HYPERACIDITY
These days, due to undesirable eating habits and way of life, numerous individuals are fronting problems with acidity like gas. Hyperacidity is key reason for individuals that are meeting gas problems. This occurs in all types of people like in all community or all ages. The stomach is responsible for secreting a digestive juice i.e Hydrochloric Acid, that breaking down the food particles in small particles and to help assimilation. When extreme hydrochloric acid within the stomach, this state is called Hyperacidity. Moreover, it is also known as gastritis or acid reflux disease, The inflammation occurs in the lining of stomach that's triggered by infection caused by bacteria or habits, like consumption of alcohol. Gastritis may happen all of a sudden i.e acute or show up gradually over time i.e chronic and in a few serious cases may lead genuine stomach related ailments like ulcers and indeed stomach cancer.
Symptoms : Burning of Heart, Chest and Throat, acrid taste within the mouth or bitter taste, pain in chest, dry cough and asthma
Adults and children can endure from acidity at least once in their lifetimes. Individuals who devour as well much coffee, alcoholic drinks, and carbonated refreshments on an everyday basis are at chance of creating hyperacidity more frequently than regular. Taking food that are oily and spicy all the time can to upset your stomach lining and resulting in gastritis. Certain medication like ibuprofen and aspirin also increase the risk.
Hyperacidity is associated to indigestion and can be treated by OTC antacids. It is additionally suggested that you simply avoid taking certain foods which may aggravate the stomach. Your specialist may recommend other medications like h-2 receptor antagonist and proton PPIs for more serious sfferer.
GERD
Gastroesophageal reflux disease is a condition caused by reflux of gastric matter through lower esophageal sphincter into oropharynx or esophagus which causes injury to tissues of esophagus. Many people face heartburn associated with non-pathological gastric reflux once per hour due to retrograde movement of gastric matter into esophagus. While the pathologic gastric reflux shows many symptoms and pathologic changes in esophagus. Episodes of pathologic GERD are longer and more frequent and can occur in day or night. They result in mucosal damage of esophagus, inflammation and chronic injuries. GERD can be developed by conditions which complement each other which enhance the stay time of refluxed acid in esophagus to pathologic condition. Failure in esophageal acid clearance, decreased relaxation of lower esophageal sphincter, impaired resistance in tissues, delayed in gastric emptying and decreased saliva secretion are some mechanisms leads to pathologic GERD. Patients with mild GERD usually shows increased esophageal acid exposure during postprandial period. Esophageal acid exposure is increased by impaired clearance of acid, it can use to determine the severity and frequency of symptoms and extend of mucosal tissue injury.
Lower esophageal sphincter is ring of thick circular smooth muscles which causes high pressure zone of about 2-4 cm in gastroesophageal junction to prevent the interference of gastric material into esophagus. Improper function of LES leads to inability of anti-reflux barriers. Pressure of LES is increased in night time and after meal but lower in daytime. There are many substances that can decrease LES pressure includes glucagon, secretin, progesterone, theophylline, serotonin and some drugs like calcium channel blockers, barbiturates alpha adrenergic agonists, some foods and beverages also contribute in it includes chocolate, peppermint, alcohol etc. many studies show that obesity assure the causal relationship with GERD and its complications like esophagitis and esophageal adrenocarcinoma. It has shown symptoms of GERD increase in people who are obese but have normal BMI. If consider separately then abdominal obesity explains major association with GERD. Some studies revealed in Pakistan GERD is more common in urban areas. During studies of lifestyle factors related to GERD it has been shown that usual patients of GERD in Pakistan are those who have increased body weight, have habit of taking snacks in midnight and skipping breakfast, don’t exercise more than 30 mins, have inadequate sleep cycle, have supper before two hours of sleep and have smoke.
PEPTIC ULCER
the inside open sores which start to develop in the stomach lining and occurs at the small intestine on its upper portion is known as peptic ulcer.
Types:
peptic ulcers are of two types
1) gastric ulcer
2) duodenal ulcer
· Gastric ulcer:
its occurence is inside the stomach.
· Duodenal ulcer:
its occurrence is on the portion which is located at the upper side of tbe small intestine which is duodenum.
causes:
· H. pylori bacterium:
when H.pylori bacteria starts to stick in the digestive tract on the mucosal lining of stomach through which irritation or inflammation starts to occur and the lining which protect the stomach breaks down and cause ulcers because for the digestion of food our stomach contains acid and when this protective layer break down the acid will harm your stomach.
medicines:
· Medicines
like NSAIDS (ibuprofen, naproxen, aspirin) can be the reason for inflammation in the stomach lining. SSRIs and anticoagulants.
foods which are spicy can worsen the peptic ulcers.
· Tumours:
the occurrence of tumors in duodenum, pancreas or stomach which can be malignant or benign can cause peptic ulcer.
symptoms:
· heart burn
· nausea
· vomiting, blood in vomiting
· bloating
· belching
· stomach pain like burning
· loss of weight
· stools will be dark
· indigestion
Complications Of Peptic Ulcer:
· when the ulcers are not treated for a long time the situation will become worse day by day.
· bleeding internally:
if the internal bleeding starts there will be the loss of blood and also the stools with black color can worse the condition and the sign of loss of blood.
· tissue scar:
when there is any injury occurs inside the lining of stomach the thick tissue will develop which can cause difficulty in digestion of food and it can occur due to vomiting.
· perforation:
in the small intestine lining of stomach, the hole starts to develop which cause infection and the sever pain in abdominal is the sign of perforated ulcer.
· Refractory ulcer:
the ulcer which is not treated by any of the medication or the treatment is called as refractory ulcer and this ulcer cause due to some reasons
Ø there is excessively production of acid in stomach
Ø the presence bacteria, but not the H.pylori bacteria that means other than this bacteria.
Ø disease such as crohn's disease or the cancer of stomach.
How to prevent peptic ulcer:
· to avoid from infections and bacteria wash your hand properly.
· dont take alcohol and also avoid smoking.
· if there is need to take NSAIDS than limit these medications and instead of this you can take acetaminophen. and if you are taking NSAID than take the medicine which can lowers the acid amount in stomach such as PPIs and H2 blockers.
· drink clean water and east cooked food.
· manage your stress because high level of stress can worse peptic ulcers.
· avoid spicy foods and maintain a healty diet and add fruits and vegetables in your diet.
Diagnostic test for peptic ulcer:
· endoscopy upper
· upper GI series
TREATMENT
PROTON PUMP INHIBITORS
PPI’s used to cure symptoms of gastroesophageal reflux disease (GERD) or acid reflux to reduce acidity or acid secretion in stomach. In this condition food or liquid moves up from the stomach to the esophagus. It is used in the treatment of gastric or duodenal ulcer. They are commonly available as capsules or tablets and taken 30 minutes before the first meal of the day.
Types of PPIS
· Lansoprazole
· Esomeprazole
· Omeprazole
· Pantoprazole
· Rabeprazole
The main goals of antacids are:
Alleviating pain sensations
Relieving pylorospasms
Avoiding corrosion by highly acidic chime.
METHODS & MATERIALS:
The questionnaire was developed by a group of Pharmacy students, who had especial knowledge about the management diagnosis and treatment of Hyperacidity. The questions were designed to identify the sensations & symptoms experienced by the patients. We used the software of Microsoft to develop the questionnaire. The subjects were specifically above 13 so that a specific age scale could be maintained. Occurrence to factors that are known to provoke hyperacidity, for example: meals, lifting, spicy food, taking any drug was taking into considerance. For each sensation response was assessed over a scale of positive, negative or neutral . On the basis of pathophysiology and significance for GERD more focus was placed over the predominance of the disease. The provocative factors were given negative values over a score assessed through the bar chart. The results were based over the statistical analysis through the score stated in the bar chart.
TESTING QUESTIONNAIRE:
Questions designed were built on the study of several articles. The first section of questionnaire was based on the symptoms occurring by meals or any other factor. The occurrence of the heart burn, acid regurgitation, degree of pain etc. Also how did the subject got it relieved weatherly antacids or any other remedy. The questions ahead were the branch of the previous questions as the next question was linked with the previous one, designed to assess the influence of hyperacidity on the scale from highest to lowest. Other questions were also designed to assess the comorbidities faced by the patient to assess the high specificity reasoning for the occurrence of hyperacidity. For better assessment & feasibility questions were also designed according to the treatment usually subject take for the treatment weather is it a natural remedy, a medication, or nothing at all. Statistical analysis was calculated so that the results could be summarised accordingly & reliability of each question could be maintained.
RESULT:
In total, 46 people participated in a 2 day study survey for hyperacidity. Among which most were students ages were between 18-25 who basically knew what hyperacidity was. 65.2% correctly described the symptoms while other mixed up the symptoms with other gastrointestinal diseases or chest pain. 32.8% suffered hyperacidity with no specific time while 30.4% suffered with hyperacidity after the intake of food, which 51% took aspirin to relieve or in consideration with natural remedies mostly took cold milk, concluding that hyperacidity is a disease which should be given proper attention.
DISCUSSION:
Hence, in this study we addressed various aspects of hyperacidity. We provided a series of questions related to self/ natural diagnosis and remedies, symptoms, and treatment for patients with hyperacidity, founded on the responses to a questionnaire-based survey we concluded that more than half population don’t visit physician when suffering from hyperacidity rather self-medicate or use natural remedies. Majority knew what hyperacidity was and didn’t give serious attention towards the disease. Most of them labelled it as a disease but not a severe one which could be relived just by aspirin or even cold milk (acc to responses).
These days, due to undesirable eating habits and way of life, many individuals are fronting issues with acidity. Hyperacidity is main reason for individuals are meeting gas problems. Hyperacidity is also acknowledged as gastritis or acid reflux which is the inflammation of the linning of stomach that is generally caused by bacterial infection or different habits such as consumption of alcohol or even stress. Eating a hefty meal and even back lying or bending from the waist. Eating at the time of bed or snacking certain foods, such as chocolates, citrus, garlic, tomato, mint, onions, or spicy or fatty foods. Drinking beverages like alcohol, carbonated drinks, coffee, or tea may cause hyperacidity. A popular treatment approach for gastric hyperacidity is the use of proton-pump inhibitors.
for making symptoms easier:
Avoid going to bed with a full stomach. Eat your meals as a minimum 2 to 3 hours before lying down. Avoid overeating. Eat lesser portions at suppertimes, or try to eat four to five small meals in its place of three big meals. Eat calmly and slowly. Take your time to eat. Reduce triggers of heartburn.
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