Gatroesophageal Reflux Disease

My thesis: A digestive system disorder known as Gastroesophageal reflux disease, which is also known as GERD, acid reflux, or acid regurgitation, is a dental health risk. Briefly on digestive systems- The system comprises organ that partake in the ingestion of food, mastication of food and its digestion. It involves system of nutrients absorption and defecation of undigested food particles. The parts are upper gastrointestinal tract and the lower gastrointestinal portion. The tract or gut has primitive development form the foregut, midgut and the hindgut of a developing embryo.

While the upper tract constitute the mouth part, the slightly dilated pharynx , the narrow esophagus and a large chamber called stomach, the mouth contains the buccal cavity that partake in the digestion of carbohydrate through the presence of salivary glands openings, it also has the tongue and the tooth. Peristaltic movement occurring in the upper gastrointestinal tract also takes place in the lower gastrointestinal tract. This is the process of spasmodic contraction of the muscle lining the digestive tract in order to propel food direction down the tract spanning through the chest and transverse or pierce the diaphragm (central portion).

The lower gastrointestinal tract comprises the small and large bowel. The small intestine is composed of duodenum, the jejunum and the ileum while the large bowel has the cecum, the colon and the rectum. Each of these parts is equally subdivided. Description of anatomy of the digestive system is incomplete without mentioning accessory organs of digestion that pour their contents into the alimentary canal. These are the liver or hepatic organ, the gall bladder and the pancreas. The liver secretes bile products that assist in the digestion of fatty content of the food. The secretion pours into the first part of the duodenum.

The secretion responds to the presence of food content in the small intestine on exiting the stomach. In addition to the concentration of bile, gall bladder is functionless. The pancreas, an accessory part of the digestive system functions in the secretion of bicarbonate fluids and several digestive enzymes that digest protein, fat and carbohydrate. Gastrooesophageal Reflux Diseases (GERD) Gastroesophageal reflux disease (GERD), is also known as acid reflux, is a disease that happens when there is irritation of the esophagus. The normal body physiologic response to this irritation is inflammation.

The resulting inflammation is complicated by the presence of hydrochloric acid moving abnormally upwards into the esophagus by foaming action and full gastric content among others. The esophagus lies close to the heart thereby producing a radiating sensation usually termed as “heartburn”. This sensation describes a burning pain on the anterior of the chest wall occurring during the experience of gastroesophageal reflux disease. About 40% of healthy living Americans has been reported to suffer this disease in a life time. The incidence increased with age above forty years. There is no known sex prevalence.

But women of productive age group shows slight high tendency of this disease own to the additional risk prone to during pregnancy. The pregnancy has an upward push causing pressurized compression on the gastro. The mechanism of reflux is traced to the resistance of the parietal cells of the stomach to acid secretions by its oxyntic cells through the compensatory release of abundant mucous fluid. When this acid is pushed to the esophagus, the absence of such compensatory mechanism of neutralization by the mucous secretions causes the irritation and inflammation results which is characterized by pain.

Furthermore, the ring of the lower esophageal sphincter that normally prevents the upward flows of the acid contributes to how acidic content gain entrance to the esophagus. The presence of normal sphincteric relaxation when ingesting meal opens the esophageal channel to upward sucking of hydrochloric acid. It is also confirmed that spontaneous opening or incomplete closure resulting from abnormal loss of tonicity also causes the leakage of acidic gastric content.

The etiology of GERD has been linked to excessive alcohol intake, cigarettes smoking, bad posture while eating, sitting or resting, and obesity with body mass index above 30kg/square meter. More so, fatty diet, excess eating before bed time, regular caffeine intake and other acidic food ingestion such as spicy foods and pepper are also etiologic agent of GERD (Barham, 1995). Symptoms of GERD Dentists are often the first health care professionals who notice a potential reflux problem in a patient with erosion of facial, occlusal, and lingual surfaces of the teeth.

Besides the most prevailing heartburn in affected individuals, adults give history of regurgitation, difficulty in swallowing, pain in swallowing, chest pain, excessive salivation, nausea and vomiting. In the presence of long standing GERD, injurious findings are; necrosis of gastro-esophageal region, esophageal stenosis caused by the inflammation, transformation of the normal esophageal squamous epithelium to columnar variety and lastly is the presence of adenocarcinoma (very rare).

On rare occasions are the findings of laryngitis, haematemesis, prolong cough and symptoms similar to asthmatic attack. In children and infants with GERD, presentation occurs lately with slight difference to that of adult above. The symptoms include episodic vomiting, effortless regurgitation, cough, and few respiratory associated symptoms. They also cry helplessly, evidence of weight loss, loss of appetite, belching, and present with disgusting breath odour. There is moment of what is called “spitting up” in children within the first 5 months of live.

Here, they show problems associated with reflux. Prevalence of “spitting up” accounts for about 40% of babies in United States annually. Majority of them get over this symptom about the age of 12 months. The tender and underdeveloped digestive tract usually results in the condition. Diagnosing GERD After a compulsory patient clerking, important investigations used are; Barium swallow, X-ray imaging, Esophageal Manometry, documentation of esophageal pH status, and esophagogastroduodenoscopy and biopsy to rule out Barrett’s esophagus and tumor growth.

Fisichella (2008) defined the Gastroesophageal reflux disease – commonly referred to as GERD or acid reflux – as a normal physiological occurrence experienced occasionally by most people, usually after eating. For a more intensive understanding of GERD, Marks (2009) explained …

•Aluminum-containing antacids oIndications: oTherapeutic effect: oAction: oAdverse effects: oRoute of administration: oPt education: •H2 Antagonist oIndications: GERD, peptic ulcer disease, erosive esophagitis oTherapeutic effect: oAction: Block H2 receptor oAdverse effects: oRoute of administration: oPt education: •Bismuth subsalicylate oIndications: Diarrhea, heartburn, …

oIndications: Diarrhea, heartburn, indigestion, upset stomach oTherapeutic effect: Antacid and anti dirrhea oAction: Coat the walls of the GI tract. Bind the causative bacteria or toxin to their adsorbent surface for elimination from the body through the stool. oAdverse effects: …

Marks (2009) said that there are actually certain conditions vulnerable to having GERD. He said that one example is the situation of pregnant women who, apparently, have elevated hormone levels which may cause a reflux, not to mention the growing …

According to Hayden (2006), PPIs can suppress over 90 percent of stomach acid production. She added that when the dose is adjusted correctly, these drugs become very effective in eliminating symptoms of GERD – even becoming more effective than H2 …

Gastroesophageal reflux disease, also known as GERD, is gastroesophageal reflux through the lower esophageal sphincter (LES) into the esophagus or oropharynx that produces symptoms, injury to esophageal tissue, or both. The stomach continuously produces hydrochloric acid that helps in digesting …

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