MORNING ODOR...MOUTH ODOR

Bad breath, morning breath, breath odor or halitosis are all terms used to describe a noticeably unpleasant odor exhaled on the breath. Halitosis is not a problem by itself, but it can cause concerns in our interpersonal relationships. 

Have you ever noticed that while talking to someone, the person felt so uncomfortable; not because the person had to use the rest room but because of the odor coming from your mouth? Before you are quick to say; No; I think the person probably didn’t want to embarrass you, so he just managed to get through the conversation. Statistics show that about 85-90% of mouth odor is transient (not pathological). In most cases (85–90%), bad breath originates in the mouth  itself. The intensity of bad breath differs during the day, due to eating certain foods (such as garlic, onions, meat, fish, and cheese), obesity, smoking, and alcohol consumption. Since the mouth is exposed to less oxygen and is inactive during the night, the odor is usually worse upon awakening ("morning breath"). Bad breath may be transient, often disappearing following eating, brushing one's teeth, flossing, or rinsing with specialized mouthwash.

Bad breath may also be persistent (chronic bad breath), which is a more serious condition, affecting some 25% of the population in varying degrees.

How Does What You Eat Affect Breath?

Basically, all the food eaten begins to be broken down in your mouth. As foods are digested and absorbed into the bloodstream, they are eventually carried to your lungs and given off in your breath. If you eat foods with strong odors (such as garlic or onions), brushing and flossing -- even mouthwash -- merely covers up the odor temporarily. The odor will not go away completely until the foods have passed through your body.

Why Do Poor Habits Cause Bad Breath?

If you don't brush and floss teeth daily, food particles can remain in your mouth, which promotes bacterial growth between teeth, around the gums, and on the tongue. This causes bad breath. In addition, odor-causing bacteria and food particles can cause bad breath if dentures are not properly cleaned.

Smoking or chewing tobacco-based products can also cause bad breath, stain teeth, reduce your ability to taste foods, and irritate the gums .

What Health Problems Are Associated With Bad Breath?

Persistent bad breath or a bad taste in the mouth may be warning signs of gum (periodontal) disease. Gum disease is caused by the buildup of plaque on teeth. The bacteria cause toxins to form in the mouth, which irritate the gums. If gum disease continues untreated, it can damage the gums and jawbone.

Other dental causes of bad breath include poorly fitting dental appliances, yeast infections of the mouth, and dental caries.

The medical condition dry mouth (also called xerostomia) can also cause bad breath. Saliva is necessary to moisten and cleanse the mouth by neutralizing acids produced by plaque and washing away dead cells that accumulate on the tongue, gums, and cheeks. If not removed, these cells decompose and can cause bad breath. Dry mouth may be caused by the side effects of various medications, salivary gland problems, or continuous breathing through the mouth.

Many other diseases and illnesses may cause bad breath. Here are some to be aware of: respiratory tract infections such as pneumonia or bronchitis, chronic sinus infections, postnasal drip, diabetes, chronic acid reflux, and liver or kidney problems.

 

 What Can I Do to Prevent Bad Breath?

Bad breath can be reduced or prevented if you:

·         Practice good oral hygiene. Brush twice a day with fluoride toothpaste to remove food debris and plaque. Brush teeth after you eat (keep a tooth brush at work or school to brush after lunch). Don't forget to brush the tongue, too. Replace your toothbrush every two to three months. Use floss or an interdental cleaner to remove food particles and plaque between teeth once a day. Dentures should be removed at night and cleaned thoroughly before being placed in your mouth the next morning.

·         See your dentist regularly -- at least twice a year. He or she will conduct an oral exam and professional teeth cleaning and will be able detect and treat periodontal disease, dry mouth, or other problems that may be the cause of bad mouth odor.

·         Stop smoking/chewing tobacco-based products. Ask your dentist for tips on kicking the habit.

·         Drink lots of water. This will keep your mouth moist. Chewing gum (preferably sugarless) or sucking on candy (preferably sugarless) also stimulates the production of saliva, which helps wash away food particles and bacteria.

·         Keep a log of the foods you eat. If you think they may be causing bad breath, bring the log to your dentist to review. Similarly, make a list of the medications you take. Some drugs may play a role in creating mouth odors.

Who Treats Bad Breath?

In most cases, your dentist can treat the cause of bad breath. If your dentist determines that your mouth is healthy and the odor is not of oral origin, you may be referred to your family doctor or to a specialist to determine the odor source and treatment plan. If the odor is due to gum disease, for example, your dentist can either treat the disease or refer you to a periodontist, a dentist who specializes in treating gum conditions.

What Products Can I Use to Eliminate Bad Breath?

You can buy a number of mouthwashes over-the-counter that claim to eliminate bad breath. However, keep in mind that many of these mouthwashes generally provide only a temporary way to mask unpleasant mouth odor. There are, however, several antiseptic mouth-rinse products available that instead of simply masking breath odor kill the germs that cause bad breath. Ask your dentist about which product is best for you.

STEM CELL THERAPY FOR HEART FAILURE

Skin cells turned into healthy heart muscle cells

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Ultimately they hope this stem cell therapy could be used to treat heart failure patients.Scientist say they have managed to turn patients' own skin cells into healthy heart muscle in the lab.

As the transplanted cells are from the individual patient this could avoid the problem of tissue rejection, they told the European Heart Journal.

Early tests in animals proved promising but the experimental treatment is still years from being used in people.

Experts have increasingly been using stem cells to treat a variety of heart problems and other conditions like diabetes, Parkinsons disease or Alzheimer's.

Stem cells are important because they have the ability to become different cell types, and scientists are working on developing ways to get them to repair or regenerate damaged organs or tissues.

'New and exciting'

More than 750,000 people in the UK have heart failure.      

It means the heart is not pumping blood around the body as well as it used to.

Researchers are looking at ways of fixing the damaged heart muscle.

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Causes of heart failure

• a heart attack
• high blood pressure
• problems with the valves in your heart
• cardiomyopathies - diseases of the heart muscle
• too much alcohol
• congenital conditions - ones you are born with

Source: British Heart Foundation

In the latest study, the team from Rambam Medical Center in Haifa, Israel, took skin cells from two men with heart failure and mixed the cells up with a cocktail of genes and chemicals in the lab to create the stem cell treatment.

The cells that they created were identical to healthy heart muscle cells. When these beating cells were transplanted into a rat, they started to make connections with the surrounding heart tissue.

Lead researcher Professor Lior Gepstein, said: "What is new and exciting about our research is that we have shown that it's possible to take skin cells from an elderly patient with advanced heart failure and end up with his own beating cells in a laboratory dish that are healthy and young - the equivalent to the stage of his heart cells when just born."

The researchers say more work is needed before they can begin trials in humans.

Dr Mike Knapton of the British Heart Foundation, said: "This is a very promising area of study.

"However, we still have a way to go before these findings could be applied to the clinic."

SNORING

Is this topic for you?

This topic is about simple snoring. If you stop breathing, choke, or gasp during sleep, you may have a problem called sleep apnea, which can be serious.

What is snoring?

You snore when the flow of air from your mouth or nose to your lungs makes the tissues of your throat vibrate when you sleep. This can make a loud, raspy noise. Loud snoring can make it hard for you and your partner to get a good night’s sleep.

You may not know that you snore. Your bed partner may notice the snoring and that you sleep with your mouth open. If snoring keeps you or your bed partner from getting a good night’s sleep, one or both of you may feel tired during the day.

Snoring may point to other medical problems, such as obstructive sleep apnea.Sleep apnea can be a serious problem, because you stop breathing at times during sleep. So if you snore often, talk to your doctor about it.

Snoring is more common in men than in women.

What causes snoring?

When you sleep, the muscles in the back of the roof of your mouth (soft palate),tongue, and throat relax. If they relax too much, they narrow or block your airway. As you breathe, your soft palate and uvula vibrate and knock against the back of your throat. This causes the sounds you hear during snoring.

The narrower the airway is, the more the tissue vibrates, and the louder the snoring is.You do not snore when you are awake because the muscles of the throat hold the tissues in the back of the mouth in place. When you sleep, the muscles relax, allowing the tissues to collapse.

Snoring may be caused by:

• Enlarged tissues in the nose, mouth, or throat. Enlarged tonsils are a frequent cause of snoring in children.
• Blocked nasal passages, which make it more difficult to inhale. This affects the tissue of the throat, which may pull together during the extra effort it takes to breathe, which in turn narrows the airway. A blocked nasal passage can be caused by an upper respiratory infection (such as a cold), an allergy, or nasal polyps.
• A deviated nasal septum , which disturbs airflow in the nose.
• Loss of muscle tone in the throat, which makes it easier for tissue to collapse. This can be due to aging or lack of fitness.

Other things that may contribute to snoring include:

• Drinking alcohol, which depresses the part of the brain that regulates breathing. This can overly relax the tongue and throat muscles, causing them to partially block air movement.
• Obesity. Fat in the throat may narrow the airway.
• Medicines that relax you or make you drowsy, such as those taken for allergies,depression, or anxiety.

Snoring - What Increases Your Risk

Factors that may increase your risk of snoring include:

• Being male. Men are more likely to snore than women.
• Age. Snoring is most common in middle-aged people. One study reports that among men, the chance that they will begin snoring increases until 50 to 60 years of age and then decreases.
• Heredity. Snoring may run in families.
• Weight gain and obesity.
• Smoking. Exposing children to tobacco smoke may also increase their risk of snoring.
• Use of alcohol or sedative medicines.
• Chronic nasal congestion during sleep. This is often caused by colds or allergies.
• Jaw abnormalities, such as a small chin and overbite (class II malocclusion -the upper jaw and teeth overlap the bottom jaw and teeth). This may be an especially important factor in women.

How is it treated?

You may be able to treat snoring by making changes in your lifestyle and in the way you prepare for sleep. For example:

• To help prevent snoring, you can:
  • Avoid the use of alcohol and medicines that slow your breathing, such as sleeping pills and tranquilizers.
  • Eat sensibly, exercise, and stay at a healthy weight.
  • Go to bed at the same time every night and get plenty of sleep. Regular sleep patterns help you sleep better, and more restful sleep may reduce snoring.
  • Sleep on your side, not on your back. Sleeping on your back can increase snoring. Try sewing a pocket in the middle of the back of your pajama top, putting a tennis ball into the pocket, and stitching it closed. This will help keep you from sleeping on your back.
  • Quit smoking. This reduces inflammation and swelling in the airway, which may contribute to the narrowing of the airway.
  • Raise the head of your bed 4 in. (10 cm) to 6 in. (15 cm) by putting bricks under the legs of the bed. (Using pillows to raise your head and upper body will not work.) Sleeping at a slight incline can prevent the tongue from falling toward the back of the throat and contributing to a blocked or narrowed airway.
  • Promptly treat breathing problems, such as a stuffy nose caused by a cold orallergies. Breathing problems can raise the risk of snoring.

If these treatments do not work, you may be able to use a machine that helps you breathe while you sleep. This treatment is called continuous positive airway pressure, or CPAP (say "SEE-pap"). In rare cases, your doctor may suggest surgery to open your airway.

Snoring is not always considered a medical problem, so find out if your insurance covers the cost of treatment.

AVOIDANT PERSONALITY DISORDER

Avoidant Personality Disorder

Avoidant personality disorder is characterized by feelings of extreme social inhibition, inadequacy, and sensitivity to negative criticism and rejection. Yet the symptoms involve more than simply being shy or socially awkward. Avoidant personality disorder causes significant problems that affect the ability to interact with others and maintain relationships in day-to-day life. About 1% of the general population has avoidant personality disorder.

Avoidant Personality Disorder Symptoms

Avoidant personality disorder symptoms include a variety of behaviors, such as:

• Avoiding work, social, or school activities for fear of criticism or rejection. It may feel as if you are frequently unwelcome in social situations, even when that is not the case. This is because people with avoidant personality disorder have a low threshold for criticism and often imagine themselves to be inferior to others.
• Low self-esteem
• Self-isolation

When in social situations, a person with avoidant personality disorder may be afraid to speak up for fear of saying the wrong thing, blushing, stammering, or otherwise getting embarrassed. You may also spend a great deal of time anxiously studying those around you for signs of approval or rejection.

A person who has an avoidant personality disorder is aware of being uncomfortable in social situations and often feels socially inept. Despite this self-awareness, comments by others about your shyness or nervousness in social settings may feel like criticism or rejection. This is especially true if you are teased, even in a good-natured way, about your avoidance of social situations.

Social Impact of Avoidant Personality Disorder

Avoidant personality disorder causes a fear of rejection that often makes it difficult to connect with other people. You may be hesitant to seek out friendships, unless you are certain that the other person will like you. When you are involved in a relationship, you may be afraid to share personal information or talk about your feelings. This can make it difficult to maintain intimate relationships or close friendships.

According to the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders (DSM-IV), a person diagnosed with avoidant personality disorder needs to show at least four of the following criteria:

• Avoids occupational activities that involve significant interpersonal contact, because of fears of criticism, disapproval, or rejection.
• Is unwilling to get involved with people unless they are certain of being liked.
• Shows restraint within intimate relationships because of the fear of being shamed or ridiculed.
• Is preoccupied with being criticized or rejected in social situations.
• Is inhibited in new interpersonal situations because of feelings of inadequacy.
• Views self as socially inept, personally unappealing, or inferior to others.
• Is unusually reluctant to take personal risks or to engage in any new activities because they may prove embarrassing.

Avoidant behavior may commonly be seen in children or adolescents, but a diagnosis of a personality disorder cannot be made in childhood because shyness, fear of strangers, social awkwardness, or being sensitive to criticism are often a normal part of child and adolescent development.

A mental health professional can assess your symptoms, make an accurate diagnosis, and suggest the appropriate treatment options.

Avoidant Personality Disorder Treatments

As with other personality disorders, a mental health professional will design a treatment plan that is appropriate for you. Avoidant personality disorder treatments vary, but they will likely include talk therapy. If a co-existing condition, such as depression or anxiety disorder, is also diagnosed, appropriate medications may also be used.

Avoidant Personality Disorder and Other Conditions

Other mental health disorders can occur along with avoidant personality disorder. Treatments in these cases will be designed to help with the symptoms of each disorder. A few of the conditions that most frequently occur with avoidant personality disorder include:

• Social phobia, in which a person experiences overwhelming anxiety and self-consciousness in common social situations. 
• Dependent personality disorder, in which people rely excessively on others for advice or to make decisions for them. 
• Borderline personality disorder, in which people have difficulties in many areas including social relationships, behavior, mood, and self-image.

Many avoidant personality disorder symptoms are commonly shared among these other conditions, particularly in the case of generalized social phobia. Because of this, the disorders can be easily confused. It may take some time for a mental health professional to make a clear diagnosis and choose the appropriate treatments for you.

ANDROPAUSE.. MANOPAUSE

                             ANDROPAUSE...WHAT IS IT

Most people know that women experience menopause, but did you know that some men go through a kind of male menopause? For men who believe they are going through the proverbial midlife crisis, some doctors and researchers say you may actually be experiencing a form of male menopause called "andropause."

Shocking as it may be to some men, male menopause, or andropause, is becoming more widely recognized and accepted by physicians for the changes many middle-aged men experience — from energy loss to depression to loss of libido to sexual dysfunction. And some clinicians are recommending that certain men experiencing these symptoms, along with a host of others such as decreased bone density and weight gain, seek hormone replacement therapy and other treatments.

"Male andropause can be very insidious," explains Dr. Stephen Sinatra, a Manchester, Conn., cardiologist board certified in anti-aging medicine. The loss of testosterone, which can happen to men as young as 35, is gradual, with testosterone levels dropping just 1 percent to 1.5 percent annually. Unlike the precipitous loss of estrogen that women hitting menopause face, the gradual loss of testosterone may take years to exact its mark on men with a host of symptoms not unlike changes menopausal women experience.

Irritability, fatigue, depression, reduced libido and erection problems are hallmark signs of andropause. "I felt like I didn't want to move," says Cecil Dorsey of Vernon, Conn. The 68-year-old retired truck driver, who discovered via a blood test nearly four years ago that his testosterone levels dropped, said, "I just didn't want to be bothered by anything."

                                           Testosterone Replacement

"Conventional means [of treatment] don't look at it as a pattern," Diamond says, who believes a more holistic approach is needed to address all of the symptoms of andropause. This could include conventional therapies combined with testosterone replacement therapy, psychotherapy, herbs, and diet and exercise.

                           Pros and Cons of Testosterone Replacement

Testosterone replacement therapy is the primary means of treating men with declining levels of testosterone, and this is still a controversial area. "What are the problems faced and can they be treated with testosterone? That's where the question lies," Dr. Dobs says.

"All men should be brought up to a certain level of testosterone," advocates Dobs, who suggests that minimum levels should be 300 nanograms per deciliter of total testosterone. The mean level for a 40-year-old is 500 nanograms, she says.

Instances where testosterone replacement therapy is advised, Dobs says, include men with clear bone density loss, which can lead to osteoporosis and decreased height, and in treating sexual dysfunction in cases where Viagra or other often prescribed remedies don't work. Another area of possible benefits of testosterone therapy may be in cases to maintain body composition and muscle — for instance, in patients fighting cancer.

But testosterone replacement therapy is "not a benign treatment," warns Dr. Michael A. Werner, a White Plains, N.Y., urologist with specialized training in male reproductive medicine and surgery and male erectile dysfunction.

Specialists say that men considering testosterone replacement therapy—whether by injection, patches, cream, gel or oral form—should get their PSA levels checked as testosterone replacement therapy could increase the risk of prostate cancer. (A PSA blood test identifies a man's risk for prostate cancer.) Other risks associated with hormone supplementation, particularly with injections, include the risk of stroke, an increase in liver toxicity and breast development. Ironically, testosterone supplementation also shuts down the production of sperm, Werner says.

Retired trucker Dorsey used to get testosterone shots monthly, but in the last year his doctor has prescribed a pill form, after Dorsey complained that the injections would make him feel uneven—great at first but three weeks after the shot, "I'd feel like crap." Although some doctors warn against oral medication, Dorsey says the treatments increase his energy level, and he generally feels better. His hormone and PSA levels are checked monthly.

                     

                                                     Male Diet

But some men are waiting for more accurate treatment. Mendocino County, Calif., engraver and artist Michael Stewart says that the new and popular AndroGel, a clear and odorless topical testosterone gel by Unimed Pharmaceuticals, was too strong for him. While it gave him "a lot of good energy" sexually and otherwise, Stewart felt as though he was getting an unnatural amount of "testosterone juice." He is more cautious, he says. Meanwhile, Stewart is waiting for a product where the user can better regulate testosterone dosage, he says.

                            Reconsidering Grapefruit in the Male Diet

That grapefruit you've been eating to keep those pounds away may not be good for you after all if you're a man suffering declining testosterone levels. The body's aromatase enzyme turns testosterone into the female hormone estrogen when certain substances are ingested, says Dr. Stephen Sinatra, a cardiologist specializing in anti-aging medicine. Grapefruit is one of those catalysts.

Sinatra, author of "Heartbreak and Heart Disease", also advises his male clients suffering from the symptoms of andropause to cut out alcohol from their diet and increase exercise. The aromatase enzyme is also turned on by alcohol and fat, so men with declining levels of testosterone are particularly vulnerable.

To help increase testosterone production, Sinatra, who heads the New England Heart and Longevity Center in Manchester, Conn., suggests men take zinc and vitamins C and E. Sinatra also suggests herbs, such as muira puama, and L-arginine to increase a man's libido.

Sinatra does a blood screen for all his male patients older than age 50 to check their testosterone levels. While testosterone replacement therapy is the standard for treating men with declining levels of testosterone—which can set off symptoms ranging from depression and fatigue to sexual dysfunction—some experts advocate a more holistic approach to andropause, including diet and exercise.

Loss of libido, for example, can be treated with the vasodilator ginkgo biloba, suggests Jed Diamond, author of "Male Menopause." For men hitting midlife, Diamond recommends, eat soy products, lower fat foods, vegetables and tomato products, the last of which can reduce the risk of prostate cancer. Furthermore, drinking plenty of water is a key component for healthy living.

"Some of it's common sense,"  Jed Diamond says. "Some of it is working to change patterns."

ACID REFLUX

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                              WHAT IS ACID REFLUX

Gastroesophageal reflux disease (GERD), gastro-oesophageal reflux disease(GORD), gastric reflux disease, or acid reflux disease is a chronic symptom of mucosal damage caused by stomach acid coming up from the stomach into the esophagus. At the entrance to your stomach is a valve, which is a ring of muscle called the lower esophageal sphincter (LES). Normally, the LES closes as soon as food passes through it. If the LES doesn't close all the way or if it opens too often, acid produced by your stomach can move up into your esophagus. This can cause symptoms such as a burning chest pain called heartburn.

                  

                 What is the difference between acid reflux and heartburn?

Acid reflux is the action, while heartburn is the sensation. The pain is heartburn, while the movement of acid into the esophagus from the stomach is acid reflux.

                                       

                                   BARRETT'S ESOPHAGUS

GERD may lead to Barrett's esophagus, a type of intestinal metaplasia, which is in turn a precursor condition for carcinoma. The risk of progression from Barrett's to dysplasia is uncertain but is estimated at about 20% of cases. Due to the risk of chronic heartburn progressing to Barrett's, EGD every five years is recommended for patients with chronic heartburn, or who take drugs for chronic GERD

                                                       

                         WHAT ARE THE MAIN SYMPTOMS OF GERD

The main symptom of GERD in adults is frequent heartburn, also called acid indigestion—burning-type pain in the lower part of the mid-chest, behind the breast bone, and in the mid-abdomen. Most children under 12 years with GERD, and some adults, have GERD without heartburn. Instead, they may experience a dry cough, asthma symptoms, or trouble swallowing.          

                                 WHAT CAN I DO TO HELP MYSELF

GERD is largely preventable through changes in lifestyle, which are also used as treatment

• Sleep on the left side, or with your upper body raised. 

Relief is often found by raising the head of the bed to 30 degrees, raising the upper body with pillows, or sleeping sitting up. The upper body must be raised, not just the head; pillows that only raise the head do little for heartburn and put strain on the neck. Sleeping on the left side also keeps gravity working for you, keeping your stomach below your esophagus.

• Eat smaller meals. 

Eating a big meal causes excess stomach acid production, so attacks can be minimized by eating smaller meals. It is also important to avoid eating shortly before bedtime.

• Lose weight. 

Gaining even a few pounds increases your risk of heartburn. Exactly why isn't clear, but the leading theory is that more body fat puts more pressure on the stomach, which can cause highly acidic stomach contents to reflux to the lower esophageal sphincter. For the same reason, tight clothing around the abdomen can also increase the risk of heartburn.

• Avoid acidic and rich foods. 

Though less well supported by evidence, a sufferer may benefit from avoiding foods that trigger their symptoms. These commonly include acidic fruit or juices, fatty foods, coffee, tea, onions, peppermint, chocolate, especially shortly before bedtime.

• Avoid consuming acidic substances that can trigger heartburn symptoms such as caffeine, nicotine, and alcohol

                                                 

                        CAN ACID REFLUX DISEASE BE TREATED WITH MEDICATIONS?

  In many cases, lifestyle changes combined with over-the-counter medications are all you need to control the symptoms of acid reflux disease.

  Antacids, such as Alka-Seltzer, Maalox, Mylanta, Rolaids, or Riopan, can neutralize the acid from your stomach. But they may cause diarrhea or constipation, especially if you overuse them. It's best to use antacids that contain both magnesium hydroxide and aluminum hydroxide. When combined, they may help counteract these gastrointestinal side effects.

  If antacids don't help, your doctor may try other medications. Some require a prescription. Your doctor may suggest more than one type or suggest you try a combination of medications such as these:

  • Foaming agents (Gaviscon) coat your stomach to prevent reflux.
  • H2 blockers (Pepcid, Tagamet, Zantac) decrease acid production.
  • Proton pump inhibitors (Prilosec, Prevacid, Protonix, Aciphex, Nexium) also reduce the amount of acid your stomach makes.
  • Prokinetics (Reglan, Urecholine) can help strengthen the LES, empty your stomach faster, and reduce acid reflux.

  Don't combine more than one type of antacid or other medications without your doctor's guidance.

                         

                                     Points to Remember

  • Frequent heartburn, also called acid indigestion, is the most common symptom of GERD in adults. Anyone experiencing heartburn twice a week or more may have GERD.
  • You can have GERD without having heartburn. Your symptoms could include a dry cough, asthma symptoms, or trouble swallowing.
  • If you have been using antacids for more than 2 weeks, it is time to see your health care provider. Most doc-tors can treat GERD. Your health care provider may refer you to a gas-troenterologist, a doctor who treats diseases of the stomach and intestines.
  • Health care providers usually recom-mend lifestyle and dietary changes to relieve symptoms of GERD. Many people with GERD also need medica-tion. Surgery may be considered as a treatment option.
  • Most infants with GER are healthy even though they may frequently spit up or vomit. Most infants outgrow GER by their first birthday. Reflux that continues past 1 year of age may be GERD.
  • The persistence of GER along with other symptoms—arching and irritability in infants, or abdominal and chest pain in older children—is GERD. GERD is the outcome of frequent and persistent GER in infants and children and may cause repeated vomiting, coughing, and respiratory problems.