Bay Biosciences provides high quality, clinical grade, biopsy tissue samples, FFPE tissue blocks with matched cryogenically preserved sera (serum), plasma, peripheral blood mononuclear cells (PBMC) biofluid samples from patients diagnosed with gastroesophageal reflux (GERD).
The sera (serum), plasma and PBMC biofluid specimens are processed from gastroesophageal reflux (GERD) patient’s peripheral whole-blood using customized collection and processing protocols.
Biopsy tissue and matched biofluid samples are collected from unique patients diagnosed with gastroesophageal reflux (GERD) and are provided to a valued pharmaceutical customer for research, diagnostics, discovery and drug development.
The gastroesophageal reflux (GERD), sera (serum), plasma and peripheral blood mononuclear cells (PBMC) biofluids are processed from patients peripheral whole-blood using customized collection and processing protocols.
Gastroesophageal Reflux (GERD) Overview
Gastroesophageal reflux (GERD) is a condition where you have chronic acid reflux and the stomach acid persistently flows back up into the mouth into the tube connecting your mouth and stomach known as esophagus.
This backwash (acid reflux) can irritate the lining of the esophagus. GERD patients may experience heartburn, acid indigestion, trouble swallowing (dysphagia), feeling of food caught in the throat and other issues.
According to NIDDK gastroesophageal reflux (GERD) affects around 20 percent U.S. population. If left untreated, it may cause serious complications.
Causes of Gastroesophageal Reflux (GERD)
The term “gastroesophageal” refers to the stomach and esophagus. Reflux means to return or blow back. Gastroesophageal reflux occurs when whatever is in your stomach backs up into the esophagus.
Gastroesophageal reflux disease (GERD) is a digestive disorder that affects the ring of muscle between the esophagus and the. This ring is called the lower esophageal sphincter (LES).
In normal digestion, the lower esophageal sphincter (LES) valve, is a circular band of muscle at the end of the esophagus, opens to allow food into the stomach. Then it closes to stop food and acidic stomach juices from flowing back into the esophagus. Gastroesophageal reflux happens when the LES is weak or relaxes when it shouldn’t. This lets the stomach’s contents rise up into the esophagus.
Sigs and Symptoms of Gastroesophageal Reflux (GERD)
Following are the common signs and symptoms of gastroesophageal reflux (GERD):
- A burning sensation in the chest (heartburn), usually after eating, which may gets worse at night time
- Chest Pain
- Difficulty swallowing (dysphagia)
- Hoarseness
- Sensation of a lump in the throat
- Swallowed food or sour liquid coming up to the mouth (Regurgitation)
- Wearing away of tooth enamel
Patients who have nighttime acid reflux, they may also experience the following conditions:
Diagnosis of Gastroesophageal Reflux (GERD)
- Endoscopy: Endoscopy is a procedure where a small lighted tube with a tiny video camera on the end (endoscope) into the esophagus to look for inflammation or irritation of the tissue (esophagitis). If the results are abnormal or questionable, they may remove a small tissue (biopsy) sample for pathology testing.
- pH testing: In case of difficulty to make a definite diagnosis, the doctor may measure the acid levels inside the esophagus through the pH test, which is an effective tool in diagnosing GERD. It tracks how much acid is in your esophagus during meals, activity, and sleep.
- Upper GI series Tests: Upper GI series test are one of the first tests conducted for the diagnosis of GERD. It’s a special X-ray that shows the esophagus, stomach, and the upper part of your small intestine (duodenum). It gives limited information about possible reflux, but it can help rule out other conditions, such as peptic ulcers.
- Esophageal manometry and impedance study: This test checks for low pressure in the esophagus. It can also show defects in how the esophageal muscles contract.
Surgical Procedure for Severe GERD
If a patient have damage to the esophagus and need regular high doses of PPIs to control the symptoms and even with medication, and a hiatal hernia, symptoms are not getting better, the patient may need surgery for GERD.
- Fundoplication: This is a procedure that raises the pressure in your lower esophagus. The doctor will wind the top of your stomach around the lower esophageal sphincter (LES). This done through a laparoscope (small holes through the belly) or through open surgery. This procedure tightens the muscle and raises pressure in the lower esophagus to stop reflux.
- Transoral Incisionless Fundoplication (TIF): TIF is a from of surgery which uses an endoscope (a small tube with a camera) to wrap the stomach around the lower esophageal sphincter (LES) with plastic fasteners. This procedure less invasive than standard fundoplication.
- Stretta Procedure: In the Stretta procedure the doctor puts a small tube down the esophagus that uses low-radiofrequency heat to reshape the lower esophageal sphincter (LES).
- LINX Surgery: A doctor wraps a band of magnetic titanium beads around the place where your stomach and esophagus meet. The magnetic attraction of the beads keeps it loose enough to let food pass through into the stomach, but tight enough to stop reflux.
Diet and Gastroesophageal Reflux (GERD)
In some GERD patients, certain types of foods and beverages may trigger gastroesophageal reflux. These dietary triggers can vary from one person to another.
Following are the common foods (dietary triggers) that can trigger GERD:
- Acidic foods
- Alcoholic drinks
- Coffee
- Citrus fruits
- Foods that are high in fat
- Spicy foods
- Chocolate
- Pineapple
- Sodas
- Tea
- Tomatoes
- Orange juice lemon juice
- Onion
- Garlic
- Mint
Risk Factors of Gastroesophageal Reflux (GERD)
Following are some of the conditions that can increase the chances of developing GERD:
- Connective tissue disorders
- Hiatal hernia
- Obesity
- Pregnancy
Following are some of the lifestyle behaviors which can raise the risk of developing GERD:
- Alcohol consumption
- Drinking certain types of beverages, such as coffee and soda
- Having large meals
- Sleeping or lying down shortly after eating
- Eating fried foods
- Eating spicy foods
- Nonsteroidal anti-inflammatory drugs (NSAIDS) e.g. aspirin or ibuprofen
- Smoking
Lifestyle changes for Gastroesophageal Reflux (GERD)
Following are some of the lifestyle changes suggested by the doctors to help lessen the symptoms of gastroesophageal reflux (GERD):
- Avoid foods and beverages triggers: Don’t eat foods that can relax the lower esophageal sphincter (LES), such as alcoholic drinks, chocolate, food high in fat, caffeine and peppermint. Foods such as tomato products, peppers and spices, and citrus fruit juices can irritate and damage esophageal lining causing GERD symptoms.
- Eat smaller servings: Eating smaller portioned meals may also help control the symptoms. Also, eating meals at least 2 to 3 hours before bedtime lets the acid in your stomach go down and your stomach partially empty.
- Eat slowly: Eating slowly and take your time at every meal.
- Chew your food thoroughly: It may help you remember to do this if you set your fork down after you take a bite. Pick it up again only when you’ve completely chewed and swallowed that bite.
- Stop smoking: Cigarette smoking weakens the LES. Stopping smoking is important to reduce GERD symptoms.
- Elevate your head: Raising the head of your bed on 6-inch blocks or sleeping on a specially designed wedge lets gravity lessen the reflux of stomach contents into your esophagus. Don’t use pillows to prop yourself up. That only puts more pressure on the stomach.
- Maintain healthy weight: Being overweight often worsens symptoms. Many overweight people find relief when they lose weight.
- Wear loose clothes: Avoid clothes that squeeze your waist put pressure on your belly and the lower part of your esophagus.
- Acupuncture: In a study, treatment with acupuncture stopped reflux in the test group better than PPIs, with results that lasted longer.
Complications of Gastroesophageal Reflux (GERD)
Without proper and effective treatment, gastroesophageal reflux (GERD) can sometimes cause serious following complications over time:
- Esophageal Ulcer: Stomach acid eats away at your esophagus until an open sore forms. These sores are often painful and may bleed, this can make it hard to swallow (dysphagia).
- Barrett’s esophagus: Acid reflux changes the cells in the tissue that lines your esophagus. The lining gets thicker and turns red. This condition is linked to a higher chance of esophageal cancer.
- Lung Problems: If reflux reaches the back of the throat, it can cause irritation and pain. From there, it can get into the lungs. If this happens, the patients voice may get hoarse. They could have chest congestion, persistent cough and can also have postnasal drip. If the GERD patients lungs get inflamed they can develop asthma, bronchitis and pneumonia.
Treatment of Gastroesophageal Reflux (GERD)
Usually for the new gastroesophageal reflux (GERD) patients doctors are likely to recommend that you first try lifestyle modifications and over-the-counter medications. If the patient don’t experience any relief within a few weeks, your doctor might recommend prescription medication or surgery.
Over-the-counter medications
Following are some of the common over-the-counter medications for gastroesophageal reflux (GERD):
- Antacids that neutralize stomach acid: Antacids, such as Mylanta, Rolaids and Tums, may provide quick relief. But antacids alone won’t heal an inflamed esophagus damaged by stomach acid. Overuse of some antacids can cause side effects, such as diarrhea or kidney problems.
- Medications to reduce acid production: Medications known as H-2-receptor blockers include cimetidine (Tagamet HB), famotidine (Pepcid AC) and nizatidine (Axid AR). H-2-receptor blockers don’t act as quickly as antacids, but they provide longer relief and may decrease acid production from the stomach for up to 12 hours.
- Medications that block acid production and heal the esophagus: Proton pump inhibitors PPI’s are stronger acid blockers than H-2-receptor blockers and allow time for damaged esophageal tissue to heal.
Prescription Medications for Gastroesophageal Reflux (GERD):
Following are some of the available prescription medicines used to treat -strength treatments for gastroesophageal reflux (GERD):
- Prescription-strength H-2-receptor blockers: These include prescription-strength famotidine (Pepcid) and nizatidine. These medications are generally well-tolerated but long-term use may be associated with a slight increase in risk of vitamin B-12 deficiency and bone fractures.
- Prescription-strength proton pump inhibitors (PPI’s): Prescription strength PPI’s are esomeprazole (Nexium), lansoprazole (Prevacid), omeprazole (Prilosec, Zegerid), pantoprazole (Protonix), rabeprazole (Aciphex) and dexlansoprazole (Dexilant). Although generally well-tolerated, these medications might cause diarrhea, headache, nausea and vitamin B-12 deficiency. Long term use of PPI’s might increase the risk of hip fracture.
- Medication to strengthen the lower esophageal sphincter: Baclofen may ease gastroesophageal reflux (GERD) by decreasing the frequency of relaxations of the lower esophageal sphincter. Side effects might include fatigue or nausea.
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