Gastroesophageal
Reflux:
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Very
often, gastroesophageal reflux (stomach acid coming up) can be "silent".
You don't have to have heartburn to experience the symptoms of reflux
which can lead to anything from hoarseness to the feeling of a lump in
the throat to difficulty swallowing. The following are several things
that you can do to minimize your symptoms of reflux including:
1. Avoidance of acid containing foods (such as coffee, tea, chocolate,
orange juice, cranberry juice, tomatoes and tomato sauce). Avoidance of
spicy foods (such as garlic and onion). Avoidance of most soft drinks
such as coca-cola and Pepsi cola. |
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| GENERAL: |
EFFECT: |
| Eat three nutritionally
balanced meals per day. No snacks between meals. Avoid overeating. |
Minimizes the number
of times reflux occurs (reflux occurs most commonly with eating). |
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| Do not eat or drink
for 3 hours prior to lying down for sleep or for other reason. |
Minimizes the number
of times reflux occurs. (Minimizes the effects of gravity as the stomach
does not totally empty for 2-3 hours.) |
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| Attain appropriate
body weight. |
Minimizes the number
of times reflux occurs. (The heavier you are, the more pressure there
is on your stomach that tends to squeeze it and cause reflux). |
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| SPECIFIC: |
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Avoid cocoa, chocolate,
regular coffee, decaf, and all other caffeinated and decaffeinated products,
carminatives (peppermint, spearmint), nuts, alcohol, and theobromine
products (tea).
|
Minimizes the decrease
in esophagus function brought about by these items. (Since all of these
relax the esophagus avoidance will cause the esophagus to work more
strongly. Alcohol has the additional effect of slowing the clearance
of acid out of the esophagus).
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| Avoid citrus fruits,
juices, tomato products and spicy foods. |
Minimizes irritation
of the esophagus (these products are highly acidic). |
|
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| 2.
Liquid antacids, one to two teaspoons an hour after eating and a tablespoon
before bed. Prevacid, Zantac Pepaid, Axid, Prilosec, Tagamet may be prescribed
to be used in conjunction with liquid antacids but should be taken 1 hour
apart. |
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| AGENT: |
EFFECT: |
| Antacids (preferably
liquid, take one hour after eating). |
Minimizes the acidity
of stomach contents. |
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If heartburn is very
frequent, suck on antacid tablets whenever possible. This stimulates salivary
secretions which are alkaline. This along with the swallowing that occurs,
in conjunction with sucking on the tablet, leads to better clearance of
refluxed gastrointestinal contents and neutralizing of any acid that remains.
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| (Axid) Vizatidine,
Cimetidine (Tagamet), Ranitidine (Zantac), Famotidine (Pepcid), Omeprazole
(Prilosec), Lanasprole (prevacid) |
Minimizes the acidity
of Stomach contents. |
|
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| 3.
Elevation of the head of your bed so that your whole body is at an angle.
not lust your head and shoulders. One way to do this is with a prescribed
foam rubber wedge. Another way to do it is to elevate the head of your
bed on bricks or a cinder block. |
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| MEASURE: |
EFFECT: |
| Elevate the head
of your bed with 4 - 6 inch blocks (avoid head elevation with pillows).
|
Minimizes the number
of times reflux occurs (it is harder for stomach contents to reflux uphill). |
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 |
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| Avoid constricting
clothing. |
Minimizes the number
of times reflux occurs (increased pressure on the belly tends to squeeze
the stomach). |
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| Avoid eating prior
to exercise. Consider modifying vigorous exercise habits. |
Minimizes the number
of times reflux occurs. (Vigorous exercise has been associated with more
frequent reflux. Some reflux occurs in normal individuals during exercise
and eating). |
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| Avoid bending over. |
Minimizes the opportunity
for reflux to occur. (Minimizes the effects of gravity). |
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| Avoid smoking. |
Minimizes the number
of times reflux occurs. (Smoking causes the esophagus to relax). |
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| 4.
Possible consultation with a gastroenterololist. |
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