World AIDS Day 2023
1 Dec 2023
10 mins
World AIDS Day 2023 World AIDS Day is honored every year on December 1st. For the last 33 years, the World Health Organization (WHO) has acknowledged it as one of the eleven official global public health campaigns. Since its inception in 1988, people worldwide have united on this day to raise awareness about HIV (human immunodeficiency virus) and AIDS (acquired immunodeficiency syndrome).    Various organizations conduct awareness campaigns and activities, emphasizing the significance of understanding and combating HIV, as well as addressing the stigma around HIV and AIDS [https://www.mrmed.in/health-library/health-care/hiv-stigma-discrimination]. The day stands as a global moment of solidarity for those living with HIV, honoring those lost to AIDS-related diseases and rallying against the virus spread.    WORLD AIDS DAY 2023 THEME   This year's theme, "LET COMMUNITIES LEAD!" underscores communities' influence in responding to HIV and advancing global health. It's a call to action, recognizing the collective strength of communities in making a positive impact on the ongoing fight against HIV/AIDS.   IMPORTANCE OF AIDS AWARENESS: A STATISTICAL OVERVIEW   * HIV is a significant global health issue, with 40.4 million lives lost so far and ongoing transmission worldwide. * Approximately 39.0 million people were living with HIV [https://www.unaids.org/en/resources/fact-sheet#:~:text=In%202022%2C%20there%20were%2039,(0%E2%80%9314%20years).] at the end of 2022, with the number of People Living with HIV (PLHIV) estimated at around 24 lakhs in India [https://neigrihms.gov.in/Latest%20News/DDA/2023/Final%20HIV%20_%20AIDS%20Policy%202023.pdf]. * In 2022, 630,000 people died from HIV-related causes, and 1.3 million people acquired HIV. * While there's no cure for HIV, access to effective prevention, diagnosis, and treatment has turned it into a manageable chronic condition. * WHO, the Global Fund, and UNAIDS (Joint United Nations Programme on HIV/AIDS) have aligned strategies to end the HIV epidemic by 2030.   DECODING HIV AND AIDS   HIV is a virus that strikes our immune system, leading to the most advanced stage, known as Acquired Immune Deficiency Syndrome (AIDS). It weakens white blood cells, making the body susceptible to opportunistic diseases like tuberculosis and infections. The virus spreads through infected body fluids but not through everyday contact. It can also pass from a mother to her baby.   Fortunately, HIV can be treated and prevented with anti-retroviral therapy (ART) [https://www.mrmed.in/health-library/viral-infections/hiv-medication]. If left untreated, it can develop into AIDS (advanced HIV disease) after many years. WHO identifies Advanced HIV Disease (AHD) based on CD4 cell count or WHO clinical staging. In adults and adolescents, AHD is indicated by a CD4 count below 200 cells/mm3. In addition, WHO identified WHO's clinical staging [https://www.ncbi.nlm.nih.gov/books/NBK374293/]: stages 3 and 4 as AHD. For children under five, all HIV cases are considered advanced.    SIGNS AND SYMPTOMS OF AIDS   *  Early Stage:   - Spread more easily in the first months   - Many are only aware of the later stages   - Initial weeks may have no symptoms or flu-like signs   * Progressive Stage:   - Weakening of the immune system   - Symptoms include swollen lymph nodes, loss of weight, fever, diarrhea, and cough   * Advanced Stage:   Severe Illnesses Without Treatment leads to the development of opportunistic infections like:   - Tuberculosis (TB)   - Cryptococcal meningitis   - Severe bacterial infections   - Cancers like lymphomas and Kaposi's sarcoma   - Hepatitis C   - Hepatitis B   - Pox infections   TRANSMISSION OF AIDS   AIDS can spread through body fluids: blood, breast milk, semen, and vaginal secretions. Factors increasing the risk of HIV transmission include: - Unprotected anal or vaginal sex (semen and vaginal secretions) - Presence of other sexually transmitted infections (STIs) [https://www.mrmed.in/health-library/health-care/world-sexual-health-day-2022] - Sharing contaminated needles and injecting equipment - Unsafe medical procedures, including unsterile cutting or piercing - Accidental needle stick injuries, especially among healthcare workers - Through breast milk from an HIV-infected mother to the baby. - Through Organ transplantation: Organ transplant-related HIV risk is low due to donor screening but may not detect recent exposures.   AIDS TESTING AND SCREENING   Although HIV tests are highly accurate, none can detect the virus immediately after infection. The timing for HIV detection depends on the test type. There are three types of HIV tests: antibody tests, antigen/antibody tests, and nucleic acid tests (NAT). HIV testing and screening [https://www.mrmed.in/health-library/viral-infections/national-hiv-testing-day-2023] is the gateway to prevention, care, and treatment.   How can I self-test for HIV using home testing kits?   HIV home testing kits offer rapid and convenient testing from the comfort of your home. Simply follow these steps:   1. Collect a throat swab or blood sample as per the kit instructions.   2. Place the swab or blood sample in the provided solution or test well.   3. Wait 20 to 30 minutes for the results, indicated by single or double lines on the kit.   Through these are reliable, lab testing is necessary to confirm the diagnosis.    PREVENTION OF AIDS   HIV is preventable through various measures, including the use of condoms during sex, regular testing for HIV and other infections, and considering circumcision for men. Harm reduction services [https://hri.global/what-is-harm-reduction/] are essential for individuals using drugs. Pre-exposure prophylaxis (PrEP) pills, special rings during sex, and injectable prophylactic antiretroviral drugs are recommended for prevention. Pregnant women at high risk receive antiretroviral drugs to protect their babies. If on treatment, maintaining control of HIV through regular testing and medication ensures non-transmission and overall health.   U-Test: Youth-Friendly HIV Prevention   UNICEF's U-Test [https://www.unicef.org/innovation/stories/bringing-hiv-prevention-twenty-first-century] uses AI (artificial intelligence) and social media to help young people learn about HIV in a friendly way. It lets them do a simple, private test at home using a kit. If needed, it connects them to support. In places like West Africa, over a million young people have used U-Test, with 10,000 testing themselves for HIV in just a year. It's spreading to more countries, making it easier for young people to get information and support about HIV.   TREATMENT FOR AIDS   HIV has no cure, but daily anti-retroviral drugs (ART) control the virus, improving overall health. ART lowers virus levels, preventing symptoms and transmission.  Additionally, Complementary therapies for HIV [https://www.mrmed.in/health-library/viral-infections/complementary-therapies-hiv] can manage stress and anxiety. Pregnant women with HIV take ART to protect themselves and their babies. Medications like pre-exposure prophylaxis (PrEP) and post-exposure prophylaxis (PEP) help prevent and manage HIV. WHO supports advanced HIV care, and ongoing research seeks more convenient treatments. Overall, ART is a lifelong commitment for a normal life, and its benefits extend beyond individual health.   NACO'S HOLISTIC SUPPORT FOR HIV PATIENTS IN INDIA   National AIDS Control Organization (NACO) addresses the care, support, and treatment needs of HIV-positive individuals tailored to the infection stage. NACO focuses on low-cost care for common opportunistic infections, enhancing ART accessibility for the poor, and strengthening family and community care, particularly for marginalized women and children. Community Care Centres, established in high-prevalence districts, offer counseling, nutritional support, treatment assistance, and legal services.    BUSTING MYTHS   Myth: I can get HIV by being around HIV-positive people. Fact: You can't catch HIV through touch, tears, sweat, saliva, or pee. It is not transmitted by inhaling the same air, using the same toilet seat or touching the door handle, drinking from a water bottle, hugging, kissing, shaking hands, sharing eating utensils, or using exercise equipment at a gym. HIV is only transmitted through infected blood, semen, vaginal fluid, or breast milk.   Myth: I believe oral sex is just as risky when it comes to HIV. Fact: The risk from oral sex is almost negligible compared with other types of sex. In theory, it seems possible if your partner has HIV, but in reality, that is not the case.   Myth: I believe I would show symptoms if I had HIV, and I can tell if my partner is positive. Fact: HIV can remain asymptomatic for years. Testing is the only way for you or your partner to determine positivity. Recognizing the prolonged asymptomatic phase, the CDC (Centers for Disease Control and Prevention) recommends testing for everyone between 18 and 64 as part of routine blood work.   TAKE AWAY As we mark World AIDS Day, let us collectively prioritize education, dispel misconceptions, and work towards a future where HIV is no longer a global health threat. Together, we can contribute to the goal of ending the HIV epidemic by 2030.   "Anti-retroviral Anthem; Let's March in Harmony Against HIV"
Dr Archana Gupta
What Is Triple Negative Breast Cancer
29 Nov 2023
7 mins
What Is Triple Negative Breast CancerUnderstanding Triple Negative Breast Cancer: Unraveling The Complexity   Breast cancer, a formidable adversary in the realm of oncology, manifests in various subtypes, each possessing distinct characteristics and treatment challenges. Among these, Breast cancer is the most common cancer among women globally. In 2020, an estimated 2.3 million new cases of breast cancer [https://news.abplive.com/science/breast-cancer-is-most-common-cancer-in-india-1-38-million-cases-diagnosed-annually-estimated-incidence-by-2030-abpp-1644363#:~:text=all%20cancer%20deaths.%E2%80%9D-,There%20were%202.3%20million%20new%20cases%20of%20breast%20cancer%20in,of%20all%20new%20cancer%20cases.&text=In%202020%2C%20breast%20cancer%20accounted,to%20the%20Globocan%20data%202020.]were diagnosed worldwide. Triple negative breast cancer (TNBC) stands out as a particularly aggressive and enigmatic form, affecting a significant number of women worldwide. In this blog, we delve into the intricacies of Triple negative breast cancer, exploring its unique features, challenges in diagnosis and treatment, and ongoing research efforts aimed at unraveling its mysteries. DEFINING TRIPLE NEGATIVE BREAST CANCER   Breast cancer is broadly categorized based on the presence or absence of three receptors: estrogen receptor (ER), progesterone receptor (PR), and human epidermal growth factor receptor 2 (HER2). Triple-negative breast cancer, as the name suggests, lacks the expression of all three receptors, making it distinct from other subtypes. This absence renders TNBC unresponsive to hormonal therapies or drugs targeting HER2, limiting treatment options and complicating the management of the disease. EPIDEMIOLOGY AND RISK FACTORS   Triple-negative breast cancer accounts for approximately 10-15% of all breast cancer [https://www.mrmed.in/health-library/womens-health/breast-cancer-awareness-month] cases. It is more prevalent in younger women and individuals of African or Hispanic descent. Notably, TNBC tends to be more aggressive and has a higher likelihood of recurrence within the first few years after diagnosis compared to other subtypes.   Several risk factors contribute to the development of TNBC, including genetic mutations (such as BRCA1), family history of breast cancer, and certain reproductive factors like early age at first menstruation or late age at first childbirth. Obesity and a lack of physical activity also appear to increase the risk of developing TNBC. CHALLENGES IN DIAGNOSIS   The diagnosis of Triple negative breast cancer  involves a combination of imaging studies, such as mammography and ultrasound, and a biopsy to analyze tissue samples. However, identifying TNBC is not solely about detecting the absence of the three receptors; it also requires the exclusion of other subtypes. Accurate and timely diagnosis is crucial, influencing the treatment choice and prognosis.   TNBC tends to be more aggressive, with a higher grade and increased proliferation rates, making it challenging to treat. Additionally, the lack of targeted receptors makes TNBC less responsive to traditional hormonal and various targeted therapies [https://www.mrmed.in/health-library/cancer-care/targeted-therapy-hope-breast-cancer], such as HER2-targeted therapies [https://pubmed.ncbi.nlm.nih.gov/31548601/], necessitating alternative treatment approaches. TREATMENT MODALITIES   The aggressive nature of triple negative breast cancer  demands a comprehensive and often multimodal treatment approach. Standard treatments include surgery, chemotherapy, and radiation therapy [https://www.mrmed.in/health-library/cancer-care/radiation-therapy-for-breast-cancer-treatment]. Surgery, such as mastectomy or lumpectomy, aims to remove the tumor, while chemotherapy targets rapidly dividing cancer cells throughout the body. Radiation therapy is employed to eliminate any remaining cancer cells in the breast or surrounding tissues.   Immunotherapy, a relatively recent addition to the arsenal of cancer treatments, has shown promise in some cases of TNBC. This approach leverages the body's immune system to recognize and destroy cancer cells. Clinical trials are ongoing to explore the effectiveness of immunotherapy in treating triple Negative Breast Cancer. RESEARCH FRONTIERS AND TARGETED THERAPIES   Given the challenges posed by TNBC, researchers are actively engaged in unraveling its molecular intricacies to identify potential targeted therapies. One promising avenue involves exploring the role of specific genetic mutations, such as BRCA1 and BRCA2, which are more prevalent in TNBC. Drugs like PARP inhibitors [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8164563/], initially developed for other types of cancer associated with BRCA mutations, are being investigated for their efficacy in treating TNBC.   Additionally, efforts are underway to understand the tumor microenvironment and the interactions between cancer cells and the surrounding tissues. This knowledge could uncover vulnerabilities in TNBC that can be exploited for therapeutic purposes. Targeting specific pathways involved in cell growth and survival is another area of active investigation. THE ROLE OF PRECISION MEDICINE   Precision medicine, tailoring treatment based on the unique genetic makeup of an individual's cancer, holds great promise for improving outcomes in TNBC. Advances in genomic profiling allow oncologists to identify specific molecular alterations driving the growth of cancer cells. This information can guide the selection of targeted therapies, potentially enhancing treatment efficacy while minimizing side effects. Clinical Trials and Collaborative Efforts   Participation in clinical trials is crucial for advancing our understanding of triple negative breast cancer and developing more effective treatment strategies. Many ongoing trials explore novel drugs, combination therapies, and immunotherapeutic approaches. Patients, healthcare providers, and researchers are collaboratively working to accelerate progress in the field. Empowering Hope: Uniting Against Triple Negative Breast Cancer   Triple negative breast cancer  remains a formidable challenge in the realm of oncology, necessitating a multidisciplinary and personalized approach to treatment. As research continues to unravel the complexities of TNBC, new avenues for targeted therapies and improved outcomes are emerging. A collective effort involving healthcare professionals, researchers, and patients is essential to push the boundaries of knowledge and make significant strides in the battle against this aggressive form of breast cancer.
Dr Archana Gupta
Cancer Patient Diet During Chemotherapy
27 Nov 2023
9 mins
Cancer Patient Diet During ChemotherapyNavigating through chemotherapy for cancer treatment is a challenging journey, and what makes it even trickier is how it can affect your appetite and eating habits. But worry not! We have a guide filled with simple yet powerful tips to help you manage the hurdles and keep yourself well-nourished during this phase. Let's explore these diet options and make your mealtime a bit more manageable and delicious!   DIET DURING YOUR CHEMOTHERAPY DAY: A MEALTIME BLUEPRINT   It is recommended that you eat lightly on your chemotherapy day [https://www.mrmed.in/health-library/cancer-care/understanding-chemotherapy-in-cancer-care]. Eating small portions slowly every few hours works best. Avoid skipping meals on these days and stay away from fatty, greasy, or spicy foods. Now, let's explore your diet choices that you can add before, during, and after that day:   I. BEFORE CHEMOTHERAPY:   On the day of your chemotherapy, it is wise to go easy on your digestive system. Here is a menu to consider:   1. Plain or Fruited Yogurt: A gentle, nutritious option that won't overwhelm your stomach.   2. Fresh Fruit and Cottage Cheese: A refreshing combo offering vitamins and protein.   3. Poached Egg and Toast: A simple, protein-packed choice that's gentle on the stomach.   4. Toasted Bagel with Peanut Butter: Satisfying yet light, providing sustained energy.   5. Cereal and Milk: Opt for lactose-free alternatives like chewable pills or Soy milk.   6. Chicken Rice Soup with Saltine Crackers: Warm and comforting, easy on digestion.   Remember, the key is small, consistent portions throughout the day. Avoid fatty, greasy, or spicy foods to avoid discomfort.   II. DURING CHEMOTHERAPY:   While undergoing chemotherapy, keep your energy up with bland snacks:   1. Low Acid Juices: Apple, grape, and fruit nectars are gentle on the stomach.   2. Liquid Yogurts: Easy to consume, packed with essential nutrients.   3. Fruits like Bananas: Portable and easily digestible.   4. Crackers/Biscuits: A light option to settle your stomach.   Stay hydrated with a water bottle. Avoid acidic foods that may irritate your digestive tract.   III. AFTER CHEMOTHERAPY AND FOR THE NEXT FEW DAYS:   As you recover, focus on nutrition with these tips:   1. Small, Frequent Meals: Aim for 5-6 smaller meals instead of three large ones.   2. Lower-Fat, Bland Foods: Opt for foods that ease your digestive system.   3. Cooler Foods: Choose colder options to minimize strong odors, especially if you're feeling nauseous.   4. Hydration is Key: Drink fluids regularly, with options like apple and grape juice, low-salt broth, or herbal teas.   CHEMO BITES: SAVORING SOLUTIONS FOR SIDE EFFECTS   Facing chemotherapy can be tough because they are designed to knock out those sneaky cancer cells. But here's the tricky part – they can also affect the good guys, your healthy cells. And when that happens, you might run into eating issues that impact your diet. Let's explore these side effects of chemotherapy [https://www.mrmed.in/health-library/cancer-care/managing-chemotherapy-side-effects] and how to manage them through diet.   1. FEELING BLOCKED UP (CONSTIPATION):   What is Constipation? [https://www.mrmed.in/health-library/gastroenterology/constipation-awareness-month-2022] Think of it as a traffic jam in your body, making bowel movements hard and uncomfortable.    Combat it with: * Staying Hydrated: Drink at least 8 cups of liquids daily. * Drinking Warm Liquids: Try coffee, tea, or soup to ease discomfort. * Fiber Power: Whole grains, dried fruits, and beans are constipation fighters.   Soothing Chemo-Induced Constipation: Try Apple Prune Sauce  This simple and effective recipe for Apple Prune Sauce is designed to provide relief from constipation.  * Recipe: To prepare, blend 1/3 cup unprocessed bran, 1/3 cup applesauce, and 1/3 cup mashed stewed prunes thoroughly. * Afterward, store the mixture in the refrigerator for convenience. For optimal results, take 1 to 2 tablespoons of this mixture before bedtime, followed by the consumption of 8 ounces of water. * It's essential to ensure you drink the water to experience the intended relief from constipation. With a yield of 16 servings, each tablespoon of this Apple Prune Sauce amounts to just 10 calories, making it a healthy and low-calorie option.   2. THE RUNNY TUMMY SITUATION (DIARRHEA):   What is Diarrhea? It's like a speed race for your digestive system, causing frequent, watery bowel movements.    Manage it with: - Stay Hydrated: Drink fluids to replace what you lose during diarrhea. - Let Fizz Fade: Avoid carbonated drinks; skip foods that worsen diarrhea. - Mini Meals: Opt for 5 or 6 small meals a day. - Sodium and Potassium Boost: Consume foods high in sodium and potassium. - Low-Fiber Delights: Stick to low-fiber options. - Temperature Matters: Enjoy foods and drinks at room temperature.   3. THE TIREDNESS TANGO (FATIGUE):   What's Fatigue? It's an overwhelming tiredness affecting your energy levels and appetite.    Combat it with: - Sip on Goodness: Go for protein shakes, smoothies, or milkshakes. - Mini Meals: Swap big meals for smaller, more frequent ones. - Snack Attack: Keep snacks handy—peanut butter crackers, nuts, granola bars. - Power Up Protein and Calories: Boost your diet with extra protein and calories. - Stay hydrated, drink nutrient-rich liquids regularly. - Midnight Snack Magic: Have a small bedtime snack. - Get Creative with Food: Experiment with different forms, like a fruit milkshake. - Cool and Comforting Foods: Opt for soft, cool, or frozen options. - Time It Right: Plan larger meals when you feel well and rested. - Sip and Savor: During meals, take small sips of liquids.   Recipe Tips: Tantalize Your Taste Buds with Banana Milkshake * Boost your appetite with a delicious Banana Milkshake. Simply slice a whole ripe banana and place it in a blender. * Add a few drops of vanilla extract and 1 cup of your preferred milk—whether whole milk, 2% milk, or soy milk. * Blend at high speed until smooth. This delightful shake not only tantalizes your taste buds but also provides nutritional benefits.   4. MISSING THE FLAVOR PARTY (LOSS OF TASTE):   When your favorite foods are suddenly not tasting so great, that's a loss of taste for you. Loss of taste or Changes in taste or smell can happen during chemotherapy.    Elevate your meals with: - Pick the Winners: Choose foods that still look and smell delicious. - Marination Magic: Boost flavor with marinades. - Tangy Treats: Experiment with tart foods and drinks. - Sweeten the Deal: Add sugar to balance tastes. - Flavorful Upgrades: Enhance meals with bacon bits, onions, herbs, and sauces.   5. THE NAUSEA AND VOMITING ROLLERCOASTER:   What is Nausea? Ever felt that queasy, uneasy feeling in your stomach? That's nausea.    Nausea Survival Guide [https://www.mrmed.in/health-library/cancer-care/nausea-remedy-foods]: - Gentle on the Stomach Foods: Opt for stomach-friendly choices. - Mini Meals Power: Swap three large meals for smaller, more frequent ones. - Don't Skip, Even if You're Not Hungry: Eating can help, even when not hungry. - Follow Your Cravings: Choose foods that appeal to you. - Sip, Don't Guzzle: Take small sips of liquids during meals.   What is Vomiting? Vomiting, the dramatic exit from the stage, might follow after nausea.    Deal it with: - Hold Off on Eating or Drinking: Give your stomach a break. - Start Slow with Clear Liquids: Ease back in with small sips. - Gradual Reintroduction to Foods: Move to full-liquid and solid foods gradually. - Mini Meals Rule: Stick to 5 or 6 small meals daily.   LIFE AFTER CHEMO: YOUR TOP QUERIES ANSWERED   1. Can diet help prevent cancer recurrence?  After cancer treatment, some alter their diet, hoping to reduce cancer recurrence. Evidence, mainly from bowel and breast cancer [https://www.mrmed.in/health-library/cancer-care/breast-cancer-causes-symptoms-and-treatment] studies, suggests diet may influence cancer recurrence [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8837082/]. However, there's no clear advice for specific cancer types. Cancer experts recommend maintaining a healthy, balanced diet post-treatment, similar to cancer prevention guidelines. Factors increasing cancer risk may also impact recurrence risk. Hence, improve your post-cancer health through a balanced diet.   2. What dessert recipe is suitable for chemo patients? Consider trying Better Brownies – made with whole grain flour, gluten-free, healthy fats, and bursting with flavor.  Indulge in guilt-free delights with these Better Brownies, specially crafted for cancer patients as part of nutrition services. Simply follow this cooking directions for a delicious treat!  * The preparation involves a simple combination of dry ingredients, melted chocolate with olive oil, and a frothy egg mixture sweetened with maple syrup and sugar. * Baked to perfection, these brownies offer a delightful texture with optional walnuts for added crunch. * Follow the easy cooking directions for a delicious outcome, and refrigerate for an hour before cutting into 16 squares. Treat yourself to these nutrient-packed brownies, embracing both health and taste.  3. Can I take dietary supplements during chemotherapy? A balanced diet rich in fruits and vegetables often covers your nutrient needs by choosing cancer-reducing foods [https://www.mrmed.in/health-library/cancer-care/cancer-reducing-foods]. If maintaining such a diet is challenging, consider talking to your doctor, nurse, or dietitian before opting for multivitamins or mineral supplements. They can provide personalized advice based on your situation, ensuring you take the right supplements in suitable doses.   THE BOTTOM LINE   Navigating chemotherapy is undoubtedly a challenging journey, but a thoughtful and gentle approach to your diet can contribute to your overall well-being. Remember to listen to your body, stay hydrated, and seek professional guidance to ensure you're nourishing yourself effectively during this time. Consider making an appointment with a cancer dietitian to personalize your nutrition plan. These experts can provide tailored advice to meet your unique needs and help manage your nutrition during chemotherapy. Your health is a priority, and by taking small, intentional steps, you're supporting your body through this process.   "Nourish Your Strength and Taste the Victory with Healthy Options."
Dr Archana Gupta
Heartburn, Acid Reflux, Or GERD: What’s The Difference
25 Nov 2023
9 mins
Heartburn, Acid Reflux, Or GERD: What’s The Difference"Heartburn whispers, acid reflux murmurs, while GERD speaks of persistent struggles."   Have you ever felt confused about how to judge whether you have a heartburn, acid reflux, or GERD? No wonder everyone is confused because of their similarities. But indeed, it isn't the same problem. Today, we are going to break the confusion through this blog and expand our knowledge about a thorough understanding of heartburn, acid reflux, and GERD. ESSENTIAL OF KNOWING THE DIFFERENCE   GERD is the most common chronic condition of the gastrointestinal tract, which affects over a billion people [https://aoe.amegroups.org/article/view/7211/html]all over the world, and it is estimated to affect up to 20% [https://www.peptest.co.uk/wp-content/uploads/2021/03/2020_Boulton_et_al_A_narrative_review_of_the_prevalence_of_gastroesophageal_reflux.pdf] of the population worldwide. This is because people are often unable to differentiate the symptoms and are unaware of identifying the GERD from acid reflux or heartburn. It is important to understand the difference between them to reduce the mortality rate. This can be prevented by early diagnosis and treatment options, which can be achieved by a proper understanding of GERD. This blog helps us give a clear-cut answer to most of your confusion about GERD, heartburn [https://www.mrmed.in/health-library/gastroenterology/what-is-heartburn], and acid reflux [https://www.mrmed.in/health-library/gastroenterology/acid-reflux-symptoms-treatment-and-medication]. Continue to read for more information. HEARTBURN EXPLAINED: UNVEILING THE SENSATION   Heartburn refers to an irritation of the esophagus (food pipe), which is caused due to acid reflux in the stomach. You may feel a burning sensation in your chest after eating or drinking a beverage. Heartburn is very common during pregnancy due to physical and hormonal changes in the body. Even though the symptoms of heartburn are undesirable, they won't be that harmful when compared to other GI disorders. However, it is important to note, if it is more frequent, which may also indicate GERD.   Common symptoms   * Burning sensation in the chest * Increase of pain when lying down or bending over * Bitter taste in the mouth   Prevention options   1. Eat a healthy diet 2. Avoid eating spicy foods 3. Avoid drinking alcohol 4. Avoid eating foods 2 to 3 hours before bedtime 5. Wearing comfortable clothes when you have heartburn 6. Quit or limit the habit of smoking 7. Do regular physical exercise   Treatment   Medicines like antacids and alginate (maharaft Suspension 150ml [https://www.mrmed.in/medicines/maharaft-suspension-150ml]), H2 blockers, and proton pump inhibitors (PPIs) help to neutralize the stomach acids and relieve heartburns. However, it is advised to consult your doctor before using any medicines. UNDERSTANDING ACID REFLUX: EXPLORING THE BASICS   Acid reflux is the backflow of acid from the stomach into the food pipes, which leads to undesirable symptoms. Heartburn is caused due to acid reflux; people with a weak lower esophageal sphincter (LES) often face these issues.    Common symptoms   * Feeling sick * Feeling uncomfortable * Bitter or sour taste in the mouth (backflow of stomach acid in the back of your mouth)   Prevention   1. Eating small meals more frequently 2. Avoid drinking alcohol or beverages 3. Drink more water 4. Avoid eating midnight snacks 5. Quit or limit your smoking habits (nicotine may relax the lower esophageal sphincter) 6. Avoid eating spicy food or foods that trigger stomach acids   Treatment   Acid reflux can be treated with antacids, H2 blockers, and proton pump inhibitors (PPIs). Your doctor will prescribe you an appropriate medicine based on your health condition. Always remember that untreated acid reflux may cause a GERD (gastroesophageal reflux disease), which is an advanced stage of acid reflux. UNDERSTANDING GERD: A DEEPER DIVE   Gastroesophageal reflux disease (GERD) is a chronic condition that affects your digestive system. People who experience heartburn several times (twice a week) may have the risk of getting GERD. It is a more serious and long-lasting condition of acid reflux. People are often unaware of the symptoms and refuse to get proper treatment by imagining it as a heartburn or acid reflux.    7 COMMON SYMPTOMS OF GERD   1. Pain in the middle chest 2. Nausea 3. Pain during swallowing 4. Chronic/persistent cough 5. Loss of appetite 6. Persistent vomiting 7. Bleeding in the GI (blood vomiting or stool)   Always remember that the signs and symptoms may vary based on the stage and severity of the GERD [https://www.mrmed.in/health-library/gastroenterology/stages-of-gerd]. So, it is recommended to take some proactive steps and speak about the signs and symptoms with your doctor. A hiatal hernia (stomach extending through an opening of the diaphragm) can also increase the chance of getting GERD or worsening GERD symptoms.   Prevention   * Eat a healthy diet [https://www.mrmed.in/health-library/gastroenterology/what-to-eat-when-you-have-gerd]that comprises non-citrus fruits, vegetables, lean proteins, whole grains, low-fat dairy, and ginger. * Avoid smoking and drinking alcohol. * Stay up after a big dinner (lack of activities after a meal may lead to acid reflux). * Get a proper treatment for hiatal hernia (increases the risk of GERD). * Do regular physical exercise.   Treatment   Based on your GERD stage, your doctor will prescribe you the appropriate medicine; proton pump inhibitors (e.g., pantoprazole [https://www.mrmed.in/molecule/pantoprazole]) or histamine 2 receptor blockers (e.g., ranitidine [https://www.mrmed.in/molecule/ranitidine]) are effective in treating GERD. 5 SIMILARITY SHARED AMONG HEARTBURN, ACID REFLUX, OR GERD   1. Patients often or rarely feel pain in the chest or the middle of the chest. 2. You may feel a burning sensation in the breastbone, neck, and throat. 3. You may have a feeling of nausea or vomiting. 4. You may experience a bitter taste in the mouth. 5. You may experience digestion-related problems (indigestion). 5 DIFFERENCE BETWEEN HEARTBURN VS ACID REFLUX VS GERD   TitleHeartburnAcid RefluxGERDPrevalenceHeartburn are common in people with poor eating habits Acid Reflux is common in patients with weak lower esophageal sphincter.GERD is common only in people with severe reflux problems.SeverityNot a serious conditionNot a serious condition unless it is frequentSerious conditionRecoveryCurableCurableIncurable MedicationMedication: antacids, H2 blockers, proton pump inhibitors Medication: antacids, H2 blockers, proton pump inhibitors Medication: Medication may vary based on the stage of GERD (anti-secretory medications)Risk of cancerNo risk of cancerNo risk of getting cancer if properly treated (unless change to GERD)Risk of developing esophageal cancer END NOTES   Even though the above-discussed conditions share similarities in symptoms, it is mandatory to know about the differences to avoid esophageal cancer (end stage of GERD). Everyone should wake up and protect our loved ones with a proper understanding about each and every step of the enemy (GERD) before it turns into an incurable condition. Prevention is better than cure, and for that, we need a proper understanding of heartburn, acid reflux, and GERD. Let's fight against GERD and understand each and every symptom, which acts as a proactive step to avoid it.    "Common heartburn, often known, Chronic hints, a signal shown”.
Dr Archana Gupta
B508
24 Nov 2023
7 min
What To Eat When You Have GERDA CULINARY GUIDE TO SOOTHING GERD SYMPTOMS THROUGH THOUGHTFUL FOOD CHOICES   Gastroesophageal reflux disease (GERD) is a chronic condition when stomach acid flows back into the esophagus, causing irritation and discomfort. While medications can help manage symptoms, making informed dietary choices is crucial for those with GERD to alleviate discomfort and promote overall digestive health. This blog post will explore a comprehensive guide on GERD [https://my.clevelandclinic.org/health/diseases/17019-gerd-or-acid-reflux-or-heartburn-overview] treatment diet, focusing on foods that can help manage symptoms and promote digestive wellness.   WHAT IS GERD?   Before delving into dietary recommendations, it's essential to understand the factors that contribute to GERD and various stages of GERD [https://www.mrmed.in/health-library/gastroenterology/stages-of-gerd]. Certain foods and lifestyle choices can exacerbate symptoms of GERD [https://www.mayoclinic.org/diseases-conditions/gerd/symptoms-causes/syc-20361940], including spicy and acidic foods, large meals, lying down after eating, and excessive consumption of caffeine and alcohol. Conversely, adopting a GERD-friendly diet can significantly reduce symptoms and improve quality of life. Early management is important as chronic duration can lead to stomach cancer [https://www.mrmed.in/health-library/cancer-care/all-about-stomach-cancer].    WHAT IS THE GERD TREATMENT DIET?   * Non-Citrus Fruits: While citrus fruits are known for their acidity, non-citrus options like bananas, melons, and apples are gentle on the stomach and can be included in a GERD-friendly diet. These fruits provide essential vitamins and fiber without triggering acid reflux [https://www.mrmed.in/health-library/gastroenterology/acid-reflux-symptoms-treatment-and-medication]. * Vegetables: Most vegetables are well-tolerated by individuals with GERD. Green leafy vegetables, broccoli, carrots, and cauliflower are excellent choices. These vegetables are low in fat and acid, promoting digestive health. * Lean Proteins: Opt for lean protein sources such as poultry, fish, and tofu. These options are less likely to trigger acid reflux compared to fatty meats. Be mindful of cooking methods; grilling, baking, or steaming are preferable to frying. * Whole Grains: Whole grains like brown rice, quinoa, and oatmeal are high in fiber and can contribute to a healthy digestive system. They also help maintain stable blood sugar levels, preventing the overproduction of stomach acid. * Low-Fat Dairy: Dairy can be a source of discomfort for some individuals with GERD. Choose low-fat or fat-free dairy products like yogurt and milk to minimize the risk of triggering reflux symptoms. * Ginger: Known for its anti-inflammatory properties, ginger can benefit those with GERD. Whether in the form of ginger tea or as a spice in cooking, ginger may help soothe the digestive tract. * Herbal Teas: Chamomile, licorice, and peppermint teas are soothing to the digestive system and may help alleviate symptoms of GERD. It's crucial to choose caffeine-free options to avoid triggering acid reflux.   WHAT ARE THE GERD-TRIGGER FOODS TO AVOID?   * Citrus Fruits: Oranges, grapefruits, and lemons are highly acidic and can worsen GERD symptoms. Opt for non-citrus alternatives to meet your vitamin C needs. * Tomatoes and Tomato-Based Products: Tomatoes are acidic and can contribute to acid reflux. This includes tomato sauces and ketchup. Consider alternatives like pesto or olive oil-based sauces. * Chocolate: Unfortunately, chocolate is a known trigger for GERD symptoms. Limit your intake or opt for white chocolate as a milder alternative. * Coffee and Caffeinated Beverages: Caffeine can relax the lower esophageal sphincter, leading to increased acid reflux. Choose decaffeinated coffee and herbal teas instead. * Peppermint and Spearmint: While herbal teas with peppermint are generally considered safe, concentrated peppermint oil can relax the esophagus muscles and worsen GERD symptoms. * Fried and Fatty Foods: High-fat meals can delay stomach emptying and increase the risk of acid reflux. Choose lean protein sources and cooking methods that minimize added fats. * Spicy Foods: Spices can irritate the esophagus and exacerbate GERD symptoms. Opt for milder seasonings and herbs in your cooking.   LIFESTYLE TIPS FOR MANAGING GERD   In addition to making thoughtful food choices, incorporating certain lifestyle changes can further enhance GERD management [https://www.mrmed.in/health-library/gastroenterology/stages-of-gerd]: * Portion Control: Consuming smaller, more frequent meals can help prevent overeating, reducing the likelihood of acid reflux. * Meal Timing: Avoid lying down or going to bed immediately after eating. Allow at least two to three hours for digestion before lying down. * Stay Hydrated: Daily water can help dilute stomach acid and promote healthy digestion. However, avoid excessive fluid intake during meals to prevent overfilling the stomach. * Maintain a Healthy Weight: Excess weight can contribute to GERD symptoms. Adopting a healthy lifestyle that includes regular exercise can aid in weight management and reduce the severity of reflux.   SAVORING WELLNESS AND COMFORT - A GERD JOURNEY TOWARDS A HEALTHIER TOMORROW   While GERD can present challenges, adopting a mindful and informed approach to your diet can significantly improve symptoms and enhance overall well-being. Individuals with GERD-friendly foods can take control of their digestive health by focusing on GERD-friendly foods, avoiding triggers, and incorporating lifestyle changes. Always consult a healthcare professional or a registered dietitian to create a personalized plan that meets your needs and addresses any underlying health concerns. Making informed choices and embracing a holistic approach can pave the way for a more comfortable and enjoyable life for those managing GERD.
Dr Archana Gupta
Stages, Diagnosis & Management Of GERD
23 Nov 2023
10 mins
Stages, Diagnosis & Management Of GERDHave you ever experienced a burning sensation after indulging in your favorite spicy snacks and desserts at a party? Unable to resist the temptation, you dive into the deliciousness, only to later feel that discomfort in your chest – it's heartburn [https://www.mrmed.in/health-library/gastroenterology/what-is-heartburn] caused by GERD (gastroesophageal reflux disease). This unpleasant condition occurs when your stomach contents decide to take a detour and head back up into your throat. It is a severe form of acid reflux [https://www.mrmed.in/health-library/gastroenterology/acid-reflux-symptoms-treatment-and-medication]. Now, GERD is not just a fleeting annoyance but a constant companion. Understanding the stage of GERD you're in is like having a roadmap for the right treatment.   So, why does it matter? Understanding your GERD stage helps you and your doctor pick the best plan to tackle it. GERD doesn't just pack its bags and leave; it is more like a long-term guest. But fear not; managing it is the name of the game. So, let's team up with your doctor, create that plan, and make sure GERD doesn't steal the spotlight in your life's story!   THE STAGES OF GERD   GERD is considered a chronic disease and may not be completely curable. GERD is one of the most common gastrointestinal disorders, with a prevalence of approximately 15% of adults in the Indian population [https://pubmed.ncbi.nlm.nih.gov/33409947/]. There are four types of GERD based on the severity. For most people, changing their diet and lifestyle can help with GERD. But sometimes, you might need medicine or surgery. Receiving the proper treatment for your particular stage of GERD is vital for keeping your condition from worsening.   Stage Severity Symptoms Management I Mild Heartburn and regurgitation occur infrequently (less than once a week) Lifestyle modifications; antacids II Moderate Heartburn and regurgitation occur a few times a week Lifestyle modifications; daily antisecretory medications (histamine 2 receptor blockers or proton pump inhibitors) III Severe Heartburn, regurgitation, atypical GERD Lifestyle modifications; daily antisecretory medications (histamine 2 receptor blockers or proton pump inhibitors) IV Reflux-induced Precancerous Lesions or Esophageal Cancer Heartburn, regurgitation, atypical GERD, dysphagia, endoscopic findings of esophageal strictures, Barrett’s esophagus, esophageal cancers Lifestyle modifications; daily to twice daily antisecretory medications (histamine 2 receptor blockers or proton pump inhibitors) under the supervision of GERD specialist   STAGE 1: MILD HEARTBURN MARCHES   Stage 1 of GERD, where the mild heartburn starts! At this point, most GERD warriors experience mild heartburn and the occasional regurgitation dance. Take it as a gentle warning from your esophagus, saying, "Hey, let's take it easy!"   Spot the Symptoms: * Heartburn * Chest pain * Feeling like there's a lump in your throat * Food or liquid making a surprise return   Treatment Tactics: To tackle Stage 1, the primary focus is on lifestyle changes. Extinguish the heartburn flame by avoiding fiery foods like coffee, alcohol, and spicy delights. Over-the-counter antacids are your trusty allies, and avoiding late-night feasts can be a game-changer. Pro tip: Elevate your head while sleeping or lift your bed head a little —6 inches to prevent reflux.   STAGE 2: MODERATE REFLUX RANGERS   When you do not take up the warning of stage 1, you end up in stage 2. Now, meet the Moderate Reflux Rangers – about a third of GERD adventurers find themselves here. Symptoms start appearing more often, like weekly visitors overstaying their welcome.   Spot the Symptoms: * The familiar heartburn encores * Chest pain * Lump-in-the-throat sensation * Repeated food or liquid flashbacks   Battle Plan: Unlike in Stage 1, over-the-counter medications might not be sufficient. It's time to consult with a GERD specialist who truly understands your reflux woes. Cue the prescription drug troops, like proton pump inhibitors (e.g., pantoprazole [https://www.mrmed.in/molecule/pantoprazole]) or histamine 2 receptor blockers (e.g., ranitidine [https://www.mrmed.in/molecule/ranitidine]).   STAGE 3: SEVERE SYMPHONY   Stage 3 brings us the Severe Symphony – about 15% of GERD crusaders find themselves here. The symptoms take center stage with daily appearances. It isn't easy to get over without the help of specialists.   Spot the Symptoms: * Heartburn encores (it is getting louder) * Food or liquid reruns * Sore throat * Hoarse voice * Chronic cough takes the spotlight   Special Ops Treatment: Prescription medications don't do the trick anymore; it's time for special operations – like advanced tests such as endoscopy and esophageal manometry [https://www.ncbi.nlm.nih.gov/books/NBK559237/]. If you find yourself in this situation, there is a higher risk of serious complications from GERD. Stage 3 GERD demands the attention of a GERD specialist who will craft a personalized plan to tackle the symphony of symptoms.   STAGE 4: REFLUX'S GRAND FINALE – THE PRECANCEROUS PLOT   Stage 4 GERD is the dramatic climax, representing the Grand Finale of long-term reflux. Only about 10% of GERD warriors reach this stage. It's time to face the hassles and consult with a specialist immediately.   Spot the Symptoms * The relentless heartburn anthem prolongs. * Food or liquid flashbacks continue. * Sore throat takes center stage. * A hoarse voice joins the chorus. * Chronic cough won't leave the spotlight. * Dysphagia – it gets difficult to swallow the food.   Critical Care Complications may arise – esophageal strictures, Barrett's esophagus, or even esophageal cancers, explained below. Diagnostic endoscopy, esophageal manometry, and pH testing become the weapons of choice. Surgery or cancer treatment may enter the script. If you suspect Stage 4 GERD, don't delay – schedule an appointment with a specialist ASAP. Your esophagus will thank you.   GERD COMPLICATIONS: UNWANTED GUESTS YOU WANT TO AVOID   Let's talk about the not-so-friendly side of GERD – the complications that can crash the party if you don't show it the door. These complications tend to get more serious as GERD stages advance. Brace yourself for a journey through GERD's not-so-pleasant aftermath.   1. Esophageal Stricture – The Narrow Path Picture your esophagus as a road. If left untreated, GERD can turn it into a narrow, bumpy path due to scar tissue buildup. Result? Swallowing becomes a bit difficult, like navigating a tricky road.   2. Esophageal Ulcer – The Unwanted Souvenir Stomach acid can leave a nasty mark – an open sore in the esophagus, an esophageal ulcer. It brings pain, difficulty swallowing, and sometimes even bleeding. Not the kind of souvenir you wished for.   3. Barrett's Esophagus – The Precancerous Plot Twist Imagine your esophagus as a book, with GERD as an unexpected plot twist that alters its pages – that's Barrett's esophagus. This condition occurs when acid reflux damages the esophagus. Consider it a warning sign, signaling a slightly increased risk of developing esophageal cancer. The good news? Early detection can rewrite the ending and prevent the big battle.   4. Esophageal Cancer – The Final Showdown Introducing the villain of the game: Esophageal cancer. If GERD advances to Stage 4 without intervention, this could be the ultimate showdown. Years of neglect can pave the way for a serious health battle that you'd be wise to avoid through simple lifestyle changes.   5. Esophagitis – The Irritated Guest GERD may invite stomach acid to throw a party in your esophagus, but the aftermath is irritation and inflammation – known as esophagitis (inflammation of the esophagus). Ulcers, heartburn, chest pain, bleeding, and the feeling of a tough swallow may join the not-so-fun aftermath.   GERD might start with a bit of heartburn, but these complications are like uninvited guests overstaying their welcome. Prevention and early action are your best allies to keep the GERD party drama-free.   TO SUM UP   In the grand narrative of GERD, understanding its stages is the key to navigating the twists and turns of this condition. Remember, GERD is an ongoing story, and the key is to find the right treatment script to keep things under control. Collaborate with specialists, embrace lifestyle changes, and take proactive steps to shape a healthier narrative. Whether it is mild heartburn or severe symptoms, the key lies in prevention, early detection, and decisive action. Be the author of your health story, spread GERD awareness [https://www.mrmed.in/health-library/gastroenterology/gerd-awareness-week-2022], and keep GERD from stealing the limelight.    "Transform Heartburn into Fuel: Ignite the Flames of Your Inner Resilience."
Dr Archana Gupta