GERD and Sleep

This time the outcome has not been so good. The GI doctor I saw prescribed two different medications.

Stagnant food in the stomach can lead to increased gastric pressure and allow bile and stomach acid to back up into the esophagus. Bile and food mix in the duodenum and enter your small intestine through the pyloric valve, a heavy ring of muscle located at the outlet of your stomach. The pyloric valve usually opens only slightly – enough to release about an eighth of an ounce (about 3.5 milliliters) of liquefied food at a time, but not enough to allow digestive juices to reflux into the stomach.

This can lessen reflux and its associated symptoms. Antiemetic drugs are another option to relieve nausea.

The acid perfusion test, however, is used only rarely. A better test for correlating pain and acid reflux is a 24-hour esophageal pH or pH capsule study during which patients note when they are having pain. It then can be determined from the pH recording if there was an episode of acid reflux at the time of the pain. This is the preferable way of deciding if acid reflux is causing a patient’s pain.

There are several possible results of endoscopy and each requires a different approach to treatment. If the esophagus is normal and no other diseases are found, the goal of treatment simply is to relieve symptoms. Therefore, prescription strength H2 antagonists or PPIs are appropriate. If damage to the esophagus (esophagitis or ulceration) is found, the goal of treatment is healing the damage. In this case, PPIs are preferred over H2 antagonists because they are more effective for healing.

My original symptoms started when I was about 10 years old. I was diagnosed with a peptic ulcer.

Children younger than age 12 will often have different GERD symptoms. They will have a dry cough, asthma symptoms, or trouble swallowing. They won’t have classic heartburn.

The amount of time that the esophagus contains acid is determined by a test called a 24-hour esophageal pH test. (pH is a mathematical way of expressing the amount of acidity.) For this test, a small tube (catheter) is passed through the nose and positioned in the esophagus. On the tip of the catheter is a sensor that senses acid. The other end of the catheter exits from the nose, wraps back over the ear, and travels down to the waist, where it is attached to a recorder.

Over time, this may cause long-term problems. These can include esophageal narrowing (stricture) and abnormal cells in the lining of the esophagus (Barrett’s esophagus). Most babies with reflux have no symptoms other than spitting up often.

U.S. Department of Health and Human Services. Updated November 2014. Because GERD can cause you to breathe stomach acid into your lungs that can then irritate your lungs and throat, respiratory problems can occur. Barrett’s esophagus is a condition in which the esophagus, the muscular tube that carries food and saliva from the mouth to the stomach, changes so that some of its lining is replaced by a type of tissue similar to that normally found in the intestine.

Each time acid refluxes back into the esophagus from the stomach, it stimulates the sensor and the recorder records the episode of reflux. After a 20 to 24 hour period of time, the catheter is removed and the record of reflux from the recorder is analyzed. Biopsies of the esophagus that are obtained through the endoscope are not considered very useful for diagnosing GERD.

Symptoms of diverticulitis are pain on the left side of the abdomen, fever, chills, gas, constipation or diarrhea, nausea and loss of appetite. Treatment for GERD includes over-the-counter antacids, proton pump inhibitors (PPIs) and H2 blockers.

There are potentially injurious agents that can be refluxed other than acid, for example, bile. Until recently it has been impossible or difficult to accurately identify non-acid reflux and, therefore, to study whether or not non-acid reflux is injurious or can cause symptoms. One of the more interesting theories that has been proposed to answer some of these questions involves the reason for pain when acid refluxes. It often is assumed that the pain is caused by irritating acid contacting an inflamed esophageal lining.

can reflux cause nausea and vomiting

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