Talk:Gastroesophageal reflux disease/Archive 1

Gerd
This page has been merged with the contents of Gerd (no capitals), which was an NIH patient information page. A lot of irrelevant stuff had to be slashed to keep this readable and informational. Additions will still have to be made. JFW | T@lk  00:38, 25 Apr 2004 (UTC)


 * Thought I might just mention that GERD is abbreviated GORD in Australia... (and the UK?) Though I'm not sure how to integrate that into the article. Techelf 12:05, 27 Jun 2004 (UTC)

Totally agree. I've stuck to US spelling as much as possible, but a mention of GORD would only be reasonable. Same in the UK and European mainland. JFW | T@lk  15:01, 27 Jun 2004 (UTC)


 * Done now; I had to replace all instances of "oesophagus" with "esophagus" because someone had changed a large number of them to BE without checking the page title... JFW | T@lk  15:30, 27 Jun 2004 (UTC)

Antacids
Would the author of the original page provide a reference for the information about calcium-based antacids exacerbating acid production? All the information that I can find says exactly the opposite. Thanks -- Minerva9 06:33, 1 August 2005 (UTC)Minerva9


 * I'm not the original author, but I added a link to a 1995 paper that discusses "acid rebound" with CaCO3 antacids. -- Kaszeta 14:36, 1 August 2005 (UTC)


 * There is some debate over this matter. See here -- Wikifish2 22:13, 17 January 2007 (UTC)

help with link
Could you please help me understand what parts of this site can be used as a useful contribution. We are very interested in adding our medical expertise to this article and are inquiring about any need for further content. Thanks

Ryan Acid Reflux


 * It is a secondary source and hence not very useful compared to directly cited journal articles. JFW | T@lk  22:22, 21 January 2006 (UTC)

Reference needed
"EGD every 5 years is recommended for patients with chronic heartburn, or who take medication for GERD chronically."

This needs a reference. (A reference would also be particularly helpful to those of us in HMOs.)

"When combining drug therapy, food avoidance before bedtime, and elevation of the head of the bed, over 95% of patients will have complete relief"

This also needs a reference desperately. The percentage quoted sounds grossly inaccurate and without a reference, the entire statement should be deleted from the article. —Preceding unsigned comment added by 70.144.172.53 (talk) 08:36, 3 September 2007 (UTC)

Stretta and endocinch
There is currently controversy in the GI literature on how effective and durable these approaches are. Kd4ttc 14:55, 7 February 2006 (UTC)

IFFGD?
Does any one know anything about "International Foundation for Functional Gastrointestinal Disorders" that is in the external links? Are they recognised by anyone as an authority? Are they legitimate? -- Barrylb 14:20, 27 March 2006 (UTC)

Acid-Reflux-Online.com
I want to suggest a site for inclusion among the links, www.acid-reflux-online.com was written by a former acid reflux sufferer who advocates natural solutions for acid reflux, heartburn and related conditions. I believe the Wiki audience would benefit -- people need to know about alternative and complementary therapies. I'll try inserting the link one more time. Hope this is ok. Any help would be *greatly* appreciated. Thank you!


 * I'm not sure why the link needs to be included. If your aim is to provide "information", then why is that information not in the article itself? Many articles have sections about "alternative and complimentary therapies". As long as these are adequately sourced, there is no need to resort to offsite information that is unauthoratitive and supported by ads. JFW | T@lk  21:49, 6 April 2006 (UTC)


 * Thank you Jfdwolff. You asked why the information is not in the Wikipedia article itself. Would it be a stretch for your guidelines to include the specific practical steps in elevating the head of the bed, for instance? Doctors will of course recommend elevating the bed in most cases.... however, only someone who has lived with the condition really knows the details of cinderblocks, bed risers and wedge pillows. This is the kind of information that is needed by others to save them valuable time and effort -- and yet it is tough to source in a conventionally authoritative way. Basically this website walks a fine line by providing information for individuals to discuss with their doctors. Similarly, herbal remedies have proven effective with respect to acid reflux, even though they are not generally favored by conventionally practicing doctors especially here in the U.S. And there are other aspects of the site's content that I could mention. I happen to be the site's author, and I developed it to speak to those who have few other places to turn for alternative information. Let me try to add the link once again, because I'm not sure whether this note will be seen otherwise. By adding the link, I'm reasonably sure this will come to your attention again. I'll respect whatever decision you make. Thanks again and have a nice holiday.


 * This site has far too much emphasis on selling "remedies". It is not appropriate for our links. -- Barrylb 23:17, 6 April 2006 (UTC)


 * I'd like you to consider my recommendations before blindly reinserting the link. The modalities you recommend on your site may well deserve mention on this page itself, even if doctors do not commonly recommend it. As long as it has a fair support base, this belongs here and not in an external link. You are free to use your site as a reference, although I can think of more primary references in support of this. JFW | T@lk  23:19, 6 April 2006 (UTC)


 * Jfdwolff, thank you for your help. I included a paragraph on raising the head of the bed mentioning the site as a reference only. I trust this will be ok. All the best.


 * Please note I am now adding the link again... it seems to have been removed, even though okayed through dialogue with editors a couple of months ago.
 * The above discussion does not pertain to advertising within the text, it suggests that it may be okay to add as a reference, as I have changed it to now. Sparkleyone 02:39, 2 June 2006 (UTC)
 * Upon checking the article today, I noticed the reference was deleted. (It had been a footnote, and previously was a textual reference.) I'm going to include it once again as a textual reference. On the other hand, would be happy with just a footnote, if there were ways to keep it included as such. Can anyone surf in to the site and delete material from an article? This is perplexing. All the best to Wiki editors, and happy 1st day of summer.


 * Even as a footnote it does not fit any criteria for inclusion in Wikipedia. It is a personal account, perhaps the least useful source of information on any health-related article. As to deleting material from articles, please peruse wiki. If you can add material, then you can also delete material. A pleasant summer. JFW | T@lk  16:15, 21 June 2006 (UTC)


 * Hello Jfdwolff: In that case, let's keep the page included as a reference, as mentioned in your comment of April 6.

question?
I have a chronic cough that began around the same time as i starting taking Tetracycline. i would like your oppinion on weather or not it could be Gastroesophageal reflux disease, and if so could Tetracycline of caused it? 67.162.66.69 01:43, 29 April 2006 (UTC)
 * Been taking Doxycycline and my acid reflux has gone through the roof. Noam Chomsky

That is the same with me I also have a chronic cough, and heartburn. I had a Barium Meal and then was dianogsed with gerd the cough may be caused by the vagus nerve, []asthma [] may also be linked to gerd

Evidence based
This review shows that most dietary measures have not been studied well enough. Worth pointing out in the article? JFW | T@lk  10:17, 9 May 2006 (UTC)

Reflux in children
I wanted to suggest the following addition to the section on reflux in children. I've marked the addition with "**". This information is based on several studies. Please let me know if okay to add. Thanks, MIke Davenport

Children GERD may be difficult to detect in infants and children. Symptoms may vary from typical adult symptoms. GERD in children may cause repeated vomiting, effortless spitting up, coughing, and other respiratory problems. Inconsolable crying, failure to gain adequate weight, refusing food and bad breath are also common. Children may have one symptom or many - no single symptom is universally present in all children with


 * It is it estimated that of the approximately 8 million babies born in the US each year, upwards of 35% of them may have difficulties with reflux in the first few months of their life. A majority of those children will outgrow their reflux by their first birthday, however, a small but significant number of them will not.**

GERD. Babies' immature digestive systems are usually the cause, and most infants stop having acid reflux by the time they reach their first birthday. Some children don't outgrow acid reflux, however, and continue to have it into their teen years. Children that have had heartburn that doesn't seem to go away, or any other symptoms of GERD for a while, should talk to their parents and visit their doctor.

I tihnk the article should also include info (sourced, of course) about GERD in teenagers, also, the way the reflux disease is beomcing more and more of an increasing "epidemic" nowadays. Knuckles sonic8 23:03, 9 November 2006 (UTC)

I Know two teenagers that suffer from gerd it is a big problem for these people!

Laryngeal cancer
Expect 1000s of people demanding endoscopy and PPIs: this paper links GERD to laryngeal cancer. JFW | T@lk  08:23, 3 September 2006 (UTC)

Episodic treatment subsection
I added a new section for Episodic treatment Nov 20, 2006 -- what to do when one is having an episode. It doesn't do much good in the middle of the night to know that the solution is a change in diet... Hopefully, this section is just a start and others will add more information, perhaps with citations.


 * You added a lump of text with no sources and essentially based on your personal opinion. The solution of episodic reflux is antacids, pure and simple. There is no need for a paragraph telling the readership that you couldn't find this. JFW | T@lk  23:23, 20 November 2006 (UTC)


 * Second Kd4ttc 22:24, 22 November 2006 (UTC)


 * Then where it is on Wikipedia and why isn't it linked here? You state "The solution of episodic reflux is antacids, pure and simple" but even this "pure and simple" information isn't on Wikipedia and it's not accurate anyway. Most antacids do nothing directly to acid which is lodged in the esophagus. I know that from experience. If you're such an expert, what's the answer there?


 * If you think the "surprising" comment is inappropriate, remove it, but what does that have to do with a section about episodic treatment, which is perfectly appropriate for this article?


 * If the actual eposodic treatment information isn't accurate or appropriate, then propose appropriate information, don't stonewall because you happen to already know the information (or think you do). If Wikipedia didn't include information that various contributors already knew (or, again, think they know), it would be empty.


 * I will check back in a few days and if Jfdwolff, who deleted the information (and claims to be far more knowledgable than me on the subject), hasn't inserted an appropriate section, I will do so.

'Smoking' seems out of place within 'Foods'
Under a heading on food changes as treatment, smoking is mentioned as an aside. Maybe under treatments there should be an "Other", and smoking could go there, or have a "Smoking" entry even if it only has one sentence to it. —The preceding unsigned comment was added by 67.124.149.163 (talk) 00:23, 18 December 2006 (UTC).

Fasting
The section on fasting seems out of place and needs to be cited. Who says it's an effective treatment? 199.126.44.35 06:42, 5 January 2007 (UTC)

Not only does it need to be cited, it desperately needs a grammar overhaul.

Unfortunately the whole article needs a grammar overhaul. 82.36.228.184 11:36, 20 January 2007 (UTC)

I can't imagine that fasting helps anyone with GERD, and I was told by multiple doctors never to go for long periods without eating because it aggravates symptoms.

I agree, fasting is a typical "folk remedy" and I have found no scientific support for it in any major journal (pubmed etc. journals)

I deleted the fasting instructions since there was no source, and a fairly extensive search of the information for patients put out by reputable agencies did not support the contention. Mhickcoxhoward 05:43, 17 February 2007 (UTC)

I dont think fasting works because it will just make symptoms worse because the will be only acid in your stomach not a mixture of acid and food and if you fast contact a docter before you star i dont reccomed this.

Laryngopharyngeal Reflux
There are two forms of Acid Reflux, and I don't think that this one is covered adequately here. I might add some information in time, but does anyone have more experience or knowledge of this form? Do you agree that this form should be described here, or on a separate page? 70.44.177.151 04:07, 15 March 2007 (UTC)

If laryngopharyngeal reflux is still diagnosed as GERD then I can't see why it wouldn't fit in here. Also, redirecting Laryngopharyngeal_reflux to here would then be appropriate. It sounds like it wouldn't be a large enough article to warrant seperation. Ichibani 16:58, 19 March 2007 (UTC)

Not merged with Heartburn
This article was suggested for merge with Heartburn. Consensus was against it. The discussion is at Talk:Heartburn. However, it seems that there is a lot of overlap between the two articles. As I understand it, heartburn's the symptom, GERD's the disease. Perhaps it would be appropriate to move information common between the two (if any) to Heartburn. Ichibani 16:58, 19 March 2007 (UTC)

Spambait?
Is it just me, or does this kind of articles attract "relevant" linkspam? Is links to the chewing gum near-adds really needed here? Greswik 14:37, 16 April 2007 (UTC)


 * Not just you. Simply looking at this talk page gives immediate evidence. I count four or five ads... er ahem. I should say informational articles? ;-)--Shark Fin 101 16:19, 25 May 2007 (UTC)
 * Yes, this article attracts alot of spam--Hu12 10:01, 15 August 2007 (UTC)

Nonerosive Reflux Disease
Is anyone able to perhaps put in a section with regards to this? I'd look into it myself by my knowledge and time are limited at the moment! Thanks 58.6.123.195 04:26, 11 May 2007 (UTC)


 * It is also a problem that NERD redirects to this article which does not even contain the substring nerd or nonerosive. I kind of considering removing the redir unless someone plans to put in at least a sentence about it... --grin ✎ 08:10, 8 June 2012 (UTC)

Obesity
abdominal obesity increases oesophageal acid exposure. JFW | T@lk  10:25, 27 May 2007 (UTC)

Unsupported claims
Please do not delete content that cites peer-reviewed research and replace with contradictory unsupported claims. This was done today in the positional therapy section. I do not mind someone adding a second opinion in their interpretation of the existing research. You can even put your opinion first, but please support it with a legitimate citation to reseach.Badgettrg 21:31, 31 May 2007 (UTC)


 * I added a citation of a study of sleep position (left vs right side) and its effects on GERD sufferers. I left it listed first, as simply sleeping on one's left side is much simpler for patients to implement than elevating the head of the bed.Beerios 02:09, 6 June 2007 (UTC)

The portion about "posture and GERD" sounds bogus, or at least suspicious. Are there any actual references? —Preceding unsigned comment added by 136.152.168.236 (talk) 05:15, 3 February 2009 (UTC)

Foods
The foods section to me seems very unclear. While some of the entries in this section are explained quite clearly, others are merely listed, and it seems ambiguous to me whether these encourage or prevent acid reflux (especially the acidic fruit part), even in light of the labal at the top of the list saying some foods prevent it. I was wondering if perhaps someone familiar with the subject could make all of these clear, or simply reorganize into two lists, foods to avoid, foods that may prevent reflux. Someguy1221 04:47, 14 June 2007 (UTC)

I agree this doesn't seem to clearly cover the topic of an acid reflux diet. Beyond the medicine and other treatments, prevention is key. This food section doesn't seem to discuss the topic. WebMD covers the topic with a diet log, meal planning tips and some sample meals. (http://www.webmd.com/solutions/heartburn-relief-lifestyle/meal-planning) Even the Nexium purplepill site has a meal planner, a tool to check your recipe for triggers, and a recipe section

The myth on acidic food. They say to avoid certain things such as hot sauce, tomatoes, onions, bacon.....ect. Although, these foods cannot harm you in anyway. The major foods to stay away from is citric acid. such as oranges, lemons, some milk.....ect

(http://www.purplepill.com/nexium_users/meal_planner/browse.aspx#mp) Allergy-mom 21:04, 27 June 2007 (UTC)allergy-mom

Pathophysiology
is a 12-page review into the pathophysiology of GERD. JFW | T@lk  22:52, 23 June 2007 (UTC)


 * The DOI link is broken. –Uïfareth Cúthalion (talk) 20:17, 31 January 2008 (UTC)

Living with reflux support group
I have also been trying to add www.livingwithreflux.org to the links and it keeps being removed. I would like to request it being added. We offer every day information from parents with infants and adults living with this condition. This is so invaluable to raising awareness and people being able understand what gastric reflux is and how to control it. We feel strongly that people should get help from all aspects. which is why people can read personal storys along side information and forums. We would really appreciate it being added, or if some one could tell me were i have gone wrong? i have tried one more time but am sure it will go again. Thank you. — Tracey guilliattparks (talk • contribs) has made few or no other edits outside this topic.
 * Unfortunately you have a conflict of interest, and your editing involves contributing to Wikipedia in order to promote livingwithreflux.org. Such a conflict is strongly discouraged. Your contributions to wikipedia under Tracey guilliattparks and IP84.159.81.236, consist entirely of adding external links to livingwithreflux.org and is considered  WP:Spam. Looking through your contributions as a whole, the all seem to be livingwithreflux.org related only. Please do not continue adding links to your own websites to Wikipedia. It has become apparent that your account and IP's are only being used for spamming inappropriate external links and for self-promotion.  Wikipedia is NOT a "repository of links" or a "vehicle for advertising" and persistent spammers will have their websites blacklisted. Any further spamming may result in your account and/or your IP address being blocked from editing Wikipedia. Please see the welcome page. You're here to improve Wikipedia -- not just to promote livingwithreflux.org right?  --Hu12 10:09, 15 August 2007 (UTC)

It was never my intention and do apologize if this is how it seemed, to advertise the web site as a group we felt it could be used as a resource tool for many people and yes help add and improve wikipedia with what people have put together, as we have information and links out to many other sites offering a range of advice and support. I never intended to promote the site, just give further information to people, that was relavant to this page. I do undersand now why it was removed — Tracey guilliattparks (talk • contribs) has made few or no other edits outside this topic.

I have personally found the support site to be incredibly informative and supportive. It goes way beyond what Wikipedia offers in terms of information so it does add to the readers' experience of using your site. Your information is useful but sufferers and their parents need more than basic info, and they need to know there are ways of improving symptoms and obtaining support. — 91.125.220.36 (talk • contribs) has made few or no other edits outside this topic.


 * Glowing review by the WP:SPA anon IP attempting to give the impression of more support for this links inclusion. Sock puppets or IP's should not be used for the purpose of deception, distraction, or to create the illusion of broader support for a position than actually exists. Yet another reason for this link not to be included on Wikipedia.--Hu12 20:33, 15 August 2007 (UTC)

Clomipramine
Tricyclic antidepressants cause no reflux, apart from clomipramine. JFW | T@lk  00:08, 24 August 2007 (UTC)

Conflicting Information
Part of this article says that antacids are bad for acid reflux while other parts suggest that taking antacids will help symptoms. I know this is most likely because of conflicting opinions within the scientific and non-scientific community but if there are conflicting opinions this should be better explained in the article. I suggest adding a tag for conflicting information until this gets resolved. Agaib 23:45, 8 September 2007 (UTC)
 * Its proabably both. Back when I first had GERD I used to take tums, which settle the heart burn real nice and quick, but about five years later the tums made me violently sick to my stomache. When that happened my doctor switched me over to Nexium. TomStar81 (Talk) 17:51, 12 September 2007 (UTC)

Coprophagia

I'm a sufferer from GERD for as long as I can remember. I've tried most antacids on the market and all that hokum. Eating faeces, gold, fingernails, and eggshells works for me. This violates the guidelines for discussion because it is not "scientifically" verifiable, although at the root of the matter it is empirical TRUTH! —Preceding unsigned comment added by 24.12.251.44 (talk) 22:25, 29 June 2008 (UTC)

Sources - GastroEsophageal valve
Does anyone have references related to the Anti-Reflux Barrier and GastroEsophageal valve (Pathophysiology)? Neither of these appears in TheFreeDictionary. Google has been less than fruitful. Thanks. –Uïfareth Cúthalion (talk) 20:25, 31 January 2008 (UTC)
 * does it mean the Cardia and Pylorus? WLU (talk) 23:41, 31 January 2008 (UTC)

hiatal hernia / hiatus hernia
I had previously never heard the term "hiatus hernia", though I have heard of a "hiatal hernia" -- which apparently is simply linked to the "hiatus hernia" article, and explains that it is the same thing by a different name. Early in reading this article I was effectively confused by the "hiatus" variant, only to discover a later use (under the surgical treatment section) referencing "hiatal hernia" rather than showing consistency with the article summary (hiatus hernia was used at the beginning, and that was the instance that actually had a wikilink) kuzetsa (talk) 13:41, 16 June 2008 (UTC)


 * wasn't logged in (cookie or user error) with that last comment. Incidentally I'm not awake enough to edit even a section of actual article so I just left a note that someone may wish to look at that issue. While I'm at it... I was astonished that "gurd" "gord" and "gerd" are not the same thing, even though they can be pronounced the same way phonetically. there is some band named "gurd" and that really had me confused Kuzetsa (talk) 14:11, 16 June 2008 (UTC)

Subjective sensations of the pylorus
I don't have this condition, but for a short time years back I had repeated episodes of reflux while asleep, which was very disconcerting. It was immediately apparent that this was due to excessive stomach contents due to the refusal of the pylorus to open. Not believing in taking a pill to control my sphincter, I found that it was generally possible to persuade this to open manually, and in the process came to understand that there were certain subjective rules which it was following. It seemed to have an ability to feel and taste the stomach contents. Smooth, sour contents seemed most right and made it feel at ease. I could make it open even without sourness (i.e. with milk and sugar), but if it felt sharp edges (bran flakes) then I usually could not succeed. It seemed to have a protective instinct (like your eyelid if you try to put something in your eye). In the process I found that it had been a habit I'd adopted shortly before of eating bran flakes as a late snack that was responsible for the trouble, and by ending this the problem was ended.

Anyway, my purely subjective experience makes me wonder whether there is evidence to be found to add bran flakes or "sharp objects" to the list of foods, and more generally whether the mental aspects of treatment can be expanded. I see that this article already covers the influence of acid, and autonomic nervous system describes the close relationship of taste with primary visceral sensory neurons that detect the composition of stomach contents. At the moment I'm reluctant to make edits to push the article in the direction I seek because my anecdotal experience may bias my opinions, but I'm curious if others would corroborate these feelings. Wnt (talk) 04:56, 14 October 2008 (UTC)

Nice NEJM review article
May be worth including - http://content.nejm.org/cgi/content/short/359/16/1700 Wawot1 (talk) 14:57, 18 October 2008 (UTC)

Some suggestions for improvement
A few sections of the article seem to leave room for improvement. I'll attempt to address them as time permits. Some suggestions:

Any thoughts? Wawot1 (talk) 19:36, 18 October 2008 (UTC)
 * General Organization - The article could use some tidying (i.e.  keeping info about treatment in the treatment section and moving the Barrett's esophagus section to pathophysiology)
 * Needs some info about the poor correlation between symptoms and findings on endoscopy. —Preceding unsigned comment added by Wawot1 (talk • contribs) 15:16, 19 October 2008 (UTC)
 * Diagnosis - this section seems to over-represent the role of imaging studies, endoscopy, etc. in diagnosis. Clearly, mentioning them is warranted, but I don't think it's clear that most of the time, GERD is a clinical diagnosis.
 * Posture and GERD - section is totally unreferenced...should be verified or removed.
 * Surgical treatment - needs some info about the problems with Nissen fundoplication.
 * Drug section - some info about response rates to PPI's and H2 blockers would be helpful.

Perhaps some info on the dangers of PPI's as well and the fact the condition was created by GlaxoSmithKline to market the drug Zantac. 68.109.69.48 (talk) 08:42, 19 October 2008 (UTC)

Not exactly what I had in mind...please see neutral point of view Wawot1 (talk) 15:00, 19 October 2008 (UTC)

Please see Reality 68.109.69.48 (talk) 11:15, 20 October 2008 (UTC)


 * It is NPOV if 68 documents his sources, which might be very interesting to read. Wnt (talk) 16:39, 20 November 2008 (UTC)

Hey MDs, how do you pronounce "pH-metry"?
It's part of GERD jargon. Is it "pee-AICH-muh-tree"? That's what would seem logical. 63.125.147.253 (talk) 20:05, 29 December 2008 (UTC)

Milk products containing calcium
Latic acid can cause heartburn and fats can encourage its continuation. However, calcium is basic and should, if anything, fight heartburn. Overall, milk may certainly cause heartburn, and so may even milk products that have no lactic acid, but is the calcium really the cause of this?  Andrew Nutter  Talk |  Contribs  15:33, 13 January 2009 (UTC)

Trials
added a link to the recent DIAMOND trial. I think it is useful to discuss such a study, but it remains a primary study and the contribution also discusses the importance of head-to-head trials, something that is not really the domain of primary studies to make that observation. Would anyone have a secondary source that could be used to support this statement? JFW | T@lk  08:40, 18 January 2009 (UTC)

Merge
Am interested in starting the discussion on merging heart burn into GERD. Heart burn is the symptoms of GERD. You use the two phrases the patient has GERD symptoms interchangeably with the patient has heart burn. Keeping the two as separate pages doesn't make sense.

Both are potentially serious as they are the same thing. The comment that heart burn is less serious is not in fact true. If heart burn is added to this page we could right under symptoms: Heartburn is usually the layman's term for GERD describing a burning sensation from the stomach to the back of the throat. Heartburn however is sometimes used to mean epigastrictic pain seen in gastritis or heart attacks.

-- Doc James (talk · contribs · email) 18:20, 20 January 2009 (UTC)
 * A improperly sourced comment saying one is more serious than the other is not, in my opinion, a reason for merging here. To my understanding, heartburn is the sensation associated with acid reflux and acid reflux is the chronic condition of gastric acid going up the esophagus. Heartburn could probably be merged here, but the proposed "layman's term" is inadequate considering we have a full article on heartburn, its treatment and various other bits of information. A full section, below the lead section of this article, would be appropriate if a merge was to happen. — Moe   ε  13:49, 29 April 2009 (UTC)


 * Heartburn is a symptom that may be attributable to a number of underlying pathologies. GORD is one possible diagnosis - perhaps the heartburn page should be modified such that it describes the symptom then links to pages like GORD and so on... APTSmith (talk) 09:08, 14 May 2009 (UTC)


 * Oppose merge This article is fine as it is. --DThomsen8 (talk) 15:39, 18 June 2009 (UTC)


 * This has been discussed before (see Talk:Heartburn). The consensus was not to merge. --Lambiam 18:55, 3 July 2009 (UTC)

Western toilets as causal factor
The use of the unnatural sitting position for defecation has been cited in 2 peer-reviewed journals as a key factor in the etiology of GERD and hiatal hernia. Here are the references:  My mention of this was deleted, for reasons that seem unjustified. WP:Weight is designed to exclude "fringe theories" like the belief that the earth is flat. It is not designed to bar any mention of a plausible etiology, published in respectable journals by mainstream scientists, and not ever challenged. --Jonathan108 (talk) 11:38, 3 March 2009 (UTC)

Childhood section
Is very weird. That is all. Huw Powell (talk) 02:06, 25 April 2010 (UTC)

Dry Mouth
I have congestion from allergies and therefore I have to mouth breath a lot, especially at night, so I came to the hypothesis of dry mouth as a contributing factor to my GERD as there was no saliva to keep the reflux down. Especially since my GERD was only bad at night and not an issue during the day when I was drinking fluids and didn't have dry mouth. Before bed I used Pilocarpine to increase saliva production, an antihistamine to prevent congestion and nasal blockage, breathe right nasal strips to keep my nasal passages open, and a humidifier and I've remarkably had no reflux for the past week. I know GERD is a problem with a sphincter, and this is just anecdotal, but lack of saliva could be something to watch out for. —Preceding unsigned comment added by 74.198.8.59 (talk) 00:42, 8 August 2010 (UTC)

Review
Gastroesophageal reflux disease (GERD): a review of conventional and alternative treatments.

Doc James (talk · contribs · email) 13:08, 7 September 2011 (UTC)

Dysphagia as common symptom of GORD
Perhaps i am mistaken but is dysphagia considered a common symptom of regular gord? my knowledge of GORD is limited to the basics but i would have though dysphagia is more commonly associated with eosphageal irritation/ulceration. it is a referral point to the GP if you are a pharmacist in my country. — Preceding unsigned comment added by 122.150.109.211 (talk) 07:17, 21 February 2012 (UTC)

treatment section disagrees with itself about antacids
From the Diet section: "The following may exacerbate the symptoms of GERD: Antacids based on calcium carbonate (but not aluminium hydroxide) were found to actually increase the acidity of the stomach. However, all antacids reduced acidity in the lower esophagus, so the net effect on GERD symptoms may still be positive."

From the Medication section: "Antacids before meals or symptomatically after symptoms begin can reduce gastric acidity (increase pH)."

Understandably, there may be evidence both ways. It could be that antacids increase acidity and yet are still often prescribed. However the article looks like it's saying in one place that antacids should be avoided, and in another place that they should be used to fix the problem. One of those sections is wrong, or both are, or they evidence is mixed and so they're both incomplete. 67.110.219.135 (talk) 05:14, 1 April 2012 (UTC)

Home remedies
I don't think "society and culture" is the right section to discuss treatments. A treatment, after all, is a treatment. I am not fundamentally opposed to discussing home remedies or alternative medicine treatments, but their widespread use should be widely catalogued in reliable sources. I have no problem discussing saw palmetto in prostate disease or echinacea for the common cold, because their widespread use is documented in reliable sources. JFW &#124; T@lk  21:34, 13 November 2012 (UTC)

Nausea
The article list nausea as a symptom, citing "Gastroesophageal Reflux Disease", Kahrilas, PJ (2008), New England Journal of Medicine. In my reading, I do not find any mention of nausea in the referenced material. — Preceding unsigned comment added by 146.115.166.221 (talk) 20:17, 12 January 2013 (UTC)

Table showing availability without prescription and generic forms
I just added this table -

I have never seen any such table in an article, but I think that it is useful. I regret that I only have United States drug information, and I wish there were some more general way to state the availability of generic drugs and drugs without prescription. How I am imagining that this could be used is that people coming to this article because of GERD symptoms may be able to learn about the availability of generic alternatives to brand name drugs, which is a decision in which patients can often participate, and the availability of over-the-counter drugs, for which usage decisions often happen with input from the patient. Thoughts on this?  Blue Rasberry   (talk)   19:52, 12 April 2013 (UTC)
 * Lets discuss it here. IMO it is way to US specific. We have dozens of countries that speak English as their primary language and adding how / where each of this medicine is available is to specific for an article about a disease. This type of content is best suited to the medication article itself in the section on society and culture. Doc James  (talk · contribs · email) (if I write on your page reply on mine) 21:01, 12 April 2013 (UTC)
 * I agree that it is not desirable to only give US information. I think that it is useful to readers to know if a drug is available without a prescription and in a generic form where they live. Can you comment on the extent to which you feel that this information would be useful if there was a way to share it with local relevance? I do not want to list only the United States, but I am not sure where to get more information just now, and I wanted to get thoughts on having this information in the article at all.
 * There is no article about the drugs used to treat GERD so I started one - please see Drugs for acid-related disorders. For diabetes, there is Anti-diabetic medication and that is the heart of Template:Oral hypoglycemics and insulin analogs. There already is Template:Drugs for peptic ulcer and GORD, so I made an article based on that and put the table there. Thoughts on that? I am in agreement that the table is US-centric, but I think the information should go somewhere and I would like some hope of describing the availability internationally.  Blue Rasberry    (talk)   15:06, 17 April 2013 (UTC)
 * This info should be on the pharmaceutical page rather than the disease page. In some countries these medications do not even exist. Doc James  (talk · contribs · email) (if I write on your page reply on mine) 23:50, 17 April 2013 (UTC)
 * Yes, I think I understood. Please look at Drugs for acid-related disorders. To what extent is that a better place?  Blue Rasberry    (talk)   17:15, 18 April 2013 (UTC)
 * Yes better. :-) Doc James  (talk · contribs · email) (if I write on your page reply on mine) 01:19, 19 April 2013 (UTC)

Pepsin immunoassay
Moved from my talk page. Content was added to / removed from GERD. Shown below italicized. Jim1138 (talk) 04:28, 15 March 2014 (UTC)
 * A series of research has been undertaken into the use of a non-invasive method of detecting GERD through a Pepsin immunoassay Pepsin test called Peptest. The lateral-flow based test can detect minute amounts of the enzyme in saliva and exhaled breath. Ref:

Hello, you recently removed mention of a non-invasive Pepsin immunoassay from the research section of the GERD page. How much evidence do you require of its widespread use? There are a number of video case studies from UK clinicians available see an example here - http://www.youtube.com/watch?v=63du5yS7NHU Please advise. Thank you. Medguy14 (talk) 09:10, 14 March 2014 (UTC)
 * How reliable is Hindawi Publishing Corporation? They seem to have had some issues. The way you state the pepsin test does not suggest much in the way of wp:notability. I suspect there are numerous tests being considered, developed, or abandoned. This does seem like wp:spam. Why is this notable to be included in this article? The pepsin immunoassay doesn't seem revolutionary. I am not familiar with the term "A series of research" Is this a clinical trial, or something else? What is I would rather see a study from a reputable journal than youtube. Is this test approved by the FDA and/or other governmental agencies, or is just a research program? "Lateral-flow" is not defined. This type of article should be written for lay-persons, not professionals. Jim1138 (talk) 04:28, 15 March 2014 (UTC)

This is the first non-invasive reflux test of this nature in the world - I don’t know of any similar tests in development. By ‘series of research’ I meant that many different studies had been undertaken in different patient groups in many different countries. Many other studies are either in press or reaching their conclusion experimentally. Publication dates range from 2005 to 2014 and with presentations at United European Gastroenterology Week among other. Peptest is registered with the MHRA and CE marked. It is also registered in Turkey, Bosnia and Serbia. Registration studies are under way in Taiwan, China and many other countries. Studies in the USA at Harvard and North Western University are intended to support FDA application this year. Would linkage to the the lateral flow article be sufficient explanation? Lateral flow test The test is currently used in a number of clinics across the UK and Europe. Medguy14 (talk) 12:08, 25 March 2014 (UTC)
 * A recent review article is all we are requesting. Doc James  (talk · contribs · email) (if I write on your page reply on mine) 12:10, 25 March 2014 (UTC)

Treatment/Surgery
Although the LINX procedure is still a relatively new surgical procedure, I think that the content could be moved under the headline for Surgery for Treatment options. While there is still research being done regaurding the LINX procedure, it is being accepted and used more for a method of treatment. I think it could be useful to move it there to note the reduced complications that the LINX procedure has compared to the Nissen Fundoplication. — Preceding unsigned comment added by MakeeverJ (talk • contribs) 01:44, 14 December 2014 (UTC)

Gastroesophageal reflux disease- Section 4
BBC made a documentary and it talked about how this disease was invented by drug companies to make loads of money. Still can't believe that there is no discussion about this matter.FinnishBeef124 (talk) 22:25, 19 July 2014 (UTC)
 * If you had GERD, you wouldn't be asking this. I developed it about three years ago, and the symptoms were so classic that my Nurse Practitioner was able to diagnose it strictly by my description in an email and send out omeprazole by mail.  Even now, if I run out before my refill arrives, the symptoms come back after about three days.  Trust me: the condition wasn't invented by Big Pharma, although I wish it were.  JDZeff (talk) 03:31, 23 July 2015 (UTC)


 * What is the title of that BBC show and when was it broadcast? Having GERD for a long time and it's corollary, Barrett's esophagus, I have little doubt of GERD's existence. I would like to see what their basis is. Might, (but probably not) provide some useful addition to the article. Ping me with &#123;&#123;u&#124;Jim1138&#125;&#125; and sign "&#126;&#126;&#126;&#126;" or message me on my talk page. 04:51, 23 July 2015 (UTC)

Cause of GERD incorrect and misleading
This wiki article cites a failure of the lower oesophageal sphincter as the cause of GORD. However, it has been well established that resting pressures of the LOS are not inferior in GORD patients compared to healthy subjects. In addition, it is agreed most reflux occurs during transient relaxations of the LOS. The majority of studies have reported that GORD patients do not have a higher number of transient relaxations than healthy controls. Thus there is no physiological or behavioural basis to believe the LOS or angle of HIS is the primary cause of GORD. Other possible explanations - the more proximal reach of the refluxate, inadequate oesophageal clearance mechanisms - have also been postulated but no definitive, proven explanation has been given. Please can we revert this article to the cause/mechanisms of GORD is not fully understood? Lpr-hell (talk) 19:24, 11 October 2016 (UTC)

GERD or GORD?
This article - and this talk page - use GERD and GORD indiscriminately. Is there a definitive statement we could standardize on, please? JohnHarris (talk) 15:21, 6 February 2017 (UTC)

Akkermansia muciniphila
Could increasing the population of Akkermansia muciniphila also help to decrease GERD ? Basically it increases the slime layer of the Large intestine, so I would assume it could possibly be an alternative to Pantoprazole. KVDP (talk) 09:00, 15 November 2017 (UTC)

Wording

 * "Long term" is a perfectly appropriate term
 * It is not just the enamal that wears away but also the dentin

Doc James (talk · contribs · email) 00:34, 4 December 2018 (UTC)

Chest pain
Ref specifically says chest pain as one of the symptoms. Thus so should we. Doc James (talk · contribs · email) 17:30, 6 March 2020 (UTC)