| Overview |
| Heartburn (reflux) is very common in the general population. It can often be managed well with lifestyle changes, such as avoiding carbonated soft drinks. Treatments can include medications and surgery. |
| Gastroesophageal Reflux Disease (GERD). The most common GERD symptom is chronic heartburn, but it's not the only symptom. WebMD. |
| Heartburn or GERD (Gastroesphogeal Reflux Disease)? GERD can develop as a result of chronic heartburn. GERD is associated with more serious complications including stricture (narrowing) of the esophagus or a potentially precancerous condition called Barrett's esophagus. WebMD. |
| Understanding Heartburn. The Basics. Heartburn is an irritation of the esophagus that is caused by stomach acid.Occasional heartburn isn't dangerous, but chronic heartburn can indicate serious problems and can develop into gastroesophageal reflux disease (GERD). WebMD. |
| Why Persistent Acid Reflux Sometimes Turns Into Cancer: New Clues. New research from scientists at UT Southwestern Medical Center and the Dallas Veterans Affairs Medical Center underscores the importance of preventing recurring acid reflux while also uncovering tantalizing clues on how typical acid reflux can turn potentially cancerous. Science Daily. 08/11/07. |
| Heartburn, GERD, and Scleroderma |
| Heartburn usually occurs by itself, without any underlying disease. In very rare cases, esophageal problems can be due to systemic sclerosis (scleroderma), which is an autoimmune disease. |
| Use of NSAIDs and infection with Helicobacter pylori-what does the rheumatologist need to know? Ulcer risk reduction after H. pylori eradication therapy is clearly more marked in patients beginning NSAID therapy than in patients who were already receiving and tolerating NSAID therapy. U. Kiltz. Rheumatology Advance Access. May 13, 2008 (Also see: NSAIDs ). |
| A Role of Helicobacter Pylori Infection in Gastroesophageal Reflux Disease (GERD) in Patients with Systemic Sclerosis (SSc). GERD is the most common gastrointestinal tract disease in SSc. H.pylori infection might play an important role in its severity. H. Kuno. AB0279 EULAR 2006. (Also see: Esophagus Involvement) |
| Esophageal Involvement in Scleroderma: Gastroesophageal Reflux, the Common Problem. Esophageal involvement is frequent in SSc patients. Appropriate treatment of esophageal involvement ameliorates symptoms and prevents complications. PubMed. Semin Arthritis Rheum. 2006 Oct 10. (Also see: Esophagus Involvement ) |
| Prevalence of gastroesophageal reflux in end-stage lung disease candidates for lung transplant. Gastroesophageal reflux is highly prevalent in end-stage lung disease patients who are candidates for lung transplantation. PubMed. Ann Thorac Surg. 2005 Oct;80(4):1254-60 (Also see: Pulmonary Fibrosis ) |
| About Reflux (Heartburn) |
| Heartburn (reflux) is the main symptom of Gastro Esophageal Reflux Disease (GERD). Heartburn is a painful, burning feeling in the chest, which is caused by stomach acid flowing back into the esophagus (throat). (Source: Columbia Healthcare) |
| Usefulness of the Questionnaire FSSG (Frequent Scale for the Symptoms for GERD) for the Evaluation of GERD in Patients with Scleroderma. The questionnaire FSSG is a useful tool for detecting GERD in scleroderma patients and evaluating the efficacy of treatment. Rabeprazole, a new proton pump inhibitor (PPI), is effective for lowering FSSG score. K. Amano. AB0492 EULAR 2007. |
| Acidic and Non-Acidic Reflux During Sleep Under Conditions of Powerful Acid Suppression. PPI treatment reduced overall reflux events, but non-acidic reflux events were relatively more likely to occur with PPI treatment. Chest. 2007; 131:460-465. (Also see: Reflux Treatments ) |
| Nonacid Reflux in Patients With Chronic Cough on Acid-Suppressive Therapy. Recent studies indicating that cough can be temporally associated with reflux episodes of pH 4 to 7 (ie, nonacid reflux) reinvigorates the need for a more careful workup in patients with cough suspected to be due to GERD. Chest. 2006;130:386-391 |
| Predictors of Heartburn During Sleep. Heartburn during sleep is very common in the general population. Reports of this type of symptom of GERD are strongly associated with increased BMI, carbonated soft drink consumption, snoring and daytime sleepiness, insomnia, hypertension, asthma, and usage of benzodiazepines. Chest. 2005;127:1658-1666. |
| Chest Pain, Chronic Many different types of problems can cause discomfort, shortness of breath, pain with swallowing, and many other symptoms in the chest area. This chart may help you pinpoint your problem as you confirm your symptoms. familydoctor.org |
| About GERD |
| The Relation Between Gastroesophageal Reflux and Respiratory Symptoms in a Population-Based Study. In spite of numerous investigations, the relation between respiratory symptoms and reflux symptoms in the general population remains unclear, since population-based studies are few. Chest. 2006;129:1051-1056. . (Also see: Asthma) |
| Gastroesophageal Reflux Disease is the condition wherein acidic stomach contents regurgitate or back up (reflux) into the esophagus. The esophagus is a long cylindrical tube that transports food from the mouth to the stomach. MedicineNet |
| Guidelines Set Standard on Test to Diagnose Acid Reflux, Heartburn. Abnormalities that cause diseases of the esophagus include achalasia, where the nerves are damaged; esophageal spasms; non-cardiac chest pain; a condition called scleroderma, or chronic autoimmune disease of the connective tissue; and hiatal hernia. newswise. Cedars-Sinai Medical Center. 12/05/03. |
| How is the diagnosis of gastroesophageal reflux made? "The diagnosis of GERD is usually suggested by the patient's symptoms. Tests to confirm GERD include barium x-rays of the esophagus, endoscopy, esophageal acid tests, and, occasionally, Bernstein's test." MedicineNet |
| Nausea and Vomiting Many illnesses can cause stomach pain, nausea and vomiting. Some are mild sicknesses that will pass by themselves, but others are serious and need medical attention. familydoctor.org |
| The pattern of esophageal manometry in progressive systemic sclerosis. Patients with progressive systemic sclerosis usually present with heartburn, dysphagia and regurgitation. Esophageal manometry typically shows lower pressure and aperistalsis. Gastroesophageal reflux is frequent. PubMed. Saudi Med J 2003 Jan;24(1):68-71 (Also see: Esophageal Involvement: Barrett's ) |
| Hiatal Hernia |
| Hiatal Hernia. Hiatal hernia is a condition in which a portion of the stomach protrudes upward into the chest, through an opening in the diaphragm. This condition may cause reflux (backflow) of gastric acid from the stomach into the esophagus. |
| Hiatal Hernia. Most hiatal hernias are asymptomatic and are discovered incidentally. On rare occasion, a life-threatening complication, such as gastric volvulus or strangulation, may present acutely. eMedicine.com. |
| Paraesophageal Hiatal Hernia. There are two categories of hiatal hernias, sliding or paraesophageal. About.com. |
| Hiatal Hernia Diet Tips. A few quick tips about eating with a hiatal hernia. About.com. |
| Reflux Prevention |
| Lifestyle and Dietary Changes MedicineNet |
| Hold the Heartburn: Heartburn Log. Tracking your triggers can help manage heartburn effectively and naturally. WebMD. |
| Investigators Uncover Intriguing Clues To Why Persistent Acid Reflux Sometimes Turns Into Cancer. "The research supports why it is important to prevent reflux, because the more reflux you have and the longer you have it, the more it might predispose you to getting Barrett's esophagus. So you want to suppress that reflux," said Dr. Rhonda Souza.Medical News Today. 08/13/07. (Also see: Barrett's Esophagus ) |
| Body-Mass Index (BMI) and Symptoms of Gastroesophageal Reflux in Women. BMI is associated with symptoms of gastroesophageal reflux disease in both normal-weight and overweight women. Even moderate weight gain among persons of normal weight may cause or exacerbate symptoms of reflux. The New England Journal of Medicine. Vol 354:2340-2348. 06/01/06. |
| Soda, Sleeping Pills May Cause Heartburn. Carbonated soft drinks and one of the most commonly prescribed types of sleeping pills, benzodiazepines, may be some underappreciated causes of nighttime heartburn—so severe that it disturbs a person's sleep. WebMD. 05/09/05. |
| Heartburn: To relieve nighttime reflux, sleep on your left side. reported MSNBC on 5/22/98: "If all reflux sufferers followed this advice, we'd see a lot less nighttime reflux," says Dr. Don Castell of the American Gastroenterological Association. |
| Eradication of Helicobacter pylori Confers no Significant Benefit for Patients with Heartburn or Gastroesophageal Reflux. Helicobacter pylori infection appears associated with a small increased prevalence of heartburn but not with gastroesophageal reflux, however, eradication of H pylori does not offer a significant benefit for patients with either condition, according to findings from the Bristol helicobacter project. Doctor's Guide. BMJournal 05/06/04. |
| Reflux and Diet |
| Good Foods, Bad Foods, Recipes, Menus. Charts to show you what you can eat and what you shouldn't. Heartburn-free recipes. There are also links to menus with heartburn-friendly foods. About.com. |
| Diet for Heartburn. Relief of mild heartburn is typically achieved through diet and lifestyle changes, although medication (eg. antacids) is usually necessary if the heartburn is caused by gastroesophageal reflux disease (GERD). Buzzle.com. |
| The Acid Reflux Disease Diet. An acid reflux disease diet is an easy way to reduce or eliminate the painful symptoms alone or with any medication. Ezine Articles. |
| Use Beano before eating foods that are troublesome. |
| Survey Reveals Heartburn Sufferers Experience More Heartburn During The Holidays. By incorporating lifestyle changes into their diets, heartburn sufferers can learn to alleviate symptoms so they can enjoy the holidays. Medical News Today. 11/14/07. |
| Before you Go to Bed - Easing Nighttime Heartburn. Here's what you can do before you go to bed to help you feel better and get a good night's rest, free of heartburn. About.com. |
| 10 Steps to Lesson Nighttime Heartburn. If staying up all night isn't the option you are prepared to take for handling your nighttime heartburn, the following suggestions should help you. About.com |
| Reflux and GERD Treatments |
| Acid Reflux Drugs May Up Fractures. Using acid reflux drugs called proton pump inhibitors for at least seven years may be linked to increased risk of osteoporosis-related fractures. WebMD. 08/11/08. (Also see: Osteoporosis) |
| Acidic and Non-Acidic Reflux During Sleep Under Conditions of Powerful Acid Suppression. PPI treatment reduced overall reflux events, but non-acidic reflux events were relatively more likely to occur with PPI treatment. Chest. 2007; 131:460-465. (Also see: GERD ) |
| Endoscopic GERD Surgery Gives Long-Term Relief. An endoscopic surgical procedure to treat symptomatic gastroesophageal reflux disease (GERD) was safe and effective over a three-year follow-up, found researchers here and at four other centers. Medpage Today. 01/07/07. |
| Study finds unexpected results in acid suppression between two OTC heartburn treatments. This study showed the proton pump inhibitor (PPI) had more profound effects on stomach acid over time. EurekAlert! 01/10/07. |
| Acid suppression medication linked with increased risk of hip fracture. We observed that proton-pump inhibitors (PPI) therapy is associated with a significantly increased risk of hip fractures, with the highest risk seen among those receiving high-dose PPI therapy. E urekAlert! 12/26/06. |
| GERD: endoscopic antireflux therapies. Radiofrequency (Stretta) has proved only a very modest effect, while implantation techniques have been abandoned due to lack of long-term efficacy (Gatekeeper) or serious side effects (Enteryx). PubMed. Schweiz Rundsch Med Prax. 2006 Aug 2;95(31-32):1185-7. |
| GERD Information Resource Center by Astra Merck Inc. |
| Metoclopramide response in patients with early diffuse systemic sclerosis. Effects on esophageal motility abnormalities. The results of our study show that metoclopramide may improve LES (lower esophageal sphincter) pressures in patients with early and late dSS. Because metoclopramide can be used orally, it may mitigate both dysphagia and heartburn. PubMed. Clin Exp Rheumatol. 2005 Sep-Oct;23(5):685-8. (Also see: Esophagus Involvement and Dysphagia) |
| Endoscopic antireflux therapy: the Stretta procedure. The Stretta procedure is safe and effective for the treatment of GERD. PubMed. Thorac Surg Clin. 2005 Aug;15(3):395-403. |
| Management of gastroesophageal reflux disease: medications, surgery, or endoscopic therapy? (Current status and trends). Because of its symptomatic diversity, physicians may select from a variety of therapeutic approaches. PubMed.J Long Term Eff Med Implants. 2005;15(4):375-88. |
| G.I. Cocktail. Ask your doctor about this! It's a mixture of Maalox, Donnatol, and Xylocaine which can quell severe heartburn/reflux right away. Many SD patients give it rave reviews. |
| GERD is a chronic, severe form of heartburn that has the potential to erode the inner lining of the lower esophagus over time. Acrobat Reader required to view. NMT Brief from Center Watch. |
| Propulsid (cisapride) Physicians who are treating patients with severely debilitating conditions for whom they believe the benefits of the cisapride may still outweigh its risks are encouraged to contact Janssen at 1-800-JANSSEN. |
| Surgery |
| In severe cases of heartburn, where medication does not help or there are complications, surgery may be done. |
| Laparoscopic Nissen Fundoplication is a surgery which wraps the stomach tighter around the base of the esophagus to lessen the likelihood of reflux. Laparscopy.com |
| Heartburn Surgery Done Through Patient's Mouth. Physicians used a remote control instruments to repair the valve between the esophagus and stomach without using a scalpel. Medical News Today. 01/11/08. |
| Comparison of surgical approaches to recalcitrant gastroesophageal reflux disease in the patient with scleroderma. This finding suggests that laparoscopic Roux-en-Y gastric bypass (RYGBP) may be an option for the primary management of scleroderma-associated gastroesophageal reflux. PubMed. Ann Thorac Surg. 2007 Nov;84(5):1710-5. |
| Surgery Unlikely to Douse Fires That Fuel Heartburn Over Time, Medicine a Better Option for Reflux Disease For the millions of Americans suffering from GERD, or gastroesophageal reflux disease, a surgical fix may be no better than treatment with medications called proton pump inhibitors. In fact, surgery may increase the risk of death over time. WebMD 5-8-2001 |
| Nissen Fundoplication Surgery Personal Stories |
| Jon F: Gastroesophageal Reflux Disease (GERD) I believe my vagus nerve was damaged in some way during the Nissen fundoplication surgery or as a result of it... |
| Moomary: Diffuse Scleroderma The endoscopy showed that my esophagus does not close at all when I swallow. The surgeon suggested that he could do a Nissen Fundoplication... |
| Rosie: Limited Systemic Sclerosis (Australia) Some of my symptoms may not be due to limited scleroderma, however most of these symptoms have appeared since my diagnosis... |
| Personal Stories of Heartburn/Reflux and Esophageal Problems |
| Amy: Daughter of Systemic Sclerosis Patient: What is Scleroderma? Imagine for me if you would that in certain areas of your body the skin has begun to thicken and harden... |
| Annette: Diffuse Scleroderma (Illinois) I can see where having friends who understand what I am going through would be a big help... |
| Annette G: MCTD, Systemic Scleroderma, Chronic Kidney Disease, CFS, Fibromyalgia, Trigeminal Neuralgia, TMJ People think that because I am a nurse I have all the answers. Well guess what? I don't... |
| Barb: Diffuse Systemic Scleroderma I was diagnosed in 1985 with systemic scleroderma and Raynaud's. It has affected my esophagus, fingers, toes and bowels, and recently I started having mini strokes... |
| Beverly: CREST Scleroderma I was overtired and needed naps in the afternoon, pain was slowly getting the better of me and I finally went to the doctor... |
| Chris Beck: In Memory of My Mother, Veta Breit Can someone help me? My hands hurt and get cramped sometimes when they get cold... |
| Christene: Limited Scleroderma I was diagnosed when I was just nineteen and at that time it was one of the scariest moments of my life... |
| Danie: CREST Scleroderma My parents always thought of it as an excuse to miss school. It all started with my hands... |
| D.M. Hoffe: Progressive Systemic Sclerosis (Scleroderma CREST) After an endoscopy it was discovered I had a Watermelon Stomach... |
| Easter: Scleroderma My name is Easter, and I'm Iraqi. About 16 years ago I began my struggle with scleroderma... |
| Elaine L: Scleroderma When I was about 20 years old, I started experiencing stomach problems and my fingers would turn a waxy white and feel so cold... |
| Elva: Mother of Diffuse Scleroderma Patient My son is unable to put on his own socks and shoes. He is very tired, and has tremendous pain... |
| Gaynor: Morphea and Possible Systemic Sclerosis I was diagnosed in 2003 with morphea. It began as a bruise-like patch on my upper right arm... |
| Gazea: Diffuse Scleroderma I would like to at least try to suggest a small ray of hope for other sufferers of diffuse scleroderma... |
| Gertie: Systemic Scleroderma without Skin Involvement or Raynaud's She looked thoughtful for a moment, then quietly asked "Is there hope?" |
| Gipi: Raynaud's, Scleroderma (Italy) I'm a 53 year old woman. When I was 21 my illness began, my fingers turned white and I had pain in my bones... |
| (Italiano) Gipi: Raynaud's, Sclerodermia Sono una donna di 53 anni. Quando avevo 21 anni ho avuto l'esordio della mia malattia con pallore alle dita delle mani e dolori alle ossa... |
| Heidi: Difficult Diagnosis of UCTD Do these symptoms resemble the beginning symptoms for others who have gone on to be diagnosed with scleroderma? |
| Helen P: CREST Scleroderma I was diagnosed ten years ago when the symptoms kicked in with a vengeance following a very traumatic personal tragedy... |
| Iceback: CREST or Limited Scleroderma Never having heard of scleroderma, I never really asked any questions when he told me and went home to look it up on the Internet... |
| Ingrid: Daughter of CREST and Overlap Patient (Germany) Maybe there is someone who has a similar or the same problem and this person could write to me. The doctors cannot help my father... |
| (Deutsche) Ingrid: Vater das CREST Sydrom sowie Overlap Syndrom Vielleicht kann mir jemand schreiben der das gleiche... |
| Jay: Scleroderma and CREST When I was fifteen or so, I noticed that my fingertips were starting to get very sore... |
| Jenny: CREST Scleroderma My symptoms started to appear over ten years ago, but I was only recently diagnosed... |
| Jenny S: Morphea, etc. After a biopsy, I was diagnosed with morphea at age fourteen. A small spot, size of a quarter on my lower back that progressed to the size of two of my hands... |
| Jerri: CREST Syndrome I was twenty-one years of age when I first noticed that my fingers, toes and lips were turning colors... |
| Jewell: Diffuse Progressive Systemic Sclerosis When I think back, I had been getting sick for a long time. I just did not know it... |
| Joanne: Diffuse Scleroderma (Now in memory of Joanne by Lis) My hands became very swollen and I was unable to make a fist... |
| Jon F: Gastroesophageal Reflux Disease (GERD) I believe my vagus nerve was damaged in some way during the Nissen fundoplication surgery or as a result of it... |
| Kate: Possible Scleroderma/Lupus Overlap At some point in that dreary winter month, I began waking up with swollen hands... |
| Kym: Diffuse, CREST Scleroderma, Lupus and Fibromyalgia It all started with Raynaud's in my fingers and toes when I was about nineteen years old, in 1979... |
| Leeben: Limited Scleroderma and CREST I won't go into how many doctors I had to visit before someone took me seriously; it was a total nightmare... |
| Marilyn: Diffuse Scleroderma Being that I was a nurse you would think that I should have picked up on this myself... |
| Marthie D: CREST Scleroderma I live in a small town, which developed around a chemical and petrochemical industry in this area in South Africa... |
| Mary T: CREST Scleroderma If my rheumatologist does not explain my problems to my satisfaction, I will be looking for another doctor... |
| Michelle T: Surviving Daughter of Systemic Sclerosis Patient In memory of my mother, who was my best friend, my strength, my drive, and my compassion, I am compelled every day of my life to educate others of this disease... |
| Moomary: Diffuse Scleroderma The endoscopy showed that my esophagus does not close at all when I swallow. The surgeon suggested that he could do a Nissen Fundoplication... |
| Robin E: Scleroderma, Lupus and Raynaud's I do not know if I can describe what I am going through because it changes each week, if not each day... |
| Rosie: Limited Systemic Sclerosis (Australia) Some of my symptoms may not be due to limited scleroderma, however most of these symptoms have appeared since my diagnosis... |
| Sandy A: CREST Syndrome I have had surgery to remove the calcinosis on my knee and forearm twice, and once on my elbow. Yet it always comes back... |
| Santo: Sjogren's Syndrome (Italy) I visited gastroenterologist, mouth experts, dentists, ears, nose and throat specialists, and none of them could explain the symptoms... |
| (Italiano) Santo: Sindrome di Siogren La parte esofagea si è risolta, ma restavano i sintomi alla bocca e poi sono venuti quelli agli occhi (secchezza del dotto oculare)... |
| SariHope: CREST Scleroderma and Sjogren's Syndrome During the first few years after being diagnosed with Raynaud's, I had to go to the grocery store with gloves on to reach into the frozen freezer... |
| Susie: CREST Syndrome I have had CREST syndrome for the past eight years. My specialist is Dr. Frederick Wigley, from Johns Hopkins... |
| Syl: Systemic Scleroderma/CREST/Pulmonary Hypertension/Sjögren's The physician's assistant noticed that my hands went really blue... |
| Tami: Morphea Scleroderma I have gotten used to the stares everyone casts my way because in their eyes I am different. Unique, I guess... |
| Tata P: Diffuse Scleroderma I am thirty-two years old, and I have been suffering this illness since I was nine... |
| (Español/Spanish) Tata P: Esclerodermia Difusa Hola, tengo 32 años, y padezco esta enfermedad desde los 9... |
| Tracie S: CREST with Fibromyalgia I ache from head to toe, am cold all the time, feel like I am in a fog, in general I am just not up to par... |
| Yolima: Diffuse Scleroderma I was misdiagnosed for more than a year with so many diseases and given all types of medication for different problems except for the real disease... |
| Yuri: CREST Syndrome Now, one month before my nineteenth birthday, I live with CREST Syndrome, rheumatoid arthritis, acid reflux and anemia... |
| Media Stories |
| Maybe It is More Than Just Heartburn. A recent national survey by Harris Interactive found 88 percent of those surveyed incorrectly assumed GERD is simply heartburn. And they remained unaware of other potentially damaging symptoms such as an acid taste in the mouth, trouble swallowing or regurgitation of food. PakTribune 12/24/05. (Also see: Scleroderma, Sjogren's, and Dysphagia) |
