HEARTBURN AND DR. DOOM
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Think of it, a radio transmitter the size of a gel cap! What are we talking about here? International espionage? Think of the heartburn that won't go away, that even has its own name-- GERD. GERD would work well as the name of an evil secret organization plotting to seize control of the universe and establish an evil empire ruled by Dr. Doom.
Suppose the universe under siege is inside of you. You could well feel that Dr. Doom has set up headquarters in your gut and every time you eat he causes an eruption in your chest sending flames and molten lava upwards into your throat, your esophagus, accompanied with something that feels like hot ashes producing uncontrollable coughing.
We call it heartburn even though it has nothing to do with your heart. Most people who suffer from it force themselves to live with it. "Nothing's wrong. I just can't eat pizza. It doesn't agree with me."
Something is wrong, and it can get serious. Prolonged heartburn, usually caused by acid in the esophagus, can make sore throats almost a constant in your life. Acid can be regurgitated into the lungs, causing wheezing. In the mouth it can dissolve the enamel of the teeth. In the throat it can cause bleeding or ulcers.
In addition, scars from tissue damage can build up inside the esophagus and make swallowing difficult. Some people develop Barrett's esophagus, where cells in the esophageal lining take on an abnormal shape and color, which over time can lead to cancer. At first, one of our site visitors thought the problem wasn't serious. "Certain foods just don't agree with me," she'd say. The visitor found one over-the-counter medicine after another that gave temporary relief.
Legions of Pepcid, Zantac, Tagamet, Rolaids, and Tums were sent down her throat to battle Dr. Doom. "Nothing's wrong I just can't eat highly seasoned foods," she insisted.
The list of disagreeable foods grew rapidly. Unaware of Dr. Doom, she went to one doctor after another; sent his or her favorite prescription warrior--Prilosec, Prevacid or Nexium--into battle against Dr. Doom.
Dr. Doom continued his fiendish work. Our visitor began fearing the worst--maybe even a heart attack, maybe some sort of throat constriction that would make it impossible for her to eat. Pressure in the inner ear created an infection which caused balance problems. "I felt like I was going to die."
One of her doctors finally sent her to a specialist, a gastroenterologist, a small man with bushy eyebrows and a lab coat that trailed behind him as he rushed into the examining room at offices in Bronxville, New York. He asked a few questions and then he explained his suspicions.
He tapped the pudgy pointing finger of his right hand against the pinky finger of his left. "One, your esophagus becomes irritated because acid backs up from your stomach, as you know the esophagus is the food pipeline from your throat to your stomach."
He tapped his left forefinger with his right pointing finger, "Two, when you swallow food, it travels down the esophagus. The ring of sphincter muscles at the base of the esophagus relaxes during swallowing to allow food to pass. It then is supposed to tighten to prevent flow in the opposite direction."
"Your stomach produces hydrochloric acid after a meal to aid in the digestion of food. The inner lining of the stomach secretes large amounts of mucus, which protects it against corrosion by this acid."
The right pointing finger tapped on his left middle finger, "Three, the lining of the esophagus is not protected by this mucus so there is a burning sensation when the ring of muscles does not prevent stomach acid from backing up (refluxing) into the esophagus."
"The esophagus is just behind the heart and so the name 'heartburn' seems to describe the sensation. It's called GERD: Gastroesophageal Reflux Disease. I'm going to send you to get some lab work done."
When the lab work was complete the doctor's suspicions were confirmed: GERD. The disease has been treatable for a long time. Part of the treatment has been to place a tube through the nose into the throat with an acid (pH) monitoring electrode attached to its tip just above the sphincter muscles. The electrode is attached by catheter to a data logger worn on a waist belt or shoulder strap.
Every occurrence of acid reflux is recorded over a 24-hour period. Twenty-four hours has been the greatest length of time that patients were required to wear the catheter-attached monitoring system because it restricts their diet and normal activities during the procedure thus limiting the usual esophageal acid events that normally take place.
But now with the development of the radio transmitter the size of a gel cap: the Bravo Catheter-free pH Monitoring System developed by Medtronics, the giant Minneapolis-based medical technology company. GERD and Dr. Doom have a more formidable enemy.
The system consists of a small receiver that clips to the belt of the patient like a pager. Then the miniature radio transmitter is implanted to send back acid reflux data to the receiver for a 48-hour period while the patient goes about daily activities that are much closer to typical. When it has finished its work, the radio transmitter is eliminated from the patient's system.
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