Radu TutuianMD and Donald O CastellMD

The availability of highly effective medications with infrequent side effects for treatment of a condition that affects 40% of the adult US population leads to an almost "knee jerk reflex" answer to the patient's complaint "Doctor, I've got heartburn." Many practitioners will prescribe a proton pump inhibitor (PPI) once daily. Fortunately, this approach is highly successful in most patients despite the inability of PPIs to correct the underlying pathophysiology of gastroesophageal reflux disease (GERD), which is an abnormally relaxing lower esophageal sphincter (LES) with or without an abnormal esophageal motility leading to an abnormal amount of acid gastric material in the esophagus. By decreasing the acidity of the refluxed material, however, PPIs do satisfy the following two major goals of medical therapy in GERD: (1) healing of lesions and (2) alleviation of symptoms. We will discuss the practical, day-to-day approach to the medical treatment of GERD.

Constipation Prescription

Constipation Prescription

Did you ever think feeling angry and irritable could be a symptom of constipation? A horrible fullness and pressing sharp pains against the bladders can’t help but affect your mood. Sometimes you just want everyone to leave you alone and sleep to escape the pain. It is virtually impossible to be constipated and keep a sunny disposition. Follow the steps in this guide to alleviate constipation and lead a happier healthy life.

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