Histamine 2 receptor antagonists (H2RA) decrease the acid production in the stomach by blocking the histamine 2 receptor. Common H2RA are cimetidine (Tagamet), famotidine (Pepcid) and ranitidine (Zantac).
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Proton pump inhibitors (PPI) block the acid production more profoundly than the H2RA. Common PPI are omeprazole (Losec), esomeprazole (Nexium), pantoprazole (Pantaloc), lanzoprazole (Prevacid), rabeprazole (Pariet) and dexlanoprazole (Dexilant)
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A hiatal hernia occurs when part of the stomach pushes up into the chest above the diaphragm through a loosening of the diaphragm opening. This also causes a breakdown in the defence against reflux.
A person with a hiatal hernia will often complain of heartburn and regurgitation. Since food may sit in the hernia before it passes into the rest of the stomach, they may feel full more quickly. |
Should I be checked with a gastroscopy?Most patients have simple acid reflux that is easily treated with medications or lifestyle changes. Since there is no worry of complications there is no need to investigate. However, the following groups of people should have a gastroscopy.
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1. Patients over the age of 50 with new onset heartburn 2. Patients over the age of 40 with at least a 5 years of regular acid reflux (to assess for Barrett's esophagus) 3. Patients not adequately treated with PPI twice daily 4. Patients with any alarming symptom such as swallowing difficulties, blood loss, weight loss, vomiting or anemia |
It can unfortunately but it is rare. The cancer related to acid reflux is called esophageal adenocarcinoma.
Acid damage to the esophagus over a period of many years can cause the lining of the esophagus to change. This lining change is called Barrett's esophagus. This is the first step that is present before cancer develops. Barrett's esophagus is detected by performing a gastroscopy. People with Barrett's esophagus are then screened every 3 years for further cell changes called dysplasia that may increase the risk for cancer further. |
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