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Gastroesophageal reflux disease, or GERD, occurs when the muscle located at the end of your esophagus--called the lower esophageal sphincter (LES)--does not close properly. Your esophagus is the tube that carries food from your mouth to your stomach. Because your LES does not close properly when it should, your stomach contents leak back, or reflux, into your esophagus and irritate it.

Gastroesophageal reflux disease Symptoms

Most people who have gastroesophageal reflux disease feel a burning sensation in their chest or throat. This is called heartburn. Sometimes, you can taste stomach fluid in the back of the mouth. This is acid indigestion. If you have these symptoms for two weeks in a row or more, you may have GERD.

Who gets reflux disease?

Anyone can have Gastroesophageal reflux disease, including infants and children.


What You Can Do

Here are some tips on what you can do to improve your symptoms.

  • Avoid drinking alcohol and eating spicy, fatty or acidic foods that trigger your heartburn
  • Eat smaller meals
  • Avoid eating close to bedtime
  • Try to lose weight if you are overweight or obese
  • Avoid wearing too tight belt

Gastroesophageal reflux disease Treatment

Your doctor may recommend medicines such as antacids or H2 blockers to relieve your symptoms. If your symptoms are not relieved by medications, your doctor may recommend surgery to correct the cause of your reflux disease.

More Digestive Diseases Topics

References:
Heartburn, Gastroesophageal Reflux (GER), and Gastroesophageal Reflux Disease (GERD). National Digestive Diseases Information Clearinghouse < http://digestive.niddk.nih.gov/ddiseases/pubs/gerd/index.htm>. December 15, 2010

GERD. Medline Plus, National Library of Medicine < http://www.nlm.nih.gov/medlineplus/gerd.html>. December 15, 2010


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Hiatal hernia is a digestive problem in which a part of your stomach protrudes through the opening of your diaphragm. Your diaphragm is a thin sheet of muscle that helps your breathe. It also separates your chest from your abdomen.

The opening in your diaphragm, called the hiatus, is normally just large enough to allow your esophagus to pass, but prevents your stomach to push upward beyond your diaphragm. The esophagus is the tube connecting your mouth to your stomach.

Causes Hiatal Hernia

The true cause of hiatal hernia is unknown. However, experts believe that it may be associated with weakening of the hiatus or surrounding tissues.

Some people may be at risk of developing hiatal hernia, such as

    Advancing age
  • Being overweight or obese
  • Smoking
  • Pregnancy

Hiatal Hernia Symptoms

Most cases of hiatal hernia have no symptoms. Sometimes, hiatal hernia symptoms are associated with gastroesophageal reflux disease, or GERD, which may include heartburn, chest pain and difficulty swallowing.

If your symptoms seem to persist, get medical help.

Hiatal Hernia Treatment

Mild hiatal hernia that does not cause symptoms usually does not need special medical treatment. If your condition causes symptoms, you may need treatment. Your doctor may recommend medications to relieve your symptoms caused by GERD.

Surgery may be the last option if your symptoms are not relieved by medication.

More on Hernia

Learn About

References:
Heartburn, Gastroesophageal Reflux (GER), and Gastroesophageal Reflux Disease (GERD). National Digestive Diseases Information Clearinghouse < http://digestive.niddk.nih.gov/ddiseases/pubs/gerd/index.htm>. Accessed on December 15, 2010

Hiatal Hernia. Medline Plus, National Library of Medicine < http://www.nlm.nih.gov/medlineplus/ency/article/001137.htm>. Accessed on December 15, 2010


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Proctitis is a digestive disease in which the inner lining of the rectum, called rectal mucosa, is inflamed. It can be acute (short term) or chronic (long term) proctitis.

Causes

There are several causes of proctitis. Sometimes inflammation of the rectum is caused by sexually transmitted diseases, such as herpes, gonorrhea, or chlamydia. In other cases, the condition is associated with autoimmune digestive conditions causing inflammation in the colon or small intestine like ulcerative colitis or Crohn's disease. Proctitis may also be the result of certain medical treatments, such as radiation therapy or antibiotics.

Other causes of proctitis may include:

  • injury to the rectum (rectal injury)
  • bacterial infection
  • malfunctioning nerves in the rectum
  • allergies

Symptoms

The most common symptom of proctitis is frequent or continuous urge to have a bowel movement. Other symptoms may include:
  • constipation
  • a feeling of rectal fullness
  • left-sided abdominal pain
  • passage of mucus through the rectum
  • bleeding in the rectum
  • pain in the rectum or anus (anorectal pain)

Diagnosis

Physicians diagnose proctitis by looking inside the rectum with a proctoscope or a sigmoidoscope. A biopsy (a tiny piece of tissue from the rectum) may be removed and tested for diseases or infections. A stool sample may also reveal infecting bacteria. If the physician suspects Crohn's disease or ulcerative colitis, colonoscopy or barium enema x rays may be used to examine areas of the intestine.

Treatment

Treatment of proctitis depends on the specific cause. For example, the physician may prescribe antibiotics for proctitis caused by bacterial infection. If the inflammation is caused by Crohn's disease or ulcerative colitis, the physician may recommend the drug 5-aminosalicyclic acid (5ASA) or corticosteroids applied directly to the area in enema or suppository form, or taken orally in pill form. Enema and suppository applications are usually more effective, but some patients may require a combination of oral and rectal applications.

Suggested Readings:

View all Digestive Diseases Topics

Source:
National Digestive Diseases Information Clearinghouse (NDDIC). Proctitis (NIH Publication No. 05–4627, March 2005) . Accessed on September 25, 2010.

Page Last Revised: December 4, 2010

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Gastroesophageal reflux (GER) occurs when stomach contents reflux, or back up, into the esophagus during or after a meal. The esophagus is the tube that connects the mouth to the stomach. A ring of muscle at the bottom of the esophagus opens and closes to allow food to enter the stomach. This ring of muscle is called the lower esophageal sphincter (LES).

The LES normally opens to release gas after meals. With infants, when the LES opens, stomach contents often reflux into the esophagus and out the mouth, resulting in regurgitation, or spitting up, and vomiting. GER can also occur when babies cough, cry, or strain.

Symptoms

GER is common in healthy infants. More than half of all babies experience reflux in the first 3 months of life, but most stop spitting up between the ages of 12 to 24 months. Only a small number of infants have severe symptoms. An infant with GER may experience

* spitting up
* vomiting
* coughing
* irritability
* poor feeding
* blood in the stools
In a small number of babies, GER results in symptoms that cause concern. These symptoms include
* poor growth due to an inability to hold down enough food
* irritability or refusing to feed due to pain
* blood loss from acid burning the esophagus
* breathing problems
These problems can be caused by disorders other than GER. Your health care provider will need to determine whether GER is the cause of your child’s symptoms.

Diagnosis

A baby who is consistently spitting up or vomiting may have GER. The doctor or nurse will talk with you about your child’s symptoms and examine your child. Tests may be ordered to help determine whether your child’s symptoms are related to GER. Sometimes treatment is started without tests. If the infant is healthy, content, and growing well, often no tests or treatment are needed.

Treatment

The treatment for baby reflux depends on an infant’s symptoms and age. Some babies may not need treatment because GER often resolves by itself. Healthy babies may only need their feedings thickened with cereal and to be kept upright after eating. Overfeeding can aggravate reflux, so your health care provider may suggest different ways of handling feedings. For example, smaller quantities with more frequent feedings can help decrease the chances of regurgitation. If a food allergy is suspected, you may be asked to change the baby’s formula.

Breastfeeding mothers may be asked to change their own diets for 1 to 2 weeks. If a child is not growing properly, higher-calorie food or tube feeding may be recommended.

When an infant is uncomfortable, has difficulty sleeping or eating, or does not grow, your health care provider may suggest a trial of medication to decrease the amount of acid in the stomach. Any potential complications related to the medication will be explained. However, most infants don’t need medication and outgrow reflux by 1 or 2 years of age.

*If medication is needed, treatment will often start with a class of medications called H2-blockers, also called H2-receptor agonists. These drugs help keep acid from backing up into the esophagus. H2-blockers are often used to treat children with GER because they come in liquid form. H2-blockers include

Call your child’s health care provider right away if any of the following occur:

* vomiting large amounts or persistent projectile (forceful) vomiting, particularly in infants younger than 2 months old
* vomiting fluid that is green or yellow or that looks like coffee grounds or blood
* difficulty breathing after vomiting or spitting up
* refusing food that seems to result in weight loss or poor weight gain
* excessive crying and irritability

Learn About

Source: Gastroesophageal Reflux in Infants. http://digestive.niddk.nih.gov/ddiseases/pubs/gerdinfant/index.htm. Accessed June 17, 2010.

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