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I?m from a small town in the southwest corner of the Southwest. At around 6,000 feet, Silver City, New Mexico is a beautiful, mountainous, and environmentally- and culturally-rich area. It has been, and always will be, the place where I feel most at home. During my last visit, I…
7 Ways Your Health Is Like a River (And Why We Should Take Care of Both)
GERD or gastroesophageal reflux disease aka heartburn or acid reflux plagues many people on a weekly and some on a daily basis. GERD occurs when stomach acid or, occasionally, stomach content, flows back into your food pipe (esophagus). The backwash (reflux) irritates the lining of your esophagus and causes GERD.
How is GERD diagnosed?
GERD is typically diagnosed when reflux symptoms occur at least twice a week. Diagnosis of GERD may be clinical (presentation with typical symptoms, such as heartburn); physiologic (evidence of abnormal pH levels in the distal esophagus); anatomic (evidence of esophagitis on endoscopy); or functional (clinical response to antacid medications). However, the correlation between these diagnostic approaches is relatively poor. Some patients may be asymptomatic and have serious esophageal disease or deterioration.
A recent study developed a new diagnostic score, the Gerd Q, which is based on data from primary care patients with upper gastrointestinal (GI) symptoms. The study used variables from several previous symptom scores, and used focus groups to ensure that the resulting questionnaire was easy for patients to use as a self-reported instrument. The reference standard for GERD was defined as any of the following:
•Esophageal pH of less than 4 for more than 80 minutes per day
•Evidence of esophagitis on endoscopy (inflammation of the esophagus)
•Indeterminate esophageal pH in combination with a positive response to a 14-day course of a proton pump inhibitor
•A highly abnormal symptom score
•Narrowing of the esophagus (esophageal stricture). Damage to cells in the lower esophagus from acid exposure leads to formation of scar tissue. The scar tissue narrows the food pathway, causing difficulty swallowing.
•An open sore in the esophagus (esophageal ulcer). Stomach acid can severely erode tissues in the esophagus, causing an open sore to form. The esophageal ulcer may bleed, cause pain and make swallowing difficult.
•Precancerous changes to the esophagus (Barrett’s esophagus). In Barrett’s esophagus, the tissue lining the lower esophagus changes. These changes are associated with an increased risk of esophageal cancer. The risk of cancer is low, but your doctor will likely recommend regular endoscopy exams to look for early warning signs of esophageal cancer
Bell, M. Diagnosis of Gastroesophageal Reflux Disease. Am Fam Physician. 2010 May 15;81(10):1278-1280.
Mayo Foundation for Medical Education and Research. GERD. (2014). http://www.Mayoclinic.org.
When do I need to see a health practitioner about my headaches?
• When it is the “worst headache” you have ever had, go to emergency room
• When it occurs 3 times a week, even if relieved by OTC medications
• When it is not readily relieved with OTC medications, i.e. ibuprofen, Tylenol, Aleve
• When it is accompanied by nausea, vomiting, photophobia (sensitivity to lights) or phonophobia (sensitivity to sounds)
General types of headaches
• Primary –no underlying cause can be found, i.e. hereditary
o Rebound headache – caused by frequent use of short acting acute treatment
• Secondary –caused by tumor, hemorrhaging (bleeding in brain), blood pressure, other underlying cause
Treatment for headaches:
o Hydration, mainly water
o Ice pack or cool rag to forehead and/or neck
o Muscle rubs to neck, if muscle tension present (Ben-Gay, Icy Hot)
o Acute/abortive medications: OTC –naproxen (Aleve), ibuprofen (Motrin), acetaminophen (Tylenol); Rx –Triptans (sumatriptan, zolmitriptan), ergotamines (DHE)
o Prophylactic/preventative: (usually prescribed for >= 2 severe headaches per week or headaches significantly affecting quality of life)
Anti-convulsants/neuroleptics- valproic acid (Depakote), topiramate
o Anti-hypertensive –beta-blockers, calcium channel blockers
o Antidepressants –SSRIs (Effexor, Lexapro), TCA (amitriptyline)
o Anti-emetics –ondansetron (Zofran), promethazine (Phenergan)
o Opioids- usually not first line treatment, but should be reserved for rare use or for intractable migraines/status migrainous, can cause rebound headaches
Gilmore B, Michael M. Treatment of acute migraine headache. Am Fam Physician. 2011;83:271-280.
Silberstein SD, Holland S, Freitag F, et al. Evidence-based guideline update: Pharmacologic treatment for episodic migraine prevention in adults: Report of the Quality Standards Subcommittee of the American Academy of Neurology and the American Headache Society. Neurology. 2012;78:1337-1345.
Listening to music is helpful for me!
Stress is a normal physical response to events that make you feel threatened or upset your balance in some way. One common reaction is the fight or flight reaction.
The cognitive symptoms include memory lapse, inability to concentrate, poor judgment, seeing only negatively view, having anxious or racing thoughts, and constant worrying. The emotional symptoms include moodiness, irritability, agitation, overwhelmed feelings, senses of loneliness and isolation, depression or general unhappiness. Physical symptoms include aches and pains, diarrhea or constipation and a decrease in sex drive. The behavioral symptoms include eating more or less, sleeping too much or little, isolating you from others, procrastinating or neglecting responsibility, abusing alcohol, cigarettes, or drugs to relax and creating nervous habits (Feldman, 2006).
The relationship between stress and depressed mood go hand in hand because a lot of stress whether it’s a good stress or bad stress can create depression. The acts of neglecting…
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Bronchitis and asthma are both respiratory diseases that cause inflammation to the airways leading from the mouth to the lungs. These conditions usually cause the airways deep in the lungs to swell, resulting in shortness of breath and difficulty breathing. Asthma is a chronic illness that causes repeated narrowing of the airways leading to the lungs. On the other hand bronchitis can be chronic or acute and more times than not acute bronchitis last for several weeks.
Even though both diseases have some similarities, they are different and they both need different treatment strategies.
Acute bronchitis is a contamination or infection of the bronchial tubes which characterizes of cough that naturally lasts several weeks. Acute bronchitis is usually caused by bacterial and viral however, less than ten percent (10%) of bronchitis infection are caused by bacterial infection according to bronchitis-symptoms.com. After the infection has cleared the bronchial…
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