Is Gastroesophageal Reflux Disease Related To Heart Disease? | Article

Acid reflux is a chronic condition where stomach acids leak back into the esophagus and irritate the stomach lining causing heartburn. Gastroesophageal reflux disease is a chronic condition, diagnosed by a gastroenterologist, where acid reflux occurs more than twice a week for a few weeks. GERD is generally considered a harmless disease where you have a burning sensation in your chest after eating acidic foods. Many people have GERD, 93 million people in the U.S. to be exact. Just take some antacids. No biggie, right? Wrong!

People who have GERD are more likely than others to end up with heart disease, characterized by abnormal heartbeats, plaque buildup in the heart arteries or reduced blood flow to the heart. In 2010, heart disease caused one out of every four U.S. deaths. If you have abnormal signs or symptoms, go to the emergency room.

It is important for patients and healthcare providers to be aware of health problems that might signal heart disease. Diabetes, high blood pressure and abnormal cholesterol levels are known to increase heart disease risks.

New research suggests that GERD may be another risk factor. Doctors at the National Area Military Health System found that military service members and their family members with GERD were 40 percent more likely than those without GERD to end up with atrial fibrillation – a type of heart disease that causes irregular heartbeats. Atrial fibrillation can lead to stroke and heart failure. If you have chest pain, go to the emergency room.

Another study found that patients with coronary heart disease were twice as likely to have been previously diagnosed with GERD. Individuals with coronary heart disease have excess plaque buildup in the coronary arteries. In yet another study, a subset of patients who sought medical care for GERD were found to have ischemic heart disease or reduced blood flow to the heart. Scientists are not sure why a link between GERD and heart disease exists. Some think the proximity of the heart to the esophagus may cause one to affect the other.

GERD can be managed by monitoring the following behaviors: avoiding foods such as chocolate, coffee, peppermint, spicy foods and tomato products; quitting smoking; taking over-the-counter or prescribed medication or losing weight. Maintaining a healthy weight is the only known cure for GERD. Maintaining a healthy weight can also reduce risks for the different types of heart disease. Patients diagnosed with acid reflux should use that information as a reminder that maintaining a healthy weight can prevent heart disease.

People diagnosed with GERD should also remember to get annual physical exams. The key to preventing cardiovascular disease is managing your risk factors. But how do you know which risk factors you have? The best way to find out is through screening tests during regular doctor visits. Annual physicals can detect heart disease at early stages. It can also let you know if you have risk factors such as obesity, diabetes, high blood pressure, abnormal cholesterol levels, or GERD.

If your test results are less than ideal, it does not mean you are destined to develop a serious heart disease. It means you are in a position to change your health in a positive way. Screening results can serve as a wake-up call to modify your diet and get more physical activity to prevent future heart disease.

To maintain a healthy weight, follow the Performance Triad guidelines at http://phc.amedd.army.mil/topics/campaigns/perftriad/Pages/default.aspx.

For information about heart disease, visit the Centers for Disease Control website at http://www.cdc.gov/heartdisease/index.htm.

The Veterans Administration/Department of Defense Cardiovascular Clinical Practice has heart healthy materials at https://www.qmo.amedd.army.mil/QMOCPGShopCart/products.asp?cat=4.

For information on symptoms of a heart attack, visit the National Institute for Health website at http://www.nhlbi.nih.gov/health/health-topics/topics/heartattack/signs.

Army Public Health Center (Provisional)

Performance Triad Guidelines

Centers for Disease Control

National Institute for Health

VA/DOD Cardiovascular Clinical Practice

Heart disease and heartburn: What’s the overlap?

Heart and stomach-related problems can share underlying causes and symptoms.

Heartburn and heart disease have one big thing in common: their classic symptoms cause discomfort in the center of the chest. Heartburn happens when acid from the stomach splashes up into the esophagus (the tube connecting the stomach to the throat) and creates a burning sensation. Insufficient blood flow to the heart’s arteries can cause angina or a heart attack, which often produces a feeling of tightness or pressure in the chest. But it’s not always easy to tell the difference.

“Even emergency room physicians grapple with distinguishing between heart attacks and heartburn based on how people describe their symptoms,” says Dr. Michelle O’Donoghue, cardiovascular specialist at Harvard-affiliated Brigham and Women’s Hospital. In cases where heartburn seems more likely, doctors often give people a fast- acting antacid such as Mylanta to see if that relieves their symptoms, she says.

Of the over eight million emergency room visits for chest pain each year, severe heartburn (known as gastroesophageal reflux disease, or GERD) accounts for over half the cases in which actual heart problems are ruled out. But to be on the safe side, always see a doctor if you have symptoms you are unsure about, and head to the emergency room if you have other heart attack symptoms (see “Heartburn or heart attack?”).

Heart-stomach overlaps

In addition to its role in GERD, acid in the digestive tract can also eat away at the lining of the stomach or small intestine, creating irritated, raw spots that can turn into painful, bleeding sores called peptic ulcers. The main symptom of peptic ulcer disease is a dull or burning pain in the stomach, anywhere between the breastbone and navel.

“Some factors that make people more likely to develop heart disease, such as smoking and being older or overweight, also increase the risk for GERD or a peptic ulcer,” says Dr. O’Donoghue. Common medications — namely, aspirin and proton-pump inhibitors (PPIs) — used to treat these conditions may also be part of the picture.

Nearly everyone who’s had a heart attack takes low-dose aspirin, which helps avert future heart attacks by preventing blood components called platelets from sticking together and forming blood clots. People who’ve received an artery-opening stent are often prescribed clopidogrel (Plavix), a more potent anti-platelet drug. Here’s the problem: Aspirin also blocks a chemical that protects the lining of the stomach from stomach acid. Taking clopidogrel or a similar medication with aspirin can further increase the risk of stomach bleeding.

People with heartburn often take PPIs, which include over-the-counter drugs such as omeprazole (Prilosec) and prescription drugs such as pantoprazole (Protonix). These drugs prevent certain cells in the stomach from pumping out acid. Even people who don’t have heartburn may benefit from this stomach-protecting effect. That’s why doctors sometimes prescribe PPIs for people who take aspirin, clopidogrel, or related drugs that may increase stomach irritation, says Dr. O’Donoghue. She typically recommends PPIs for people who are taking long-term aspirin or clopidogrel if they have ever had a peptic ulcer or are at high risk of developing one.

Take-home advice

GERD is far more common than peptic ulcer disease, however. If you take PPIs to treat GERD, be sure to seek medical attention if you have chest discomfort brought on by exercise that’s not relieved with an antacid, as that scenario is more characteristic of a heart-related problem.

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Complications of gastroesophageal reflux disease – Clinic Zdorovye 365 Yekaterinburg

Complications of gastroesophageal reflux disease (GERD)

Although most patients never develop serious complications, gastroesophageal reflux does not always flow easily. Without timely treatment, chronic GERD can lead to diseases of the esophagus – the occurrence of inflammation, ulcers, bleeding and scarring of the tissues of the esophagus.

Gastroesophageal reflux disease can cause serious diseases:

Erosive esophagitis – severe inflammation of the esophageal mucosa with the formation of erosions.

Ulcers of the esophagus – crater-like sores on the lining of the esophagus that can bleed and sometimes lead to anemia.

Esophageal stricture – Narrowing of the esophagus caused by scar tissue that can cause food to remain in the esophagus and make it difficult to swallow.

Barrett’s esophagus . In disease, the natural lining of the esophagus is replaced by abnormal cells. Approximately 10-15% of people with GERD develop the disease. Most often, Barrett’s esophagus occurs in men over 50 who belong to the Caucasian race. People with Barrett’s esophagus are also at risk of developing esophageal cancer, so these patients should undergo videoesophagogastroduodenoscopy (FGS) at regular intervals to detect early signs of cancer.

Reflux laryngitis . When gastric juice is thrown into the throat, a sore throat and chronic cough may appear. If the juice enters the larynx, it can lead to irritation of the larynx, trachea and vocal cords, which causes a hoarse voice. The relationship between reflux and laryngitis is not entirely clear, so other causes of laryngitis, such as allergies or smoking, should always be looked at.

Bronchitis and pneumonia . If the contents of the stomach enter the trachea and further into the bronchi and lungs, a bronchial response develops: shortness of breath, cough, worsening of asthma or the appearance of infectious diseases, such as pneumonia.

Abnormal tooth decay . Because stomach acids break down tooth enamel, severe GERD increases the risk of tooth decay.

Increased risk of esophageal cancer . Even if people with severe and prolonged GERD do not have Barrett’s esophagus, there is an increased risk of developing esophageal cancer.

Some disorders may present with the same symptoms as gastroesophageal reflux disease. These diseases include esophageal spasms, esophageal cancer, peptic ulcers, gastritis, asthma, and coronary heart disease.

Asthma in adults . There is a link between asthma and gastroesophageal reflux, which is especially noticeable in people who are short of breath. The onset of attacks occurs more often at night when a person takes a horizontal position or after eating, as well as in the presence of problems in the respiratory tract (hoarseness, recurring pneumonia, coughing often occurs). According to the American Academy of Allergy, Asthma and Immunology, approximately 70% of people with asthma have gastroesophageal reflux disease.

Heart disease . Chest pain due to heart disease is one of the most serious symptoms and diseases that can be confused with GERD. The question arises: when is heartburn, and when is a heart attack? There are several differences.

During a heart attack, there is shortness of breath and constrictive, severe, or dull pain behind the breastbone, which may radiate to the neck, shoulders, or arms. This pain usually resolves after taking nitroglycerin.

GERD-related chest pain is usually characterized as burning and may radiate upward. Pain due to GERD occurs after eating and resolves after taking antacids. However, this pain can be so similar to heart pain that it can be difficult to distinguish between them without special examination.

WARNING: The symptoms of chest pain that accompanies a heart attack are sometimes known not to fit the traditional description, especially in women who experience atypical pain such as pain in the abdomen or back. Unlike heart disease pain, gastroesophageal reflux pain should not radiate to the back, shoulders, or arms. However, the absence of these symptoms does NOT rule out the possibility that heart disease is the cause of the pain. If the pain lasts for several minutes, do not try to diagnose yourself, but consult a doctor.

You can get more detailed information about the symptoms of gastroesophageal reflux disease from the gastroenterologists of the Health 365 clinic in Yekaterinburg.

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Esophagitis: causes, symptoms and treatment

Contents

• 1 Esophagitis: causes, symptoms, treatment and prevention
  • 1. 1 Esophagitis: what it is and how it manifests
  • 1.2 Causes of esophagitis
  • 1.3 Signs of esophagitis
  • 1.4 Diseases associated with esophagitis
    • 1.4.1 Reflux esophagitis
    • 1.4.2 Hypereosinophilic esophagitis
    • 1.4.3 Bacterial esophagitis
  • 1.5 Diagnosis of esophagitis
    • 1.5.1 History and physical examination
    • 1.5.2 Laboratory and instrumental examinations
    • 1.5.3 Diagnosis of reflux
    • 1.5.4 Diagnosis of esophagitis in children
  • 1.6 Treatment of esophagitis
    • 1.6.1 Medical treatment
    • 1.6.2 Diet for esophagitis
    • 1.6.3 Surgery
  • 1.7 Groups of medicines for the treatment of esophagitis
    • 1.7.1 Prokinetics
    • 1.7. 2 Antisecretory drugs
    • 1.7.3 Antiacids
    • 1.7.4 Antibiotics
    • 1.7.5 Corticosteroids
  • 1.8 Antibiotics and antifungals for esophagitis
  • 1. 9 Procedures to help treat esophagitis
    • 1.9.1 Esophagogastroscopy
    • 1.9.2 Medications
    • 1.9.3 Avoidance of certain foods
    • 1.9.4 Surgery 90 150
  • 1.10 How to prevent esophagitis
    • 1.10.1 Manage your diet
    • 1.10.2 Watch your weight
    • 1.10.3 Don’t smoke
    • 1.10.4 Avoid stress
  • 1.11 Related videos:

Find out what esophagitis is, its causes and symptoms. Find out how to properly treat this pathology and what methods are most effective. Useful information for everyone suffering from this disease.

Esophagitis is a disorder that occurs when dental debris and stomach acid back up into the esophagus, causing inflammation in the lining of the esophagus. This can be very painful and unpleasant, limiting the quality of life and causing some serious problems.

There are many causes that can lead to esophagitis, but the most common cause is difficulty swallowing. This may be due to stenosis of the esophagus, reflux (backflow of stomach contents into the esophagus), or a foreign body in the throat.

Symptoms of esophagitis may include pain when swallowing, numbness or interruption in the esophagus, nausea, vomiting, and a sour taste in the mouth. If you notice these symptoms, contact your doctor to recommend treatment. Treatment options will depend on the cause of the disease, and may include medication, surgery, or dietary changes.

Esophagitis: what it is and how it manifests

Esophagitis is an inflammatory disease of the esophagus that can be caused by a number of causes. It is characterized by irritation, swelling, and sometimes ulcers in the wall of the esophagus, which can lead to difficulty swallowing, chest pain, heartburn, and other uncomfortable symptoms.

Disease can be caused by a variety of factors, including acid reflux, infections, damage to the esophagus, allergies, and autoimmune disorders.

Symptoms of esophagitis may include chest pain, difficulty swallowing, sensation of a lump in the throat, heartburn, cough, and nausea. They may be temporary or permanent and may worsen with eating or lying down.

The diagnosis of esophagitis is usually made after gastroenteroscopy, where an internal examination of the esophagus is performed using a thin tube with a camera, or fluoroscopy, in which the patient is given a drink of an x-ray contrast agent to study the walls of the esophagus.

Causes of esophagitis

Esophagitis occurs as a result of an inflammatory process that affects the lining of the esophagus. The main causes of this disease can be heartburn, prolonged alcohol consumption, smoking, obesity, gastrointestinal disorders, stomach acids penetrating into the esophagus and other factors.

It is important to note that the specific cause of esophagitis may vary depending on the individual situation. For example, in a person suffering from gastric reflux, the risk of esophagitis will be much higher because the acid is constantly in contact with the lining of the esophagus.

• Causes of esophagitis
  1. Heartburn;
  2. Long-term alcohol use;
  3. Smoking;
  4. Obesity;
  5. Gastrointestinal disorders;
  6. Ingestion of acids from the stomach into the esophagus;

Very often, esophagitis can be caused by improper diet, which includes fast food, sour and spicy foods, and overeating.

The general rule is that reducing the amount of acid content in food and in the stomach in general can minimize the likelihood of developing esophagitis.

Signs of esophagitis

Esophagitis is an inflammation of the lining of the esophagus. It occurs due to the contact of stomach acid with the esophagus. Signs of esophagitis can be different and depend on the form of the disease. However, there are characteristic signs that indicate the presence of the disease.

• Burning sensation and discomfort in the chest . This is one of the most common signs of esophagitis. The burning sensation may be so severe that the patient confuses it with pain in the heart.
• Pain when swallowing . They can be of varying intensity and may indicate that the esophagus is mutilated.
• Heaviness in the stomach . Often, food that has not yet gone into the intestines stops during its movement through the esophagus, causing a feeling of rough heaviness.
• Effect of vomiting or nausea . Esophagitis may imply a disorder of GERD (gastroesophageal reflux), which causes nausea as well as heartburn through the throat.
• Voice problems . Sometimes the disease can affect the functioning of the vocal cords. Patients may experience problems with pronunciation of words or a change in tone of voice.

If you notice signs of esophagitis, contact your doctor who will determine the diagnosis, determine the cause and prescribe a comprehensive treatment, including diet and drug therapy.

Diseases associated with esophagitis

Reflux esophagitis

Reflux esophagitis is caused by the reverse movement of the contents of the stomach into the esophagus, which leads to inflammation of its walls. The cause of the disease may be non-compliance with the diet, medication, certain types of sports (gymnastics, athletics).

Symptoms: burning sensation and pain, which are aggravated by bending over, coughing, sneezing, head turning.

Treatment: prescribing drugs that limit the acidity in the gastric juice, antibiotics, diet.

Hypereosinophilic esophagitis

Hypereosinophilic esophagitis is caused by an allergic reaction to foods, drugs, and certain infections.

Symptoms: pressure sensation, pain, difficulty swallowing, heartburn, vomiting and nausea.

Treatment: diet, drugs that reduce the number of eosinophilic granulocytes in the blood.

Bacterial esophagitis

Bacterial esophagitis is caused by the action of bacteria on the mucous membrane. This can happen with a decrease in immunity, long-term use of hormonal drugs, and certain diseases.

Symptoms: pain when swallowing, belching, heartburn, fever.

Treatment: prescription of antibiotics, abundant drinking regimen, nutrition.

Main types of esophagitisType of esophagitisSymptomsTreatment

Diagnosis of esophagitis

History and physical examination

For the diagnosis of esophagitis, it is important to take anamnesis, knowing the patient’s symptoms, dietary habits and the presence of other diseases. Physical examination may reveal symptoms such as chest tenderness, dysphagia, and vomiting.

Laboratory and instrumental tests

Laboratory and instrumental tests may be ordered to confirm the diagnosis of esophagitis. Blood and urine can be analyzed to determine the level of inflammation in the body.

Other imaging techniques that may be used for diagnosis include gastroscopy, which allows you to see the inside of the esophagus and assess the extent of inflammation and damage. In some cases, an x-ray or MRI may be ordered.

Reflux diagnosis

Esophagitis can be caused by reflux, when acidic fluid from the stomach rises up into the esophagus. To diagnose reflux, an esophageal pH meter, which measures acidity in the esophagus, or esophageal manometry, which assesses the force of contraction of the esophageal muscles, may be prescribed.

Diagnosis of esophagitis in children

Diagnosis of esophagitis in children may include a medical examination, the collection of a child’s history, laboratory and instrumental studies, including radiography or gastroscopy. Infants and young children may show symptoms such as refusal to eat, vomiting, stuttering, and poor weight gain.

Treatment of esophagitis

Drug treatment

The main treatment for esophagitis is medication. To reduce the acidity of the contents of the stomach, drugs that have an antisecretory effect are used. Anti-inflammatory drugs help relieve inflammation and eliminate pain. Drugs that improve the motor function of the esophagus and stomach are also used, which reduces the risk of recurrence of esophagitis.

Individually selected doses and duration of treatment. At the end of the course of drug therapy, a control esophagogastroduodenoscopy is performed to assess the effectiveness of the treatment.

Diet for esophagitis

A proper diet is especially important for esophagitis. It is recommended to eat small meals 5-6 times a day. Avoid spicy, fatty, salty, sour and fried foods. It is not recommended to consume alcohol, carbonated drinks, coffee and chocolate. The diet should be rich in vitamins A, C, E, natural antioxidants and plant fibers. The drinking regimen is important: it is necessary to consume a sufficient amount of liquid, preferably still water.

Surgical treatment

Surgical treatment of esophagitis is used for misposition of the cardia, which leads to permanent reflux esophagitis. The most common technique is laparoscopic fundoplication, in which the upper part of the stomach is sutured to the lower part of the esophagus. This method helps eliminate acid reflux into the esophagus and eases the course of esophagitis.

Groups of medicines for the treatment of esophagitis

Prokinetics

Prokinetics improve esophageal motility and accelerate the movement of stomach contents, which helps to reduce acid reflux into the esophagus and prevents mucosal damage. An example of a prokinetic is metoclopramide.

Antisecretory drugs

Antisecretory drugs such as proton pump, blockers and histamine antagonists reduce the amount of acid secreted by the stomach, thereby reducing its reflux into the esophagus. These drugs can be used in combination with antiacids. Some of these include omeprazole or ranitidine.

Antiacids

Antiacids reduce stomach acid, which can help manage symptoms of esophagitis such as heartburn. They may be used along with other drugs such as antisecretory agents. Examples of antiacid drugs are algelate or mylan.

Antibiotics

If esophagitis is caused by a bacterial infection, antibiotics may be used. They will help destroy bacteria and prevent re-infection. Examples of antibiotics for treating infectious esophagitis are ampicillin or metronidazole.

Corticosteroids

In some cases, for certain types of esophagitis, such as eosinophilic esophagitis, corticosteroids may be used. They can help reduce inflammation in the esophagus and reduce symptoms. These drugs are betamethasone or pednisolone.

Antibiotics and antifungals for esophagitis

Antibiotics and antifungals may be used to treat esophagitis if it is caused by an infectious agent. For example, Candida infection may be one of the causes of esophagitis.

Antibiotics and antifungals are used to treat infections to kill the pathogens that cause the disease. The drug and dosage depend on the type and extent of the infection.

In some cases of esophagitis, antibiotics and antifungals may be given prophylactically to prevent infections if they are risk factors.

However, the use of antibiotics and antifungals should only be prescribed by a doctor, as the wrong choice of drug or dosage can lead to negative consequences and aggravate the disease.

Procedures to help treat esophagitis

Esophagogastroscopy

This test measures the degree of damage to the lining of the esophagus and stomach. During the procedure, the doctor uses an endoscope, a flexible tube with a camera at the end, to view the inner walls of organs. If a patient is diagnosed with esophagitis, the doctor may take tissue samples for further analysis.

Medications

To treat esophagitis, your doctor may prescribe drugs that reduce stomach acid, such as proton pump inhibitors. In addition, anti-inflammatory and anti-allergic medicines are used to reduce inflammation and related symptoms.

Avoid certain foods

Certain foods can aggravate esophagitis symptoms and should therefore be avoided. These foods include: spicy, fatty, sour, alcohol, coffee and chocolate. It is also recommended not to eat before bed and not to go to bed immediately after eating.

Surgery

In some cases, if esophagitis is very severe or does not improve with medication and dietary changes, surgery may be required. Doctors may perform surgery to improve the function of the lower esophageal sphincter, which usually helps prevent acid from refluxing into the esophagus.

How to prevent esophagitis

Esophagitis is a serious condition that needs to be treated. However, it is even better to prevent its occurrence by following a few recommendations.