Heartburn Hiatus hernia is a common finding at gastroscopy AND MAY CAUSE NO SYMPTOMS. What Is HEARTBURN (gastro-oesophageal reflux)?
Gastroesophageal reflux is the return of the stomach's contents back up into the oesophagus. There is a
sphincter, or muscle in the lower oesophagus. Normally, the sphincter opens to allow food to pass into the
stomach and closes to prevent acidic stomach juices from flowing back into the oesophagus.
Gastroesophageal reflux occurs when the sphincter is weak or relaxes inappropriately allowing the stomach's contents to flow up into the oesophagus. The severity of reflux depends on the level of sphincter dysfunction as
wel as the type and amount of fluid brought up from the stomach.
What Is the Role of a Hiatus Hernia?
Hiatus hernia occurs when the upper part of the stomach moves up into the chest through a small opening in the
diaphragm (the muscle separating the stomach from the chest).
A HIATUS HERNIA IS NOT LIKE OTHER HERNIAS AND IS NOT GENERALLY CAUSED BY LIFTING
Many otherwise healthy people age 50 and over have a small hiatus hernia and never have any symptoms.
What Is the Treatment for Reflux?
Avoiding foods and beverages that can weaken the sphincter is recommended.
Chocolate, peppermint, fatty foods, coffee, and excess alcoholic beverages.
Foods and beverages that can irritate a damaged oesophageal lining,
such as citrus fruits and juices, tomatoes, and pepper, should also be avoided.
In addition, being overweight often worsens symptoms.
Cigarette smoking weakens the sphincter. Therefore, stopping smoking is important
to reduce reflux symptoms. .Medication Antacids taken regularly can neutralize acid in the oesophagus and stomach and stop heartburn.
They are effective WHEN you have symptoms. TABLETS THAT REDUCE ACID
These medicines include proton pump (or acid pump) inhibitors (also called PPI’s omeprazole (Losec),esomeprazole (Nexium) Lansoprazole (Zoton) or Somac; and inhibits an enzyme (a protein in the acid-
producing cells of the stomach) necessary for acid secretion. These drugs are the most effective way of controlling symptoms. They are usually taken for 4 to 8 weeks depending on the severity of the reflux. THEY SHOULD BE TAKEN 1 HOUR BEFORE A MEAL to work effectively.
After healing has occurred you may be able to take these tablets intermittently but this does depend on the severity of the findings at gastroscopy. Sometimes especially when symptoms wake you a tablet such as
SURGERY and OTHER MEASURES
If your symptoms are not controlled or if there are side effects from the tablets (rare) then surgery may be discussed as an option. There are also endoscopic methods that are helpful in controlling reflux but this is an
experimental option at this stage and only used in certain cases
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Heartburn