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.

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.

Relief from Heartburn Pain (Infographic)

Posted on September 19, 2018December 27, 2024 by Granite Peaks

GERD (gastroesophageal reflux disease) is a common condition with symptoms such as heartburn, reflux, chest pain and difficulty swallowing. About 15 million Americans experience GERD symptoms daily.

GERD is caused by a weakening of the esophageal sphincter, allowing stomach contents to back up into the esophagus. The stomach contains acid and pepsin which, if allowed to contact the esophageal tissue, can irritate and cause erosions in the esophagus. Left untreated, reflux can cause esophageal inflammation, or lead to Barrett’s esophagus, a condition that increases the risk of esophageal cancer.

Don’t suffer with the burning irritation of GERD. Talk with a gastroenterologist to find the right solution for your symptoms.

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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.

Heartburn – Should You Worry?

Posted on July 3, 2015December 27, 2024 by fuelmarketing

How do you know when heartburn is something you should see your doctor about? Heartburn may be a symptom of Gastroesophageal Reflux Disease (GERD). If it is GERD, it needs to be diagnosed so further damage to the esophagus is minimized. There are simple steps that can be taken to manage your acid reflux and immediately improve your quality of life.

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. The LES then tightens 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 and complications.

Who gets GERD and when should you see a doctor?

GERD affects 15 million adults in the U.S. on a daily basis. Those who suffer with it may find it most prevalent if they eat late at night, eat acidic or spicy foods, or lie down soon after eating. Those who are overweight, smoke, drink alcohol, or are pregnant may also be more prone to GERD symptoms. If symptoms occur more than once per week, are prolonged, or if you are unable to control the symptoms with lifestyle modifications and/or medications, you should see your gastroenterologist. Do so immediately if you have any of these warning symptoms:

– vomiting blood

– passing black stool

– difficulty swallowing

– unexplained weight loss

– anemia

– chest pain

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 in the esophagus which can cause bleeding

– aspiration of acid into the lungs which may cause pneumonia or asthma

– Barrett’s esophagus which is a pre-cancerous lining of the esophagus

– esophageal cancer

How is GERD diagnosed?

Your doctor may be able to diagnose GERD 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 light sedation where a tiny lighted camera is passed through your mouth into your esophagus.

How is GERD treated?

Lifestyle modifications that can help decrease symptoms include: raising the head of the bed (placement of 6 inch blocks under the head of the bed), waiting at least 3-4 hours after eating before lying down, avoiding tight-fitting clothing, avoiding smoking and alcohol, losing weight, and eating smaller meals.

Foods that can commonly aggravate GERD include: fatty foods, chocolate, peppermint, alcohol, caffeine, and citrus drinks. There may be other aggravating foods specific to each patient.

Medications can be used to help treat GERD, including antacids such as Mylanta and Maalox, H2 blockers such as Zantac and Tagamet, and proton pump inhibitors (PPIs) such as Prilosec and Prevacid.

Summary

In summary, occasional heartburn is usually not a cause for concern. But if you experience heartburn more than once per week, lifestyle modifications are not working, or if you have any of the warning symptoms listed above, please make an appointment with one of the specialists at Granite Peaks Gastroenterology in Sandy or Lehi.