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What You Need to Know About Heartburn-Related Digestive Disorders

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Updated March 28, 2012

Many people don't like to talk about their digestive problems, so they suffer in silence. You don't have to do this. While it's important to talk to your doctor about any concerns with your health, the information below may answer some of your questions and give you an idea of what to ask your doctor.

Gastroesophageal Reflux Disease (GERD)

GERD occurs when the lower esophageal sphincter does not close properly and stomach contents back up (reflux) into the esophagus.

Heartburn and acid regurgitation are the main symptoms of GERD, though some people with GERD don't experience any heartburn episodes. This is why it's important to know all the possible symptoms.

While the majority of doctors will prescribe a trial of acid-suppressive therapy and make a diagnosis based on the patient's response to treatment, there are certain tests that can diagnose GERD.

Treatment will usually start with certain lifestyle modifications and dietary changes. If you continue to have symptoms after these changes, your physician will discuss using antacids, H2 blockers and proton pump inhibitors (PPIs). If your physician and you decide a surgical option is needed, the most common surgical treatment for GERD is the fundoplication surgery. Another procedure sometimes used is radiofrequency treatment.

If you would like to share your story about which symptoms led to your GERD diagnosis, you can do so here.

Hiatal Hernias

A hiatal hernia occurs when the upper part of the stomach pushes through an opening in the diaphragm and up into the chest. This opening is called an esophageal hiatus or diaphragmatic hiatus.

Approximately 50 percent of hiatal hernia patients don't experience any hiatal hernia symptoms. There are a number of contributing factors that can cause the condition. While some patients with a hernia may also have GERD, GERD doesn't cause a hiatal hernia.

Various tests can be used to diagnose a hiatal hernia. They include the barium X-ray and the upper endoscopy. After a hernia is diagnosed, the treatment will vary by patient. As mentioned above, approximately half of all patients with a hiatal hernia won't experience any symptoms and may not require any special treatment.

For those who do experience symptoms, which are usually heartburn-related, talk to your doctor about lifestyle modifications, dietary changes and medications (such as antacids, H2 blockers or PPIs).

In some cases, such as when complications occur with a paraesophageal hiatal hernia, surgery may be needed. This type of surgery is commonly done as a laparoscopic procedure.

If you would like to share your story on what symptoms led to your hiatal hernia diagnosis, you can do so here.

Peptic Ulcers

Peptic ulcers can cause a variety of symptoms, and these vary from patient to patient. Some patients with ulcers have minimal, unusual or even no symptoms at all. Others may have every symptom. Talk to your doctor if you have any concerns.

It is important to understand the causes of peptic ulcers. In the past, it was believed stress and diet caused peptic ulcers. Later, researchers stated that stomach acids (hydrochloric acid and pepsin) contributed to the majority of ulcer formation. Today, however, research shows that most ulcers develop as a result of infection with a bacterium called Helicobacter pylori (H. pylori).

Since most peptic ulcers are caused by H. pylori, your doctor will most likely confirm its presence before doing other diagnostic tests. Those tests can include an upper endoscopy or barium X-rays.

If testing finds H. pylori, standard treatment is a combination of drugs, including antibiotics and a PPI.

If non-steroidal anti-inflammatory drugs (NSAIDs) are the cause of your ulcer, you should stop taking these remedies. During the healing process for an NSAID-induced ulcer, your doctor may recommend antacids to neutralize the acid and H2-blockers or PPIs to reduce stomach acid production. Your doctor may also recommend lifestyle changes, such as diet.

Many people think that ulcers are an "adult disease." However, childhood peptic ulcers can and do develop. Children develop both duodenal and stomach (gastric) ulcers, though gastric ulcers are more common in children. The ulcer's location will determine the treatment.

Share your experience: If you have a peptic ulcer, what symptoms led to your peptic ulcer diagnosis?

Gallstones

Most people don't give their gallbladder a second thought. They may not even know where it is located in the body. Many people can go through their lives without gallbladder problems.

Then there are those of us who have gallbladders who make their presence known .... with intense pain caused by gallstones.

There are two types of gallstones - cholesterol and pigment. Cholesterol stones are the most common. Gallstones can form in the gallbladder when bile hardens into stone-like material. Bile can harden if there is too much bile salt, cholesterol or bilirubin.

Many people with gallstones do not have any symptoms. They are said to have "silent" gallstones. For those who experience symptoms, they can have a "gallbladder attack," which most often occurs after eating a fatty meal. The pain can occur in the upper abdomen, in the back between the shoulder blades or under the right shoulder. Bloating and heartburn can also occur.

Risk factors and causes of gallstones include:

  • Obesity
  • Rapid weight loss
  • Excess estrogen
  • Ethnicity
  • Gender
  • Age
  • Cholesterol-lowering drugs
  • Diabetes

Some people don't know they have gallstones until their doctor finds them during testing for another problem. Others learn they have gallstones after developing severe pain that requires medical care.

Gallstone symptoms are similar to those of a heart attack, appendicitis, peptic ulcers, irritable bowel syndrome, hiatal hernia, pancreatitis and hepatitis, so tests are needed to make an accurate diagnosis. Tests include:

  • Ultrasound
    Ultrasound is most often used if gallstones are suspected.

  • Cholescintigraphy
    This scan is done by nuclear-medicine physicians and can detect bile leaks or an obstruction in the gallbladder or bile ducts.

  • Blood tests
    Blood tests can look for signs of infection or abnormal levels of bilirubin, which can happen if a bile duct is obstructed.

Treatment will depend partly on whether you have symptoms or not. If you have no symptoms, you and your doctor may decide that no treatment is needed. If you do, surgical removal of the gallbladder is the most common treatment.

The most common operation for gallbladder removal is called laparoscopic cholecystectomy. If infection or scarring from other surgeries is found, a surgeon may perform an open surgery instead of the laparoscopic procedure.

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Sources:

"http://digestive.niddk.nih.gov/ddiseases/pubs/gerd">Heartburn, Hiatal Hernia, and Gastroesophageal Reflux Disease (GERD)." NIH Publication No. 03–0882 May 2007. National Digestive Diseases Information Clearinghouse.

"What I need to know about Peptic Ulcers" NIH Publication No. 05–5042 October 2010. National Digestive Diseases Information Clearinghouse (NDDIC).

"Gallstones." NIH Publication No. 07–2897 July 2007. National Digestive Diseases Information Clearinghouse (NDDIC).

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