This health video is focusing on the causes and symptoms of GERD (Gastroesophageal Reflux Disease).
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What is GERD? Dr. Daniel C. DeMarco: Heartburn is very common. 40 million Americans have heartburn on a daily or weekly basis and 40 million Americans don't need to go see their doctor about it. But what a person or what should prompt a person to come see their doctor is if they are having symptoms that are really interfering with their lifestyle, keeping them awake all nights, they can't work during the day or if they have a new onset or change in their symptoms, if some must has been have an heartburn all their life is probably not a big problem or big concern. There's probably nothing new going on in their esophagus, but if someone in their 40 to 50 or 60 age range they has the sudden onset of heartburn whereas last week they didn't have it or if they are having trouble swallowing or if they are losing weight, then they should to see their doctor and get their esophagus checked out to make sure that there is not any thing wrong with their esophagus as far as growing abnormal tissue or tumor or anything like that. Rajeev Jain: GERD is Gastroesophageal Reflux Disease and it comprises two major symptoms and that one is heartburn or that burning acid sensation in the chest and the other symptom is regurgitation where you feel as if food is coming up into your chest. Daniel C. DeMarco: You feel like acid or burning fluid coming up from your stomach in to your esophagus and causing you discomfort in your chest, frequently by those people at night, frequently it's associated with excessive eating and overweight society. Also people occasionally have problems with it, coming up in the back of the throat at night and even I've heard patients say, reflux is up into their ears, which is hard to believe but it's a burning sensation in one's chest associate with acid reflux. Now reflux is simply acid coming up into the esophagus from the stomach due to a transient relaxation of a lower esophageal sphincter. When you swallow, food and secretion of saliva are propel it down through peristalsis and then the lower esophageal sphincter relaxes briefly and blood flew from the esophagus into the stomach where a digestion continues with stomach acid. What happens with reflux is there is a transient relaxation of that lower esophageal sphincter or some people think of it is a valve, but it's really just an area of increased pressure in the musculature of the lower esophagus and when it relaxes acid comes up into this esophagus. Rajeev Jain: Other symptoms also that can be attributed to heartburn include narrowing of the esophagus or peptic stricture where there's irritation subside, the esophageal lining becomes narrow. So phthisis trouble swallowing could often have complications of heartburn as well. Daniel C. DeMarco: Now there's other things that cause chest pain which we need to eliminate such as cardiac disease or other problems with the chest but GERD is primarily a diagnoses based on your symptoms. Test that we can do to look at someone to see if, it truly is acid reflux causing that disease is to measure the acid in the esophagus over the course of 24 or 48 hours, and the newest way to do this is using a technique called the Bravo technique, which involves endoscopy to look in the esophagus most of the times and then to place a little probe, a little radio telemetry capsule in the esophagus and that measures a pH over 48 hours and it's kind of clip to the inside of the esophagus and after 48 hours surely it passes out through the digestive system but during that 48 hours, it constantly transmits the esophageal pH or acid content to a recorder that the patient wears. Two days later the patients brings the recorder back and we download the information after that. We can tell, how much acid has come up over 24 hours and we can even give them a grade or a score based on that and also we correlate with their symptoms because some people can be having heartburn and not have any heartburn symptoms and not have acid coming up and to be