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Category	Prescription Drug	Strength	Quantity	Cost
Heartburn	Aciphex (heartburn) Bentyl (spasm) Detrol LA (bladder) Nexium (gerd) Prevacid (gerd) Prilosec (gerd) Ranitidine HCL (ulcer)	20 mg 20 mg 4 mg 40 mg 15 mg 20 mg 150 mg	30 pills 90 pills 30 pills 30 pills 30 pills 30 pills 30 pills	$175 $64 $135 $178 $182 $78 $74

Aciphex

Aciphex decreases the amount of acid produced in the stomach. Aciphex is used to treat ulcers, heartburn, gastroesophageal reflux disease (GERD) and other conditions involving excessive stomach acid production.

Bentyl

Bentyl is used to relieve cramps and spasms of the stomach, intestines and bladder.

Detrol LA

Detrol LA capsules are once daily extended release capsules indicated for the treatment of overactive bladder with the bothersome symptoms of urge urinary incontinence, urgency and frequency.

Nexium

Nexium is used to treat gastroesophageal reflux disease (GERD), allowing the esophagus to heal. Nexium is proton pump inhibitor and may be used with other medications to prevent stomach ulcers.

Prevacid

Prevacid is used to treat and prevent stomach and intestinal ulcers, GERD, erosive esophagitis (damage to the esophagus from stomach acid) and other conditions involving excessive stomach acid.

Prilosec

Prilosec is used to treat various acid-related stomach and throat problems including GERD, ulcers, erosive esophagitis and Zollinger-Ellison Syndrome.

Ranitidine

Prescription Ranitidine HCL is used for the treatment and maintenance of active duodenal ulcer.

For More Information Click:    [Heartburn]    [GERD]    [Peptic Ulcers]    [Urinary Incontinence]    

Heartburn is a pain behind the breast bone, often described as ‘burning’ in quality. Pain can also be felt at the same level in the mid-line of the back. Most people suffer from heartburn at one time or another. In fact heartburn has nothing to do with the heart - it is a digestive problem. Heartburn is generally related to meals and posture and can often be relieved by remedies for indigestion.

Acid is present in the stomach to digest food. Heartburn occurs when small amounts of this acid rise up into the gullet (oesophagus) - the tube which carries food from the mouth to the stomach. This is called reflux. The gullet, unlike the stomach, does not have a protective lining. So when it is exposed to the acid, it can become inflamed and painful. At the bottom of the gullet there is a muscle which, by its contraction, acts as a barrier to keep the acid in the stomach. If this doesn’t work properly, reflux occurs. The reason why this muscle fails to work properly is not fully understood.

The most important and helpful aspects of treatment are those which you can do for yourself.

Lifestyle - If at all possible, stop smoking and do not become overweight. Let your evening meal digest well before you go to bed. Night-time symptoms can also be reduced by raising the head of the bed on blocks by 6 inches. Gravity helps to keep the acid in the stomach where it should be. Some people are helped by sleeping on their left side.

Diet - You may find particular foods can make your symptoms worse. These might include:acidic fruit drinks, drinks which are too hot, spirits (such as whiskey and brandy), or fatty and spicy meals. It is better to eat ‘little and often’, fill but do not over-fill the stomach. Food should be eaten slowly and chewed well.

Posture - Avoid bending from the waist or stooping just after meals. Instead, try and bend from the knees, keeping the back straight. Meals are better taken while sitting on an upright chair rather than slumped in front of the television. Also, do not let tight belts increase the pressure on your stomach.

Medicine - Many people who suffer from occasional heartburn take antacids either in tablet or liquid form, which are available over-the-counter. Antacids, such as Alka-Seltzer, Maalox, Mylanta, Pepto-Bismol, Rolaids, and Riopan, are usually the first drugs recommended to relieve heartburn and other mild GERD symptoms. Many brands on the market use different combinations of three basic salts—magnesium, calcium, and aluminum—with hydroxide or bicarbonate ions to neutralize the acid in your stomach. Antacids, however, have side effects. Magnesium salt can lead to diarrhea, and aluminum salts can cause constipation. Aluminum and magnesium salts are often combined in a single product to balance these effects. Calcium carbonate antacids, such as Tums, Titralac, and Alka-2, can also be a supplemental source of calcium. However, they can cause constipation as well.

Hiatus Hernia

A sheet of muscle (called the diaphragm) separates the stomach from the chest. If a small part of the stomach rises into the opening where the gullet passes through the diaphragm (called the hiatus), this is called a hiatus hernia. Many people who suffer from frequent heartburn have a hiatus hernia, which can be shown on an X-ray. However, not everyone with a hiatus hernia suffers from heartburn.

Confusion with Heart Problems

Pain from the heart is also felt in the chest and sometimes in the upper abdomen. There are two kinds of heart pain. The first, angina, is a pain in the chest due to a temporary shortage of oxygen being carried in the blood to the heart muscle. Angina should be suspected if the chest pain is brought on by exercise and relieved by rest. The second is the more severe and prolonged pain of a heart attack. A heart attack should be suspected if the pain is felt intensely in the centre of the chest, spreading perhaps to one or both arms (especially the left) and into the lower jaw; or feels like a heavy pressure or is ‘vice-like’.

Gastroesophageal reflux disease, or GERD, occurs when the lower esophageal sphincter (LES) does not close properly and stomach contents leak back, or reflux, into the esophagus. The LES is a ring of muscle at the bottom of the esophagus that acts like a valve between the esophagus and stomach. The esophagus carries food from the mouth to the stomach. When refluxed stomach acid touches the lining of the esophagus, it causes a burning sensation in the chest or throat called heartburn. The fluid may even be tasted in the back of the mouth, and this is called acid indigestion. Occasional heartburn is common but does not necessarily mean one has GERD. Heartburn that occurs more than twice a week may be considered GERD, and it can eventually lead to more serious health problems.

The main symptoms are persistent heartburn and acid regurgitation. Some people have GERD without heartburn. Instead, they experience pain in the chest, hoarseness in the morning, or trouble swallowing. You may feel like you have food stuck in your throat or like you are choking or your throat is tight. GERD can also cause a dry cough and bad breath.

If you have had heartburn or any of the other symptoms for a while, you should see your doctor. You may want to visit an internist, a doctor who specializes in internal medicine, or a gastroenterologist, a doctor who treats diseases of the stomach and intestines. Your doctor may recommend over-the-counter antacids, which you can buy without a prescription, or medications that stop acid production or help the muscles that empty your stomach. Foaming agents, such as Gaviscon, work by covering your stomach contents with foam to prevent reflux. These drugs may help those who have no damage to the esophagus.

H2 blockers, such as cimetidine (Tagamet HB), famotidine (Pepcid AC), nizatidine (Axid AR), and ranitidine (Zantac 75), impede acid production. They are available in prescription strength and over the counter. These drugs provide short-term relief, but over-the-counter H2 blockers should not be used for more than a few weeks at a time. They are effective for about half of those who have GERD symptoms. Many people benefit from taking H2 blockers at bedtime in combination with a proton pump inhibitor.

Proton pump inhibitors include omeprazole (Prilosec), lansoprazole (Prevacid), pantoprazole (Protonix), rabeprazole (Aciphex), and esomeprazole (Nexium), which are all available by prescription. Proton pump inhibitors are more effective than H2 blockers and can relieve symptoms in almost everyone who has GERD.

A peptic ulcer is a sore on the lining of the stomach or duodenum, which is the beginning of the small intestine. Peptic ulcers are common: One in 10 Americans develops an ulcer at some time in his or her life. One cause of peptic ulcer is bacterial infection, but some ulcers are caused by long-term use of nonsteroidal anti-inflammatory agents (NSAIDs), like aspirin and ibuprofen. In a few cases, cancerous tumors in the stomach or pancreas can cause ulcers. Peptic ulcers are not caused by stress or eating spicy food, but these can make ulcers worse.

Helicobacter pylori (H. pylori) is a type of bacteria. Researchers believe that H. pylori is responsible for the majority of peptic ulcers. H. pylori infection is common in the United States: About 20 percent of people under 40 years old and half of those over 60 years have it. Most infected people, however, do not develop ulcers. Why H. pylori does not cause ulcers in every infected person is not known. Most likely, infection depends on characteristics of the infected person, the type of H. pylori and other factors yet to be discovered.

H. pylori weakens the protective mucous coating of the stomach and duodenum, which allows acid to get through to the sensitive lining beneath. Both the acid and the bacteria irritate the lining and cause a sore, or ulcer. H. pylori is able to survive in stomach acid because it secretes enzymes that neutralize the acid. This mechanism allows H. pylori to make its way to the "safe" area—the protective mucous lining. Once there, the bacterium's spiral shape helps it burrow through the lining.

Symptoms of an ulcer

Abdominal discomfort is the most common symptom. This discomfort usually is a dull, gnawing ache comes and goes for several days or weeks and occurs 2 to 3 hours after a meal. It may occur in the middle of the night (when the stomach is empty) and may be relieved by eating or antacid medications. Other symptoms include: weight loss, poor appetite, bloating, burping, nausea and vomiting.

If you have any of the follow emergency symptoms, call your doctor right away:

sharp, sudden, persistent stomach pain
bloody or black stools
bloody vomit or vomit that looks like coffee grounds

They could be signs of the following serious problems:

perforation—when the ulcer burrows through the stomach or duodenal wall
bleeding—when acid or the ulcer breaks a blood vessel
obstruction—when the ulcer blocks the path of food trying to leave the stomach

Drugs for Peptic Ulcers

Antibiotics: metronidazole, tetracycline, clarithromycin, amoxicillin
H2 blockers: cimetidine, ranitidine, famotidine, nizatidine
Proton pump inhibitors: omeprazole, lansoprazole, rabeprazole, esomeprazole, pantoprozole
Stomach-lining protector: bismuth subsalicylate

Treatment usually involves a combination of antibiotics, acid suppressors, and stomach protectors. Antibiotic regimens recommended for patients may differ across regions of the world because different areas have begun to show resistance to particular antibiotics. The use of only one medication to treat H. pylori is not recommended. At this time, the most proven effective treatment is a 2-week course of treatment called triple therapy. It involves taking two antibiotics to kill the bacteria and either an acid suppressor or stomach-lining shield. Two-week triple therapy reduces ulcer symptoms, kills the bacteria, and prevents ulcer recurrence in more than 90 percent of patients.

Loss of bladder control is called urinary incontinence. It can happen to anyone, but is very common in older people. At least 1 in 10 people age 65 or older has this problem. Symptoms can range from mild leaking to uncontrollable wetting. Women are more likely than men to have incontinence. Aging does not cause incontinence. It can occur for many reasons. For example, urinary tract infections, vaginal infection or irritation, constipation, and certain medicines can cause bladder control problems that last a short time. Sometimes incontinence lasts longer. This might be due to problems such as: weak bladder muscles, overactive bladder muscles, blockage from an enlarged prostate, damage to nerves that control the bladder, diseases such as arthritis that can make walking painful and slow.

The body stores urine in the bladder. During urination, muscles in the bladder contract or tighten. This forces urine out of the bladder and into a tube called the urethra that carries urine out of the body. At the same time, muscles surrounding the urethra relax and let the urine pass through. Spinal nerves control how these muscles move. Incontinence occurs if the bladder muscles contract or the muscles surrounding the urethra relax without warning.

Types of Incontinence

Stress incontinence happens when urine leaks during exercise, coughing, sneezing, laughing, lifting heavy objects, or other body movements that put pressure on the bladder. It is the most common type of bladder control problem in younger and middle-age women. In some cases it is related to childbirth. It may also begin around the time of menopause.

Urge incontinence happens when people can’t hold their urine long enough to get to the toilet in time. Healthy people can have urge incontinence, but it is often found in people who have diabetes, stroke, Alzheimer’s disease, Parkinson’s disease, or multiple sclerosis. It is also sometimes an early sign of bladder cancer.

Overflow incontinence happens when small amounts of urine leak from a bladder that is always full. A man can have trouble emptying his bladder if an enlarged prostate is blocking the urethra. Diabetes and spinal cord injury can also cause this type of incontinence.

Functional incontinence happens in many older people who have normal bladder control. They just have a hard time getting to the toilet in time because of arthritis or other disorders that make moving quickly difficult.

Treatment of Incontinence

Your doctor may suggest you try to get back control of your bladder through training. With bladder training you can change how your bladder stores and empties urine. Pelvic muscle exercises (also known as Kegel exercises) work the muscles that you use to stop urinating. Making these muscles stronger helps you hold urine in your bladder longer. These exercises are easy to do. They can lessen or get rid of stress and urge incontinence. The muscles you want to exercise are your pelvic floor muscles. These are the ones you use to stop the flow of urine or to keep from passing gas. Often doctors suggest that you squeeze and hold these muscles for a certain count, and then relax them.

Biofeedback helps you become more aware of signals from your body. This may help you regain control over the muscles in your bladder and urethra. Biofeedback can be used to help teach pelvic muscle exercises. Also, timed voiding and bladder training also can help you control your bladder. In timed voiding, you keep a chart of urination and leaking to determine the pattern. Once you learn that, you can plan to empty your bladder before you might leak. When combined with biofeedback and pelvic muscle exercises, these methods may help you control urge and overflow incontinence.

A doctor can prescribe medicines to treat incontinence. Some drugs prevent unwanted bladder contractions. Some relax muscles, helping the bladder to empty more fully during urination. Others tighten muscles in the bladder and urethra to cut down leakage. These drugs can sometimes cause side effects such as dry mouth, eye problems, or urine buildup. Vaginal estrogen may be helpful in women after menopause. Talk with your doctor about the benefits and side effects of using any of these medicines for a long time.

A doctor can inject an implant into the area around the urethra. The implant adds bulk. This helps close the urethra to reduce stress incontinence. Injections may have to be repeated after a time because your body slowly gets rid of these substances. Sometimes surgery can improve or cure incontinence if it is caused by a problem such as a change in the position of the bladder or blockage due to an enlarged prostate. Common surgery for stress incontinence involves pulling the bladder up and securing it. When stress incontinence is serious, the surgeon may use a wide sling. This holds up the bladder and narrows the urethra to prevent leakage.

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