Article preview from Medtech Insight – May 28, 2013
With health care becoming increasingly data driven, third-party payors are requiring a higher level of evidence before making a positive coverage determination for a new technology or procedure. This has made the road to reimbursement much longer and tougher for device companies in general, and manufacturers of transoral devices for GERD are a prime example.
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Patients who have chronic cough with no known cause may be more likely to suffer from gastroesophageal reflux disease or GERD, West Penn Allegheny Health System physicians reported in a study published today.
The article, “Antireflux Surgery in Patients with Chronic Cough and Abnormal Proximal Exposure as Measured by Hypopharyngeal Multichannel Intraluminal Impedance” appears in JAMA Surgery.
“These findings could be of great importance to individuals who live with a nagging cough without a known cause,” said Blair A. Jobe, MD, principal investigator of the study and Director of the Institute for the Treatment of Esophageal and Thoracic Disease at West Penn Allegheny Health System.
“Undergoing screening and, if applicable, treatment for GERD can not only improve patients’ quality of life by curbing chronic cough, it can also help prevent serious conditions such as Barrett’s esophagus and esophageal cancer.”
GERD occurs when the muscles at the end of the esophagus fail to properly close, allowing stomach contents to leak back or reflux into the esophagus, causing irritation. Common symptoms of GERD include heartburn, regurgitation, and tasting stomach acid in the back of the throat. Hoarseness, a feeling of having a “lump in your throat” and frequent throat clearing are lesser known symptoms of GERD.
The trial examined 314 patients who underwent testing with a specialized catheter to detect reflux and determined that 49 of them also had chronic cough, a persistent cough with no known cause lasting more than eight weeks. Of the patients with chronic cough, 52 percent were diagnosed with GERD.
“These patients did not display classic symptoms of GERD and may not have been diagnosed with conventional pH testing which measures the amount of stomach acid in the esophagus,” said Toshitaka Hoppo, MD, a general surgeon specializing in esophageal surgery who was involved in the trial.
For such patients, undergoing Hypopharyngeal Multichannel Intraluminal Impedance (HMII) testing is key to achieving a diagnosis. HMII is ideal for assessing the proximity of reflux events from the lower esophageal sphincter muscle regardless of their pH level.
Of the 49 patients with chronic cough in the study, 73 percent were found to have abnormal proximal exposure of reflux. Sixteen of those patients underwent antireflux surgery with 81 percent achieving resolution of their cough.
“Once GERD is diagnosed, many patients may benefit from antireflux surgery,” Dr. Jobe said. “The increased sensitivity of HMII testing enables us to properly diagnose patients who don’t display the telltale signs and symptoms of GERD, treat the underlying problem and prevent future complications while relieving their cough.”
Chronic cough is a condition that affects 8 to 12 percent of adults.
The Institute for the Treatment of Esophageal and Thoracic Disease at WPAHS is a comprehensive, multi-disciplinary program that focuses on the treatment of patients with lung cancer, mediastinal diseases, esophageal cancer, Barrett’s esophagus, hiatal hernia, esophageal motility disorders, gastroesophageal reflux disease, and swallowing issues.
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Also known as heartburn, acid indigestion is the primary symptom caused by gastroesophageal reflux disease. You are definitely suffering from heartburn symptoms when you feel a painful ache in the middle of your chest and stomach.
However, adults and kids under 12 that are dealing with GERD can experience this condition without the heartburn. Order Nexium.
Some other methods to help keep your children safe from GERD symptoms includes avoiding certain food types like caffein, sodas, peppermint, food rich in acid like oranges and tomatoes, fried as well as fat loaded foods.
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Heartburn, burping and that gross taste when you regurgitate in your mouth after a meal – they’re all symptoms of acid reflux. The problem is, if you don’t treat the causes of acid reflux, it just gets worse. Enter you and Digestive Science Reflux Elimination System. Believe us, a loyal client base is sure to follow
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What is it?
Gastro esophageal reflux disease (GERD) is a condition in which food or liquid travels backwards from the stomach to the esophagus (the tube from mouth cavity to the stomach). This action can irritate the esophagus, causing heartburn and other symptoms.
Why it occurs?
When we swallow, the lower esophageal sphincter i.e. the circular band of muscles around the bottom part of esophagus relaxes to allow food and liquid to flow down into our stomach. Then it closes again. If this valve does not close properly, food and liquid can move backwards into the esophagus and cause heartburn.
Is there any factors which may worsen the symptoms of GERD?
# Obesity # Habit of taking food now and then # Habit of drinking Alcohol # Habit of Smoking # Lying down immediately after a meal # Spicy food, caffeine, chocolate, carbonated beverages # Habit of taking raw onions, green chili, dry chili. # Habit of taking green fibrous fruits at late of the day # Certain medications such as sedatives, painkillers/analgesic and calcium channel blockers may cause GERD
When will you go to a Doctor?
# Heartburn: Burning sensation in the chest which worsens on bending, stooping, lying down or eating #Symptoms are more during the night, usually early night. #Regurgitation of food, water or sour eructation #Belching and vomiting, sometimes nausea for long #Chest pain especially at night while lying down #Cough with wheezing in some cases #Sore throat and Hoarseness of voice # Occasional heaviness of head and vertigo found in some cases # In severe cases, sometime patient become very restless with high blood pressure
Any Complications?
#Distended abdomen with uneasiness # Increase the incidence of Apthus Ulcer # Stomatitis and Inflammation of Mouth cavity # Inflammation of the esophagus (oesophagitis), if not treated for long # Narrowing of esophagus (Stricture), if inflammation not treated # Broncho-spasm # Slightly increased risk of esophageal cancer and etc.
Any Investigations needed?
Primary diagnosis can be made on the basis of signs and symptoms. In some cases image study of the gastro-intestinal tract done to exclude any obstructive complain or any structural or any complicated state of the patient. An Endoscopy can tell the real picture more accurately than any other examination. But in normal or initial cases endoscopy is not needed. Continuous esophageal pH monitoring showing reflux.
How Homeopathy Could Help?
Patients suffering from GERD do not have to depend on antacids if they are treated by homeopathy which treats without side effects. Constitutional homeopathic medicine is prescribed after taking into account a person’s physical, emotional and psychological makeup. His likes and dislikes ups and downs which he has suffered in his life, any stress which he presently is going through. All these factors are essential in finding out a correct remedy. Further damage to the esophageal tissue is avoided as the patient feels better mentally and physically.
How Acupuncture Could help?
With proper tongue diagnosis acupuncture points could be selected. As per various experiences we could try LI4, St34, and Sp9 for regulation of digestion.
Treatment Gerd Related Barrett's Esophagus. The burning sensation that gradually travels upward from trying to quit just limited to coffee. The burning sensation that works for you. To find out if that helps to reduce heartburn in childhood but it …
These are a few of the reasons why heartburn or indigestion feels so much worse in the evening. For overweight individuals and pregnant females, cases of indigestion can be ravaging. Pregnancy causes a rise in bodily hormones as well as an increase in fat. It may enhance in seriousness as the infant expands; displacing the stomach by pushing it further. Excessive weight triggers comparable troubles as excess fat pushes against the digestive tract and various other internal organs.
Exactly what the majority of individuals don’t understand is that reflux has lots of different degrees of extent. The majority of babies have a moderate kind of reflux that is either treatable by some way of life modifications or a light medicine. Other children have reflux so extreme that they need to have several surgeries and be fed through a tube. It ares more discouraging to meet other parents who blow off your child’s condition as insignificant. Once when I was choosing up Mason’s prescribed of Prevacid, a woman in front of me reversed and informed me, “Oh, you shouldn’t medicate your kid like that. Just provide him a glass of vinegar and water which’s all you require for indigestion.” Gee, why didn’t I consider that?
The books out there for diendan.tienkiem.net overall possibly hundreds of them. However there are some that are particularly great. In my post here, I am going to point out a few of guides I think you must have in your library on this digestive concern.
The very best way to prevent coughing indigestion is to prevent acid reflux from happening. This can be accomplished by staying clear of overindulging, and staying clear of foods that generally cause indigestion. Some foods to avoid are anything extremely greasy, soft drinks, chocolate, tomato sauces, garlic and onions, spicy foods, and acidic foods like citrus fruits, for instance. In general, stay clear of any food that is considered a normal trigger for heartburn, then coughing acid reflux will be a non-issue.
There are lots of different elements that can trigger the LES to breakdown. Whether periodic or regular, overindulging can shut out the LES from closing totally. Other conditions might cause the LES to open at the wrong time. Smoking cigarettes, extreme caffeine usage, and particular medicines can also contribute to acid reflux. There is not constantly a clear, recognizable cause in individuals who struggle with indigestion.
Heartburn and Acid Reflux for Dummies is a softcover book that has 360 pages. Guide not only enters therapies and therapies, however likewise discusses heartburn in a direct way. There are medications listed that you should not take with GERD, and a section talking about whether or not the surgical procedure is a good selection for you. Stress is also concentrated on and getting the right doctor to treat your GERD trouble. Diet is likewise mainly discussed too.
Extreme salvation – A boost in saliva manufacturing after eating could be the body’s response to taking care of too much acid, as saliva helps to neutralize acid. In some cases the tummy produces excessive acid which enhances the risk of reflux.
I am a non smoker and I don’t drink that much. I do consume a fair little coffee nonetheless. The genuine culprit for me though has been drinking fruit juice of any kind previously bed. When I have, my indigestion has been substantially even worse.