Gastroesophageal reflux disease is a condition where a person is experiencing reflux of acid from stomach into mouth. The person will describe the symptom as heartburn on his chest. This can occur from time to time. It is usually worse after eating certain food or laying down flat. Acid in stomach can be corrosive to the inner esophageal linnings. Repeat reflux can cause inflammation and ulceration to the esophagus causing pain when swallowing (dysphagia).

Foods known to worsen reflux are chocholate, tea, coffee, spicy foods and fried foods. Some medications can also worsen the heartburn.

Longstanding untreated reflux can lead to changes to the inner lining of the esophagus which called Barrett's esophagus. Barrett's esophagus means the lining of esophageal changes from squamous cells to intestinal metaplasia which allows the esophagus to withstand the corrosive effect of the acid. However, Barrett's esophagus can increase the risk of esophageal cancer (adenocarcinoma). To investigate for the changes, gastroscopy (fibre optic camera) to look into the esophagus and biopsy of esophagus to be taken and send to pathology. The pathologist will identify the cells in biopsy to see any changes to the cells.

Treatment of GORD will usually be medications such as Proton Pump inhibitor or Histamine 2 blockers. I prefer using Proton Pump inhibitor (Nexium) as it can reduce acid secretion in stomach by 90%. Whereas Histamine 2 blocker (Zantac), it can reduce acid secretion in stomach by 60% only. Nexium is a slow release and can last up to 19 hours. 

In patients who have severe GORD despite on maximal medical terapy, surgery can be considered to solve the problem. Surgery like Nissen fundoplication which can be done through laparoscopic (keyhole) surgery. 

Eustachian tubes are small passageways that connect behind the nose to the middle ears. When you sneeze, swallow or yawn, the Eustachian tubes open to allow air to flow in and out. However, sometimes, Eustachian tubes can become blocked which is called Eustachian tube dysfunction. When this happens, sounds become muffled and your ear may feel full.

The most common causes of Eustachian tube dysfunction is caused by cold (flu) or sinusitis.

Most of the time, the Eustachian tube dysfunction will resolved without any treatment.

Hearing test is best done by audiologist as they have the equipment to do so. Hearing test is not covered under Medicare. However, there are people who will be eligible for free hearing test provided by Australian government through Hearing Service Voucher.

To be eligible to a Hearing Service Voucher, you must be an Australian citizen or permanent resident 21 years or older and you meet one of the following,

• Centrelink Pensioner Concession Card
  
• Centrelink Sickness Allowance
• DVA Pensioner Concession Card
• White Health Repatriation Card (for hearing loss)
• Gold Health Repatriation Card
• Are a member of the Australian Defence Forces
• Partner or dependent child of an eligible person

Here, I would like to give you some understanding of types of hearing loss. There are conductive hearing loss, sensorineural hearing loss or mixed (combination of both conductive hearing loss and sensorineural hearing loss).

Conductive hearing loss occurs when there is a problem conducting sound waves anywhere along the route through the ear canal, eardrum or the middle ear.

Sensorineural hearing loss is the problem with the hearing organs such as cochlear, vestibulocochlear nerve or auditory centre of the brain. 

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