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Reflux, "Heartburn",

G.E.R.D. (GastroEsophageal Reflux Disease)

Many reports have suggested that regurgitated gastric acid damages the teeth. 
Recent evidence has strengthened the possible association of reflux and “dental erosions”.  Dental erosions involve the non-reversible loss of dental enamel by a chemical process that leaves the outer protective shell of enamel thin, cupped or even missing.  It is not like typical decay because it does not involve bacteria.  In its most severe form, dental erosion can lead to need for extensive dental work and even the loss of teeth. 
Dental erosion is the most common oral manifestation of GERD.  The prevalence of dental erosions has been reported to range between 20-55% among individuals with GERD.  Since up to 20% of GERD sufferers are not even aware that they have the problem, dental erosion often serves as a diagnostic flag which identifies the syndrome.
Other symptoms of GERD in adults include:
• Acid taste in mouth
• Persistent coughing
• Vomiting
• Sense of lump in the throat
• Stomach ache
• Sore throat
• Hoarseness of voice
• Choking spells
• Voice change
• Excess salivation
• Gastric pain on awakening
• Halitosis (bad breath)
• Belching Heartburn

Symptoms in children include:
• Difficulty sleeping
• Failure to gain weight
• Feeding problems
• General irritability
• Asthma
• Recurrent pneumonia
• Anemia
• Bronchitis Laryngitis
Gastroesophageal reflux can occur without any symptoms present, especially at night when in the horizontal position.   Various tests are available to confirm the diagnosis.  An upper GI endoscopy can visualize inflammatory changes associated with GERD.  A more thorough “Upper GI Series” test can also be used to diagnose the presence of GERD. However, the standard for confirming gastroesophageal reflux is the 24 hour pH monitoring study.
If the diagnosis is fairly certain, relief may be accomplished by altering one’s dietary habits.  Simple weight management accompanied by small frequent meals often helps.  Certain foods and drugs have been identified which may worsen GERD, including caffeine, nicotine, alcohol, estrogen, progesterone, nitrates, chocolate and high-fat foods.
Raising the head of your bed may decrease passive reflux while you sleep.  Not eating or drinking immediately before bed may also help.
Additionally, one of many effective medications used to treat GERD may be helpful.  The diagnosis and best treatment should be made by your physician.
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