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Gastroesophageal Reflux Disease (GERD); Prevention.

The primary focus of prevention for gastroesophageal reflux disease (GERD) is to pay attention to your lifestyle and avoid activities or triggers that cause symptoms.

Remember: GERD occurs when stomach acid abnormally flows back up into the esophagus, the long, muscular tube that connects the back of the mouth to the stomach. Acid refluxing occurs when the sphincter between the esophagus and the stomach, the lower esophageal sphincter, doesn't work properly or when a hiatal hernia has developed (when part of the stomach protrudes up through the diaphragm-the muscular layer between the abdomen and the chest) and into the chest. Acid refluxing may also happen when a person eats food or drinks beverages that relax the lower esophageal sphincter, which allows fluid to travel backwards from the stomach to the esophagus. The most common symptom people with GERD suffer is heartburn.

To prevent mechanical dysfunction of the lower esophageal sphincter avoid activities that increase the amount of pressure on your abdomen or increase the pressure on the lower esophageal sphincter. These activities include:

* Avoid bending over and other exercises that squeeze your abdomen. Also, avoid exercising on a full stomach.

* Loosen your belt. Tight clothing around your waist, such elastic waist bands and girdles can increase the pressure on your stomach.

* Avoid lying down after a meal. If you are flat on your back after a large meal, stomach contents can easily wash back up into your esophagus. For this same reason, no late night snacks, or treats just before going to sleep.

* Decrease the size of your meal portions or snacks. Large amounts of food in the stomach put more pressure of the lower esophageal sphincter causing it to remain open.

* Elevate the head of your bed six to eight inches to aid gravity in preventing acid from washing back up into your esophagus while sleeping.

Prevention of functional problems, which weaken the lower esophageal sphincter or irritate the lining of the esophagus, include some of the following steps:

* Stop smoking and avoid tobacco products. Some studies indicate that nicotine causes relaxation of the lower esophageal sphincter. Other studies show that smoking changes the saliva so that acid isn't cleared from the esophagus quickly enough resulting in damage to the esophagus.

* Avoid foods that trigger symptoms; these may vary for each individual. Common food triggers include citrus products, tomato sauces, peppermints, chocolate, onions, coffee, fried foods, and carbonated beverages.

* Avoid drinking alcoholic beverages. Alcohol can relax the lower esophageal sphincter, and it can also cause erratic contractions of the esophagus. These erratic contractions allow acid to reflux into the esophagus and cause heartburn.

* Some medications may worsen your symptoms. Do not stop a medication without first consulting with your health care professional. Some symptoms might occur with the start of a medication, while other symptoms might develop over time. It may take some detective work by both you and your physician to determine if a medication is a trigger. Here are a few examples of medications that might contribute to GERD symptoms:

* Certain drugs to treat asthma and emphysema such as theophylline.

* Anticholinergic drugs used to treat Parkinson's disease and are in some over-the-counter cold medications.

* Hormones such as progesterone-which may be included in birth control pills.

* Some calcium-channel blockers, alpha-blockers and beta-blockers used to treat heart conditions or high blood pressure.

* Certain drugs that affect the central nervous system.

* Iron tablets.

While some drugs worsen GERD symptoms, other drugs can cause pill esophagitis, a condition that causes symptoms similar to GERD. Pill esophagitis happens when the pill is swallowed into the esophagus but does not make it into the stomach (it gets stuck on the esophagus wall), and burns the lining of the esophagus, causing terrible chest pain and esophageal ulcers. Medications associated with pill esophagitis include non-steroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen (Motrin, Aleve) and aspirin, and celecoxib (Celebrex), another type of pain reliever medication used to treat severe arthritis. Alendronate (Fosamax) also is associated with pill esophagitis.

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Editorial Staff of the National Women's Health Resource Center 2002/12/01 2005/03/16 Gastroesophageal reflux disease (GERD) is the abnormal backflow of stomach acid up into the esophagus, the long, muscular tube that connects the back of the mouth to the stomach. Acid Laryngitis,acid regurgitation,Barrett's esophagus,Esophageal strictures,Esophagitis,Gastroesophageal reflux disease,GERD,Reflux dyspareunia
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Publication:NWHRC Health Center - Gastroesophageal Reflux Disease
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Date:Mar 16, 2005
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