GERD, Gastroesophageal Reflux Disease: Difference between revisions

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=== Clinic ===
=== Clinic ===


* Gastro-oesophageal reflux disease (GORD or GERD) is one of the chronic upper GI diseases where stomach content persistently and regularly flows up into the esophagus
* GORD or GERD is one of the chronic upper GI diseases where stomach content persistently and regularly flows up into the esophagus
* Risk factors include obesity, pregnancy, smoking, hiatal hernia, and taking certain medications.
* Risk factors include obesity, pregnancy, smoking, hiatal hernia, and taking certain medications.
* Acid reflux is due to poor closure of LES (Lower Esophageal Sphincter)
* Acid reflux is due to poor closure of LES (Lower Esophageal Sphincter)


=== Signs / Symptoms ===
=== Signs / Symptoms ===
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* Complication: Reflux esophagitis, Esophageal strictures, Barrett's esophagus, Esophageal adenocarcinoma, Laryngeal injury and Aspiration pneumonia.
* Complication: Reflux esophagitis, Esophageal strictures, Barrett's esophagus, Esophageal adenocarcinoma, Laryngeal injury and Aspiration pneumonia.
* Note that these are dynamic post nodes
* Note that these are dynamic post nodes


==== Children / Babies ====
==== Children / Babies ====
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* Failure to gain adequate weight, bad breath, and burping are also common.
* Failure to gain adequate weight, bad breath, and burping are also common.
* Children may have one or many symptom and no single symptom is universal in all children with GERD.
* Children may have one or many symptom and no single symptom is universal in all children with GERD.


=== Causes ===
=== Causes ===
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''H. pylori'' infection: In 1999, a review of existing studies found that,  40% of GERD patients also had ''H. pylori'' infection. The eradication of ''H. pylori'' can lead to an increase in acid secretion, leading to the question of whether ''H. pylori''-infected GERD patients are any different than non-infected GERD patients. A double-blind study, reported in 2004, found no clinically significant difference between these two types of patients with regard to the subjective or objective measures of disease severity.
''H. pylori'' infection: In 1999, a review of existing studies found that,  40% of GERD patients also had ''H. pylori'' infection. The eradication of ''H. pylori'' can lead to an increase in acid secretion, leading to the question of whether ''H. pylori''-infected GERD patients are any different than non-infected GERD patients. A double-blind study, reported in 2004, found no clinically significant difference between these two types of patients with regard to the subjective or objective measures of disease severity.


=== [[Entities list|Entities]] ===
=== [[Entities list|Entities]] ===
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* Stomach, Eructation
* Stomach, Eructation
* Gastric dilation
* Gastric dilation


=== Miasms ===
=== Miasms ===
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* [[Sandifer syndrome entities|Sandifer syndrome]]
* [[Sandifer syndrome entities|Sandifer syndrome]]
* [[Dyspepsia]]
* [[Dyspepsia]]


== Remedies ==
== Remedies ==
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=== [[Banerji protocols]] ===
=== [[Banerji protocols]] ===
|-
|-
|First line
|'''First line'''
|
|
* Iris C200 two doses daily or 15-20 min before food
* [[Iris, Iris versicolor|Iris]] C200 two doses daily or 15-20 min before food
* Lyc C30 two doses daily
* [[Lyc , Lycopodium clavatum|Lyc]] C30 two doses daily
|-
|-
|Second line
|'''Second line'''
|
|
* Condurango C30 two doses daily
* Condurango C30 two doses daily
* Ars C3 two doses daily 15 min before food  
* [[Ars, Arsenicum Album|Ars]] C3 two doses daily 15 min before food  
|-
|-
|Third line
|'''Third line'''
|
|
* Nat-p C30 5-20 min before food
* [[Nat-p, Natrium Phosphoricum|Nat-p]] C30 5-20 min before food
|}
|}


=== [[Ambr, Ambra grisea|Ambr]] ===
=== [[Ambr, Ambra grisea|Ambr]] ===


* Adapted to hypersensitive and hysterical women, who are weakened by age or overwork.  
* Hypersensitive / Hysterical women, who are weakened by age or overwork.
* Patients are very bashful, intensely shy.
* Sensation as if food did not go down into the stomach.
* After eating there is a feeling as if food did not go down into the stomach.  
* Eructation + Violent convulsive cough  
* Eructations with violent convulsive cough are a peculiar symptom
* Distension of abdomen after midnight.  
* Distension of abdomen after midnight.  
* Heartburn from drinking milk.
* Heartburn from drinking milk.


=== [[Ip, Ipecacuanha|Ip]] ===
=== [[Ip, Ipecacuanha|Ip]] ===


* Heart burn with nausea or vomiting and excessive flatulence.  
* Heart burn with nausea or vomiting and excessive flatulence.  
* It is suitable in pregnancy also.
* Suitable in [[pregnancy]] digestive problems
* Clean tongue with thirstlessness.
* Clean tongue + Thirstless
 


=== [[Nux-v , Nux Vomica|Nux-v]] ===
=== [[Nux-v , Nux Vomica|Nux-v]] ===


* Heart burn with flatulence and much acidity but without nausea and vomiting,
* Heart burn + Flatulence but without Nausea / Vomiting
* Tongue is coated with creamy fur, stomach is generally out of order.
* Stomach is generally out of order + Coated Tongue with creamy fur
* Acidity after rich and spicy food and after alcohol.  
* Acidity after Rich / Spicy food / Alcohol.
* Patient is irritable in temperament
* [[Polycrest]] of  modern lifestyle.
* It is great [[polycrest]] and frequently prescribed medicine for several conditions that originate from so called modern lifestyle.  
* Gastralgia, pain goes into back and chest
* He is very industrious, quick and irritable.
* Nausea/ Violent retching and patient feels if he vomits, he will get relief.
* Such patients who do a lot of mental work, lead a sedentary life and frequently indulge in stimulants, drugs or alcohol.
* All gastric problem starts from heart burn; gastralgia, pain goes into back and chest
* Amel from vomiting.
* Nausea; violent reteching and patient feels if he vomits, he will get relief.




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=== [[Calc-c, Calcerea carbonica|Calc]] ===
=== [[Calc-c, Calcerea carbonica|Calc]] ===


* Burning sensation in the stomach, acrid eructations; feeling of pressure over the stomach with vomiting of food and mucus.  
* Burning sensation / Acrid eructation / Heartburn/ Acidity / Hyperchlorhydria.
* This polycrest is very effective in cases of heartburn, acidity or hyperchlorhydria.
* Feeling of pressure over the stomach +Vomiting of food and mucus.
* Heartburn with loud belching.  
* Loud belching.
* Frequent sour eructations and sour vomiting.  
* Sour Eructation / Vomiting.
* Swelling over pit of stomach like an inverted saucer.
* Swelling over pit of stomach
* Craving for indigestible things like chalk, coal, pencil; marked craving for eggs.
* Pica: Craving for indigestible things like chalk, coal, pencil
* Milk disagrees
* Craving for eggs
* [[Milk intolerance remedies|Milk disagrees]]




=== [[Staph, Staphysagria|Staph]] ===
=== [[Staph, Staphysagria|Staph]] ===


* Heart burn caused by smoking.
* Heart burn caused by [[Cigarette smoke poisoning|smoking]].  
* Patient often has lot of frustration and suppressed anger that precipitates sickness.




=== [[Ars, Arsenicum Album|Ars]] ===
=== [[Ars, Arsenicum Album|Ars]] ===


* Foul or sour taste, hot burning sensation in the esophagus and pharynx
* Foul / Sour taste/ Hot burning sensation in Esophagus / Pharynx
* Eructation of sour, acrid fluid, nausea, retching and vomiting of slimy mucus tingled with blood.  
* Eructation of Sour/ Acrid fluid/ Nausea
* Trembling and coldness of extremities with pain in stomach and oppressive anxiety
* Retching / Vomiting of slimy mucus tingled with blood.
* Irregular and frequent pulse.
* Trembling / Coldness of extremities + Oppressive anxiety + Stomachache
* Irregular / Frequent pulse.




=== [[Chin, China Officinalis|Chin]] ===
=== [[Chin, China Officinalis|Chin]] ===


* Abdominal discomfort which is only relieved by belching.  
* Abdominal discomfort, Only relieved by belching.
* Key point: Sour and bitter eructations or offensive flatus, worse at night and after meals
* Sour and bitter eructation or offensive flatus, Worse
* Another key note: Food does not digest but lies a long time in the stomach causing eructations and finally is vomited undigested.
** At night  
** After meals
* [[Dyspepsia]] causes eructation and finally undigested food is vomited




=== [[Nat-p, Natrium Phosphoricum|Nat-p]] ===
=== [[Nat-p, Natrium Phosphoricum|Nat-p]] ===


* Hyperacidity, sour smelling sweats, acid condition of stomach with nausea and vomiting of acrid fluid,
* Sourness / Hyperacidity (Like vinegar): Eructation/ Vomiting/ Stomach/ Stools/ Expectoration / Perspiration
* Sour eructations, Vomiting of sour fluid like vinegar.
* Ulceration of stomach with sour risings.
* Ulceration of stomach with sour risings.
* Ailments from too much lactic acid in the system as a result of too much sugar.
* Vomiting and diarrhea of infants who have been fed with excess sugar and milk.
* Sourness; sour eructation, vomiting, stomach, stools, expectoration even sweats.
* Suitable in cases of vomiting and diarrhea of infants who have been fed with excess sugar and milk- excess of acidity.  
* Key point: Yellow creamy coating of tongue and posterior portion of the roof of mouth  
* Key point: Yellow creamy coating of tongue and posterior portion of the roof of mouth  


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=== [[Puls, Pulsatilla pratensis|Puls]] ===
=== [[Puls, Pulsatilla pratensis|Puls]] ===


* Key point: Dryness of the mouth, Putrid taste in the morning on walking, A sensation as if food had lodged under the sternum  
* Dryness of the mouth + No thirst, only a desire to moisten the mouth
* Tongue coated with thick rough white fur; acidity and heartburn
* Putrid / Bad / Sour-bitter taste in the morning on walking
* Food taste bitter, sour or putrid; water-brash and eructation tasting of food
* Sensation as if food had lodged under the sternum
* No thirst, only a desire to moisten the mouth
* Tongue coated with thick rough white fur;  
* Bad taste is special indication of Puls
* Water-brash / Acidity / Heartburn and eructation tasting of food
* Dyspepsia arising from fatty foods, pork, from pastry or mixed diets.  
* [[Dyspepsia]] due to Fatty foods/ Pork/ Pastry / Mixed diets.  
* The patient is chilly, but is worse from heat, Worse in the evening.
* The patient is chilly, but is worse from heat, Worse in the evening.


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=== [[Phos, Phosphorus|Phos]] ===
=== [[Phos, Phosphorus|Phos]] ===


* Wonderful remedy for Acid peptic disorders (A.P.D).
* [[Peptic ulcer disease|Acid peptic disorders]] (A.P.D)  
* Regurgitation of ingesta, waterbrash with spasm of esophagus.
* Regurgitation of ingesta/  Water-brash + Esophagus spasm  
* Patient has marked craving for cold drink and cold food, which gives temporary relief in the burning and heartburn.  
* Craving for Cold Drink / Food, which gives temporary relief in Burning / Heartburn.
* Hungry soon after eating.  
* Hungry soon after eating.  
* Belching after eating.  
* Belching after eating.  
* Vomiting; water is thrown up as soon as it gets warm in the stomach.  
* Vomiting; water is thrown up as soon as it gets warm in the stomach.  
* Gastritis with burning extending to throat.  
* [[Gastritis]] +  Burning extending to throat.  
* Craving for salt, acid and spicy things.  
* Craving for Salt/ Acid / Spicy things.
* Craving for cold food which is vomited as soon as it becomes hot in the stomach
* Spitting of blood without nausea
* Spitting of blood without nausea is also common in this remedy.




=== [[Aesc , Aesculus hippocastanum|Aesc]] ===
=== [[Aesc , Aesculus hippocastanum|Aesc]] ===


* Excellent remedy for heart burn, great burning distress  
* Heart burn / Great burning distress
* Pressure as from stone in the pit of stomach
* Pressure as from stone in the pit of stomach
* Empty eructations of wind
* Empty eructation of wind




=== [[Ferr, Ferrum Metallicum|Ferr]] ===
=== [[Ferr, Ferrum Metallicum|Ferr]] ===


* Remarkable remedy for heart burn, vomiting only of food after eating and drinking.
* Heartburn
* Vomiting only of food after eating and drinking




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* Sourness is so marked that even washing does not remove that sour smell from child.  
* Sourness is so marked that even washing does not remove that sour smell from child.  
* Desire for many things but cannot eat them.
* Desire for many things but cannot eat them.


=== [[Carb-v, Carbo vegetabilis|Carb-v]] ===
=== [[Carb-v, Carbo vegetabilis|Carb-v]] ===


* Slowness, sluggishness and lack of reaction are the key points
* Key points: Slowness/ Sluggishness / Lack of reaction
* Slowness in metabolism or weak digestion causes excessive flatulence and distension esp in the upper part of abdomen.  
* Slow / Weak digestion causes excessive flatulence and distension esp in the upper part of abdomen.
* Eructions rancid and loud, but do not give any relief to the patient.  
* Eructions rancid and loud, but do not give any relief to the patient.  
* Asthmatic breathing with waterbrush.  
* Asthmatic breathing with water-brush.
* Constrictive pain extending to chest with acidity.  
* Constrictive pain extending to chest with acidity.  
* Aversion to meat, fat and milk.  
* Aversion to meat, fat and milk.  
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=== [[Sul-ac, Sulphuric acid|Sul-ac]] ===
=== [[Sul-ac, Sulphuric acid|Sul-ac]] ===


* Like all acids, it also has marked debility
* Marked debility /Weakness esp the digestive tract
* Here the debility or weakness affects esp the digestive tract; makes it relax, with a craving for stimulants.
* Craving for stimulants / Fresh food
* Heartburn and gastralgia.
* Heartburn / Gastralgia
* Water causes coldness of the stomach; must be mixed with liquors.  
* Water causes coldness of the stomach; must be mixed with liquors.  
* Aversion to the smell of coffee.  
* Aversion to the smell of coffee.  
* Desire for fresh food.
* Recurring [[Aphthous stomatitis|aphthae]] in Mouth / Throat
* Recurring apthae in mouth and throat.

Revision as of 11:58, 8 November 2023

Clinic

  • GORD or GERD is one of the chronic upper GI diseases where stomach content persistently and regularly flows up into the esophagus
  • Risk factors include obesity, pregnancy, smoking, hiatal hernia, and taking certain medications.
  • Acid reflux is due to poor closure of LES (Lower Esophageal Sphincter)


Signs / Symptoms

Adults

  • Acidic taste in the mouth, Regurgitation, and Heartburn are most common
  • Other symptoms include Odynophagia, Sore throat, Increased salivation (Water brash), nausea, chest pain, coughing, and globus sensation.
  • Acid reflux can induce asthma attack symptoms like shortness of breath, cough, and wheezing in those with underlying asthma.
  • Complication: Reflux esophagitis, Esophageal strictures, Barrett's esophagus, Esophageal adenocarcinoma, Laryngeal injury and Aspiration pneumonia.
  • Note that these are dynamic post nodes


Children / Babies

  • GERD may be difficult to detect in infants and children since they cannot describe it.
  • It may cause repeated vomiting, effortless spitting up, coughing, and other respiratory problems, such as wheezing.
  • Inconsolable crying, refusing food, crying for food and then pulling off the bottle or breast only to cry for it again,
  • Failure to gain adequate weight, bad breath, and burping are also common.
  • Children may have one or many symptom and no single symptom is universal in all children with GERD.


Causes

  • Hiatal hernia, which increases the likelihood of GERD due to mechanical and motility factors.
  • Obesity: increasing body mass index is associated with more severe GERD. In a large series of 2,000 patients with symptomatic reflux disease, it has been shown that 13% of changes in esophageal acid exposure is attributable to changes in body mass index.

Factors that have been linked with GERD, but not conclusively:

  • Obstructive sleep apnea
  • Gallstones, which can impede the flow of bile into the duodenum, which can affect the ability to neutralize gastric acid

H. pylori infection: In 1999, a review of existing studies found that, 40% of GERD patients also had H. pylori infection. The eradication of H. pylori can lead to an increase in acid secretion, leading to the question of whether H. pylori-infected GERD patients are any different than non-infected GERD patients. A double-blind study, reported in 2004, found no clinically significant difference between these two types of patients with regard to the subjective or objective measures of disease severity.


Entities

  • Stomach, Eructation
  • Gastric dilation


Miasms

Related disease

Remedies

  • Ambr, Asaf, Bry, Calc, Caps, Carb-v, Chin, Lob, Lyc, Mag-c, Nat-m, Nux-v
  • Phos, , Puls, Rheum, Sep, Sulph-ac, Anac, Apis, Arg-m, Arg-n, Ars, Bism, Canth, Carb-ac, Chel, Dios, Ign, Iris, Kali-c, , Nat-c, Nat-p, Nat-s, Nit-ac, Staph, Tab, Teucr, Val
  • Morgan Pure By Paterson (Bowel Nososde), Robinia Pseudacacia, Tamarindus Indica and Populus Tremuloides

Banerji protocols

First line
  • Iris C200 two doses daily or 15-20 min before food
  • Lyc C30 two doses daily
Second line
  • Condurango C30 two doses daily
  • Ars C3 two doses daily 15 min before food
Third line
  • Nat-p C30 5-20 min before food

Ambr

  • Hypersensitive / Hysterical women, who are weakened by age or overwork.
  • Sensation as if food did not go down into the stomach.
  • Eructation + Violent convulsive cough
  • Distension of abdomen after midnight.
  • Heartburn from drinking milk.


Ip

  • Heart burn with nausea or vomiting and excessive flatulence.
  • Suitable in pregnancy digestive problems
  • Clean tongue + Thirstless


Nux-v

  • Heart burn + Flatulence but without Nausea / Vomiting
  • Stomach is generally out of order + Coated Tongue with creamy fur
  • Acidity after Rich / Spicy food / Alcohol.
  • Polycrest of modern lifestyle.
  • Gastralgia, pain goes into back and chest
  • Nausea/ Violent retching and patient feels if he vomits, he will get relief.


Robinia

  • Excellent remedy for hyperchlorhydria when the eructation and vomiting is so sour that it sets the teeth on edge or dulls them.
  • The acidity in Robinia is accompanied by frontal headache, which agg with motion.
  • Acidity in children; infants with sour smell of the body.


Calc

  • Burning sensation / Acrid eructation / Heartburn/ Acidity / Hyperchlorhydria.
  • Feeling of pressure over the stomach +Vomiting of food and mucus.
  • Loud belching.
  • Sour Eructation / Vomiting.
  • Swelling over pit of stomach
  • Pica: Craving for indigestible things like chalk, coal, pencil
  • Craving for eggs
  • Milk disagrees


Staph


Ars

  • Foul / Sour taste/ Hot burning sensation in Esophagus / Pharynx
  • Eructation of Sour/ Acrid fluid/ Nausea
  • Retching / Vomiting of slimy mucus tingled with blood.
  • Trembling / Coldness of extremities + Oppressive anxiety + Stomachache
  • Irregular / Frequent pulse.


Chin

  • Abdominal discomfort, Only relieved by belching.
  • Sour and bitter eructation or offensive flatus, Worse
    • At night
    • After meals
  • Dyspepsia causes eructation and finally undigested food is vomited


Nat-p

  • Sourness / Hyperacidity (Like vinegar): Eructation/ Vomiting/ Stomach/ Stools/ Expectoration / Perspiration
  • Ulceration of stomach with sour risings.
  • Vomiting and diarrhea of infants who have been fed with excess sugar and milk.
  • Key point: Yellow creamy coating of tongue and posterior portion of the roof of mouth


Puls

  • Dryness of the mouth + No thirst, only a desire to moisten the mouth
  • Putrid / Bad / Sour-bitter taste in the morning on walking
  • Sensation as if food had lodged under the sternum
  • Tongue coated with thick rough white fur;
  • Water-brash / Acidity / Heartburn and eructation tasting of food
  • Dyspepsia due to Fatty foods/ Pork/ Pastry / Mixed diets.
  • The patient is chilly, but is worse from heat, Worse in the evening.


Phos

  • Acid peptic disorders (A.P.D)
  • Regurgitation of ingesta/ Water-brash + Esophagus spasm
  • Craving for Cold Drink / Food, which gives temporary relief in Burning / Heartburn.
  • Hungry soon after eating.
  • Belching after eating.
  • Vomiting; water is thrown up as soon as it gets warm in the stomach.
  • Gastritis + Burning extending to throat.
  • Craving for Salt/ Acid / Spicy things.
  • Spitting of blood without nausea


Aesc

  • Heart burn / Great burning distress
  • Pressure as from stone in the pit of stomach
  • Empty eructation of wind


Ferr

  • Heartburn
  • Vomiting only of food after eating and drinking


Rheum

  • Rheum is a remedy for suckling and children where liver and bile duct is mainly affected.
  • Sourness is so marked that even washing does not remove that sour smell from child.
  • Desire for many things but cannot eat them.


Carb-v

  • Key points: Slowness/ Sluggishness / Lack of reaction
  • Slow / Weak digestion causes excessive flatulence and distension esp in the upper part of abdomen.
  • Eructions rancid and loud, but do not give any relief to the patient.
  • Asthmatic breathing with water-brush.
  • Constrictive pain extending to chest with acidity.
  • Aversion to meat, fat and milk.
  • Desire for salty things.


Sul-ac

  • Marked debility /Weakness esp the digestive tract
  • Craving for stimulants / Fresh food
  • Heartburn / Gastralgia
  • Water causes coldness of the stomach; must be mixed with liquors.
  • Aversion to the smell of coffee.
  • Recurring aphthae in Mouth / Throat
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