Identify the cells in the circled area

Gastroesophageal Reflux Disease (GERD)

GERD is a chronic digestive disorder that occurs when stomach acid or bile frequently flows back up into the esophagus — the tube connecting your mouth to your stomach. This backwash (reflux) can irritate the lining of your esophagus.
Symptoms:
-Heartburn: A burning sensation in your chest that often occurs after eating and worsens when lying down.
-Regurgitation: The backward flow of stomach contents into the mouth.
-Chest pain: May mimic heart attack pain.
-Difficulty swallowing
-Chronic cough
-Hoarseness
-Sore throat
-Asthma
Causes:
-Weakening of the lower esophageal sphincter (LES): The LES is a ring of muscle that normally prevents stomach acid from flowing back up into the esophagus. If it weakens or relaxes inappropriately, acid can reflux.
-Hiatal hernia: A condition where part of the stomach pushes up through the diaphragm (the muscle separating the chest and abdomen).
-Certain foods and drinks:
Fatty foods
Spicy foods
Citrus fruits
Tomato-based products
Alcohol
Caffeine
Chocolate
Peppermint
Onions
Garlic
Medications:
Some medications, such as aspirin, ibuprofen, and some blood pressure medications, can relax the LES.
Pregnancy: Hormonal changes during pregnancy can relax the LES.
Obesity: Excess weight can increase pressure on the abdomen, forcing stomach acid back up into the esophagus.
Diagnosis:
Medical history and physical exam
Upper endoscopy: A procedure to examine the esophagus with a thin, flexible tube with a light and camera.
Esophageal manometry: Measures the pressure within the esophagus and LES.
24-hour pH monitoring: Monitors the acidity of the esophagus over a 24-hour period.
Treatment:

Lifestyle changes:
Dietary changes: Avoid trigger foods and eat smaller, more frequent meals.
Weight loss: If overweight or obese.
Elevate the head of the bed:
Quit smoking:
Avoid lying down after eating
Medications:
Antacids: Neutralize stomach acid.
H2 blockers: Reduce stomach acid production.
Proton pump inhibitors (PPIs): Strongly reduce stomach acid production.
Surgery: In severe cases, surgery may be an option.

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Growling noises in the stomach, known as borborygmi, are typically caused by the movement of food, liquid, and gas through the stomach and intestines. Here are some common reasons for these noises:

Hunger: When you haven't eaten for a while, your stomach releases hormones that trigger the contraction of the muscles in the stomach and intestines, which creates the growling sound. This is a signal that your body is ready for food.

Digestive Process: As your digestive system works to break down food, gases and liquids move through the intestines, creating sounds, especially if the stomach is empty or digestion is still in progress.

Swallowed Air: Eating, drinking, or talking can cause you to swallow air. This air moves through your digestive tract and can create growling noises as it shifts around.

Food Breakdown: Some foods, especially those high in fiber or complex carbohydrates (like beans, broccoli, and whole grains), can produce more gas as they are broken down in the intestines, leading to louder growling.

Gas and Bloating: Conditions like bloating or indigestion can lead to increased gas production and movement, making stomach noises more pronounced.

Growling noises in the stomach, known as borborygmi, are typically caused by the movement of food, liquid, and gas through the stomach and intestines. Here are some common reasons for these noises:

Hunger: When you haven't eaten for a while, your stomach releases hormones that trigger the contraction of the muscles in the stomach and intestines, which creates the growling sound. This is a signal that your body is ready for food.

Digestive Process: As your digestive system works to break down food, gases and liquids move through the intestines, creating sounds, especially if the stomach is empty or digestion is still in progress.

Swallowed Air: Eating, drinking, or talking can cause you to swallow air. This air moves through your digestive tract and can create growling noises as it shifts around.

Food Breakdown: Some foods, especially those high in fiber or complex carbohydrates (like beans, broccoli, and whole grains), can produce more gas as they are broken down in the intestines, leading to louder growling.

Gas and Bloating: Conditions like bloating or indigestion can lead to increased gas production and movement, making stomach noises more pronounced.