Normal Heartburn or GERD?

Acid reflux is a serious disorder that can and must be treated to prevent symptoms and stave off potentially life-threatening consequences. Known medically and commercially as GERD, the acronym for gastroesophageal reflux disease, repeated bathing of the soft tissues of the esophagus with corrosive stomach acid can seriously damage them and even cause esophageal cancer, which is often fatal.

Acid reflux is more than just a nuisance. It involves the backward flow of stomach acid into the tissues above it. It results when the lower esophageal sphincter, a ring of muscle between the esophagus and the stomach, fails to close tightly enough to prevent the contents of the stomach from moving up instead of down. Sometimes the upper sphincter, between the esophagus and the throat, malfunctions as well.

Contrary to what many believe, heartburn is but one of the many symptoms of GERD, and failure to recognize the others when heartburn is not among them can result in harmful untreated reflux. In addition to indigestion, GERD can cause:

  • persistent dry cough
  • sore throat
  • frequent throat clearing
  • hoarseness
  • burping or hiccups
  • bloating
  • difficulty swallowing
  • a sensation of a lump in the throat

If, when faced with such an otherwise unexplainable symptom, your doctor fails to thinkhand holding stethoscope with GERD word. medical concept of GERD as a possible reason, you might suggest it yourself. An examination of the esophagus may be the only way to find out if someone without obvious heartburn has acid reflux but doesn’t know it.

One characteristic often associated with acid reflux — being overweight, especially with abdominal obesity — largely explains why the condition has become so common in Western countries. Someone with a body mass index in the overweight range is almost twice as likely to have GERD as a person of normal weight. Losing weight is one of the best ways to find relief without having to rely on medication. Other ways to relieve GERD symptoms include:

  • quitting smoking
  • limiting alcohol
  • avoiding carbonated drinks
  • eating five or six small meals a day rather than one or two big ones
  • avoiding eating within three hours of bedtime
  • Raising the head of the bed by six inches or more

If you suffer from GERD and are looking for treatment, schedule an appointment with Dr. Shawn Tsuda. Among other procedures, Dr. Tsuda specializes in a revolutionary treatment for GERD called LINX. Find out if it’s right for you.

 

Most Common Surgical Treatments for Clinically Severe Obesity

The obesity epidemic continues to grow in our country, and with obesity comes a whole host of additional health risks, like type 2 diabetes, heart disease, high blood pressure, osteoarthritis and stroke. Those looking to reduce these obesity-related health risks are turning to bariatric or medical weight-loss surgeries like gastric bypass.

With weight-loss surgery, your surgeon makes changes to your stomach or small intestine, or both. The procedure resolves diabetes 80 percent of the time, and patients lose an average of 70 percent of extra weight. However, gastric bypass isn’t the only choice. Learn about your options:

Laparoscopic Adjustable Gastric Band – The surgeon puts a small band around the top of your stomach. The band has a small balloon inside it that controls how tight or loose the band is. The band limits how much food can go into your stomach. This surgery is done using a laparoscope. Advantages include:

  • Minimally invasive with small incisions
  • Short hospital stay
  • Adjustable without additional surgery
  • Can support pregnancy
  • Removable at any time

Laparoscopic Gastric Sleeve – This surgery removes most of the stomach and leaves only a narrow section of the upper part of the stomach, called a gastric sleeve. The surgery may also curb the hunger hormone ghrelin, so you eat less. Advantages include:

  • No cutting, bypassing, or stapling of the intestine
  • Little concern about vitamin and calcium absorption
  • No adjustments or artificial devices put into place
  • Most foods are possible

Laparoscopic Roux-en-Y Gastric Bypass Surgery – The surgeon leaves only a very small part of the stomach (called the pouch). That pouch can’t hold a lot of food, so you eat less. The food you eat bypasses the rest of the stomach, going straight from the pouch to your small intestine. This surgery can often be done through several small incisions using a camera to see inside (laparoscope). Doctors can also perform a mini-gastric bypass, which is a similar procedure also done through a laparoscope. Advantages include:

  • Tiny incisions, resulting is less scarring and easier healing
  • Excellent cosmetic result
  • Little pain
  • Few wound complications
  • Fast recovery
  • Short hospital stay
  • Resuming physical activity soon
  • Little risk of hernia formation

Duodenal Switch- This is complicated surgery that removes most of the stomach and uses a gastric sleeve to bypass most of your small intestine. It limits how much you can eat. It also means your body doesn’t get as much of a chance to absorb nutrients from your food, which could mean you don’t get enough of the vitamins and minerals you need. Advantages include:

  • Results in greater weight loss than other methods, i.e. 60 – 70% percent excess weight loss or greater, at 5 year follow up
  • Allows patients to eventually eat near normal meals
  • Reduces the absorption of fat by 70 percent or more
  • Causes favorable changes in gut hormones to reduce appetite and improve satiety
  • Is the most effective against diabetes compared to other methods

If you’re considering bariatric surgery, schedule an appointment with Dr. Shawn Tsuda. He can help you decide which, if any, of these treatments is right for your unique situation.Fat man running

 

Does your Diet Support your Warm-Weather Exercise Regimen?

Spring is here, and you might be changing up your fitness routine with warm weather in mind. However, just taking your exercise outside and hydrating more might not cut it for your new regimen. You need to properly fuel your body for the exercise you are doing.

Whether you’re training for fat-loss, a race personal best or just fun, how you fuel your body around the clock – not just immediately before or after exercise – affects your workouts. Try to avoid starving and then feasting; just stay fed by regularly eating while you’re awake. By eating regularly throughout the day, you can largely eliminate the need to worry about dedicated pre- and post-workout meals. Just schedule your workout between your regular meals.

Americans are notorious for getting the bulk of their protein intake at dinner. However, 2014 research published in the Journal of Nutrition shows that simply distributing your regular protein intake more evenly throughout the day improves the body’s ability to build lean muscle. Whatever your sport or workout goal, having healthy levels of muscle will help you reach it. Eat at least 25 to 30 grams of protein per meal. And, remember, those meals should be frequent.

It is important to boost your hydration factor. Most of us are chronically dehydrated, which can take a toll on your ability to focus and concentrate when exercising, and it can impair your strength and power. Research in the Journal of Athletic Training also shows that dehydration can worsen post-exercise muscle soreness. During exercise, aim to drink 6 to 8 ounces of water every 15 to 30 minutes. Ideally, when you finish your workout, your weight should be no more than 2 percent less than your starting weight. Any additional losses in weight point to significant dehydration.

Cutting down on packaged foods and focusing on nature-made foods such as fruits, vegetables, whole grains, dairy and meats is also important. Put junk in, and you can expect to get junk out.

Whatever your exercise goals or routines, know that you can’t out-exercise a bad diet. After all, food is fuel. Without the right fuel in the tank, you’re not going to get where you want to go.

If you’re in the Las Vegas area and are interested in weight-loss surgery, schedule an appointment with Dr. Shawn Tsuda. He can help you find the perfect treatment for your situation.Screen Shot 2017-04-10 at 11.19.07 AM

Gallstones and Gallbladder Disease

Some people think of their gallbladder as being “expendable”. Not that anybody wants any of their organs to be removed, but since many people live a seemingly normal life after getting their gallbladder removed, many people don’t think their gallbladder plays an important role in their overall health. After all, how important can your gallbladder be if you can do just fine after it’s surgically removed? The gallbladder actually plays a very important role in your body. It is an essential part of the digestive system.

In the United States, about a million new cases of gallstone disease are diagnosed each year, and some 800,000 operations are performed to treat gallstones, making it the most common gastrointestinal disorder requiring hospitalization. Gallstones or gallbladder disease can quickly turn a great meal into a period of misery.

Gallstone disease is the most common disorder affecting the body’s biliary system, the network of organs and ducts that create, transport, store, and release bile. Bile is a thick fluid, made in the liver and stored in the gallbladder, which acts in the small intestine to digest fat. Bile contains cholesterol, water, proteins, bilirubin (a breakdown product from blood cells), bile salts (the chemicals necessary to digest fat), and small amounts of copper or other materials. If the chemical balance of bile contains too much of any of these components, particularly of cholesterol, crystals form and can harden into stones.

Bile is stored in the Gallbladder and is concentrated up to five times by the removal of water. Gallstones form when liquid stored in the gallbladder hardens into pieces of stone-like material. Bile contains water, cholesterol, bilirubin and other substances. Ideally these minerals remain in liquid form until they are passed out of the body. However, excessive amounts of these minerals in bile can cause them to crystallize.

These small crystals that form out of the saturated bile may begin to clump together. Any existing crystals makes it easier for other crystals to form. If they stay in the gallbladder too long, the crystals gradually grow larger until they become a gallstone so large that it cannot pass through the biliary ducts.

In terms of size, gallstones can be as small as a grain of sand or as large as a golf ball. A person can form one large stone in his or her gallbladder, or hundreds! About 10 percent of the population has gallstones, but the vast majority experiences no symptoms and need no treatment. However, in 1 percent to 2 percent of these people, gallstones can cause problems by lodging in bile ducts, stopping the flow of bile or digestive enzymes, and leading to severe abdominal pain, vomiting, inflammation, and even life-threatening infection.

Gallstone attack has some classic symptoms:

The most agonizing pain is experienced in the upper right part of the abdomen under the ribs. Usually it appears suddenly, sometimes an hour or two after eating a fatty meal. The pain may get worse quickly, and then last for several hours. Many times the pain may radiate to the back between the shoulder blades or under the right shoulder. Inhaling deeply, or moving, often makes the pain worse. The primary therapy for gallstones that are causing pain, inflammation, or infection is removal of the gallbladder.

A number of factors put people at higher risk of gallstones:

  • Gender: Women between the ages of 20 and 60 are 3 times more likely to develop gallstones than are men in the same age group. By age 60, 20 percent of American women have gallstones.
  • Age: The incidence of gallstone disease increases with age.
  • Genetics: Family history and ethnicity are critical risk factors in development of gallstones, though no gene responsible for gallstone formation has yet been discovered. African-Americans seem to have lower rates of gallstone disease than American Indians, whites, or Hispanics.
  • Obesity: Obesity is a significant risk factor, particularly for women. Obesity also slows down the emptying of the gallbladder.
  • Location of body fat: Belly fat, that spare tire around the middle, dramatically increases the chance of developing stones.
  • Diabetes: People with diabetes often have high levels of triglycerides in their blood, and these fatty acids tend to increase the risk of gallstones.

Even if you’re not at risk for gallstones, it is wise to maintain a healthy body weight, by among other things, sticking to a diet that is low in fat and cholesterol and high in fiber.

If you are in the Las Vegas area and suffering with gallstones or gallbladder disease, schedule a consultation with Dr. Shawn Tsuda.

Gallbladder Disease - Doctor with chalkboard on white background