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Heartburn| Is it a heart related disease?

Heartburn| Is it a heart related disease?

Heartburn: Is is a heart related disease?

Health experts from US Preventive Services Task Force released a guideline indicating that a low-dose of aspirin can help people in their 50s to reduce the risk of heart-related diseases.

The updated set of recommendations aim to add new information on the use of aspirin for preventive measures against certain types of heart diseases and cancer. The last published recommendation by the task force was released in 2009. It detailed that low-aspirin can help men aged 45 to 79 and aged 55 to 79 for women.

“In this recommendation, we try to provide additional guidance about who is most likely to achieve benefits from aspirin. We think for people taking aspirin to prevent cardiovascular disease, there is an additional benefit for colorectal cancer protection. We’re not recommending you take aspirin for colorectal cancer if you’re not at high risk for cardiovascular disease,” explained Dr. Doug Owens, a member of the task force and a professor of medicine at Stanford University.

Heart-related diseases include high blood pressure and high cholesterol. But what about heartburn?

Is heartburn a heart-related disease?

Heartburn is a burning sensation around the lower chest. It occurs due to acidic digestive juices that are washed back into the esophagus. Common causes of heartburn include bad eating habits such as overeating, hurried eating, not chewing the food well; excessive intake of oily foods, spicy foods, citrus fruits, chocolates, mints, and tomato products; smoking; being overweight; alcohol, coffee, and tea intake; tight clothing around the abdomen; lying down, bending over, squatting, and carrying heavy objects right after eating; weakened muscle that controls the opening of the lower end of the esophagus; and even pregnancy.

Common heartburn symptoms include burning sensation in the upper abdomen that moves up into the chest and sometimes up to the throat, belching, bitter or sour taste in the mouth, wheezing or choking sensation when asleep, discolored teeth, and chronic cough. It is important to pinpoint the cause of the symptoms because these symptoms can also be associated with heart and gastrointestinal problems.

There is no cure for heartburn but actions can be taken to alleviate the condition and lessen the risk. You may take antacids, but do take note that antacids can have side effects. You may also improve eating habits and reduce intake of foods that causes heartburn such as chocolates, oily foods, spicy foods, mints, tomato products, among others. Reducing weight and living an active lifestyle is also recommended. Quit smoking and learn how to manage stress properly. Avoid wearing tight clothing that squeezes the abdomen. Avoid lying or bending down immediately after eating. Lastly, elevate your upper body when sleeping.

If the condition still grows worse, it is best to consult your doctor.

Adrenal Glands

Adrenal Gland Functions

The Adrenal Glands sit above  our kidneys  and are responsible for some very complicated processes in our body. They contain cells that secrete a variety of hormones that participate in the auto regulation of many functions in our body.  Adrenal hormones and by products control our blood pressure, sex hormones, stress hormones,how we metabolize sugars and help control how our circadian rhythms work. The substances that are manufactured and releases by these glands are involved in much of what keeps us alive and makes us who we we are. When abnormalities or tumors affect these glands they can have profound effects on how we feel and function.  Fortunately we have two glands and if one has to be removed for various reasons the second is more than capable of handling all the duties.

Adrenal Gland Surgery

Adrenal surgery is complicated and requires a significant amount  of  surgical experience to minimize risks and to  provide the best outcomes.  These glands can be removed by either traditional open surgery or laparoscopic surgery.  The benefit of laparoscopic adrenalectomy is that it can accomplish all the goals of open surgery with the benefit of decreased pain and a reduced recovery time in experienced hands.

There are various reasons why a patient will need their an adrenal gland removed.  Sometimes the gland is secreting too much of a hormone  and it is creating problems for the patient with respect to metabolism, blood pressure or sexual function.  There may be a mass or adenoma that is hyper-functional or worrisome for malignancy.  Every case is unique and requires special management and coordination between the surgeon, the endocrinologist and the anesthesia staff.

Dr. Gillian is experienced in this type of surgery and would be happy to review your particular case with you or your doctor.

GERD| Study finds LINX should be first line of therapy

GERD| Study finds LINX should be first line of therapy

Torax Medical announced completion of a landmark study confirming the long-term results of the LINX® Reflux Management System in controlling reflux-related symptoms and eliminating dependence on acid suppression medications called proton pump inhibitors (PPIs). Findings from the clinical study demonstrated that the LINX procedure normalized the amount of acid in the esophagus, while safely and effectively relieving heartburn and regurgitation, and improving quality of life without the need for PPIs. The LINX device was approved by the FDA in early 2012 and is currently the only medical device approved by the FDA to be safe and effective for the treatment of gastro-esophageal reflux disease (GERD). Authors of the clinical study, published this week in a leading medical journal; [Clinical Gastroenterology and Hepatology (] concluded LINX should now be considered a first-line anti-reflux therapy for appropriate patients.

All patients included in the LINX study had pathologic levels of acid in their esophagus, had compromised quality of life from their reflux disease and were refractory to continuous PPI therapy (median duration of treatment with PPIs was 5 years). The study’s efficacy endpoints for success at 5 years, restored quality of life and reduced PPI dependence, were both met.

Robert Ganz, MD, FASGE, Chief of Gastroenterology, Abbott Northwestern Hospital and Associate Professor of Medicine, University of Minnesota commented, “This study demonstrates the LINX procedure provides significant and durable improvement in heartburn, regurgitation, PPI independence and quality of life. Patients can now have a relatively simple procedure to restore their sphincter function and avoid the invasiveness required in fundoplication procedures. In my view, LINX represents the next generation of anti-reflux treatment.”

GERD| After 5 years…

85 percent of patients were free from daily dependence on PPIs
Bothersome heartburn was reduced to 11.9% from 89% at baseline
Bothersome regurgitation was reduced to 1.2% from 57% at baseline
Because medications are less effective at managing regurgitation, the near elimination of regurgitation in this clinical study after LINX represents an extraordinary benefit for patients with this life-altering symptom. Importantly, no new safety risks emerged during the 5-year follow-up period. If needed, the device can be removed and the rates for reoperation were less than the expected range for other anti-reflux procedures at 5 years. Overall, patients in this clinical study achieved significant clinical benefits from the LINX procedure; these benefits are now shown to be sustained at 5 years.

GERD|The Disease

Gastro-esophageal Reflux Disease (GERD) is a chronic, often progressive disease resulting from a weak lower esophageal sphincter that allows harmful gastric fluid to reflux into the esophagus, resulting in both pain and injury to the esophageal lining. Symptoms of GERD include heartburn and regurgitation, often associated with chronic sleep disruption, and may also include persistent cough, excessive throat clearing, hoarseness and a feeling of a “lump” in the throat. Acid reflux medications, such as Prevacid®, Nexium®, and Prilosec®, affect gastric acid production, but do not repair the sphincter defect, allowing continued reflux. The FDA has issued a series of statements on possible side effects of long-term PPI use including: possible fracture risk, low magnesium levels, and clostridium difficile-associated diarrhea. More recently, a study out of Stanford University published in the journal PLOS ONE showed PPI use may increase the risk of heart attack.1 Anti-reflux surgery called Nissen fundoplication reconstructs a new reflux barrier using a portion of the patient’s stomach which is wrapped around the lower portion of the esophagus. GERD is associated with a pre-cancerous condition known as Barrett’s esophagus, which increases the risk of esophageal cancer.

GERD|The LINX Reflux Management System

LINX is a small implant comprised of interlinked titanium beads with magnetic cores. The magnetic attraction between the beads augments the existing esophageal sphincter’s barrier function to prevent reflux. The device is implanted using a standard minimally invasive laparoscopic procedure and is an alternative to the more anatomically disruptive fundoplication, commonly used in surgical anti-reflux procedures. The LINX Reflux Management System is indicated for those patients diagnosed with GERD as defined by abnormal pH testing, and who continue to have chronic GERD symptoms despite maximum medical therapy for the treatment of reflux.

LINX does require a surgical procedure and is associated with potential risks, contraindications and life style modifications. For more information on LINX, including a statement of risks, please visit