Meet Your Esophagus

Posted on January 12, 2022December 27, 2024 by Granite Peaks

When it comes to the internal components of your body, you probably don’t notice them until something feels “wrong.” For example, let’s discuss your esophagus. This otherwise unnoticeable tube, responsible for transporting food from your mouth to your stomach, has a big job to do and if something is wrong, you’ll notice.

Esophageal Anatomy

Your esophagus is the tube that runs from your mouth to your stomach to control the exchange of air, food, and liquids. There are sphincter muscles at the top and bottom of the esophagus. The upper muscle prevents liquids and food from going down the windpipe into the lungs and moves food down the esophagus toward the stomach. The lower muscle allows food to pass into the stomach and prevents acidic stomach contents from escaping back into the esophagus or lungs.

When Does Heartburn Become a Problem?

Most people experience heartburn at some point in time. That burning sensation felt near the center of your ribcage, usually shortly after eating or drinking, might be acidic stomach contents pushing back up the esophagus from the stomach, which is also known as reflux.

However, about 50% of American suffer with GERD (Gastroesophageal Reflux Disease), the stage when heartburn becomes a frequent, chronic condition. GERD is best managed with your gastroenterologist to monitor changes in the esophagus and effectiveness of recommended treatment. Left untreated, GERD can cause significant damage to the esophagus, leading to Barrett’s esophagus, esophageal ulcers, strictures (narrowing of the esophagus) or esophageal cancer.

Tips for Keeping Your Esophagus Healthy

Reduce your risk of acid reflux. Choose smaller meals and eat slowly, chewing food thoroughly to aid the process of breaking down food. This will also help the rest of your digestive system work better too. Avoid or limit fatty, acidic or spicy foods, and alcohol or caffeinated beverages such as cola, tea, coffee. If simple changes don’t help, see your gastroenterologist for more specific ideas for relieving symptoms and determining whether your heartburn could really be something more serious. Learn more here.

The Holidays are on the Way – Keep Your Gut Health in Check!

Posted on November 11, 2021December 27, 2024 by Granite Peaks

Let’s face it. Many of us tend to over-indulge during the holidays. So many wonderful foods you only see at this time of year can be hard to pass up, but sometimes it’s worth the pass to not deal with the gas. Gas, bloating, acid reflux, and gut pain can all be part of the “joys” of the holidays if you suffer with digestive health challenges.

Be Mindful of Your Choices

Be aware of the foods you can’t seem to resist and think carefully about how you feel after you eat them. If you’re able to have a small amount of a favorite food, go for it! Enjoy every moment of the smell, taste and texture of that small serving. You’ll probably find the smaller serving is just right for you.

If you have a condition such as celiac disease or lactose intolerance, even small amounts of offending foods can be devastating to your digestive system. There are more fantastic gluten-free or lactose-free options for all types of foods than ever before at your local grocery store. You can have your treat and eat it too!

Foods high in sugar or sweeteners can make certain conditions, such as acid reflux, worse and they can have a negative effect on your gut and other organs. When you can, choose natural sweeteners in limited quantity to make your holiday treats sweet.

Don’t Make the Holiday a Drag

Shoot for the dishes you can enjoy without experiencing painful symptoms. To be sure you can enjoy your favorites by bringing safe dishes to share at important gatherings. Your host will love the help and you’ll have more fun!

Eating foods that taste great for a moment but take you out of the action aren’t going to help you enjoy your holidays. Aim for healthy foods that help you stay feeling your best. It will also help you keep your weight in check and avoid those extra holiday pounds.

When Your Digestive Issues Need Attention

If you have been having persistent digestive issues, now is the time to get checked out. Afterall, you can’t fix a problem if you’re not sure what the problem is. People sometimes suffer longer than necessary with symptoms such as acid reflux, stomach pain, diarrhea, constipation and other digestive ailments. See a gastroenterology specialist at Granite Peaks Gastroenterology to find the cause of your symptoms. An accurate diagnosis is the first step toward feeling your best, for the holidays and every day.

Foods That Can Cause Heartburn

Posted on May 21, 2021December 27, 2024 by Granite Peaks

Foods That Can Cause Heartburn

On occasion, most people will experience heartburn after ingesting certain foods or eating too close to bedtime. When you have heartburn more than twice weekly, and it is a consistent issue, it is time to address the cause and seek treatment.

Heartburn and acid reflux are symptoms of a condition called GERD (gastroesophageal reflux disease), when stomach acids back up into the esophagus, causing pain. Untreated chronic heartburn and acid reflux can cause more serious digestive health issues, erosion or ulceration of the esophagus, esophageal inflammation and even lung issues if stomach acids are aspirated.

Common Foods That Can Cause Heartburn

Many foods can cause heartburn, and it may be different for each individual. The foods below may be a trigger

Fatty foods
Spicy foods
Acidic Foods
Chocolate
Peppermint
Caffeine
Alcohol

Sometimes the problem is not what you eat, but how much. Overfilling your stomach can put pressure on the lower esophageal sphincter that connects the esophagus and stomach, allowing stomach contents to back up into the esophagus. Eat smaller, more frequent meals until “satisfied” but not “full” to help manage symptoms.

Lifestyle Changes

There are several lifestyle changes you can try to manage symptoms. They’re simple and don’t require medication or expense. See if any of these help before trying medications.

Quit Smoking
Drop some weight
Avoid tight-fitting clothing that puts pressure on your abdomen
Avoid eating 2-3 hours before bedtime or lying down for a nap
Raise the head of your bed 6 inches

Medications

Over-the-counter medications can be helpful for temporary relief of symptoms. However, if you are taking them more than twice weekly or if they are not controlling your symptoms, it is time to see a physician about your condition. Remember, no medication, over-the-counter or prescription, should be taken long-term without consulting a physician.

Available Options:

Mylanta® or Maalox®
Acid reducers
Proton Pump Inhibitors

People may tend to think that heartburn is “no big deal” so they don’t treat it or don’t mention it to their physician. The fact is any frequent, chronic symptoms are a sign to talk with your doc. Don’t let something minor become major.

The gastroenterology specialists at Granite Peaks Gastroenterology evaluate and treat digestive health issues every day. Use their expertise to help you feel better, fast.

For additional information about GERD, read what Dr. Cutler wrote – When heartburn is more than simple indigestion.

This blog is offered for educational purposes only and should in no way to be considered medical advice, treatment or comprehensive in nature. Those with symptoms or questions should consult their primary care provider or gastroenterologist for evaluation and treatment.

When Heartburn is More than Simple Indigestion

Posted on June 11, 2019December 27, 2024 by Christopher Cutler

By Christopher S. Cutler, MD

How do you know when heartburn or “indigestion” is something more and needs to be treated? The gastroenterology specialists at Granite Peaks GI take time with their patients to determine if such symptoms may be a result of Gastroesophageal Reflux Disease (GERD). One of the red flags is heartburn occurring more than twice a week; although you can have GERD without the presence of heartburn. “If it is GERD, it needs to be diagnosed so further damage to the esophagus is minimized. There are also simple steps that can be taken to manage the disease and immediately improve one’s quality of life,” says Dr. Cutler, who explains more about the disease in the Q & A below.

What is GERD?

When we eat, food is carried from the mouth to the stomach through the esophagus. At the lower end of the esophagus where it joins the stomach there is a ring of muscle cells called the lower esophageal sphincter (LES). After swallowing, the LES relaxes to allow food to enter the stomach. Then, the LES contracts to prevent food and acid from traveling back up into the esophagus. GERD occurs when the LES weakens, allowing stomach contents and acid to back up into the esophagus, causing troubling symptoms or complications.

Who gets GERD and when should you see a doctor?

GERD affects ten million adults in the United States on a daily basis. People prone to developing it include those who are overweight, smokers or drinkers, and pregnant women. If symptoms are prolonged, or if you are unable to control the symptoms with lifestyle modifications and/or medications, you should see a gastroenterologist. Do so immediately if you have these warning symptoms: throwing up blood, passing black stool, difficulty swallowing, unexplained weight loss, or anemia.

What happens if you don’t treat GERD?

Untreated GERD may lead to the following complications: a narrowing of the esophagus which causes difficulty swallowing, ulcers which can cause bleeding, aspiration of acid into the lungs which may cause pneumonia or asthma, Barrett’s esophagus which is a precancerous lining of the esophagus, and esophageal cancer.

How is GERD treated?

Lifestyle modifications, such as the following, can help decrease symptoms: raising the head of the bed (placement of 6-inch blocks under the head of the bed), waiting at least three to four hours after eating before lying down, avoiding tight-fitting clothing, avoiding smoking and alcohol, losing weight, and eating smaller, more frequent meals. Foods that can commonly aggravate GERD include: fatty foods, chocolate, peppermint, alcohol, caffeine, and citrus drinks. There may be other foods specific to each patient. Medication can also be used to help treat this condition, including antacids such as Mylanta or Maalox, H2 blockers such as Zantac or Tagamet, and proton pump inhibitors (PPIs) such as Prilosec or Prevacid.

How is GERD diagnosed?

Your doctor may be able to diagnose this condition based upon your symptoms and response to therapy. If you have any of the classic warning symptoms mentioned above, your doctor may recommend an upper endoscopy. An upper endoscopy is a painless procedure performed under moderate sedation where a tiny lighted camera is passed through your mouth into your esophagus. Your gastroenterologist will be able to see whether there is damage to your stomach or esophageal tissue, and will be able to recommend a treatment plan to address your specific condition.

Talk to the experts at Granite Peaks Gastroenterology at our Sandy or Lehi office to help relieve your symptoms and determine the best course of action to treat your GERD.

Diagnosing GERD With the Bravo pH Test

Posted on September 5, 2017December 27, 2024 by R. Kyle Barnett

By R. Kyle Barnett, MD

What is GERD?
Frequent heartburn may mean you have Gastroesophageal Reflux Disease (GERD), a condition that lead to serious health problems. It is estimated that 40 percent of Americans are impacted by GERD. Symptoms of GERD may include heartburn, regurgitation, chronic cough, hoarseness, sore throat, chest pain, belching, asthma, and difficulty swallowing.

Up to 26.5 percent of those with chronic GERD may develop Barrett’s Esophagus in their lifetime. Barrett’s Esophagus is the primary risk factor for Esophageal Cancer. Less than 20 percent of people diagnosed with esophageal cancer survive more than five years after their diagnosis.

How is GERD diagnosed?
GERD is often suggested based on your symptoms. However, diagnostic testing may also be needed to assess the severity of your symptoms, and to exclude other contributing factors such as hiatal hernia, inflammation or ulceration in the stomach, or tumor. An upper endoscopy (EGD) is the test performed by your doctor to visualize the lining of the esophagus, stomach and duodenum. Sometimes this test may be normal despite symptoms that suggest GERD. Sometimes medical treatment may not completely control your symptoms.

What is a Bravo pH test?
We have a reflux testing option that may help. It’s a convenient, safe and patient-friendly test that is performed in our outpatient Endoscopy Center. The Bravo pH Test measures the pH level in your stomach acid to help your doctor determine if your symptoms are related to acid reflux or if there is another cause. It will reveal whether your acid is being adequately controlled with medical therapy or if surgical correction may be the solution to your acid reflux. The Bravo test can also determine whether some of your other symptoms (chronic cough, recurrent sore throats, hoarseness, sinus issues, chest pain) are related to GERD.

How is the Bravo pH test performed?
The Bravo pH Test involves performing an upper endoscopy (EGD) with sedation administered by an Anesthesia Professional. During the EGD, a location for placement of a small pH probe is identified, and the probe is attached to the lower part of the esophagus, where it is monitored for a period of 48 hours. You leave our facility with a recording device that you keep with you for the duration of the test. You are then instructed to register your activities including eating and sleeping, and record when you develop symptoms including heartburn, chest pain or regurgitation. The recorder is then returned to our office, where Granite Peaks Gastroenterology physicians will then analyze the recording, along with your diary of events, and report back to you.

How can this help with my medical care?
The Bravo test can determine if an abnormal amount of acid is present in the esophagus, and whether your ongoing symptoms are related to GERD. It can also be an important part of your evaluation if you are considering surgery for your GERD. Although medical therapy for GERD is effective for most people, there have been some recent concerns about the long-term safety of these medications (called PPIs, or proton pump inhibitors) including possible increased risk of chronic kidney disease, bone loss, heart disease and increased risk of certain gastrointestinal infections. If long-term therapy is considered with these medications, it is important to determine if abnormal acid reflux is present so that the appropriate treatment plan can be made between you and your physician.

If reflux is an issue for you and you would like an evaluation to explore treatment options, call or click today to make an appointment. Together we can decide if you are a candidate for Bravo pH testing. For more information, please visit www.utahheartburnrelief.com.

How Safe Are Proton Pump Inhibitors?

Posted on July 12, 2016December 27, 2024 by fuelmarketing

By Dr. Christopher Cutler

Proton pump inhibitors (PPIs) are medications used to treat acid-peptic disorders such as gastroesophageal reflux disease, gastritis, and peptic ulcer disease. There are several PPIs on the market including Prilosec (omeprazole), Prevacid (lansoprazole), Nexium (esomeprazole), Aciphex (rabeprazole), Protonix (pantoprazole), Dexilant (dexlansoprazole), and Zegerid (omeprazole and sodium bicarbonate). While PPIs overall are very safe, several recent studies have raised safety concerns over their long-term use. The following is a list of possible PPI side effects that have recently raised concerns with my patients:

Clostridium difficile infection (C diff). There is a concern that decreasing gastric acid increases the risk of GI infections such as C diff. Multiple studies have indeed shown a 1.4-2.8X increased risk of C diff in patients treated with PPIs, even in patients who have not received antibiotics. The risk seems to be greater than in patients taking H2 blockers such as Zantac. C diff should definitely be considered in patients taking PPIs who develop persistent diarrhea.

Pneumonia. It is possible that decreasing gastric acid may permit bacteria to grow in the stomach, thereby increasing the risk of pneumonia. In fact, there does appear to be an association between PPI use and both community-acquired pneumonia and hospital-acquired pneumonia. This does not necessarily mean that PPI use causes pneumonia, since patients prescribed proton pump inhibitors may be more likely to have other health problems that predispose them to pneumonia.

Hypomagnesemia. PPIs cause decreased absorption of magnesium, especially in patients on therapy for more than one year. The FDA suggests checking a magnesium level prior to starting PPIs in patients expected to be on therapy for a long time, and periodically thereafter. This is especially important in patients taking other medications such as diuretics, which can lower magnesium levels as well. Low magnesium levels can usually be corrected by high dose oral supplementation.

Bone fractures. Insoluble calcium, such as calcium carbonate, requires an acid environment in the stomach for optimal absorption. Long-term use of PPIs, which decrease gastric acid, may decrease calcium absorption thereby decreasing bone density and increasing the risk of fractures. The relative risk is 1.30. This mostly occurs in people over the age of 50, current and former smokers, and those taking a large dose of PPIs for an extended period of time. These patients should consider increasing their dietary calcium and taking a calcium supplement that does not require acid for absorption, such as calcium citrate.

Decreased vitamin B12 absorption. Patients who are on long-term PPIs should have their vitamin B12 levels checked annually.

Decreased iron absorption. This is not usually clinically significant, and there are no formal recommendations to check iron levels.

Kidney disease. Long-term PPI use may be associated with chronic kidney disease. This doesn’t necessarily mean there is a causal relationship. Many patients taking proton pump inhibitors are also on NSAIDs which themselves may damage the kidneys. More studies are needed.

Dementia. There have been at least 2 studies showing an association between dementia and long-term PPI use, but it is unknown if this relationship is causal. More studies are needed.

Heart disease. One study estimated that patients taking PPIs were 16-21% more likely to suffer a heart attack than people not taking a PPI. More studies are needed.

Most of the above data is from observational studies, which have limitations because they can only suggest an association, not establish a cause and effect. There is currently a lack of randomized controlled trials on long-term PPI use and their adverse effects. The current recommendation is to use the lowest dose of PPI needed, for the shortest duration of time, and to taper off the medication after being free of symptoms for at least three months. Certainly there are situations where a patient needs to be on a long-term proton pump inhibitors, such as Barrett’s esophagus, esophageal strictures, and gastroprotection from NSAIDs. If you are currently taking a long-term PPI for acid reflux or any other issues discussed, I strongly suggest that you follow up with your physician at Granite Peaks Gastroenterology to discuss the benefits and various risks.

Digestive Friendly & Not-So-Friendly Foods

Posted on July 11, 2014December 27, 2024 by fuelmarketing

Summer is notorious for bringing people together, whether it’s a barbecue, July 4th & July 24th celebrations, birthdays, and even weddings. You can almost always expect a smorgasbord of foods that may or may not agree with your digestive system. The following is a list of friendly and not so friendly food choices that could leave you partying with your friends and family, or spending the event uncomfortable and aggravated with GERD heartburn or other related concerns.

Worst:

High-Fat/ Fried Foods: for many, high-fat foods and fried foods produce acid reflux and heart-burn. This can cause a pale-colored stool called steatorrhea which is excess fat in the feces.
Spicy Food: can often cause heartburn pain
Diary: Those who are lactose intolerant should steer clear from many diary items because they don’t usually have lactase, an enzyme that breaks down lactose, which is the sugar in milk. If diary causes gas, bloating, diarrhea, or other GI issues, consult with your primary care provider.
Alcohol: This relaxes the esophageal sphincter, causing acid reflux and heartburn, especially if combined with spicy and fatty foods. Alcohol can also inflame the stomach lining, impairing enzymes and preventing nutrients from being absorbed.
Berries: Berries are a great source of antioxidants, but can cause problems for people with diverticulitis, which are pockets in the large intestine. Seeds can get stuck in these pockets and may cause infection.
Chocolate: This could cause problems for people with Irritable Bowel Syndrome, and since chocolate contains milk, those with a lactose intolerance could also find gas, bloating and other symptoms after eating this tasty treat.
Coffee, Tea, Soft Drinks: These beverages can act as a diuretic and can over-relax the esophageal sphincter, causing acid reflux and heartburn.

Best:

Yogurt: Our GI tract contains trillions of bacteria that help break down and digest food. Yogurt contains some good bacteria to promote a healthy system. Look for products that say “Live & active cultures”.
Lean Meat & Fish: Easier for your body to digest than high-fat red meats and is not associated with colon cancer.
Whole grains: Americans need 20-30 grams of whole grains, but the average consumption is around 12 grams. Whole grains help you feel full longer and can help lower cholesterol. However, those with Celiac Disease must stay away from the whole grains which contain gluten.
Bananas: “A Banana A Day is a Healthy Way” and can restore normal bowel functions, electrolytes, and potassium.
Ginger: Ginger can relieve nausea, vomiting, motion sickness, morning sickness, gas, colic, and lack of appetite.

Go forth, and have a healthy and happy gastrointestinal tract through the summer. If you have uncomfortable reactions to foods, but you’re unsure why, call 801-619-9000 to schedule an appointment with one of our specialists. Granite Peaks can help get you back on track and enjoying your summer without discomfort.