What are the key differences between occasional heartburn and GERD. How can a gastroenterologist help diagnose and treat chronic acid reflux. When should you seek medical attention for persistent reflux symptoms.

The Basics of Gastroesophageal Reflux Disease (GERD)

Gastroesophageal reflux disease, commonly known as GERD, is a chronic condition that affects millions of Americans. While most people have experienced occasional acid reflux or heartburn, GERD is characterized by persistent symptoms that occur multiple times per week. In GERD patients, the lower esophageal sphincter (LES) – a ring of muscle that normally prevents stomach contents from flowing back into the esophagus – fails to function properly.

This malfunction allows stomach acid to repeatedly enter the esophagus, potentially causing damage over time. Common symptoms of GERD include:

• Frequent heartburn (burning sensation in the chest)
• Regurgitation of food or sour liquid
• Difficulty swallowing
• Chronic cough or wheezing
• Hoarseness or sore throat
• Chest pain

Distinguishing GERD from Occasional Heartburn

How can you tell if your acid reflux is just occasional heartburn or a more serious condition like GERD? The key lies in the frequency and severity of symptoms. Occasional heartburn, while uncomfortable, is generally not a cause for concern. However, if you’re experiencing heartburn several times a week, especially if it’s interfering with your daily life or sleep, it’s time to consult a doctor.

GERD is a chronic condition that requires proper diagnosis and management. Unlike occasional heartburn, which may be triggered by specific foods or activities, GERD symptoms tend to be more persistent and can occur regardless of what you eat or do.

Key differences between GERD and occasional heartburn:

• Frequency: GERD symptoms occur at least twice a week, while occasional heartburn is less frequent
• Duration: GERD symptoms are persistent and long-lasting, whereas occasional heartburn is typically short-lived
• Severity: GERD symptoms are often more intense and may be accompanied by other symptoms like difficulty swallowing or chronic cough
• Impact on daily life: GERD can significantly affect quality of life, while occasional heartburn is usually a minor inconvenience

The Dangers of Self-Medicating for Chronic Acid Reflux

Many people with persistent acid reflux symptoms turn to over-the-counter (OTC) medications for relief. While these medications can provide temporary symptom relief, they are not intended for long-term use and may mask underlying issues. Common OTC treatments for acid reflux include:

• Antacids (e.g., Tums, Rolaids)
• H-2 blockers (e.g., Pepcid, Zantac)
• Proton pump inhibitors (PPIs) (e.g., Prilosec, Nexium)

Why is long-term use of these medications problematic? Prolonged use of PPIs, in particular, has been associated with several health risks. Studies have linked long-term PPI use to:

• Increased risk of bone fractures
• Kidney problems, including chronic kidney disease
• Higher risk of heart attacks
• Increased risk of dementia in older adults
• Greater susceptibility to Clostridium difficile (C. diff) infections
• Vitamin and mineral deficiencies, particularly vitamin B12 and magnesium

Additionally, relying solely on OTC medications without proper diagnosis can allow underlying conditions to progress unchecked. This is why it’s crucial to consult a healthcare professional if you’re experiencing frequent acid reflux symptoms.

The Role of Gastroenterologists in GERD Management

Gastroenterologists are medical specialists trained in diagnosing and treating disorders of the gastrointestinal tract, including GERD. These experts play a crucial role in properly assessing and managing chronic acid reflux. But what exactly can a gastroenterologist do for GERD patients?

Comprehensive evaluation and diagnosis

A gastroenterologist will perform a thorough medical examination and may recommend additional tests to accurately diagnose GERD and rule out other potential causes of your symptoms. These tests may include:

• Upper endoscopy: A procedure that allows the doctor to visually examine the lining of your esophagus, stomach, and upper small intestine
• Esophageal pH monitoring: A test that measures the amount of acid in your esophagus over a 24-48 hour period
• Esophageal manometry: A test that assesses the function of the muscles in your esophagus
• Barium swallow: An X-ray study that can help identify structural abnormalities in the esophagus

Tailored treatment plans

Based on the results of your evaluation, a gastroenterologist can develop a personalized treatment plan that may include:

• Lifestyle modifications to reduce acid reflux triggers
• Dietary recommendations
• Prescription medications, if necessary
• Monitoring for potential complications
• Surgical interventions in severe cases

Long-term management and follow-up

Gastroenterologists provide ongoing care to ensure that your GERD is properly managed over time. This may involve regular check-ups, adjusting treatments as needed, and monitoring for potential complications such as Barrett’s esophagus or esophageal cancer.

Recognizing When It’s Time to See a Gastroenterologist

Knowing when to seek specialist care for acid reflux can be challenging. However, certain signs and symptoms indicate that it’s time to consult a gastroenterologist. Consider making an appointment if you experience any of the following:

• Heartburn or acid reflux symptoms that persist for more than two weeks despite using OTC medications
• Symptoms that occur more than twice a week
• Difficulty swallowing or pain when swallowing (dysphagia)
• Unexplained weight loss or decreased appetite
• Persistent nausea or vomiting
• Chronic cough, wheezing, or hoarseness
• Chest pain (after ruling out cardiac causes)
• Nighttime symptoms that disrupt sleep
• Acid reflux that interferes with daily activities or quality of life

It’s important to note that these symptoms could also indicate other digestive disorders or more serious conditions. A gastroenterologist can provide an accurate diagnosis and appropriate treatment plan.

The Importance of Early Intervention in GERD Management

Why is it crucial to seek medical attention for persistent GERD symptoms rather than simply managing them with OTC medications? Early intervention by a gastroenterologist can prevent serious complications and improve overall quality of life.

Preventing esophageal damage

Chronic exposure to stomach acid can lead to inflammation and damage to the esophageal lining. Over time, this can result in complications such as:

• Esophagitis: Inflammation of the esophagus
• Esophageal strictures: Narrowing of the esophagus due to scar tissue formation
• Esophageal ulcers: Open sores in the esophageal lining
• Barrett’s esophagus: A precancerous condition where the cells lining the esophagus change, increasing the risk of esophageal cancer

Early diagnosis and proper management of GERD can help prevent or minimize these complications.

Improving quality of life

Untreated GERD can significantly impact daily life, affecting sleep, diet, and overall well-being. By working with a gastroenterologist to develop an effective treatment plan, patients can experience symptom relief and improved quality of life.

Identifying underlying conditions

In some cases, GERD-like symptoms may be caused by other digestive disorders or medical conditions. A gastroenterologist can perform the necessary tests to identify any underlying issues and provide appropriate treatment.

Advanced Diagnostic Techniques for GERD

Gastroenterologists have access to a range of advanced diagnostic tools and techniques to accurately assess GERD and related conditions. These methods go beyond basic symptom evaluation and can provide valuable insights into the underlying causes of chronic acid reflux.

Wireless pH monitoring

This innovative technique involves placing a small capsule in the esophagus to measure pH levels over an extended period, typically 48-96 hours. The capsule transmits data to a receiver worn by the patient, allowing for a more comprehensive assessment of acid exposure without the discomfort of traditional pH probes.

Impedance-pH testing

This advanced test combines pH monitoring with impedance measurements to detect both acid and non-acid reflux events. It can be particularly useful in diagnosing cases where symptoms persist despite acid-suppressing medication.

High-resolution esophageal manometry

This technique uses multiple pressure sensors to create a detailed map of esophageal muscle function. It can help identify motility disorders that may contribute to or mimic GERD symptoms.

Endoscopic ultrasound

This procedure combines endoscopy with ultrasound imaging to provide detailed views of the esophageal wall and surrounding structures. It can be helpful in assessing complications of GERD or identifying other conditions that may be causing symptoms.

Emerging Treatments and Research in GERD Management

The field of gastroenterology is continuously evolving, with new treatments and management strategies for GERD being developed and studied. Gastroenterologists stay up-to-date with these advancements to provide patients with the most effective care possible.

Minimally invasive surgical options

For patients who don’t respond well to medical management, new minimally invasive surgical techniques are being developed and refined. These include:

• Transoral incisionless fundoplication (TIF): A procedure that reinforces the lower esophageal sphincter without external incisions
• LINX device: A ring of magnetic beads placed around the lower esophageal sphincter to prevent reflux
• Stretta procedure: A non-surgical treatment that uses radiofrequency energy to strengthen the lower esophageal sphincter

Personalized medicine approaches

Researchers are exploring ways to tailor GERD treatments based on individual patient characteristics, including genetic factors and specific reflux patterns. This personalized approach may lead to more effective and targeted therapies in the future.

Microbiome research

Growing evidence suggests that the gut microbiome may play a role in GERD and other digestive disorders. Ongoing research is investigating how manipulating the microbiome through probiotics, prebiotics, or other interventions might help manage GERD symptoms.

Novel pharmaceutical treatments

Scientists are working on developing new medications that target different aspects of the reflux process. These may include drugs that enhance esophageal motility, reduce transient lower esophageal sphincter relaxations, or protect the esophageal lining from acid damage.

By staying informed about these emerging treatments and participating in clinical research, gastroenterologists can offer patients access to cutting-edge therapies and contribute to advancing the field of GERD management.

When to See a GI Doctor for Gastroesophageal Reflux Disease

Almost everyone has experienced acid reflux, which is commonly known as heartburn. Acid reflux occurs when stomach acid backs up into your esophagus, resulting in symptoms like chest pain, a burning sensation in your throat and a sour taste in your mouth.

GERD vs. Heartburn

An occasional episode of heartburn is normal, but if you’re experiencing heartburn several times a week, you’ll need to see a doctor. Chronic acid reflux is known as gastroesophageal reflux disease or GERD. In GERD patients, the lower esophageal sphincter – the ring of muscle that closes off the stomach from the esophagus – does not work properly. This allows digestive acid to enter the esophagus and can cause damage over time. Heartburn is the most common symptom of GERD, but other symptoms may include coughing, wheezing, chest pain, hoarseness, difficulty swallowing and frequent throat clearing and regurgitation.

Over-the-Counter Medications and GERD

Approximately 7 million Americans have GERD, but most people who have it have not been diagnosed. They attribute their discomfort to something they ate or drank and self-medicate with over-the-counter antacids, H-2 blockers or proton-pump inhibitors (PPI). While these medications can help provide immediate relief, they’re only intended for occasional use. PPIs, for example, should not be taken regularly for more than two weeks because of their long-term side effects. Studies have linked PPIs to bone fracture, renal failure, heart attack, dementia, Clostridium difficile (or C. diff) infections and vitamin deficiency.

How Gastroenterologists Help with GERD

The key to treating your GERD: a board-certified gastroenterologist

If you are suffering from chronic acid reflux, a specialist can help. GERD is a potentially serious condition, and it will not go away on its own. Untreated GERD can lead to inflammation of the esophagus and cause complications like ulcers, strictures and increased risk of Barrett’s esophagus, which is a precursor to esophageal cancer.

A gastroenterologist is a physician with specialized training in managing diseases of the gastrointestinal tract (esophagus, stomach, small intestine, colon and rectum, pancreas, gallbladder, bile ducts and liver). Our gastroenterologists are fellowship-trained and qualified to diagnose GERD and help develop a meet your treatment plan.

When to See a Gastroenterologist

Sometimes it’s difficult to know when your symptoms are severe enough that you need to make an appointment with a gastroenterologist, and we understand that. Here are some indications that it’s time to call a gastroenterologist:

• Symptoms that continue for more than two weeks
• Heartburn that persists after taking over-the-counter medications
• Heartburn episodes that change in frequency or intensity
• Nighttime symptoms that affect your sleep quality
• Acid reflux that interferes with your daily activities or affects your quality of life
• Unexplained weight loss or decreased appetite
• Pain or difficulty swallowing
• Heartburn accompanied by nausea or vomiting
• Unexplained weight loss
• Chronic hoarseness or wheezing

If you experience any of the symptoms above, it’s time to see one of our gastroenterologists. After performing a complete medical exam, your gastroenterologist may recommend that you undergo an upper endoscopy to evaluate your symptoms and see if you have suffered any damage to your esophagus, or provide you with the peace of mind that everything is all right. During your visit, the doctor will examine the lining of your esophagus, stomach and duodenum (the first part of your small intestine) to determine the cause of your digestive symptoms and the appropriate treatment.

The Acid Doctor: The Most Horrendous Murder in American History, 1962

Home | Short Feature Story | The Acid Doctor: The Most Horrendous Murder in American History, 1962

On the left, Hungarian born Dr. Geza de Kaplany during his trial in January 1963

One of the most painful and horrific murders in American history was committed by Hungarian born Dr. Geza de Kaplany, whose jealousy and insecurities led him to torture his young wife to death by pouring acid on her as she was bound to the bed in their San Jose, California, home on August 27, 1962. Beautiful Hajna de Kaplany, a twenty-five-year-old model, did not die right away. Police were alerted to the home when neighbors complained of loud music and wailing of someone in pain. When the ambulance attendants arrived, their hands were burned when they tried to handle the body.

Hajna, unfortunately, lived for thirty-three more days in a hospital where her mother prayed for her death and the attending nurses were barely able to look upon the damage de Kaplany had caused. One observer, wrote veteran crime writer Carl Sifakis, said it was “the most horrendous single murder in American history.”

During his trial, de Kaplany pleaded not guilty and not guilty by reason of insanity. His attorney argued he was driven to insanity because of frustration over his own impotence, and an unfounded rumor that his wife was having an affair. During the trial, he claimed he never meant to kill her, but only wanted to “destroy her beauty.”

The jury found him guilty and when they considered his punishment, they were assured that if they sentenced him to life in prison, he would be classified a special interest prisoner and would never be released. But this turned out not to be true and the country was surprised to discover that Dr. de Kaplany was quietly paroled in 1975. Forced to defend their actions to an angry public, the California Adult Authority (the state parole board) reported that a missionary hospital in Taiwan desperately needed a cardiologist with Dr. de Kaplany’s skills.

Prior to coming to the United States, de Kaplany worked in Hungary, as a heart specialist. When he came to America, he was forced to repeat his medical education and chose to specialize in anesthesiology. His parole was contingent on leaving the United States and that he serve in the missionary hospital, which he did, but only for a few years.

In 1980, Dr. de Kaplany was fired from a Munich hospital he was working at when a magazine article recounting his crimes was made known to administrators.

In 2002, reporters for the San Jose Mercury News tracked de Kaplany down to a home in Bad Zwischenahn, Germany, where he lived with his second wife whom he met in Taiwan. When the reporter interviewed de Kaplany, the doctor claimed he had suffered enough for his crime.

“I have done one mistake in my life,” de Kaplany stated. “I paid enough for it.”

He then begged the reporter not to publish his story. “It would ruin my life.” He said before adding “I was insane.”

As it turned out, de Kaplany had found the Taiwan missionary himself by reading news accounts, then told the parole board, “[I will] devote the rest of my life—however long or short it may be—to serving the poor in underdeveloped countries, whose pain and suffering I would alleviate.”

That pledge only last four years and in 1979, de Kaplany jumped bail and flew to Germany where he found work using his Hungarian credentials.

As the Mercury reporters revealed in their 2002 article, de Kaplany’s parole was a fiasco from beginning to end. The wife-killer had secured the support of several Catholic priests and one archbishop who lobbied the parole board, in secret, on the doctor’s behalf.

Two years before he was tracked down, de Kaplany became a German citizen in 2000, which placed him permanently out of the reach of California authorities, who could have returned him to prison for violating his parole.

The hypocritical audacity of de Kaplany continued in that interview when he insisted on being called “Doctor, Doctor Geza de Kaplany, because he had both medical and philosophical doctorate degrees. The seventy-six-year-old then blamed the parole board for why he left the country.

“If I stayed in California, I would be on parole. But they gave up the authority with kicking me out of the country. You can’t eat your chicken and have it too.”

It is unclear of Dr. de Kaplany still is alive or not. If so, he would be eight-eight-years-old (in 2015).

Read More:

San Jose Mercury News archived article from 2002

Dr. Geza de Kaplany – Wikipedia

Photographs from CRIA Images

—###—

True Crime Book: Famous Crimes the World Forgot Vol II, 384 pages, Kindle just $3. 99, More Amazing True Crime Stories You Never Knew About! = GOLD MEDAL WINNER, True Crime Category, 2018 Independent Publisher Awards.

Posted: Jason Lucky Morrow – Writer/Founder/Editor, March 19th, 2015 under Short Feature Story.
Tags: 1960s, California, Murder, Wife Killer

Acid peeling – features of the procedure / Laser Doctor Moscow

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Under the editorship of a doctor

October 9, 2017

Radlina Sultanovna Khasanova

Dermatovenereologist, cosmetologist 9000 3

Clinic:

st. Bratislavskaya, 6

Peeling is a popular cosmetic care procedure known to everyone. It allows you to preserve youth, give a radiant look, cleanse and nourish the skin. One of the varieties of the procedure is acid peeling. It is about him that we will talk today.

Acid peeling cleanses and tightens pores, evens out complexion, and eliminates mimic wrinkles. This is a popular procedure that will help you keep your youth and beauty for years to come.

For whom acid peeling is suitable

Peeling is relevant for men and women of any age, as it fights a wide range of problems. You can undergo the peeling procedure already from adolescence (14-15 years).

• In adolescence (14-19 years old), it will help get rid of acne, acne and increased oily skin.

• In the period of growing up (19-25 years) it will moisturize the skin, get rid of freckles and prevent the appearance of the first mimic wrinkles.

• For older people (from 25 and older), peeling will be an ideal remedy for wrinkles, help lighten age spots, and increase skin elasticity.

Peeling can be used for any skin type – the main thing is to choose the right care and intensity of exposure to avoid burns or age spots.

Types of acid peels

Acid peeling starts the processes of enhanced regeneration in the skin, as it “burns” the upper layer of the epidermis, forcing it to work in an enhanced mode. The stronger the effect on the skin, the deeper the cellular repair and collagen production occurs. Depending on the strength of the effect on the skin and the concentration of the composition, peels are divided into the following categories:

Superficial peeling. The tool works exclusively with the upper layer of the epidermis. Suitable for any skin type, as it is the least traumatic. Superficial peeling will help to solve the problem of oily skin and blackheads. Depending on the additives, acid peels will affect the skin in certain ways:

glycolic peeling – the fight against age-related changes;

milk peeling – smoothing skin color, increasing tone;

salicylic peeling – the fight against acne and inflammation.

Superficial peeling is absolutely painless. It does not cause discomfort and acts on the skin gently, sparingly. You can apply it at any time of the year.

Superficial-median peeling. Works deeper than superficial. Eliminates acne, post-acne, age spots, small scars, folds and wrinkles. Rejuvenates and tightens the skin. Often superficial-median peeling is used before the laser resurfacing procedure. The recovery period lasts from 3 to 5 days. At this time, it is necessary to protect the face from ultraviolet exposure.

Medium peeling. High concentration acids work at the entire depth of the epidermis, providing the maximum effect of rejuvenation. Fights deep wrinkles, age spots, scars, tightens the skin. The recovery period after the procedure can be up to 14 days. At this time, it is necessary to protect the face from ultraviolet exposure, apply a soothing cream.

Carrying out the procedure – clinic or home therapy?

Peelings can also be used at home – various soft peels, gommages. But they must wear a pharmacy brand. Home procedures can be a preventive measure, but they cannot replace full-fledged care in the clinic, since the concentration of acids in them is very low.

Chemical peels that cause severe peeling should be trusted exclusively by professionals. Otherwise, you risk getting a burn, exacerbation of allergic dermatitis, the appearance of pigmentation and even scarring.

In the Laser Doctor clinic, experienced cosmetologists will select the type of composition depending on the age, type and condition of your skin. They will tell you how to take care during the recovery period and teach you little tricks that will help you maintain your youth and beauty for many years to come!

Procedure in the clinic “Laser Doctor”

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Acid peeling / Laser Doctor Moscow

Under the editorship of a doctor

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Maria Vladimirovna Belomyshkina

Leading dermatovenereologist, cosmetologist

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Peeling (acid) is not only one of the oldest procedures, but also the most popular. This is not surprising: the sessions have been tested by time and have proven themselves only from the best side throughout their existence. At the same time, modern peels are safe, but effective. In our new article, you will learn what steps an acid peel consists of, what results you can expect from a peel, and how to prepare for this procedure.

Facial preparation

Most modern cosmetic procedures do not require any preparatory steps. For the most part, peeling also does not need to be specially prepared in any way. However, there are recommendations that will help improve the effectiveness of the procedure. In particular, it is recommended not to sunbathe before the session (approximately two weeks). You should also make an appointment in advance for an initial appointment with a dermatocosmetologist, so that he can advise you and examine your skin. This will help identify your contraindications to acid peeling and recommend one or another composition.

Facial peeling session

The peeling procedure consists of several main stages, which can be supplemented with other stages if necessary.

1. At the first stage, the face is cleansed of impurities and cosmetics.

2. In the second step, the specialist applies an acid peeling composition for the face to the skin. In this case, the composition is left on the skin for a certain time, which will depend on the choice of one or another type of peeling.

3. At the third stage, the composition is removed from the skin. Sometimes peeling is neutralized before washing off: it depends on its type.

4. At the fourth stage, special formulations are applied to the skin, which contribute to the restoration of the skin, and also protect it.

When the acid peeling session for the face is over, you will receive recommendations from the doctor for the recovery period. The doctor will also tell you the recommended date for the next session.

Recovery period after face peeling with acid

After the procedure, reddening of the face, slight inflammation of the skin is possible – this is a normal skin reaction to the effects of acids that make up the peeling. Depending on the type of peeling composition, this reaction can take a couple of hours or a few days. In the first 10-15 days after acid peeling, you should not sunbathe and steam the skin. Physical activity and a number of cosmetic procedures are also not recommended (or after prior consultation with a doctor).

Acid peeling

Peeling is a procedure for exfoliating keratinized skin by exposing it to various acids. Some sources even write that peeling can be considered a controlled acid burn of the skin.

Acid (or chemical) peeling is perhaps one of the most diverse types of cosmetic procedures. Depending on the peeling acid included in the composition, it can be retinol, almond, pyruvic, salicylic, lactic, glycolic, etc. In addition to acids, other components may be present in the composition. For example, substances for skin tightening or with anti-inflammatory properties.

In addition, acid peeling for the face can be divided according to the depth of penetration into the layers of the skin into superficial, superficial-median and median.

Superficial peeling

It can be called the softest or most gentle of all. It acts exclusively on the stratum corneum of the skin, so during the procedure, patients usually feel only a slight tingling sensation. It copes well with cosmetic defects that are not yet so pronounced: fine wrinkles, pimples, dull complexion. Since only the stratum corneum is affected, superficial peeling can be carried out 2-3 times a month and from the age of 18, moreover, it is suitable for any skin type. It can often be carried out for preventive cleaning of the skin. After the procedure, you can note a refreshed face, improved color and elimination of minor cosmetic flaws.

Superficial median peeling

The acids of this type of peeling penetrate a little deeper than those of the superficial one – to the middle layer of the epidermis. We can say that it is optimal in terms of efficiency and aggressiveness of the impact. Well suited for the treatment of acne, eliminating wrinkles, age spots, shallow scar formations. Also tightens pores. Has rejuvenating properties.

Medium peel

Differs in deep penetration of acids into the skin – to the border between the epidermis and dermis. When is the best time to do this type of acid peel? Experts recommend holding it between September and May, that is, at a time when the sun is at its least active. Allows you to solve pronounced cosmetic skin imperfections: hyperpigmentation, deep wrinkles, stagnant red spots, scars. In terms of efficiency, it is comparable to ultrasonic cleaning of the face.
Due to the deep impact, it requires a relatively long period of rehabilitation after the session – up to 7-10 days. In the first three to four days after the session, a thin crust forms on the skin, which peels off within 1-1.5 weeks, making the skin bright pink, as after sunburn. After that, the color gradually returns to normal, and the face takes on a rejuvenated and beautiful appearance.

Acid peeling: indications

Peeling with acids will perfectly cope with such skin problems as wrinkles, scars, acne and post-acne, age spots, reduced turgor, signs of aging.