Home | What's New | Our Services | Events & Activities | Career Opportunities | 4all.my | About Us | Contact Us
Encyclopaedia ->
Health Topics
First letter
Body System
Dictionary The Gastrointestinal System


Synonyms : Esophageal Reflux, Gastroesophageal Reflux, GERD - Gastroesophageal Reflux Disease, Pyrosis

Clinical features, Diagnosis, Management, Prognosis,

Gastro-oesophageal reflux disease (GERD) is a regurgitation of gastric contents into the oesophagus which takes place after mechanisms which normally prevent this fail (most important is the lower oesophageal sphincter). This condition is closely related to sliding hiatus hernia but can happen without the hiatus hernia, and the hiatus hernia doesn’t always include reflux. 

Hiatus hernia is a sliding of the gastro-oesophageal junction through the diaphragm into the thoracic cavity. The aetiology is unknown but obesity, pregnancy and occasionally ascites (fluid accumulated in the abdominal cavity) may be important factors. The condition is common, occurring in up to 30% of normal adults and 50% of aged individuals. The majority of individuals with a hiatus hernia have no symptoms and the hernia is of no clinical significance. In a minority (about 10%) however the hiatus hernia appears to facilitate gastro-oesophageal reflux presenting with relevant symptoms. 

Persistent exposure of the lower oesophagus to acid and pepsin results in oesophagitis with the damage to the superficial mucosa, when it is called erosive oesophagitis. Peptic stricture results from fibrosis (scarring) that causes narrowing of the oesophageal lumen. Replacement of the normal squamous epithelium of the oesophagus by columnar intestinal epithelium containing goblet (mucus producing) cells (Barrett’s oesophagus) occurs in 2-10% of patients with reflux oesophagitis. This process is known in pathology as metaplasia and is important because in 2-5% of cases it can progress to adenocarcinoma (30% of all oesophageal cancers are adenocarcinoma, the rest being squamous cell carcinoma). 

Several factors may promote gastro-oesophageal reflux, such as pregnancy, obesity, ascites, heavy lifting and straining, smoking, alcohol, fatty foods, caffeine, large volume meals.

Clinical features:  < BACK TO TOP >

  • Malfunction of the anti-reflux mechanism of the gastro-oesophageal junction allows gastric acid and pepsin to reflux into the oesophagus, causing damage to the mucosa, reflex muscle spasm and pain felt behind the sternum. Most people have experienced heartburn: the pain is a scalding or burning sensation behind the sternum and radiates towards the throat. An acid or bitter taste may develop in the mouth and reflex salivation may cause it to fill with saliva ('water brash'). The patient's description is often accompanied by a hand gesture that illustrates the upward radiation of the pain behind the sternum. Heartburn is rapidly relieved by antacids. Retrosternal chest pain caused by reflux may occasionally mimic the pain of myocardial ischaemia (angina) and in this situation the distinction between them is essential.

    A common cause of heartburn is a hiatus hernia, in which the oesophagogastric junction prolapses into the chest through the oesophageal hiatus. The heartburn is often provoked by postures which raise intra-abdominal pressure such as bending or lying down. The diagnosis may be suspected in overweight patients but confirmation relies on visualising the hernia, either by barium meal or endoscopy and assessing the response to treatment.

    Heartburn may result from a particular diet and lifestyle: chocolate and alcohol consumption and cigarette smoking relax the lower oesophageal sphincter allowing reflux to occur. It is a common symptom in the later months of pregnancy. This is due both to the increase in intra-abdominal pressure and the loss of sphincter tone caused by high oestrogen levels.

  •        Heartburn (pyrosis), deeply placed burning pain behind the sternum often radiating to the throat, is a characteristic symptom and is produced by the contact of corrosive refluxed material with the inflamed oesophageal mucosa.

           It characteristically occurs after meals and is aggravated by bending and straining; can occur on lying down in bed at night.

           Regurgitation of gastric content to the mouth during bending, after a large volume meal may also occur.

           Patients experience transient dysphagia for solids and fluid, usually due to reflex spasm. More persistent dysphagia for solids suggests development of a peptic stricture (scarring).

           Rarely there may be pain on swallowing (odynophagia), which is consistent with more serious oesophagitis.

           In long standing cases oesophageal ulcers may occur and iron deficiency anaemia due to chronic unnoticed blood loss.

Diagnosis:  < BACK TO TOP >

           Barium swallow with fluoroscopy (real-time X-ray) is the most widely used initial test for the diagnosis of oesophageal disease.

           The presence of hiatus hernia is shown by a barium meal fluoroscopy when the patient is placed in a lying position with the head down; a leakage of barium from the stomach into the oesophagus can be seen.

           The diagnosis of oesophagitis is made on the visual and biopsy findings at endoscopy; this procedure is especially important to confirm the presence of Barrett’s oesophagus.

Management  < BACK TO TOP >

           The patient should avoid the precipitating factors, and this together with weight reductions, corrections of diet and stopping smoking alone will relieve symptoms in about 75% of patients.

           The patient should sleep in a more upright position (e.g., on two pillows), and late night meals avoided to reduce reflux during sleep.

           Antacids, preferably liquid preparations, will reduce the heartburn, and can be used as needed; however they are unsuitable for regular prolonged treatment due to possible role of aluminium from antacids in degenerative brain disease (dementia) and osteoporosis.

           Histamine H2-receptor antagonists (ranitidine [Zantac], nizatidine [Tazac] and famotidine [Pepcidine, Amfamox]) or proton pump inhibitors (omeprazole [Losec] and lansprazole [Zoton]) will reduce acid and pepsin secretion in the stomach, but do not prevent the reflux.

           Dopamine antagonists (metoclopramide [Maxolon, Pramin] and domperidone [Motilium]) increase the contraction of the lower oesophageal sphincter as well as promote gastric emptying.

           Surgical treatment (antireflux surgery) is carried out in selected cases of sliding hiatus hernia with severe symptomatic reflux oesophagitis that does not respond to above-mentioned measures.

Prognosis  < BACK TO TOP >

  • - - 

Nutrition  < BACK TO TOP >

Nutrition that alleviate or prevent heartburn :-

Herbs  < BACK TO TOP >

Herbs that alleviate or prevent heartburn :-

Aloe vera (Aloe)
Anethum graveolens (Dill)
Berberis vulgaris (Barberry)
Cinnamomum zeylanicum (Cinnamon quills)
Gentiana lutea (Gentian)
Hydrastis canadensis (Golden Seal)

Mentha piperita (Peppermint)

Chillis help to alleviate Heartburn. research

Mastic (gum) alleviates Heartburn when the underlying cause of Heartburn is Helicobacter pylori infection. research

Neem (leaf extract consumed internally) alleviates Heartburn.
Slippery Elm (9 - 30 grams) alleviates Heartburn (by coating and “smoothing?the irritated upper Gastrontestinal Tract). research

(source : -)

search this site the web

search engine by freefind


Powered by visit montaine home page

Thank You visiting MONTAINE

Welcome To Montaine
action activity adventure aerobic aerobics after age air alternative medicine amateur areas arthritis athletes backpack backpacking backpacks bad bag barbeque basecamp based bay before beginners being benefit best bike biking blonde bmi body bodybuilder bodybuilding brand building BUY calculate calculated calculation calculator calculators calories camp camping camps cardiorespiratory cardiovascular center centers centre centres certification chat chi circuit climb climbing club clubs college competition competitor components conservation consumed consumption count courses day http://www.montaine.com.my/dictionary.htm definition download education environmental equipment erotica excercise exercise exercises exercising explore euro 2004 event famous fat female figure find fires fit fitness fittness for force franchise free gallery gay get getfit given glutes green greatest group groups guide guides gym gyms health height hikers hiking home homepage how human ideal idealweight in increasing index injures injuries instructions intermediates iron is kl knowing layout link locations loosing male man map maps mass massage masseur maximuscle me measure metabolism miss model models morning mount mountain mountaineering mountains mt multiple multistage muscle muscular music naked natural therapy national near new night noon nutrition occupational of online olympics or out outdoor outdoors page pages Pain park parks people per personal phisical photo photos physical picture pictures pilates porn program programs rafting rainbows reaction real recommendations recreation recreational rehab rehabilitation rentals requirements results rock rooms running school schools sclerosis scoliosis sex sexy should site sites source spinal sport sports stars state statistics studio studios student swedish swim swimsuit team techniques test testing tests the therapeutic therapist therapy time tips to top trail trails trainer trainers training trip trips ultimate university visitor watching water web weekend weekends weigh weight what white whitewater women womens workout world your yout
Tsunami online Donations and Information Tsumani online Donations and Infomation We are closed from Feb 9 to Feb 13, 2005 and will resume business on Feb 14, 2005

Donation Drive:The New Straits Times, Berita Harian, TV3, 8TV Malaysian Tsunami Disaster Fund The Star Earthquake/Tsunami Relief Fund Subang/USJ Disaster Fund theSun Tsunami Emergency Supplies Fund Asian Tsunami Disaster Fund - by the Foreign Ministry Yayasan Sultanah Bahiyah Buddhist Maha Vihara - 123 Jalan Berhala, Brickfields 50470 KL -Tel: 03 2274 1141, Fax: 03 2273 2570

Chinese New Year 2005
3 days post Chinese New Year detox programme
Local News & Info: Missing Persons E-mail Appeals Tsunami Penang Blog iPenang Screenshots The Star Bernama Project Petaling Street TV Smith's Tsunami InTech: Bloggers fill the void

7 April 2010
31 May 2006December 2005

10 December 2004 - International Human Rights Day
World No-Tobacco Day
World Health Day

 sWorkshop探 访 各 类 癌 症 的 真 相10 June 2004 7:30am-8:30pmCall (603) 2713 9288 to reserve a seat
Charting Your Way to Success workshop Organised by JCI

Venue : Montaine Menara Weld Level 4 |

 Date  : 30th July 2004 Friday (6:30pm -8:00pm)

Organizer : JCI Kuala Lumpur |

 Contact    : Kelly 012-320 3350 & Ang 012-296 5138

 speaker Mr NgThian Watt the Principal Trainer from Napoleon Hill Associates MalaysiaDetails www.kljuniorchamber.org
Montaine's Health and Weight Management Programme
Call 012 201 8020 or 03 5636 6788 NOW

January, February, March, April, May, June, July, August, September, October, November, December
April Promotion
(Gift Voucher Available)
 - Spa Gateway - Beauty Gateway
Usual RM293 Now RM138

Queen of The Day  RM138 (2 hours)

          Full Body Exfoliation worth RM68 (30 minutes)

          Full Aromatherapy Massage worth RM128 (60 minutes)

          Full Body Detox Treatment worth RM128 (30 minutes)

   All For RM138Additional RM68 – Make Over (Evening Make Up)ecretary's Day Gift, Secretarie

Call 012 201 8020 or +603 5636 6788


Massage or Reflexology Package Buy 7 get 3 Free  (First 50 Customers or till 31 October 2004 Only, Hurry call 03 7710 5593 now!!)

Jobs vacancy
Customer Service Exec at Montaine centre

Salary RM1000 - RM4000 Female is preferable call KC at 012 201 8020

MONTAINE Centre of Health and Wellness
kl, jb, jp, au, Africa Antarctica Arctic Asia Caribbean Europe North America Oceania South America Afghanistan Kabul Albania Tirana Algeria Algiers Andorra Andorra la Vella Angola Luanda Antigua and Barbuda St. John's Argentina Buenos Aires Armenia Yerevan Australia Canberra Austria Vienna Azerbaijan Baku a port on the Caspian Sea Bahamas Nassau Bahrain Al-Manámah Bangladesh Dhaka Barbados Bridgetown Belarus Mensk (Minsk) Belgium Brussels Belize Belmopan Benin Porto-Novo Bhutan Thimphu Bolivia Sucre ; Administrative capital: La Paz Bosnia and Herzegovina Sarajevo(unofficial) Botswana Gaborone Brazil Brasília Brunei Darussalam Bandar Seri Begawan Bulgaria Sofia Burkina Faso Ouagadougou Burundi Bujumbura Cambodia Phnom Penh Cameroon Yaoundé Canada Ottawa Ontario Cape Verde Praia Central African Republic Bangui Chad N'Djamena Chile Santiago China Beijing Colombia Santafé de Bogotá Comoros Moroni Congo, Republic of Brazzaville Congo, Democratic Republic of the Kinshasa Costa Rica San José Côte d'Ivoire Yamoussoukro (official) Croatia Zagreb Cuba Havana Cyprus Lefkosia (Nicosia) (in government-controlled area) Czech Republic Prague Denmark Copenhagen Djibouti Djibouti Dominica Roseau Dominican Republic Santo Domingo East Timor Dili Ecuador Quito Egypt Cairo El Salvador San Salvador Equatorial Guinea Malabo Eritrea Asmara Estonia Tallinn Ethiopia Addis Ababa Fiji Suva (on Viti Levu) Finland Helsinki France Paris Gabon Libreville Gambia, The Banjul Georgia Tbilisi Germany Berlin (capital since Oct.) Ghana Accra Greece Athens Athens Grenada St. George's Guatemala Guatemala City Guinea Conakry Guinea-Bissau Bissau Guyana Georgetown Haiti Port-au-Prince Honduras Tegucigalpa Hungary Budapest Iceland Reykjavik India New Delhi Indonesia Jakarta Iran Teheran Iraq Baghdad Ireland Dublin Israel Jerusalem Italy Rome Jamaica Kingston Japan Tokyo Jordan Amman Kazakhstan Astana(formerly Aqmola; capital since ) Kenya Nairobi Kiribati Tarawa Korea, North Pyongyang Korea, South Seoul Kuwait Kuwait Kyrgyzstan Bishkek (formerly Frunze) Laos Vientiane Latvia Riga Lebanon Beirut Lesotho Maseru Liberia Monrovia Libya Tripoli Liechtenstein Vaduz Lithuania Vilnius Luxembourg Luxembourg Macedonia Skopje Madagascar Antananarivo Malawi Lilongwe Malaysia Kuala Lumpur Maldives Malé Mali Bamako Malta Valletta Marshall Islands Majuro Mauritania Nouakchott Mauritius Port Louis Mexico Mexico City Micronesia Palikir Moldova Chisinau Monaco Monaco Mongolia Ulaan Baatar Morocco Rabat Mozambique Maputo Myanmar Rangoon (Yangon) Namibia Windhoek Nauru Yaren Nepal Kathmandu The Netherlands Amsterdam (official) ; The Hague (administrative capital) New Zealand Wellington Nicaragua Managua Niger Niamey Nigeria Abuja Norway Oslo Oman Muscat Pakistan Islamabad Palau Koror Palestinian State (proposed) Undetermined Panama Panama City Papua New Guinea Port Moresby Paraguay Asunción Peru Lima The Philippines Manila Poland Warsaw Portugal Lisbon Qatar Doha Romania Bucharest Russia Moscow Rwanda Kigali St. Kitts and Nevis Basseterre (on St. Kitts) St. Lucia Castries St. Vincent and the Grenadines Kingstown Samoa Apia San Marino San Marino São Tomé and Príncipe São Tomé Saudi Arabia Riyadh Senegal Dakar Serbia and Montenegro Belgrade Seychelles Victoria Sierra Leone Freetown Singapore Singapore Slovakia Bratislava Slovenia Ljubljana Solomon Islands Honiara (on Guadalcanal) Somalia Mogadishu South Africa Pretoria; Legislative capital and largest city: Cape Town; Judicial capital: Bloemfontein . No decision has been made to relocate the seat of government. South Africa is demarcated into nine provinces consisting of the Gauteng Northern Province Mpumalanga North West KwaZulu/Natal Eastern Cape Western Cape Northern Cape and Free State. Each province has its own capital Spain Madrid Sri Lanka Colombo; Legislative and Judicial capital: Sri Jayawardenepura Kotte Sudan Khartoum Suriname Paramaribo Swaziland Mbabane Sweden Stockholm Switzerland Bern Syria Damascus Taiwan Taipei Tajikistan Dushanbe Tanzania Dar es Salaam ; Official capital: Dodoma Thailand Bangkok Togo Lomé Tonga Nuku'alofa Trinidad and Tobago Port-of-Spain Tunisia Tunis Turkey Ankara Turkmenistan Ashgabat Tuvalu Funafuti Uganda Kampala Ukraine Kyiv (Kiev) United Arab Emirates Abu Dhabi United Kingdom London United States Washington DC Uruguay Montevideo Uzbekistan Tashkent Vanuatu Port Vila Venezuela Caracas Vietnam Hanoi Western Sahara (proposed state) El Aaiun Yemen Sanaá Zambia Lusaka Zimbabwe Harare




Health check and health consultation

Power health talks and seminars

Beauty and treatment sessions

Relaxation and sport massages

Weekly family bonding activities

Montaine outdoor activities

Fitness, self defence & leisure classes available

Fully equipped gym sets, steam, sauna, Jacuzzi

Personal trainers available.

Health drinks available.


Relaxation / Swedish Massage Remedial / Deep Tissue Massage Physiotherapy, Sport / Work-Related Injuries Stress / Anxiety Management Acupuncture, Shiatsu Aromatherapy / Essential Oils Reflexology Slimming and Weight loss Beauty and treatment sessions Ions Detox, Ozone Spa More....... Corporate Massage Mobile/home visit Hotels Montaine Center Massage Courses Montaine outdoor activities www.montaine.com.au

 Tel :  (+603) 5636 6788 www.montaine.com.my
 No 16, 1st Floor, Jalan PJS 11/28, Bandar Sunway, 46150, Selangor, Malaysia
Tel : (612) 9264 4567 www.montaine.com.my 23/203 Castlereagh St, Sydney, NSW 2000, Australia