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Sugar Bits - Jennifer Hudson Offers Reward for Nephew

PopSugarUK — Mon, 27 Oct 2008 02:00:00 -0700

Jennifer Hudson offered a $100,000 (£63,500) reward last night for the safe return of her seven-year-old nephew, who has been missing since the murder of her mother and brother at their home in Chicago on Friday. The offer was made after Jennifer’s sister Julia made an emotional plea. - Times
Olympic swimmer Mark Foster was the sixth celebrity voted off Strictly Come Dancing, losing out to GMTV presenter Andrew Castle in the dance-off. - BBC
Former Coronation Street star Tina O’Brien gave birth to a 7lb 1oz girl at 8am on Sunday, her first child with costar Ryan Thomas. Mother and baby are doing well. - The Sun
Ronnie Wood’s daughter Leah is pregnant with her first child, having married Jack Macdonald in June. It is understood Leah’s baby is due in the spring. - Daily Mail
Carol Vorderman and Fiona Phillips are to appear on a celebrity version of The Apprentice for Comic Relief next March. Liz Hurley, Jonathan Ross and Alan Carr are also thought to be in the line-up for the show. - Mirror
Prince Harry hopes to train to become a helicopter pilot, and has volunteered to join the Army Air Corps (AAC) as the next step in his military career. This follows Prince William's decision to become an RAF search and rescue helicopter pilot. - Reuters UK
Zara Phillips broke her collarbone at the weekend after landing on her head when her horse, Tsunami II, fell at a riding event in France. She was thrown from the same horse last year, and was knocked unconscious in 2004 when she fell from another horse. Tsunami II had to be put down. - Telegraph

Celebrities (and Sightings) Still Cycling Through Sundance

Molly — Thu, 24 Jan 2008 00:46:19 -0800

While my exhausted tail returned to San Francisco last night, the fun rolls on at Sundance with a whole new group of celebs coming into town to brave the cold and show off their movies. Other than Diddy, who was mostly there to show off his vodka. Lukas Haas separated himself from Leonardo DiCaprio long enough to premiere his movie, Death in Love which Buzz and I saw last night - totally disturbing (though Adam Brody was really cute in it) - before also seeing him out to breakfast this morning. It's going to be a while before I can look at him in the same way. Buzz was there to see Meg Ryan, Felicity Huffman and William H. Macy at the premiere of Meg/William's cute movie The Deal on Tuesday night, while my only other sighting of these folk was Virgina Madsen at the premiere of her movie Diminished Capacity. I had such a blast at the festival, and be sure to check out all my partner in crime's thoughts plus all the news about movies being bought over on Buzz.

To see more from the festival just read more

View 28 Photos ›

Images include: Sanaa Lathan, Sean Combs, Justin Martin, Audra McDonald, John Stamos, Phylicia Rashad, Jason Ritter, Meg Ryan, William H. Macy, Felicity Huffman, Bijou Phillips, Lukas Haas, Virginia Madsen, Jacqueline Bisset, Josh Groban, Eric Balfour, Josh Lucas, Steven Schachter, Lil Jon, Dennis Quaid, Kimberly Buffington, Lauren Graham, Brooke Mueller, Brittany Murphy

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Reese Is Praying

PopSugar — Mon, 20 Nov 2006 16:46:39 -0800

Reese spent the weekend attending services at the All-Saints Parish in Beverly Hills. Ava and Deacon were with her but as expected Ryan was nowhere in sight. Reese may be back at work with Jake Gyllenhaal but she isn't making it to all of her scheduled appearances post breakup. Last week she was supposed to host a party celebrating Carolina Herrera's new LA boutique, but ditched the event for some family time in Tennessee. We can't blame her but we would have loved to have seen her all dressed up.

It's good to see Reese has a good support system during this tough time. More pics of Reese and adorable Deacon and Ava so read more

View 10 Photos ›

Source & X17 Online

Stars Shine at South Bank Show Awards

PopSugarUK — Tue, 20 Jan 2009 23:00:00 -0800

Dozens of stars turned out for the South Bank Show Awards at London's Dorchester Hotel yesterday. Sophie-Ellis Bextor covered her baby bump with a pretty dress, and Emilia Fox also went floral as she made her first public appearance since announcing her divorce last week. Strictly Come Dancing's Arlene Phillips and John Sergeant put the past behind them and smiled together, and runner-up Rachel Stevens grinned wide even though it looks like Michelle Ryan will be the new Doctor Who assistant: previous assistant Freema Agyeman was also at the ceremony. Gavin & Stacey's Joanna Page, James Corden and Rob Brydon rubbed shoulders with lovely Will Young and Jason Donovan. We can see the fun of the show next Wednesday on ITV1.

To see 40 pictures from the awards show, including Will Young, Miquita Oliver, Rob Brydon, Sam Taylor-Wood, Ben Kingsley, Jason Donovan, John Sergeant, Arlene Phillips, Freema Agyeman and many more, just read more.

View 40 Photos ›

Images include: Rachel Stevens, Michael Ball, John Simm, Ruthie Henshall, Sophie Ellis-Bextor, Will Young, Twiggy, Johnny Borrell, Emilia Fox, Lulu, Miquita Oliver, James Corden, Joanna Page, Rob Brydon, Sam Taylor-Wood, Ben Kingsley, Jason Donovan, John Hurt, Ronnie Wood, Ronnie Corbett, Vic Reeves, Jane Asher, John Sergeant, Arlene Phillips, Tracey Emin, Michael Sheen, Nancy Sorrell, David Suchet, Liz Smith, Hermione Norris, Gina McKee, Rupert Penry Jones, Lesley Garrett, Alexandra Armstrong, Freema Agyeman

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Gastritis

FitSugar — Wed, 08 Oct 2008 17:35:33 -0700

HEALTH GUIDE REFERENCE FROM A.D.A.M

Gastritis is an inflammation of the lining of the stomach. There are many possible causes of this disorder, including an infection, an irritant, an autoimmune disorder, or a backup of bile into the stomach. The stomach lining may be "eaten away," leading to sores (peptic ulcers) in the stomach or first part of the small intestine. Left untreated, these ulcers may bleed. Gastritis can occur suddenly (acute gastritis) or gradually (chronic gastritis). In most cases, gastritis does not permanently damage the stomach lining, and sometimes no specific cause of the inflammation is identified.

Signs and Symptoms

The most common symptoms of gastritis are stomach upset and pain. Other possible symptoms include:

Indigestion (also called dyspepsia)
Heartburn
Abdominal pain
Hiccups
Loss of appetite
Nausea
Vomiting, possibly of blood (called hematemesis) or material that looks like coffee-grounds
Dark stools

Causes

Gastritis can be caused by infection, irritation, autoimmune disorders (disorders caused by the body's immune response against its own tissues), or backflow of bile into the stomach (bile reflux). Gastritis can also be caused by a blood disorder called pernicious anemia.

Infections can be any of the following types:

Bacterial (usually Helicobacter pylori)
Viral (including herpes simplex virus)
Parasitic
Fungal

A number of things can cause irritation, including:

Long-term medication use, such as , aspirin, ibuprofen or other non-steroidal anti-inflammatory drugs (NSAIDS)
Alcohol use
Cigarette smoking
Chronic vomiting
Coffee and acidic beverages
Excess gastric acid secretion (such as from stress)
Eating or drinking caustic or corrosive substances (such as poisons)
Trauma (for example, radiation treatments or having swallowed a foreign object)

Other causes for gastritis are very rare. These include:

Systemic disease (for example, Crohn's disease)
Sarcoidosis

Risk Factors

Infection with H. pylori
Crowded, unsanitary conditions -- this may increase risk of contracting H. pylori
Acquired immunodeficiency syndrome (AIDS)
Any condition that requires relief from persistent pain using NSAIDS, such as chronic low back pain, fibromyalgia, or arthritis
Alcoholism
Cigarette smoking
Older age
Genetic abnormalities

Diagnosis

Several tests can be used to make a diagnosis. These include endoscopy of the stomach, where a thin tube with a light and a camera on the end is inserted down your throat to your stomach. This allows the doctor to see into your stomach and, if necessary, take samples (called a biopsy) from the lining. The laboratory tests you may need will depend on the specific cause of your gastritis. A stool test may be used to check for the presence of blood, or a biopsy may be taken of the tissues of your esophagus or stomach to determine the cause of your discomfort. A breath test may detect H. pylori, or samples from your esophagus or stomach may be taken to look for this organism.

Prevention

Making lifestyle changes, such as avoiding the long-term use of irritants (aspirin, anti-inflammatory drugs, coffee, and alcohol), will help in preventing gastritis and its complications (such as a peptic ulcer). Stress reduction through relaxation techniques -- including yoga, tai chi, and meditation -- can also be helpful.

Treatment

Treatment of gastritis depends on the cause of the problem. Some causes may resolve by themselves over time, or may be relieved by stopping the ingestion of irritating substances, such as alcohol, tobacco, and aspirin. Some dietary changes will no doubt be recommended, although the bland diet often prescribed in the past is no longer thought to be necessary. Medications are often necessary to relieve symptoms, eradicate an infection such as H. pylori, and prevent or treat complications from gastritis, such as an ulcer.

Lifestyle

The cure for gastritis caused by ingesting irritating substances is to stop the long-term use of these substances, which may include:

Alcohol.
Tobacco.
Acidic beverages such as coffee (both caffeinated and decaffeinated), carbonated beverages, and fruit juices with citric acid.
NSAIDS, such as aspirin and ibuprofen -- switch to other pain relievers (like acetominophen)
Eat a fiber-rich diet.
Foods containing flavonoids, like apples, celery, cranberries (including cranberry juice), onions, garlic, and tea may inhibit the growth of H. pylori.
Avoid high fat foods (at least from animal studies, high fat foods increase inflammation in the stomach lining).

Medications

If you have H. pylori, you will probably be prescribed three different medications. "Triple therapy" (including a proton pump inhibitor, such as omeprazole or Prilosec, to reduce acid production and two antibiotics to get rid of the organism) is commonly used to treat H. pylori-related gastritis and ulcers. Instead of one of the antibiotics, bismuth salicylate may be the third medication recommended. This drug, available over the counter, coats and soothes the stomach, protecting it from the damaging effects of acid. Two-drug regimens are currently being developed.

Some of the same drugs are used for non-H. pylori gastritis as well as for symptoms (like indigestion) due to ulcers of any cause:

Antacids, available over the counter, may relieve heartburn or indigestion but will not treat an ulcer. Antacids include aluminum hydroxide (Amphojel, AlternaGEL), magnesium hydroxide (Phillips' Milk of Magnesia), aluminum hydroxide and magnesium hydroxide (Maalox, Mylanta), calcium carbonate (Rolaids, Titralac, Tums), and sodium bicarbonate (Alka-Seltzer). Antacids may block medications from being absorbed and thereby decrease the medicine's effectiveness. It is recommended to take antacids at least 1 hour before or 2 hours after taking medications. Ask your pharmacist or doctor for more information.
H2 blockers, such as cimetidine (Tagemet), ranitidine (Zantac), nizatidine (Axid), and famotidine (Pepcid), reduce gastric acid secretion.
Proton-pump inhibitors, including esomeprazole (Nexium), lansoprazole (Prevacid), omeprazole (Prilosec), pantoprazole (Protonix), and rabeprazole (Aciphex), decrease gastric acid production.
Sucralfate (Carafate) makes a coating over the ulcer crater, protecting it from further damage.

Nutrition and Dietary Supplements

Doctors used to recommend eating bland foods with milk and only small amounts of food with each meal. It is now know that these eating habits are not necessary for the treatment of gastritis and ulcers. Following these nutritional tips may help reduce symptoms:

Foods containing flavonoids, like apples, celery, cranberries (including cranberry juice), onions, garlic, and tea may inhibit the growth of H. pylori.
Eat antioxidant foods, including fruits (such as blueberries, cherries, and tomatoes), and vegetables (such as squash and bell peppers).
Eat foods high in B-vitamins and calcium, such as almonds, beans, whole grains (if no allergy), dark leafy greens (such as spinach and kale), and sea vegetables.
Avoid refined foods, such as white breads, pastas, and especially sugar.
Eat fewer red meats and more lean meats, cold-water fish, tofu (soy, if no allergy) or beans for protein.
Use healthy oils, such as olive oil or vegetable oil.
Reduce or eliminate trans-fatty acids, found in commercially baked goods such as cookies, crackers, cakes, French fries, onion rings, donuts, processed foods, and margarine.
Avoid beverages that can irritate the lining of the stomach or increase acid production including coffee (with or without caffeine), alcohol, and carbonated beverages.
Drink 6 - 8 glasses of filtered water daily.
Exercise at least 30 minutes daily, 5 days a week.

Nutritional deficiencies may be addressed with the following supplements:

A multivitamin daily, containing the antioxidant vitamins A, C, E, the B-vitamins, and trace minerals, such as magnesium, calcium, zinc, and selenium.
Omega-3 fatty acids, such as fish oil, 1 - 2 capsules or 1 tablespoonful oil 2 - 3 times daily, to help decrease inflammation and improve immunity. Cold-water fish, such as salmon or halibut, are good sources, but supplementation is recommended.
Probiotic supplement (containing Lactobacillus acidophilus), 5 - 10 billion CFUs (colony forming units) a day, for maintenance of gastrointestinal and immune health. Some probiotic supplements may need to be refrigerated for best results. Your child may also take probiotic supplements. Consult with your health care provider before giving your child any dietary supplements.
Alpha-lipoic acid, 25 - 50 mg twice daily, for antioxidant support.
Vitamin C, 500 - 1,000 mg 1 - 3 times daily, as an antioxidant and for immune support.
L-glutamine, 500 - 1,000 mg 3 times daily, for support of gastrointestinal health and immunity.
Grapefruit seed extract (Citrus paradisi), 100 mg capsule or 5 - 10 drops (in favorite beverage) 3 times daily when needed, for antibacterial, antifungal, and antiviral activity, and for immunity.
Resveratrol (from red wine), 50 - 200 mg daily, to help decrease inflammation and for antioxidant effects.

Herbs

Herbs are generally a safe way to strengthen and tone the body's systems. As with any therapy, you should work with your health care provider to get your problem diagnosed before starting any treatment. You may use herbs as dried extracts (capsules, powders, teas), glycerites (glycerine extracts), or tinctures (alcohol extracts). Unless otherwise indicated, you should make teas with 1 tsp. herb per cup of hot water. Steep covered 5 - 10 minutes for leaf or flowers, and 10 - 20 minutes for roots. Drink 2 - 4 cups per day. You may use tinctures alone or in combination as noted.

Green tea (Camellia sinensis) standardized extract, 250 - 500 mg daily, for antioxidant, anti-inflammatory, and heart health effects. Use caffeine-free products. You may also prepare teas from the leaf of this herb.
Cat's claw (Uncaria tomentosa) standardized extract, 20 mg 3 times a day, for inflammation and antibacterial, or antifungal activity.
Reishi mushroom (Ganoderma lucidum), 150 - 300 mg 2 - 3 times daily, for inflammation and for immunity. You may also take a tincture of this mushroom extract, 30 - 60 drops two 2 - 3 times a day.
Olive leaf (Olea europaea) standardized extract, 250 - 500 mg 1 - 3 times daily, for antibacterial or antifungal activity and immunity. You may also prepare teas from the leaf of this herb.
DGL-licorice (Glycyrrhiza glabra) standardized extract, 250 - 500 mg 3 times daily, chewed either 1 hour before or 2 hours after meals. Glycyrrhizin is a chemical found in licorice that causes side effects and drug interactions. DGL is deglycyrrhizinated licorice, or licorice with the glycyrrhizin removed.
Mastic (Pistacia lentiscus) standardized extract, 1,000 - 2,000 mg daily in divided dosages, for activity against H. Pylori.
Peppermint (Mentha piperita) standardized, enteric coated tablet, 1 tablet 2 - 3 times daily, for symptoms of peptic ulcer. Each tablet contains 0.2 ml peppermint oil.
Tumeric (Curcuma longa) standardized extract, 300 mg 3 times a day, for pain and inflammation.

Homeopathy

Although few studies have examined the effectiveness of specific homeopathic therapies, professional homeopaths may consider the following remedies for the treatment of gastritis symptoms (such as nausea and vomiting) based on their knowledge and experience. Before prescribing a remedy, homeopaths take into account your constitution -- your physical, emotional, and psychological makeup. An experienced homeopath assesses all of these factors when determining the most appropriate treatment for you individually.

Pulsatilla -- for heartburn, queasiness, a bad taste in the mouth brought on by eating rich foods and fats (especially ice cream); symptoms may include vomiting partly digested food. This remedy is most appropriate for an individual whose tongue is coated with a white or yellow substance.
Ipecacuahna -- for persistent and severe nausea, with or without vomiting and diarrhea, caused by an excess of rich or fatty foods.
Carbo vegetabilis -- for bloating and indigestion, especially with flatulence and fatigue.
Nux vomica -- for heartburn, nausea, retching without vomiting, and sour burps caused by overeating, alcohol use, or coffee drinking. This remedy is most appropriate for individuals who also feel irritable and sensitive to noise and light.

Acupuncture

Acupuncture may help reduce stress and improve overall digestive function.

Other Considerations

Return to your health care provider if your symptoms do not get better or get worse. Do not ignore potentially life-threatening symptoms, such as vomiting blood or blood in your stool. Be aware that you may not see frank blood in your stool. The stools may simply look very dark, even black. Be sure to see your health care provider regularly, and call your doctor if there is any change in your symptoms.

If you are on both antibiotics and vitamin B12, take them at different times of day because vitamin B12 interferes with antibiotic absorption.

Pregnancy

If you are pregnant or breastfeeding, you should consult with your doctor before taking any medication, including herbs.

Prognosis and Complications

Symptoms of H. pylori infection are usually relieved with treatment, but you will most likely be asked to see your doctor 4 weeks or more after stopping your drug regimen. Follow-up is very important, because the H. pylori bacteria are linked to stomach cancer.

Peptic ulcers may develop when digestive juices damage the lining of the stomach or the first part of the small intestine (called the duodenum). These ulcers can generally be treated effectively with lifestyle changes and medication.

Supporting Research

Aly AM, Al-Alousi L, Salem HA. Licorice: a possible anti-inflammatory and anti-ulcer drug. AAPS PharmSciTech. 2005;6(1):E74-82.

Bujanda L. The effects of alcohol consumption upon the gastrointestinal tract. Am J Gastroenterol. 2000;95(12):3374-3382.

Burger O, Ofek I, Tabak M, Weiss EI, Sharon N, Neeman I. A high molecular mass constituent of cranberry juice inhibits helicobacter pylori adhesion to human gastric mucus. FEMS Immunol Med Microbiol. 2000 Dec;29(4):295-301.

Burger O, Weiss E, Sharon N, Tabak M, Neeman I, Ofek I. Inhibition of Helicobacter pylori adhesion to human gastric mucus by a high-molecular-weight constituent of cranberry juice. Crit Rev Food Sci Nutr. 2002;42(3 Suppl):279-284.

Cabrera C, Artacho R, Gimenez R. Beneficial effects of green tea--a review. J Am Coll Nutr. 2006;25(2):79-99.

Cremonini F, Di Caro S, Covino M, et al. Effect of different probiotic preparations on anti-helicobacter pylori therapy-related side effects: a parallel group, triple blind, placebo-controlled study. Am J Gastroenterol. 2002;97(11):2744-2749.

El-Serag HB, Satia JA, Rabeneck L. Dietary intake and the risk of gastro-oesophageal reflux disease: a cross sectional study in volunteers. Gut. 2005;54(1):11-7.

Fox M, Barr C, Nolan S, Lomer M, Anggiansah A, Wong T. The effects of dietary fat and calorie density on esophageal acid exposure and reflux symptoms. Clin Gastroenterol Hepatol. 2007;5(4):439-44.

Gorbach SL. Probiotics in the third millennium. Dig Liver Dis. 2002;34(Suppl 2):S2-S7.

Han KS. The effect of an integrated stress management program on the psychologic and physiologic stress reactions of peptic ulcer in Korea. J Holist Nurs. 2002;20(1):61-80.

Hardin SR. Cat's claw: an Amazonian vine decreases inflammation in osteoarthritis. Complement Ther Clin Pract. 2007;13(1):25-8.

Kaptan K, Beyan C, Ural AU, et al. Helicobacter pylori -- is it a novel causative agent in vitamin B12 deficiency? Arch Intern Med. 2000;160(9):1349-1353.

Khayyal MT , el-Ghazaly MA, Kenawy SA, et al. Antiulcerogenic effect of some gastrointestinally acting plant extracts and their combination. Arzneimittelforschung. 2001;51(7):545-553.

Kim DC, Kim SH, Choi BH, Baek NI, Kim D, Kim MJ, Kim KT. Curcuma longa extract protects against gastric ulcers by blocking H2 histamine receptors. Biol Pharm Bull. 2005;28(12):2220-4.

Klausz G, Tiszai A, Lenart Z, et al., Helicobacter pylori-induced immunological responses in patients with duodenal ulcer and in patients with cardiomyopathies. Acta Microbiol Immunol Hung. 2004;51(3):311-20.

Marteau P, Boutron-Ruault MC. Nutritional advantages of probiotics and prebiotics. Br J Nutr. 2002;87(Suppl 2):S153-S157.

Marteau PR. Probiotics in clinical conditions. Clin Rev Allergy Immunol. 2002;22(3):255-273.

Martin B. Prevention of gastrointestinal complications in the critically ill patient. AACNAdv Crit Care. 2007;18(2):158-66.

McManus TJ. Helicobacter pylori: an emerging infectious disease. Nurs Pract. 2000;25(:42-46.

Olafsson S, Berstad A. Changes in food tolerance and lifestyle after eradication of Helicobacter pylori. Scand J Gastroenterol. 2003;38(3):268-76.

Paraschos S, Magiatis P, Mitakou S, et al., In vitro and in vivo activities of Chios mastic gum extracts and constituents against Helicobacter pylori. Antimicrob Agents Chemother. 2007;51(2):551-9.

Qasim A, O'Morain CA. Review article: treatment of Helicobacter pylori infection and factors influencing eradication. Aliment Pharmacol Ther. 2002;16(Suppl 1):24-30.

Rosch W, Vinson B, Sassin I. A randomised clinical trial comparing the efficacy of a herbal preparation STW 5 with the prokinetic drug cisapride in patients with dysmotility type of functional dyspepsia. Z Gastroenterol. 2002;40(6):401-408.

Ryan SW. Management of dyspepsia and peptic ulcer disease. Altern Ther Health Med. 2005;11(5):26-9; quiz 30.

Shibata K, Mariyama M, Fukushima T, Kaetsu A, Miyazaki M, Une H. Green tea consumption and chronic atrophic gastritis: a cross-sectional study in a green tea production village. J Epidemiol. 2000;10(5):310-316.

Simopoulos AP. Omega-3 fatty acids in inflammation and autoimmune diseases. J Am Coll Nutr. 2002;21(6):495-505.

Sugimoto N, Yoshida N, Nakamura Y, Ichikawa H, Naito Y, Okanoue T, Yoshikawa T. Influence of vitamin E on gastric mucosal injury induced by Helicobacter pylori infection. Biofactors. 2006;28(1):9-19.

Vonkeman HE, Fernandes RW, van de Laar MA. Under-utilization of gastroprotective drugs in patients with NSAID-related ulcers. Int J Clin Pharmacol Ther. 2007;45(5):281-8.

Woodward M, Tunstall-Pedo H, McColl K. Helicobacter pylori infection reduces systemic availability of dietary vitamin C. Eur J Gastroenterol Hepatol. 2001;13(3):233-237.

Review Date:
8/23/2007
Reviewed By:
Ernest B. Hawkins, MS, BSPharm, RPh, Health Education Resources; and Steven D. Ehrlich, N.M.D., private practice specializing in complementary and alternative medicine, Phoenix, AZ. Review provided by VeriMed Healthcare Network.

A.D.A.M., Inc. is accredited by URAC, also known as the American Accreditation HealthCare Commission (www.urac.org). URAC's accreditation program is an independent audit to verify that A.D.A.M. follows rigorous standards of quality and accountability. A.D.A.M. is among the first to achieve this important distinction for online health information and services. Learn more about A.D.A.M.'s editorial policy, editorial process and privacy policy. A.D.A.M. is also a founding member of Hi-Ethics and subscribes to the principles of the Health on the Net Foundation (www.hon.ch).

A.D.A.M. Copyright

The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed medical professional should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. © 1997-2009 A.D.A.M., Inc. Any duplication or distribution of the information contained herein is strictly prohibited.

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Gastroesophageal reflux disease

FitSugar — Wed, 08 Oct 2008 17:35:25 -0700

Overview

Signs and Symptoms
Causes
Risk Factors
Diagnosis
Treatment
Other Considerations
Supporting Research

HEALTH GUIDE REFERENCE FROM A.D.A.M

Gastroesophageal reflux disease (GERD) is a condition in which contents of the stomach or small intestine repeatedly move back up into the esophagus (the tube connecting the throat to the stomach). This regurgitating action is called reflux. Reflux causes heartburn, and although most people have an attack of heartburn at some point in their lives, persistent reflux and severe heartburn may indicate GERD.

Signs and Symptoms

Heartburn -- a burning sensation under the sternum in the chest -- is the primary symptom of GERD. Heartburn often occurs after a meal and worsens at night, when you are lying flat. It is more likely to occur following a heavy meal, or if you bend, lift, or lie down just after eating.

Other symptoms of GERD include:

Regurgitation of food
Belching
Nausea and vomiting
Chronic cough, wheezing
Sore throat, hoarseness or change in voice, difficulty swallowing
Chest pain

GERD is common in infants and young children, but is generally mild. If an infant has the following symptoms, however, call a doctor as soon as possible:

Ongoing coughing
Wheezing, gasping
Severe vomiting
Frequent burping

Causes

Normally when a person swallows, the muscular walls of the esophagus move in waves to push the food down into the stomach. Right after the food enters the stomach, a band of muscle (the lower esophageal sphincter, or LES) closes off the esophagus. If the muscle fails to close tightly enough or weakens over time, the stomach contents can back up into the esophagus, causing heartburn and other symptoms of GERD.

Substances in the digestive juices from the stomach (such as acid, pepsin, and bile) can damage the inner lining of the esophagus, causing inflammation ulcers (open sores), and, possibly, precancerous changes to cells (called Barrett's esophagus).

Any of the following may compromise the LES:

Pregnancy
Obesity
Hiatal hernia (a condition in which a portion of the stomach protrudes through an opening in the diaphragm where the esophagus normally fits snuggly and passes into the stomach)
Recurrent or persistent vomiting
Nasogastric tubes (these are inserted through the nose and into the stomach for a variety of medical reasons)
Smoking cigarettes
Some medicines, including calcium channel blockers (a class of meds used for high blood pressure such as amlodipine, diltiazem, felodipine, nifedipine, nisoldipine, and verapamil), anticholinergic drugs (including benztropine, biperiden, dicyclomine, hyoscyamine, isopropamide, and scopolamine), iron pills, non-steroidal anti-inflammatory drugs (NSAIDs including aspirin and ibuprofen), potassium, dopamine (for Parkinson's disease), sedatives, bisphosphonates (alendronate and risedronate for osteoporosis), and beta blockers (such as atenolol, labetalol, metoprolol, nadolol, pindolol, and propranolol, for high blood pressure or heart disease)

Risk Factors

Heavy meals
Lying down or bending after a meal
Eating immediately prior to exercise
Prior esophageal surgery
Esophageal stricture (narrowing of the esophagus)
Cigarette smoking
Alcohol intake
Psychological stress

Children with the following conditions are at particular risk for GERD:

Neurologic impairment
Food allergies
Scoliosis
Frequent vomiting
Cystic fibrosis
Digestive disorders

Diagnosis

GERD is generally not difficult to diagnose. Your symptoms, what you eat and drink, medications you are taking, and your lifestyle are usually enough to make a clear diagnosis. If the diagnosis is unclear to your doctor, one or more tests may be performed:

Upper endoscopy, called esophageal gastroduodenoscopy (EGD), which involves the insertion of a tube down your throat into the esophagus to look for signs of reflux, inflammation, ulcers, or other changes in the esophagus.
A barium swallow, which involves visualization of the esophagus through a series of x-rays following the swallowing of a substance called barium. This looks at the movement of the esophagus and whether any fluid comes back from the stomach into the esophagus.
Manometry measures the pressure of the sphincter muscle. If the pressure is low, this is consistent with GERD.

Treatment

The primary goals of treatment are to reduce the reflux (regurgitation), stop the harmful effect of the stomach's materials by reducing its acid content, improve the clearance of food through to the stomach, and protect the walls of the esophagus.

For mild cases, these goals can be accomplished by making lifestyle changes (such as avoiding certain foods) and by taking over-the-counter medication. Health care professionals may recommend herbs such as DGL-licorice (Glycyrrhiza glabra ) for their soothing properties. Prescription medicines may be recommended as needed.

For moderate-to-severe cases, prescription medication may be used more regularly, and the condition may be monitored more closely. If these measures fail, surgery may ultimately be required.

Lifestyle

Making changes to or avoiding certain habits can go a long way to relieving or preventing your symptoms of GERD.

The following are typical suggestions for people with GERD:

Avoid behavior that does not allow food to easily move down into and through the stomach. This includes bending, lying down, or participating in jarring exercises soon after a meal.
Don't eat heavy meals.
Avoid acidic foods and drinks. These include caffeinated beverages, decaffeinated coffee, and orange juice.
Avoid alcohol, chocolate, spearmint, and peppermint. These can relax the lower esophageal sphincter.
Avoid carbonated beverages.
Avoid eating fatty foods, including full-fat milk, which also may relax the lower esophageal sphincter tone. Take medication with plenty of water.
Lose weight if you are overweight.
Quit smoking.
Avoid medications that provoke symptoms. These include smooth-muscle relaxants, such as calcium channel blockers (including amlodipine, diltiazem, felodipine, nifedipine, nisoldipine, and verapamil, which are used for high blood pressure), anticholinergic drugs (including benztropine, biperiden, dicyclomine, hyoscyamine, isopropamide, and scopolamine), iron pills, non-steroidal anti-inflammatory drugs (NSAIDs including aspirin and ibuprofen), potassium, dopamine (for Parkinson's disease), sedatives, bisphosphonates (alendronate and risedronate for osteoporosis), and beta blockers (such as atenolol, labetalol, metoprolol, nadolol, pindolol, and propranolol, for high blood pressure or heart disease).

If you experience more frequent symptoms at night, you may be relieved by:

Raising the head of your bed about 6 inches.
Avoiding bedtime snacks.

Stress may worsen symptoms. Therefore, relaxation, such as yoga, tai chi, or meditation, is worth considering as part of your treatment plan.

Medications

The main aim of drug treatment is to control the acidity of the stomach. This can be achieved with either nonprescription or prescription drugs, depending on the severity and frequency of your reflux. Your doctor will determine which medicine is best for you.

There are several different types of medications used for GERD, and each works in a different way. Over-the-counter antacids neutralize the stomach acids. Histamine H2 blockers interfere with the production of acid, and proton pump inhibitors suppress molecules in the glands responsible for the release of acid. Avoid taking other medications within 3 hours of an antacid because antacids may limit the absorption of other drugs.

Antacids, available over the counter, may relieve heartburn or indigestion. Antacids include aluminum hydroxide (Amphojel, AlternaGEL), magnesium hydroxide (Phillips' Milk of Magnesia), aluminum hydroxide and magnesium hydroxide (Maalox, Mylanta), calcium carbonate (Rolaids, Titralac, Tums), and sodium bicarbonate (Alka-Seltzer). Antacids may block medications from being absorbed and thereby decrease the medicine's effectiveness. It is recommended to take antacids at least 1 hour before or 2 hours after taking medications. Ask your pharmacist or doctor for more information.
H2 blockers, such as cimetidine (Tagemet), ranitidine (Zantac), nizatidine (Axid), and famotidine (Pepcid), reduce gastric acid secretion.
Proton-pump inhibitors, including esomeprazole (Nexium), lansoprazole (Prevacid), omeprazole (Prilosec), pantoprazole (Protonix), and rabeprazole (Aciphex), decrease gastric acid production.
Sucralfate (Carafate) makes a coating over the ulcer crater, protecting it from further damage.
Prokinetic agents, specifically metoclopramide (Reglan), promote movement of stomach acids along the gastrointestinal tract, rather than backing up into the esophagus.

Surgery and Other Procedures

For a small number of people, diet, medication, and lifestyle changes are not enough to relieve symptoms of GERD. In such cases, a surgical procedure called fundoplication may be performed to prevent reflux and repair a hiatal hernia (a condition that may cause GERD). As many as 90% of people who have had this operation report no longer having heartburn.

Nutrition and Dietary Supplements

Nutritional therapy is one of the first treatments recommended for GERD.

Doctors used to recommend eating bland foods with milk and only small amounts of food with each meal. Following these nutritional tips may help reduce symptoms:

Eat antioxidant foods, including fruits (such as blueberries, cherries, and tomatoes), and vegetables (such as squash and bell peppers).
Eat foods high in B-vitamins and calcium, such as almonds, beans, whole grains (if no allergy), dark leafy greens (such as spinach and kale), and sea vegetables.
Avoid refined foods, such as white breads, pastas, and especially sugar.
Eat fewer red meats and more lean meats, cold-water fish, tofu (soy, if no allergy) or beans for protein.
Use healthy oils, such as olive oil or vegetable oil.
Reduce or eliminate trans-fatty acids, found in commercially baked goods such as cookies, crackers, cakes, French fries, onion rings, donuts, processed foods, and margarine.
Avoid beverages that can irritate the lining of the stomach or increase acid production including coffee (with or without caffeine), alcohol, and carbonated beverages.
Drink 6 - 8 glasses of filtered water daily.
Exercise at least 30 minutes daily, 5 days a week.

Nutritional deficiencies may be addressed with the following supplements:

A multivitamin daily, containing the antioxidant vitamins A, C, E, the B-vitamins, and trace minerals, such as magnesium, calcium, zinc, and selenium.
Omega-3 fatty acids, such as fish oil, 1 - 2 capsules or 1 tablespoonful oil 2 - 3 times daily, to help decrease inflammation and improve immunity. Cold-water fish, such as salmon or halibut, are good sources, but supplementation is recommended.
Probiotic supplement (containing Lactobacillus acidophilus), 5 - 10 billion CFUs (colony forming units) a day, for maintenance of gastrointestinal and immune health. Some probiotic supplements may need to be refrigerated for best results. Your child may also take probiotic supplements. Consult with your health care provider before giving your child any dietary supplements.
Alpha-lipoic acid, 25 - 50 mg twice daily, for antioxidant support.
Melatonin, 2 - 6 mg at bedtime, for immune support and gastric protection.
Vitamin C, 500 - 1,000 mg one to three times daily, as an antioxidant and for immune support.
L-glutamine, 500 - 1,000 mg 3 times daily, for support of gastrointestinal health and immunity.
Grapefruit seed extract (Citrus paradisi), 100 mg capsule or 5 - 10 drops (in favorite beverage) 3 times daily when needed, for antibacterial, antifungal, and antiviral activity, and for immunity.
Resveratrol (from red wine), 50 - 200 mg daily, to help decrease inflammation and for antioxidant effects.

Herbs

Green tea (Camelia sinensis) standardized extract, 250 - 500 mg daily, for antioxidant, anti-inflammatory, and heart health effects. Use caffeine-free products. You may also prepare teas from the leaf of this herb.
Cat's claw (Uncaria tomentosa) standardized extract, 20 mg 3 times a day, for inflammation and antibacterial or antifungal activity.
Reishi mushroom (Ganoderma lucidum), 150 - 300 mg 2 - 3 times daily, for inflammation and for immunity. You may also take a tincture of this mushroom extract, 30 - 60 drops 2 - 3 times a day.
Olive leaf (Olea europaea) standardized extract, 250 - 500 mg 1 - 3 times daily, for antibacterial or antifungal activity and immunity. You may also prepare teas from the leaf of this herb.
DGL-licorice (Glycyrrhiza glabra) standardized extract, 250 - 500 mg 3 times daily, chewed either 1 hour before or 2 hours after meals. Glycyrrhizin is a chemical found in licorice that causes side effects and drug interactions. DGL is deglycyrrhizinated licorice, or licorice with the glycyrrhizin removed.
Mastic (Pistacia lentiscus) standardized extract, 1,000 - 2,000 mg daily in divided dosages, for activity against H. Pylori.
Tumeric (Curcuma longa) standardized extract, 300 mg 3 times a day, for pain and inflammation.

Homeopathy

Although few studies have examined the effectiveness of specific homeopathic therapies, professional homeopaths may consider the following remedies for the treatment of GERD symptoms based on their knowledge and experience. Before prescribing a remedy, homeopaths take into account your constitutional type - your physical, emotional, and psychological makeup. An experienced homeopath assesses all of these factors when determining the most appropriate treatment for each individual.

Pulsatilla -- for heartburn, queasiness, a bad taste in the mouth brought on by eating rich foods and fats (especially ice cream); symptoms may include vomiting partly digested food. This remedy is most appropriate for an individual whose tongue is coated with a white or yellow substance.
Ipecacuahna -- for persistent and severe nausea, with or without vomiting and diarrhea, caused by an excess of rich or fatty foods.
Carbo vegetabilis -- for bloating and indigestion, especially with flatulence and fatigue.
Nux vomica -- for heartburn, nausea, retching without vomiting, and sour burps caused by overeating, alcohol use, or coffee drinking. This remedy is most appropriate for individuals who also feel irritable and sensitive to noise and light.

Other Considerations

Pregnancy

GERD is quite common during pregnancy, particularly in the third trimester.

Warnings and Precautions

Contact your health care provider if the medication recommended does not help or if you experience side effects, such as cramping or diarrhea.

Prognosis and Complications

The acidic contents of the stomach can damage the esophagus, causing narrowing, ulcers, erosion, and precancerous changes to cells known as Barrett's esophagus. GERD can also result in respiratory diseases, ear, nose, throat conditions, and tooth decay. Most people can effectively manage their symptoms with lifestyle modifications and medications.

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A.D.A.M. Copyright

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Do You Want to See Tom Cruise in More Action Roles?

BuzzSugar — Tue, 01 Jul 2008 16:31:14 -0700

Today there's news of the spy movie Edwin A. Salt, purportedly starring Tom Cruise, which may get Phillip Noyce (Clear and Present Danger, Patriot Games) on board to direct. In the story, Cruise would play "a CIA officer who's accused by a defector of being a Russian sleeper spy. He must elude capture long enough to clear his name."

It's not necessarily going to be an action film, but it does sound similar to something Jack Ryan-ish or Jason Bourne-y, and I personally don't know if I could take Cruise all that seriously as an action star at this point. Then again, maybe he's still got it. Do you want to see Cruise in any more action movies?

Source

A Piece Of Reese

PopSugar — Tue, 11 Sep 2007 10:06:20 -0700

Reese is looking fabulously fierce on the cover of the October issue of Elle and absolutely adorable on the pages inside. We just can't get enough of her bubbly personality and big smile, no matter what is going on with her personal life. In the article, Reese gets real about her going through a divorce, but also gets goofy about dealing with the media and winning an Oscar. Here are highlights:

On dealing with hard times post-split with husband Ryan Phillipe: “Right around Christmas-time I was sitting in a parking lot and I felt like I just couldn’t get out of the car. It was like, I can’t get out of the car. And I thought, Okay, half of the parking lot has dealt with this. More than half of the parking lot has dealt with this. Okay, let’s make it a little bigger. Half of this city has dealt with this. Okay, let’s make it a little bigger-half of this country, until I finally got out of the car. It was like, it’s okay. It’s okay."

On the tabloids: “Everybody is hung out to dry now. It’s one thing if you’re up for it and you want it, and you go out without your panties on. But if you’re wearing your panties-gosh darn it, leave me alone!”

On winning her Oscar: “It made me realize how much I have it all! It’s real purty on my bookcase. Everybody that comes to my house, I say, ‘You can touch it, but you have to give a speech.’”

The more we hear about Reese, the more she seems like a cool, down-to-earth star we just want to hang out with. We can't wait to see her on the big screen again when Rendition hits the theaters.

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Ryan Phillippe Still Hiding His Hotness

Molly — Thu, 16 Aug 2007 14:50:18 -0700

Ryan Phillippe was keeping it scruffy and incognito out and about in LA yesterday in some nice white new kicks. He would be a lot more handsome with a shave, but this is not the worst case of facial hair ruining hotness we've seen today. There were vague rumors recently that he and Reese were reconciling, but they were immediately followed by more stories about Reese and Jake so unfortunately it doesn't look like a Phillipe-Witherspoon reunion is in order. That's too bad, but as long as we still get to see them hanging out with their adorable kids, no complaints here.

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Flynet

Damn He's So Hot

PopSugar — Thu, 13 Oct 2005 10:40:59 -0700

We never need a reason to post pretty pics of Ryan Phillipe, but today we hit the jackpot! While it's really hard to top the Shuffle photo, seeing Ryan with Deacon just makes us want to melt. Nothing is hotter then a man with his kids. Now if only he would wear his hat in a normal fashion and he'd be 110% perfect.

2 more insanely cute pics so read more

Source: JJB