Nikki Sommer, a nurse with Key West Surgical Group, joined Good Morning Keys on KeysTalk 96.9/102.5 FM for Medical Matters this morning.
Let’s talk about looking at your stomach – from the inside.
Sommer said, “An esophogastroendoscopy or an EGD or what we call an upper scope, that is when we put the camera down and look in your stomach. You’re esophagus, when you swallow food, and it goes down the tube that carries food from your mouth to your stomach, that is called your esophagus. Obviously your stomach is the organ that holds the food, and it starts the digestive process. Then your duodenum is the upper part of your small intestines. So this is how when you eat, this is how digestion begins and your body starts to break down the food.”
Who would need an EGD?
Sommer said, “Anyone who may have heartburn or what is known as acid reflux, who has failed medical management and medications and lifestyle modifications. So a lot of times people go to the doctor and they start complaining of they’ll feel acid back up into the esophagus and into their throat and a burning sensation, or sometimes a burning or a gnawing sensation in their stomach. The idea is, first you have to review the diet. Then there are certain drugs, like Pepcid, a famous one is omeprazole, Nexium, those block acid and the goal is to see if those work. You take them for a short period of time, and then if it doesn’t, we might need to have somebody go down there and look with a camera, which is the endoscopy, to see if there is something going on, if there’s a lot of irritation, if you might need medicine for a longer period of time.”
An upper endoscopy can also treat active gastrointestinal bleeding.
Sommer said, “Sometimes you’ll have people that vomit blood, or pass blood through their stool. So a lot of times, then you’ll end up needing a colonoscopy and an EGD, they can be done on the same day, by the way.
The EGD is for the upper part and the colonoscopy is for the lower part. Sometimes people can have a narrowing digestive tract.
Sommer said, “Sometimes people get a narrowing, and it needs to be dilated, so they can go down and dilate that a little bit, so the food passes easier. Sometimes people come in and they’ll have issues where they swallow and they feel like food gets stuck, and it takes a while to pass. So it could be that you have a narrowing. They call it a dilation. You just need to be dilated a little bit.”
What is GERD?
Sommer said, “GERD stands for gastroesophageal reflux disease, and that means that the acid repeatedly backs up into your esophagus, causing irritation. It can even cause irritation in your throat. Sometimes people may present with a cough and kind of a raspy voice, and everybody thinks, oh, maybe I have a cold, maybe I have some congestion, but it’s actually GERD. So a burning sensation in your chest, usually it comes after eating at night and lying down flat. So that’s the other thing is people wake up in the middle of the night because they feel that burning sensation coming up their esophagus into their throat, a backwash or if you’ve ever burped and food or sour liquid came up, that’s an indication that you might have GERD. Upper abdominal pain or chest pain. Sometimes people will think they’re having a heart attack or feel tightness in their chest and a burning sensation, and it be confused. So kind of that’s why, when you have chest pain, you got to go to the emergency room and rule out, is it GERD or are you having a heart attack? Trouble swallowing, like I mentioned before, people have trouble swallowing food, even liquids. They’ll feel like they choke or there’s something in the back of their throat that’s preventing the food or the liquid to go down, and that’s going with the sensation of a lump in your throat.”
How can GERD be treated?
Sommer said, “There’s certain medications that you might be able to keep those symptoms at bay. H2 blockers, which is Pepcid. They reduce the amount of acid in your stomach by blocking histamine. Histamine helps to make acid. Histamine is also released when you have allergies. It also helps to make acid. So you can take an h2 blocker, and that will block the acid in your stomach.”
What can cause GERD?
Sommer said, “Obesity, pregnancy, smoking, certain medications, if you don’t take them with food and you’re supposed to, they can upset your stomach, increase that acid production, an autoimmune disease known as scleroderma, and then a hiatal hernia.”
What is Helicobacter pylori?
Sommer said, “It’s a bacteria that could be living in your stomach. Nobody really knows how you get it. It could be from food, water. What it does is the bacteria that lives in your stomach, and it could cause ulcers or peptic ulcers. If you ever get somebody that has ulcer disease, they usually, or more commonly, have this bacteria in their stomach, and it can be silent for some time, where it’s there for a while, and then when you start to feel the ache of burning in your stomach, you may have pain when your stomach’s empty, you feel nauseous. Sometimes you feel nauseous just after you eat. You have bloating. You can even have unintentional weight loss. Usually, when you have those symptoms, you go and you have an EGD. Well, while they’re down there looking if there’s a lot of inflammation, a biopsy is taken and sent off to lab to see if you have this bacteria.”
What is Barrett’s esophagus?
Sommer said, “It’s damage to the lighting of your esophagus by years and years of having too much acid, and it causes, inflammation, and then it thickens. Ongoing inflammation, kind of like a callous, you could say, in your esophagus. So again, that’s frequent heartburn, that regurgitation, where you feel like food is coming up, difficulty swallowing food, chest pain is less common with this. People with Barrett’s and I have talked to people who get diagnosed with Barrett’s, and they tell me they have never, ever, ever had any symptoms of reflux, and they want to argue that they don’t need the medicine. You cannot leave it untreated. You need to take what is known as a PPI, which is called a proton pump inhibitor, and that blocks the acid in your stomach. That is your Nexium, your omeprazole, the pantoprazole, that you can get over the counter, and it’s by prescription, but to prevent the worsening of Barrett’s esophagus, it is recommended that you stay on that medication because it can lead to stomach cancer if left untreated.”
What about a hiatal hernia?
Sommer said, “It’s when your stomach bulges through the large muscles separating your abdomen in your chest, and it’ll push up into your chest. People will have all the symptoms of acid reflux, and then sometimes they’ll feel like there’s something in their chest, and they have pressure in their chest, and it’s actually from the hernia pushing up into it. A lot of people have a small hiatal hernia, and it doesn’t cause problems. It’s not something that causes a lot of problems, but it can be a problem if you’re unaware that you have it. Again, it can be controlled by taking medication.”
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