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Table of Contents


Can We Talk?

Crimes of the Heart

"Save Adap!"

Meth Traps

How to Recognize Abuse - and Deal

Loose Threads

Milestones

International Male

Earthwatch

Soap Dish

Brief

Black Tar Smack Attack

Female Troubles

Comic Relief

Pos & Neg

Double Exposure

Quick Study: Nutrients

Paunch Punch

Report from Retro

Briefs

Tropical Trannie

Quick Study: Depression

Warning Signs

Tunnel of Grub

Resources: Good News

Say Uncle

Skin Trade

Editor's Letter

Mailbox

Trading Spaces


Most Talked About

Magic Johnson Accused of Faking HIV (41)

The POZ/DDF Ratio (blog) (30)

Guidelines Prediction: Start Treatment Earlier (blog) (16)

HIV-Positive People Living Longer Than Ever Before (14)

Bone Marrow Transplant: Potential AIDS Cure? (8)

Obama Campaign Set to Boost Domestic HIV/AIDS Funding (8)

Most Popular Lessons

The HIV Life Cycle

Herpes Simplex Virus

Human Papilloma Virus (HPV)

Shingles

Syphilis & Neurosyphilis

Treatments for Opportunistic Infections (OIs)



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June 2004


Tunnel of Grub

by David Gelman, MD

Think nine inches long and cylindrical. Then get your mind out of the gutter and up to the gullet. The esophagus is a tube that connects your throat to your stomach, pushing food on its way. Some easy-to-swallow lingo:

Esophagitis will give you a pain in the neck or chest just after swallowing (itis means inflamed). In HIVers, especially those with CD4 counts below 100, the usual cause is the yeast infection Candida. If antifungal treatment doesn’t help, an upper endoscopy (EGD) can slide a camera down the hatch to see what’s going on (and take biopsies). It finds esophageal pests, both infectious (like herpes and CMV—treated with antivirals) and noninfectious (like an ulcer).

GERD (gastroesophageal reflux disease) is a $10 word for heartburn: Stomach contents leap back up into the esophagus, a common problem even in neggies. It hurts—and scarfing large meals; lying down right after eating; smoking; or eating mints, chocolate or spicy foods make it worse. If the urge to GERD hits more than twice a week, lasts for hours or doesn’t respond to over-the-counter treatment like antacids, tell your doctor. HIVers with lipodystrophy’s extra belly fat may be especially vulnerable, because that can increase pressure and reflux. The best treatment involves stomach-acid combatants (Prilosec and its cousins), but first make sure your HIV meds play well with them.

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