Acid Reflux – GERD FAQ and Full Guide 4

What can happen if acid reflux is not treated for a long time? “If somebody at home has said well I get it and I do the over the counter medications and it doesn’t work well but I’m not going to the doctor. I don’t want to worry about surgery. I don’t want to go down there. What might be the path that they’re leading down if this goes for a long time untreated. I mean treated somewhat but still, there might be more damage going on if people keep waiting what could happen to those folks?

Dr Brown: “That wait too long yeah and those folks with the lining of the oesophagus becomes damaged again it can become inflamed it can become raw potentially it can ulcerate or bleed it can scar or stricture and cause a blockage and in rare cases cause inability to swallow so solid foods might have trouble actually passing um and then there’s the risk of developing pre-cancerous changes to the oesophagus or cancer.

What is the main reason for acid reflux? Things we eat or stomach produce too much acid? “You know we talk about acid reflux and the body and the acid again you know the purpose I believe and I was going to verify with you of course is that acid gets developed in your stomach to help break the food down and then with that is there is there something that maybe causes too much acid is it something we eat or do that might cause too much of the acid production?”

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Dr Brown: “There are very rare conditions that people can have where the body creates too much acid there’s a growth tumour called gastrinomas that can occur in the upper intestinal tract and they’re very small little tumours that can cause hormones to be secreted which then cause overproduction of the acid so those uh conditions do exist they’re very rare and they’re more prone to cause people to have ulcerations of the stomach rather than symptoms of acid reflux so much so in terms of the reflux we don’t look too much to work up people for overproduction problems.”

Does stress cause acid reflux? “What about stress? How does stress relate sometimes maybe people feel more heartburn or something you know maybe just when they’ve been stressed maybe work or the family life whatever might be happening”

Dr Brown: “So stress can be a part of aggravating reflux potentially or symptoms of stress could mimic reflux symptoms with tightness in the chest may be some burning in the chest some discomfort there and that may not really be reflux it may be symptoms of stress some people’s stresses manifest maybe as headaches well that doesn’t mean they’ve got a brain tumour nor do chest discomfort necessarily mean that they have reflux so patients who we’re looking for surgery as an option we have them undergo some additional testing and we actually measure the level of acid in the oesophagus that they are refluxing that way we can quantitatively measure yes you are reflexing or no you’re not maybe it’s just attributable to stress and hopefully then they can manage that and not have to go further down the road of surgery and avoid that path correct”

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How does endoscopy work? “You mentioned you know if you have a patient they’ve tried over-the-counter medications they’ve tried prescriptions now you put a scope down and when you put a scope down is that just a one time where you where something gets to look inside or do they wear it like a heart monitor for a while to see what happens over a – hour period of time?”

Dr Brown: “Couple of different things in that in that question the first is the scope the EGD it’s called and that’s something that I refer to my gastroenterology colleagues to do I don’t do those myself that’s a quick outpatient procedure under some sedation that just examines the lining of the oesophagus and the stomach to look for the things that I had mentioned in terms of ulceration inflammation or growths and things can be biopsied with that procedure as well so that just may only need to be done once to make sure there aren’t any complications of reflux that the patient as if they do have barrets syndrome then it’s biopsied and they will need to have repeat endoscopies to assure that that area heals or doesn’t progress into something more serious so the endoscopy can vary a little bit on how frequently it’s needed. The other testing that you’re referring to would be the monitoring of the acid that’s the people are refluxing that can be done during an EGD test the gastroenterologist will attach a small electrode to the lining of the oesophagus it’s called a bravo test bravo and that little electrode will then record the amount of acid that one is refluxing over the two-day period of time while you’re at home going about your normal day-to-day activities (Do you ever feel you have it?) No you don’t you shouldn’t even know you have it and after a couple of days it passes on its own and it transmits data to a little receiver and then that’s interpreted and it will then give us a hard score of the severity of your acid reflux.”

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