe transmits a signal, also to a small computer that you wear. After about two days, the probe falls off to be passed in your stool. Your doctor may ask that you stop taking GERD medications to prepare for this test.

  If you have GERD and you're a candidate for surgery, you may also have other tests, such as:

• An X-ray of your upper digestive system. Sometimes called a barium swallow or upper GI series, this procedure involves drinking a chalky liquid that coats and fills the inside lining of your digestive tract. Then X-rays are taken of your upper digestive tract. The coating allows your doctor to see a silhouette of your esophagus, stomach and upper intestine (duodenum).

• A flexible tube to look inside your esophagus. Endoscopy is a way to visually examine the inside of your esophagus and stomach. During endoscopy, your doctor inserts a thin, flexible tube equipped with a light and camera (endoscope) down your throat.

  Your doctor may also use endoscopy to collect a sample of tissue (biopsy) for further testing. Endoscopy is useful in looking for complications of reflux, such as Barrett's esophagus.

• A test to measure the movement of the esophagus.Esophageal motility testing (manometry) measures movement and pressure in the esophagus. The test involves placing a catheter through your nose and into your esophagus.

TREATMENTS AND DRUGS

Treatment for heartburn and other signs and symptoms of GERD usually begins with over-the-counter medications that control acid. If you don't experience relief within a few weeks, your doctor may recommend other treatments, including medications and surgery.

Initial treatments to control heartburn

Over-the-counter treatments that may help control heartburninclude:

• Antacids that neutralize stomach acid. Antacids, such as Maalox, Mylanta, Gelusil, Gaviscon, Rolaids and Tums, may provide quick relief. But antacids alone won't heal an inflamed esophagus damaged by stomach acid. Overuse of some antacids can cause side effects, such as diarrhea or constipation.
• Medications to reduce acid production. Called H-2-receptor blockers, these medications include cimetidine (Tagamet HB), famotidine (Pepcid AC), nizatidine (Axid AR) or ranitidine (Zantac). H-2-receptor blockers don't act as quickly as antacids do, but they provide longer relief and may decrease acid production from the stomach for up to 12 hours. Stronger versions of these medications are available in prescription form.
• Medications that block acid production and heal the esophagus. Proton pump inhibitors are stronger blockers of acid production than are H-2-receptor blockers and allow time for damaged esophageal tissue to heal. Over-the-counter proton pump inhibitors include lansoprazole (Prevacid 24 HR) and omeprazole (Prilosec, Zegerid OTC).

Contact your doctor if you need to take these medications for longer than two to three weeks or your symptoms are not relieved.

Prescription-strength medications

If heartburn persists despite initial approaches, your doctor may recommend prescription-strength medications, such as:

• Prescription-strength H-2-receptor blockers. These include prescription-strength cimetidine (Tagamet), famotidine (Pepcid), nizatidine (Axid) and ranitidine (Zantac).

• Prescription-strength proton pump inhibitors. Prescription-strength proton pump inhibitors include esomeprazole (Nexium), lansoprazole (Prevacid), omeprazole (Prilosec, Zegerid), pantoprazole (Protonix), rabeprazole (Aciphex) and dexlansoprazole (Dexilant).

  These medications are generally well-tolerated, but long-term use may be associated with a slight increase in risk of bone fracture and vitamin B-12 deficiency.

• Medications to strengthen the lower esophageal sphincter.Baclofen may decrease the frequency of relaxations of the lower esophageal sphincter and therefore decrease gastroesophageal reflux. It has less of an effect than do proton pump inhibitors, but it might be used in severe reflux disease. Baclofen can be associated with significant side effects, most commonly fatigue or confusion.

GERD medications are sometimes combined to increase effectiveness.

Surgery and other procedures used if medications don't help

Most GERD can be controlled through medications. In situations where medications aren't helpful or you wish to avoid long-term medication use, your doctor may recommend more-invasive procedures, such as:

• Surgery to reinforce the lower esophageal sphincter (Nissen fundoplication). This surgery involves tightening the lower esophageal sphincter to prevent reflux by wrapping the very top of the stomach around the outside of the lower esophagus. Surgeons usually perform this surgery laparoscopically. In laparoscopic surgery, the surgeon makes three or four small incisions in the abdomen and inserts instruments, including a flexible tube with a tiny camera, through the incisions.
• Surgery to strengthen the lower esophageal sphincter (Linx). The Linx device is a ring of tiny magnetic titanium beads that is wrapped around the junction of the stomach and esophagus. The magnetic attraction between the beads is strong enough to keep the opening between the two closed to refluxing acid, but weak enough so that food can pass through it. It can be implanted using minimally invasive surgery methods. This newer device has been approved by the Food and Drug Administration and early studies with it appear promising.

LIFESTYLE AND HOME REMEDIES

Lifestyle changes may help reduce the frequency of heartburn. Consider trying to:

• Maintain a healthy weight.Excess pounds put pressure on your abdomen, pushing up your stomach and causing acid to back up into your esophagus. If your weight is healthy, work to maintain it. If you are overweight or obese, work to slowly lose weight — no more than 1 or 2 pounds (0.5 to 1 kilogram) a week. Ask your doctor for help in devising a weight-loss strategy that will work for you.
• Avoid tight-fitting clothing.Clothes that fit tightly around your waist put pressure on your abdomen and the lower esophageal sphincter.
• Avoid foods and drinks that trigger heartburn. Everyone has specific triggers. Common triggers such as fatty or fried foods, tomato sauce, alcohol, chocolate, mint, garlic, onion, and caffeine may make heartburn worse. Avoid foods you know will trigger your heartburn.
• Eat smaller meals. Avoid overeating by eating smaller meals.
• Don't lie down after a meal.Wait at least three hours after eating before lying down or going to bed.
• Elevate the head of your bed.If you regularly experience heartburn at night or while trying to sleep, put gravity to work for you. Place wood or cement blocks under the feet of your bed so that the head end is raised by 6 to 9 inches. If it's not possible to elevate your bed, you can insert a wedge between your mattress and box spring to elevate your body from the waist up. Wedges are available at drugstores and medical supply stores. Raising your head with additional pillows is not effective.
• Don't smoke. Smoking decreases the lower esophageal sphincter's ability to function properly.

ALTERNATIVE MEDICINE

No alternative medicine therapies have been proved to treat GERD or to reverse damage to the esophagus. Still, some complementary and alternative therapies may provide some relief, when combined with your doctor's care.

Talk to your doctor about what alternative GERD treatments may be safe for you. Options may include:

• Herbal remedies. Herbal remedies sometimes used for GERD symptoms include licorice, slippery elm, chamomile, marshmallow and others. Herbal remedies can have serious side effects, and they may interfere with medications. Ask your doctor about a safe dosage before beginning any herbal remedy.
• Relaxation therapies.Techniques to calm stress and anxiety may reduce signs and symptoms of GERD. Ask your doctor about relaxation techniques, such as progressive muscle relaxation or guided imagery.
• Acupuncture. Acupuncture involves inserting thin needles into specific points on your body. Limited evidence suggests it may help people with heartburn, but major studies have not proved a benefit. Ask your doctor whether acupuncture is safe for you.