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Editorial

Around Our Town...To Your Health


More Than Just HEARTBURN


07/01/2005 - The decision to ignore that chronic heartburn can be a dangerous one. Fortunately, Wyoming Medical Center has an upgraded service that can help.

It's a pain that many Wyoming residents ignore. The slight burn in the chest comes and goes throughout the day, often rising up after lunch or dinner. Simple heart burn, they say. There's not much that can be done. Yet left untreated, the pain could develop into something far more dangerous. "We only see about eight patients a month," said Wyoming Medical Center GI Coordinator Mary Ann Gracey. "We really should be seeing many, many more."

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Wyoming Medical Center recently upgraded its state-of-the-art diagnostic tools that it uses for people who have trouble swallowing. Esophageal manometry is a test that measures pressure within the esophagus to determine if a swallowing problem is due to improperly working muscles in the esophagus, said Gracey.

During manometry, a tiny, pressure-sensitive tube is inserted through the patient's nose and into the esophagus. Once there, it measures the effects of muscle contractions as the patient swallows.

"When a person swallows, the muscles in your esophagus normally contract and relax in rolling waves," Gracey said. "This is called peristalsis, which propels food and liquids toward your stomach."

When working properly, the muscular valves at the top and bottom of the esophagus open to let food and liquids in. Then, they close to keep stomach acid from backing up into your esophagus. When these muscles don't work properly, the person can suffer various health ailments, the most common of which is heartburn. Caused when stomach acid flows upward into the esophagus, heartburn is a common health ailment that impacts approximately 10 percent of American adults each day. Often, people experience it as a burning sensation or pain behind the breastbone. Left untreated, some people will suffer tissue damage in the lower esophagus, which can result in various complications such as chronic bleeding and anemia.

A condition called Barrett's esophagus can occur when reflux irritates the lower esophagus over a long period of time. In this case, the stomach lining actually grows into the esophagus, which in a few rare cases has increased the risk of cancer.

Finally lung problems may develop when reflux results in stomach fluid trickling into the breathing tubes. Usually, this occurs at night when a patient is lying down, leading to wheezing, bronchitis, and even pneumonia. "The test is ordered by a physician for people who are not only having trouble with swallowing," Gracey said, "but also might be suffering such symptoms as heartburn and esophageal spasms. The test itself is painless and usually takes less than one hour." The new upgrades in February provide even greater detail about the problem. For example, with newer probes, physicians can determine how many times the patient is refluxing in a 24-hour period and how much acid is coming up each time. Gracey and Sherry Woodworth, RN, were both trained this winter on the new equipment.

Controlling Heartburn

The most common treatment for acid reflux is the use of antacids, though there are some medicines that doctors can prescribe to effectively reduce and even eliminate the secretion of stomach acid. In rare cases, surgery is prescribed. Occasional sufferers of heartburn might consider some of these steps to reduce the amount of reflux in their lives:

- Eat smaller and more frequent meals.

- Do not lie down immediately after eating, and avoid eating for several hours before going to bed.

- Lots of bending, lifting, abdominal exercises, girdles, and tight belts all increase abdominal pressure and provoke reflux.

- Lose weight. Being overweight promotes reflux.

- Stop using all tobacco; nicotine weakens the esophagus muscles.

- Avoid fatty foods, alcohol, coffee, chocolate and peppermint.

- Elevate the head of the bed eight to 10 inches so gravity keeps stomach juices out of the esophagus while the patient sleeps.

Certain prescription or over-the-counter medications can weaken the esophagus muscles or aggravate reflux. Review all medications you are taking with your physician.

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