from Bellarmine University''s are more likely to have symptoms of GERD and should have diagnostic tests performed to rule out more severe conditions or diagnose GERD. It is typical for patients with GERD to have multiple risk factors. Some of the factors that predispose patients to pathologic reflux are: 
for 1 last update 29 May 2020 MedicationsMedications
Medications used to treat symptoms of GERD include: Antacids, Histamine 2 Receptor Blockers, and Proton Pump Inhibitors. Indefinite treatment with proton-pump inhibitors or H2-blockers as needed to maintain symptom control.There are risks associated with long term use of proton-pump inhibitors.
- Neutralizes the acid
- Does not reduce it (same amount of acid is produced)
- Available over the counter, do not require a prescription
- Includes Mylanta, Maalox, Tums, Rolaids
Histamine-2 Receptor Blockers
- Reduce stomach acid produced by the stomach
- Some are sold over the counter
- Over the Counter H2 Blockers: Pepcid, Zantac, Tagamet, and Axid
Proton Pump Inihibitors
- Most potent acid-suppressing agent
- Stops acid from forming, instead of neutralizing it
- Some PPI''s can mask more serious conditions in the esophagus and stomach
- Over the counter PPI''s requiring a prescription: Prevacid, Protonix, Nexium (esomperalzole), and Aciphex
Heartburn Remedies Treatments (👍 11 Foods That Cause) | Heartburn Remedies Soothe The Painhow to Heartburn Remedies for for 1 last update 29 May 2020 People taking the above listed medications should report to the doctor if they have complaints of headache, constipation, diarrhoea, abdominal pain, or dizziness.
It is essential for the physical therapist to take note of the patient''s esophagus. Commonly used diagnostic tests used to diagnose GERD are discussed below.
A procedure where a small camera is placed at the end of flexible tube; the tube is inserted into the mouth and down the throat and examines the lining of the esophagus, stomach and upper duodenum
This is a special type of imaging that requires the patient to drink barium before undergoing an x-ray. This produces clear images of the upper digestive tract.
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This procedure involves a thin tube being inserted into the esophagus, through the mouth, to measure acid levels and the pH
Esophageal for 1 last update 29 May 2020 Manometry Esophageal Manometry
This procedure requires a thin tube to be inserted into the esophagus, through the mouth or nose, to measure the 1 last update 29 May 2020 the pressure of the esophagusThis procedure requires a thin tube to be inserted into the esophagus, through the mouth or nose, to measure the pressure of the esophagus
The lower esophageal sphincter (LES) is a ring of muscle fibers that functions to close the opening between the esophagus and the stomach. When the LES is not functioning properly, the stomach contents (food, liquid, and stomach acid) can move backward into the esophagus causing damage to the esophagus. The backward flow of food from the stomach into the esphophagus is called reflux. 
- Lower Esophageal Sphincter (LES) Dysfunction
Some of the medications that can cause GERD or make it worse are:
- Nonsteroidal anti-inflammatory drugs (NSAID''s esophagus and is linked to esophageal adenocarcinoma. Barrett''s, recently not as common due to poor outcomes and patient dissatisfaction. Some associated risks are:
- Severe dysphagia
- Inability to belch
- Increased flatulence
- Abdominal pain
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Patients with GERD occasionally present to the clinic with atypical head and neck symptoms without complaints of heartburn. It is important for the Physical Therapist to be aware of pain referral patterns for the esophagus. With an atypical presentation, the Physical Therapist may need to ask if the patient has a history of difficulty swallowing, difficulty speaking, chronic dry cough, etc.
Heartburn Remedies Naturally Treat (🔥 Home Remedies For) | Heartburn Remedies Treatment Forhow to Heartburn Remedies for There are also those patients who attend physiotherapy for other conditions, but have a history of GERD. In this case the Physical Therapist has to be aware of positioning and education on lifestyle modifications if necessary. When treating a patient with GERD:
- Assist the patient in implementing changes related to the diet and exercise
- Educate and encourage the patient on lifestyle modifications
- Educate on Positioning:
- Supine interventions should be avoided after meal
- Encourage the patient to sleep on the left side
- Right side lying allows the acid to flow into the esophagus more easily
- Head up positions minimize reflux and reduce intraabdominal pressur
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Research has found that performing the Shaker exercise, developed by Dr.Reza Shaker (a gastroenterologist at the Medical College of Wisconsin), can help improve pharyngeal swallowing and dysphagia. It is designed for patients who do not have cervical disc disease, but have dysphagia. The benefits of this technique are:
- Used to strengthen the muscles of the Upper Esophageal Sphincter (UES)
- Used with dysphagia, hiatal hernia, and GERD
- Helps restore normal swallowing
- Helps keep stomach contents from being aspirated into the lungs
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The patient should lie in the supine position on firm, flat surface, without a pillow and arms resting by their sides. They should be instructed to breathe slow and steady throughout the exercise.
- Lift Head (to look at the toes) and Hold
- Lift head to look at toes
- Shoulders should be kept flat on the surface it is only the head that lifts up.
- Hold for 1 minute then the head returns to the starting position.
- Repeat 2 more times, relaxing for 1 minute between each repetition.
- Head Lift and Lower
- Lift head up to look toward the chin and then put return to the start position. (It resembles a sit up but with the head).
- Repeat 30 times.
Changing eating habits and lifestyle along with avoiding foods that may trigger symptoms can help decrease the symptoms of GERD. 
Heartburn Remedies 7 Foods That Cause (🔥 11 Foods That Cause) | Heartburn Remedies Cause Acid Refluxhow to Heartburn Remedies for There are several foods and beverages that are linked to causing symptoms of GERD (i.e. heartburn) and linked to making the symptoms worse. Physicians suggest people with GERD should avoid these foods along with other foods or activities that have been linked to causing symptoms in the specific individual. Foods and beverages known to cause an increase in symptoms:
Lifestyle and eating habit changes that can help decrease the onset of heartburn and other GERD symptoms:
- Carbonated beverages
- Citrus fruits and beverages
- Tomatoes and tomato sauce
- Spicy or fatty foods
- Full-fat dairy products
- Peppermint flavors and tobacco can decrease saliva production. Greater saliva production helps soothe the esophagus by washing the stomach contents back down to the stomach. 
- Do not smoke
- Do not lie down 2-3 hours after a meal, especially lying flat
- Avoid clothes or belts that fit tightly around the bra line or waist
- Avoid bending over or exercising immediately after a meal
- Eat smaller meals
- Reduce stress
- Elevate the head of the bed about 6 inches with a wedge or by tilting the entire bed, do not use extra pillows to raise your head
- Weight loss may help decrease symptoms, if the individual is overweight.
- Chewing sugar less gum after meals can help promote saliva production and neutralize acid
- Keep a food diary to record foods that trigger GERD and avoid those foods
- Coronary artery disease
- Gallbladder disease
- Gastric or esophageal cancer
- Peptic ulcer disease
- Esophageal motility disorders
- Eosinophilic, infectious, or pill esophagitis
Case Reports/ Case Studies
for 1 last update 29 May 2020 ReferencesReferences
- ↑ 1.0 1.1 1.2 1.3 1.4 1.5 1.6 1.7 1.8 Goodman CC, Fuller KS. Pathology: Implications for the Physical Therapist. 3rd ed. St. Louis: Saunders Elsevier; 2009.
- ↑ 2.0 2.1 2.2 2.3 2.4 2.5 2.6↑ 2.0 2.1 2.2 2.3 2.4 2.5 2.6 Goodman, Snyder. Differential Diagnosis for Physical Therapists: Screening for Referral. 4th Ed. Philadelphia: WB Saunders; 2003.
- ↑ 3.0 3.1 3.2 3.3 3.4 3.5 National Center for Biotechnology Information, U.S. National Library of Medicine. Gastroesophageal reflux disease. http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0001311/ (accessed 17 March 2011).
- Heartburn Remedies Remedy Relief (🔴 Solutions) | Heartburn Remedies Heartburn Home Remedieshow to Heartburn Remedies for ↑ 4.0 4.1 4.2 4.3 4.4 4.5 4.6 Heartburn Remedies The Discomfort (🔥 9 Ways To Relieve) | Heartburn Remedies Home Remedies Forhow to Heartburn Remedies for Kahrilas, P.J. Gastroesophageal Reflux Disease. The New England Journal of Medicine.[serial on the Internet. (2006, Oct), [cited April 21, 2011]; 359(16): 1700-1707. Available from: PubMed.]
- ↑ 5.0 5.1 5.2 5.3 Medical College of Wisconsin. Gastroenterology & Hepatology. http://www.mcw.edu/gastrohep.htm (accessed 21 April 2011).
- ↑ HealthGuru. Understanding GERD (GERD #1). http://www.youtube.com/watch?v=o8iShP84HP4&feature=youtu.be. Accessed on April 20, 2011.
- ↑ Mayoclinic. Heartburn, Acid Reflux, GERD-Mayo Clinic. http://www.youtube.com/watch?v=TdK0jRFpWPQ&feature=youtu.be. Accessed on April 20, 2011.
- Heartburn Remedies 9 Natural Remedies (🔴 11 Foods That Help) | Heartburn Remedies Diet Forhow to Heartburn Remedies for ↑ 8.0 8.1 Bor S., Kitapciogle G., Solak Z.A., et al. Prevalence of gastroesophageal reflux disease in patients with asthma and chronic obstructive pulmonary disease. JGHF [serial on the Internet. (2009), [cited April 21, 2011]; 25: 309-313. Available from: PubMed.]
- ↑ National Center for Biotechnology Information, U.S. National Library of Medicine. EGD - esophagogastroduodenoscopy. http://www.nlm.nih.gov/medlineplus/ency/article/003888.htm (accessed 19 April 2011).
- Heartburn Remedies Home Remedy (☑ Causes) | Heartburn Remedies Best Home Remedieshow to Heartburn Remedies for ↑↑ Harvard Health Publications. Harvard Medical School. Barium Swallow (Upper Gastrointestinal Series or ""). http://www.health.harvard.edu/diagnostic-tests/barium-swallow.htm (accessed 21 April 2011).
- ↑ 11.0 11.1 Dena A. Ali, D.D.S., Ronald S. Brown, D.D.S., M.S., Luciano O. Rodriguez, D.D.S., et al. Dental erosion caused by silent gastroesophageal reflux disease. JADA [serial on the Internet. (2002 June), [cited March 31, 2011]; 133(6): 734–737. Available from: PubMed.]
- ↑ Böcskei C, Viczián M, Böcskei R, Horváth I. The influence of gastroesophageal reflux disease and its treatment on asthmatic cough. Lung. [serial on the Internet. (2005 Jan-Feb), [cited April 21, 2011]; 183(1): 53–62. Available from: PubMed.]
- ↑ Veugelers PJ, Porter GA, Guernsey DL, Casson AG. Obesity and lifestyle risk factors for gastroesophageal reflux disease, Barrett esophagus and esophageal adenocarcinoma.Diseases of the Esophagus.[serial on the Internet. (2006), [cited April 21, 2011]; 19(5): 321–328. Available from: PubMed.]
- ↑ Mayoclinic. Anti-reflux Surgery, Fundoplication-Mayo Clinic . http://www.youtube.com/watch?v=X840-6PyO4c&feature=youtu.be. Accessed on April 20, 2011.
- ↑ Padwal T, Gurudut P, Hajare S. Effect of shakers exercise with kinesio taping in subjects with gastroesophageal reflux disease: A randomized controlled trial. International Journal of Medical Research & Health Sciences. 2018;5(10):170-8.
- ↑ Stevens L. Chronic gastroesophageal reflux disease and its effect on laryngeal visualization and intubation: a case report. AANA Journal [serial on the Internet. (2002, Oct), [cited March 17, 2011]; 70(5): 373-375. Available from: MEDLINE.]
- ↑ Logemann, JA, Rademaker, A, Pauloski, BR, et al. A Randomized Study Comparing the Shaker Exercise with Traditional Therapy: A Preliminary Study. Dysphagia. [serial on the Internet. (2009 December), [cited March 31, 2011]; 24(4): 403–411. Available from: PubMed.]