Upper Digestive Disorders
Upper Digestive Anatomy
A long muscular tube in the chest area that connects the mouth to the stomach.
Lower esophageal sphincter: A muscle at the end of the esophagus which controls the opening into the stomach.
Muscular partition separating the abdominal cavity from the chest cavity.
A muscle at the end of the stomach which controls the opening into the intestine.
The first part of the small intestine attached to the stomach. Neutralization of stomach acid occurs in the duodenum.
Upper Digestive Disorders
Gastroesophageal Reflux Disease (GERD): The flowing back (or reflux) of the acid that helps you digest your food from the stomach into the esophagus. The acid irritates the esophagus producing heartburn (a pain that travels upward from the stomach) and occasionally a bitter taste in the mouth (regurgitation). Other common symptoms include sore throat, difficulty/painful swallowing or lump in the throat sensation, hoarse voice, cough, chest pain, or stomach pain. Diagnosis is often clinical, but special testing such as a Barium Swallow, Endoscopy or another special testing can be performed to help establish the diagnosis. A Hiatal Hernia can increase the risk of GERD. Ulcers can be a complication of GERD.
Hiatal Hernia: Protrusion of the stomach through the diaphragm usually from an inborn weakness in that muscular ring. These hernias vary greatly in size and may cause no symptoms of severe heartburn.
Gastritis: Inflammation of the stomach lining usually caused by drugs (aspirin, ibuprofen, etc.), alcohol, infection (viruses or a bacteria called Helicobacter pylori–see below) or reflux of fluids from the duodenum (small intestine) into the stomach. Gastritis causes discomfort often described as a gnawing or burning ache high in the abdomen often aggravated or improved by eating, fullness in the stomach after eating, loss of appetite and nausea with or without vomiting are frequently present.
Ulcer: A break in the membrane lining of the stomach or duodenum (small intestine). Classic symptoms include a gnawing or burning pain high in the abdomen 1-3 hours after meals, possibly relieved by meals or antacids. Other symptoms can include bloating and fullness in the stomach region, belching, heartburn, and nausea and vomiting. Ulcers arise largely from NSAID medications (aspirin, ibuprofen, etc.) or the presence of Helicobacter bacteria, especially in smokers. There is no proof that ulcers are caused by stress or diet. Duodenal ulcer is a chronic condition and there is a good chance that it will come back. Absence of symptoms does not necessarily mean the ulcer has healed. Serious complications of ulcers include bleeding and perforation (break) through the lining.
Helicobacter Pylori (H. Pylori) Infection: Caused by bacteria “H. Pylori” which infects a person’s stomach. Sometimes patients can have no symptoms, while others can have pain in the upper abdomen, nausea, vomiting or bloating. This could lead to ulcers or even cancer. It is unclear why it can cause problems in some individuals, but not in others. How the infection occurs is unknown, but it is most likely transmitted from person to person by fecal/oral or oral/oral routes, though not confirmed. Domestic cats have been found to have H. Pylori infection but their role in transmission is unknown. Other risks including overcrowding, sharing a bed, lack of running water, and density of housing. Testing for this particular bacterium can include blood test, breath test, stool test or endoscopy with biopsy. Treatment includes taking a combination of 3 or 4 medications for a 10 day to 14-day timeframe. The regimen includes antibiotics and stomach acid-reducing medications. These medications must be taken EXACTLY as prescribed. Follow up testing AFTER treatment is very important to ensure the infection has been eradicated or cured. This is often done approximately 1 month after the course of medication has been completed.
- Avoid food which you know to cause stomach discomfort, usually fatty, acidic and spicy foods.
- Limit your intake of coffee, tea, alcohol and cola.
- Stop tobacco use.
- Avoid aspirin, ibuprofen, and other arthritis medication unless instructed by your physician.
- Do not eat 3 hours before bedtime.
- Avoid large meals or overeating. Eat small, frequent meals (about 5-6/day)
- Elevate the head of your bed on 6” blocks.
- Propping your head up with pillows is not effective.
- Take liquid antacid (such as Maalox, Mylanta, etc.) according to the directions on the bottle, usually 30 minutes after each meal and at bedtime.
- Take TUMS as directed on the bottle.
- You have been recommended to take a medication called an “H-2 Blocker” like Zantac (generic name-Ranitidine), Pepcid (generic name-Famotidine) or a “PPI” like Nexium (generic name-Esomeprazole), Prilosec (generic name-Omeprazole), or Protonix (generic name-Pantoprazole) which helps reduce the stomach acid causing you less irritation. Follow the dosage instructions carefully and continue to take the medication until it’s finished.
- Consider weight loss, if appropriate.
Call UHS if any of the following happens:
- Any severe pain not relieved by your treatment
- Evidence of bleeding from the digestive tract (observe all bowel movement for bloody or “tarry black” stools)
- Unintentional weight loss
- Unusual weakness or paleness
In an emergency go to Mount Nittany Medical Center or call 911 for an ambulance.
Test Results and Advice Nurse
Send secure message to advice nurse via the UHS website or call 814- 863-4463.
Appointments can be made online via the UHS website, by phone 814-863-0774, or in person. If you are unable to keep your appointment, please call or go online to cancel. Otherwise you will be charged for the visit.
This content is reviewed periodically and is subject to change as new health information becomes available. This information is intended to inform and educate and is not a replacement for medical evaluation, advice, diagnosis or treatment by a healthcare professional.
Approved by the UHS Patient Education Committee Revised 3/09/18