Q
I have been hearing a lot about GERD lately. What
is it?
A
Gastroesophageal reflux disease—commonly
referred to as GERD—a ects in people in the
United States. A large majority of these individuals have
symptoms weekly, with about to percent having daily
complaints. Interestingly, GERD was fairly nonexistent
in the rst half of the th century. Environmental and
behavioral influences seem to be major factors in its
increased incidence, prompted by dietary and lifestyle
excesses. Overeating, rapidly ingested meals, late-night
snacks, highly seasoned and fatty foods, alcohol, co ee,
and carbonated beverages contribute to the problem. As
the beltline of our population expands, the prevalence of
GERD increases.
Symptoms
The classic symptoms of GERD are heartburn,
regurgitation, dyspepsia, bitter taste, bloating,
hypersalivation, hoarseness and nausea. Symptoms tend
to recur aer meals and are worst in the evening. In recent
years, there has been increased awareness of the atypical
features, including frequent throat clearing, nocturnal
choking, dry cough, morning hoarseness, wheezing,
increased salivation, spitting, ball-like fullness in the
throat, burning tongue and loss of dental enamel. Among
Q
I’m years old and have been told I need a knee
replacement. Is there anything new I should ask
about before having surgery?
A
First, the good news is that the vast majority
of patients undergoing a knee replacement do
very well, which is satisfying to both the patient and
the surgeon. About , knee replacements are
performed in the United States each year, and the number
is steadily rising. It has been found to be among the most
cost-e ective treatments of any condition, according to
the NIH and other government agencies.
KATHY M. RAYNOR, MD
Gastroenterologist
Waccamaw
Gastroenterology
GERD—a burning question
SCOTT A. SHERRILL, MD
Orthopedic surgeon
Waccamaw
Orthopaedics
Gastroesophageal
reflux disease—
commonly referred to
as GERD—aects 1 in
3 people in the United
States.
ask the
the causes for GERD are hiatal hernias and weakness of
the lower esophageal sphincter as well as inappropriately
long relaxations of the sphincter following meals. These
concepts, improved understanding of the mechanisms
causing GERD and its complications, and better treatments
(gut antihistamines, such as Pepcid and Zantac, and
proton pump inhibitors, such as Prilosec and Nexium)
have made this area of research and practice exciting and
most rewarding for patients. Treatment involves weight
loss, avoiding lying down within three hours of eating,
quitting smoking, moderation of alcohol, limiting co ee,
and steering clear of citrus juice and spicy and fried foods.
Knee replacement surgery
Not all surgeries are alike
There are some new or di erent technologies, which may
be available in the right clinical situation. The articial
joints made by most all of the current manufacturers are
very good and their advertisements should probably not
sway your decision. Your surgeon will recommend what
he or she feels is most appropriate for you and he or she
is most comfortable with. However, by far the most crucial
variables are still you and your surgeon.
Doctor
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GEORGETOWN HOSPITAL SYSTEM