Acute Respiratory Distress Syndrome (ARDS)

ARDS results when the lungs are injured, most commonly by bloodstream infection (sepsis), pneumonia or trauma. The lungs fill with fluid (pulmonary edema), severely impairing gas exchange. The patient’s blood oxygen level drops dramatically, and breathing becomes rapid and labored.

How is ARDS treated?

Mechanical ventilation, usually with PEEP (positive end-expiratory pressure), is required to support breathing and to increase oxygen levels in the blood. Diuretics may be given to reduce fluid and swelling in the lungs. Intravenous antibiotics are used to combat infections that often accompany ARDS.


Dyspnea-shortness of breath-is a symptom of many lung diseases. However, many other conditions including cardiovascular disease and anemia, can cause dyspnea.

When the cause of dyspnea is not apparent, cardiopulmonary exercise testing may be helpful in determining the cause.

Dyspnea can often be relieved with special breathing and relaxation techniques. Oxygen may also be helpful in some patients.

Gastroesophageal Reflux Disease

Heartburn is a burning sensation in the center of the chest that often occurs after eating, bending over, with exercise, and sometimes at night when lying down. Although its name implies otherwise, heartburn has noting to do with your heart. Rather, these symptoms indicate a condition called gastroesophageal reflux disease, or GERD.

What is GERD?

When you swallow, food passes down your throat and through your esophagus to your stomach. A muscle called the lower esophageal sphincter controls the opening between the esophagus and the stomach, and remains tightly closed except when you swallow food. When this muscle fails to close, the acid-containing contents of the stomach can travel back up into the esophagus. This backward movement is called reflux. When the stomach acid enters the lower part if the esophagus, it can produce a burning sensation, commonly referred to as heartburn.

Several factors might explain why this reflux action occurs and might offer some clues for relief. The most important are the following:

  • The position of your body after eating (An upright posture helps prevent reflux)
  • The size of the meal (Smaller meals reduce reflux)
  • The nature of foods you consume (Certain substances that irritates the esophagus or weaken the sphincter can cause reflux)

How is GERD treated?

To treat GERD, we recommend the following:

  • Raise the head of your bed by six inches to allow gravity to help keep the stomach’s contents in the stomach.
  • Eat meals at least three to four hours before lying down, and avoid bedtime snacks.
  • Eat moderate portions of food and smaller meals.
  • Maintain a healthy weight to eliminate unnecessary intra-abdominal pressure caused by extra pounds.
  • Limit consumption of fatty foods, chocolate, peppermint, coffee, tea, colas, and alcohol-all of which relax the lower esophageal sphincter. Also, avoid tomatoes and citrus fruits or juices, which contribute additional acid that can irritate the esophagus.
  • Give up smoking, which also relaxes the lower esophageal sphincter.
  • Wear loose belts and clothing.

If it persists

Many people will get relief from heartburn and the pressure accompanying esophageal reflux by following the above recommendations. Over-the-counter liquid antacids are also helpful in treating occasional heartburn. If your symptoms persist, do not respond to treatment, or occur frequently, you need to see a doctor for testing and treatment.

A visual examination of the esophagus, known as an endoscopy, might be necessary. Sometimes this test shows that the lining of the esophagus is severely inflamed and irritated by stomach acid. This condition, known as esophagitis, might lead to bleeding and difficulty in swallowing. Medical treatment for this condition might be necessary. This usually involves blocking acid production in the stomach or increasing the strength of the lower esophageal sphincter to help close off the opening to the stomach.

Medicine and the lifestyle changes described above provide relief for most people who suffer from esophageal reflux.