What Is Acid Reflux?
The dictionary defines reflux as a a??flowing backa?
or a??abnormal backward flow of body fluidsa?
To Investigate acid reflux or what the medical community terms acid reflux disease the first thing we have to look at is the a??stomacha? to understand what is happening. The stomach contains both an acidic liquid which helps us digest our food and it also contains acidic gases that are present over the liquid. The stomach contents are under pressure.
Reflux or acid reflux is a natural body function for lowering the pressure in our stomach and digestive system. It is much like a pressure relief valve on your hot water tank. If the pressure in your water tank increased too much and the tank was in danger of exploding the valve would be forced open and allow the pressure to escape through the valve. Thereby lowering the pressure in the tank.
The stomach is much the same way and the a??stomach pressurea? can be increased by several different things such as gastric or peptic ulcers, bowel problems, H.pylori bacterium, indigestion, food, or liquids or swallowing air. Remember back in school where some little guy was always swallowing air, just so he could buurrrp and gross the girls out. All he was doing was increasing his stomach pressure.
When we swallow and the food enters our stomach and it displaces the liquid contents and the level of liquid rises. When this happens it compresses the acidic gases that are above the liquid and greatly increases the pressure that is being exerted against the Lower Esophageal Sphincter valve.
Once the pressure against the LES valve builds up enough it will force the LES valve open and the gases will reflux into the esophagus. As the gases start refluxing into the esophagus you may experience a pressure buildup in the chest. This pressure may become uncomfortable until the pressure overcomes the Upper Esophageal Sphincter valve and the gases are expelled through our mouths and we Buurrrrp After we burp or belch we relieve the pressure in the esophagus and the stomach.
Sometimes when we burp, we might notice a burning or painful feeling in our chest. This is because the acidic stomach gases are refluxing and coming in direct contact any sores or lesions that are present in the esophagus. It's much like spilling vinegar on a cut it will cause pain.
We may have even developed a??esophagitisa? which is an inflamed esophagus and can make swallowing difficult. Although there are other things that can cause esophagitis the constant assault of acidic stomach gases or what we know as reflux or acid reflux can irritate the delicate cells of the esophagus and cause pain!.
People who have esophagitis may also experience difficulty in swallowing, and pain when consuming acidic drinks such as orange or tomato juice, because the acid in these beverages is coming in direct contact with the sores or lesions that are present in your esophagus.
The Esophagus doesn't have a protective coating or lining like your stomach does to protect it from the hydrochloric acid or acidic stomach gases, and this constant assault of acid on your esophagus will cause further damage to the delicate cells if it is allowed to continue.
In order to be successful with an acid reflux treatment, you have to first locate and then correct the root cause. This can be anything from the LES valve failing to close properly, to a stomach or bowel problem which is increasing the pressure being exerted against the valve, forcing it open, and allowing the reflux to take place.
Frequently Asked Questions
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QUESTION:
What is reflux esophagitis?
Well everything went fine today and now the doctor has me on Nexium one per day. They took a biopsy of the cells and tissues in my esophagus! The last thing I remember is having the nurse giving me some sleeping medication in my I.V. and then the next thing I know is that I was waking up in the recovering room in a chair with some crackers and a drink waiting for me. The doctor gave me a paper saying reflux esophagitis and that means that I have inflammation of the esophagus. Now I got to wait until December 31, 2008 at 2:30 P.M. to find out what the doctor found on my biopsy. I hope he took pictures of it or a movie so I can have them. I was in the hospital from 11:20 A.M. until like 3:15 P.M. I am SOOOO glad that its over now. I have gastroesophageal reflux disease (G.E.R.D.) and I think it got worst.-
ANSWER:
I got the same thing, but when thay took a biopsy thay did not put me to sleep at all, next I'm having surgery for mys and here is some infromation about it:Esophagitis is the inflammation of the esophagus (the muscular tube that carries food from the throat to the stomach).
Description of Esophagitis
The two principal types of esophagitis are corrosive esophagitis and reflux esophagitis.Corrosive esophagitis is caused by swallowing of caustic chemicals (acid or lye) accidentally or in a suicide attempt. The severity of the inflammation depends on the type, amount, and concentration of caustic chemical swallowed.
Immediately after swallowing such a chemical, there is severe pain and edema in the throat and mouth. Antidotes are of limited value and gastric lavage must be avoided as this may only increase the damage. Treatment consists mainly of reducing pain and providing nursing care until the esophagus heals.
Reflux esophagitis or gastroesophageal reflux disorder (GERD) is a very common condition. The cause is poor functioning of the musculature of the lower esophageal segment, which permits reflux of the stomach's contents.
Causes and Risk Factors of Esophagitis
Chemicals especially likely to cause very severe corrosive esophagitis include cleaning or disinfectant solutions.Factors that contribute to the development of reflux esophagitis include the caustic nature of the refluxate, the inability to clear the refluxate from the esophagus, the volume of gastric contents, and local mucosal protective functions.
Poor lower esophageal segment functioning may be associated with a hiatal hernia, in which the top part of the stomach slides back and forth between the chest and the abdomen. Symptoms may be worsened by alcohol, smoking, sedentary lifestyle and obesity.
Symptoms of Esophagitis
The main symptom of reflux esophagitis is heartburn, with or without regurgitation of gastric contents into the mouth, which worsens on bending over. Complications of GERD include esophagitis and possibly massive but limited hemorrhage.Treatment of Esophagitis
Treatment of corrosive esophagitis involves reducing pain and making the patient comfortable. Gastric lavage is to be avoided in that it may worsen the condition.Development of a severe esophageal stricture may require dilatation and perhaps surgery. Uncomplicated GERD may be tolerated for many years with good response to medical therapy.
Management consists of:
Elevating the head of the bed
Avoiding strong stimulants of acid secretions (e.g., coffee, alcohol)
Avoiding certain drugs (e.g., anticholinergics), specific foods (fats, chocolate), and smoking, all of which lower esophageal sphincter competence
Giving an antacid to neutralize gastric acidity and possibly increase lower esophageal sphincter competence
Use of cholinergic agonists to increase sphincter pressure
Use of H2 agonists to reduce stomach acidity
Surgical treatment may be necessary to correct a hiatal hernia.
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QUESTION:
what diet is appropriate for someone who suffers from acid reflux?and esophagitis. ?
i need a list of what to eat foods and foods that has to be avoided.if possible give me a list of what kinds of foods.-
ANSWER:
I had been suffering really bad and discovered that I have an ulcer in the esophagus , my Doctor gave me an alkaline diet to follow and Proton pump inhibitors .After 2 months the symptoms didn't improve so I carried on with the diet but separated the food groups as in food combining like (Hay diet ).My symptoms have greatly unproved , now im going to elevate my bed head ( using too many pillows just scrunches the stomach )and make sure I don't go to bed after eating .I haven't had any alcohol for a few months and I stay away from acidic foods.Good luck hope you get better soon and remember a lot of it can be trial and error.
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QUESTION:
what are things that relieve pain from acid reflux and esophagitis?
I'm trying to take the medicine, its' not working as well as I'd like. all of a sudden I can't sleep due to acid throat. I try lying down and I start coughing a painful acid cough. I'm already sleepign on a wedge pillow. what can I do to relieve the pain so I can sleep? it's horrid.
I've seen a dr, prevacid made problem worse, trying nexxium now. I need to know what to do when I'm trying to sleep and in pain.-
ANSWER:
Try OMEZ daily empty stomach in the morning. Drink lot of water Eat balanced diet free from spices. Never skip meal. Eat at least 2-3 hours before lying down for sleep. This will work in case it doesn't then only surgery is the option in which Doctors will sew your upper portion of stomach which attaches with your food pipe. You can also visit WebMD for more options. They have a list of dieseas and there u can check your one that is acid reflux.
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QUESTION:
can anyone help me with this endoscopic report?
Findings:
ESOPHAGUS: GE JN is at 36 cm. Large hiatus hernia seen. Lower end shows GR II to III reflux.
STOMACH: Fundus, Body, Antrum shows small erosions
DUODENUM: Bulb and 2nd part are normal
CONCLUSIONS:
Hiatus hernia with reflux esophagitis with panerosive gastritisIs it serious?
how to cure other than medicines given by doctor? what precautions???
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ANSWER:
This sounds like my reports. You have a hiatal hernia which means you could have problems when sleeping on your back. Gastritis and the small erosions are small ulcers eating away at your stomach lining. Reflux simply put means when you have an excess amount of stomach acid, it will splash against your esophagus cause an esophageal spasms which will cause you pain. If you drink alcohol, smoke, eat spicy foods you have to stop. I am on the medications for ulcers and gastritis. I never eat spicy foods, don't ever drink, and I can't even have coffee unless it's decaffeinated. This can get serious. I used to smoke as well, Quitting was hard, but I did it and it helped. You can heal this but you have to stay on the medication and stay on a strict regimen with your diet. Your diet is going to become the most important thing in this situations. I'm sure your Dr told you that. Good luck. I know what you're going through.
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QUESTION:
Help with coding Question?
Operative Report
Using your ICD-9-CM and CPT® codebooks, code the following case:
PREOPERATIVE DIAGNOSES: 1. Incontinent diarrhea 2. Severe heartburn
POSTOPERATIVE DIAGNOSIS: Severe reflux esophagitis with hiatal hernia
SURGEON: Mitchell P. Dorfsman, M.D.
OPERATION: Esophagogastroduodenoscopy with multiple biopsies
ANESTHESIA: 2 mg of Versed, 100 mcg of fentanyl, and 0.4 mg of atropine
ESTIMATED BLOOD LOSS: Minimal
INDICATIONS: A pleasant female who consulted for incontinent diarrhea, but also discussed a severe amount of what appeared to be symptoms of reflux. Consequently, we discussed doing both a colonoscopy, as well as an EGD. The procedure, risks, benefits, and alternatives were discussed about doing an EGD. She understood and wished to proceed with the scope.
FINDINGS: A severe amount of esophagitis noted, with creeping of squamocolumnar junction and erythema up along the lower esophagus. Also of note is a moderate hiatal hernia.
PROCEDURE: The patient was brought into the ER endoscopy suite area. After informed consent was obtained, the patient gargled with Pontocaine solution and was given the medication as noted above. We then had the patient sit upright, placed the scope into the oropharynx, and had her swallow it into her esophagus. We then had her lie in the left lateral decubitus position. Under direction vision, we passed the scope through the esophagus and into the stomach, through the pylorus and into the third portion of the duodenum. We then retracted the scope slowly, with no evidence of ulcers, abnormalities, or lesions noted within the duodenum. The pylorus also appeared to be unremarkable. The antrum, as well as the stomach, appeared to be unremarkable, with no evidence of erythema, which may have been secondary to the scope. Nonetheless, normal rugae folds were identified. Retroflex examination showed a moderate-sized hiatal hernia, which was erythematous as well. No evidence of polyps, lesions, or abnormalities were noted in the cardia portion of the stomach. We then changed the scope back to the antrum and directed the scope slowly with no evidence of abnormalities, lesions, or any other problems within the stomach except for what was mentioned above. We then got to the hiatal hernia with no evidence of ulcerations or lesions noted, except for mild erythema. We then continued to retract the scope to the squamocolumnar junction. At this time, we noted a severe amount of erythema creeping up along the lower esophagus. This was biopsied multiple times for pathology, as well as H. pylori, and a biopsy was taken from the antrum. After obtaining several biopsies, we went back into the stomach, aspirated the air, came back into the lower esophagus, and continued to retract the scope slowly. No evidence of abnormalities or lesions was noted throughout the rest of the esophagus and the vocal cords moved well together bilaterally, with no evidence of erythema, polyps, or lesions. It should be noted that the biopsies of the lower esophagus were obtained at what appeared to be high levels of the squamocolumnar junction, still above the squamocolumnar junction, but at times not reflective of the actual total height of the erythema. We then retracted the scope as noted above. The patient tolerated the procedure well and remained in stable condition throughout the procedure. PLAN: Place the patient on Carafate and Prilosec, and she will be scoped from below next week.
ICD-9-CM Diagnosis Code:
ICD-9-CM Diagnosis Code:
ICD-9-CM Procedure Code (Volume 3):
CPT® Code:-
ANSWER:
Wrong kind of coding for this forum. You might want to try one of the medical forums.
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