Bob Not Well and at the Clinic

Today Bob had his first Asthma Clinic appointment he got on fairly well, he has to go back in 2 months.

Bob has been up all night, badly suffering from Acid Reflux (see below), he was advised to see the Doctor, by the Asthma Nurse.

Gastroesophageal reflux disease (GERD), gastro-oesophageal reflux disease (GORD), gastric reflux disease, or acid reflux disease is chronic symptoms or mucosal damage caused by stomach acid coming up from the stomach into the esophagus.^[1] A typical symptom is heartburn.
GERD is usually caused by changes in the barrier between the stomach and the esophagus, including abnormal relaxation of the lower esophageal sphincter, which normally holds the top of the stomach closed; impaired expulsion of gastric reflux from the esophagus, or a hiatal hernia. These changes may be permanent or temporary ("transient").

The most-common symptoms of GERD are:

• Heartburn
• Regurgitation
• Trouble swallowing (dysphagia)

Typical symptoms are associated with GERD, but there is good evidence for causation only when they are accompanied by esophageal injury. These symptoms are:

• Chronic cough
• Laryngitis (hoarseness, throat clearing)
• Asthma
• Erosion of dental enamel
• Dentine hypersensitivity
• Sinusitis and damaged teeth^[5]
• Pharyngitis

Bob had a bad morning at work this morning, and he hasn't been well all afternoon and so he called in sick at work tonight.