Lifting the burden of GERD
Gastroesophageal reflux disease (GERD) occurs when the muscle at the end of the oesophagus does not close properly, which allows stomach content to leak back up.
WHAT makes life worth living? Ask any Malaysian and they would probably have “enjoying food” on their list.
Food plays a major role in our lives. It is a daily conversation topic, a compass to plan social events, a display of love, a cause for competition and a source of adventure.
No one really thinks about the inability to enjoy food, given that eating is something that we do almost automatically from birth.
However, the inability to enjoy food is a reality for those suffering a specific tummy affliction – a chronic form of heartburn called gastroesophageal reflux disease, or GERD for short.
Understanding GERD
When we eat something, food travels down a tube called the oesophagus into the stomach.
At the bottom of the oesophagus, before the opening to the stomach, lies a circular tube of muscle known as the lower oesophageal sphincter (LES).
When the LES becomes damaged or weakened, it fails to close all the way, causing the acidic contents of the stomach to move back up (reflux) into the oesophagus.
Stomach acid has a pH close to battery acid.
When this acid contacts the oesophagus and sometimes rises up into the mouth, damage and pain ensues.
Acid reflux causes a burning pain in the chest commonly known as heartburn.
When acid reflux symptoms happen more than twice a week or is accompanied by difficulty in breathing or swallowing, it could denote the more serious condition of GERD.
The prevalence of GERD has been found to be rising across South-East Asia, up to a 20% increase from data recorded after 2005.
Many people with acid reflux or GERD believe that their condition is caused by stress or from eating spicy or acidic food.
While stress is not a cause, it is one of the factors that can aggravate GERD.
Scientists have found that people are more sensitive to stomach acid when they are stressed.
Besides stress, obesity is also another driving factor of GERD development.
As weight accumulates in the belly area, it creates pressure on the diaphragm and LES that causes further weakening of the LES muscles.
With Malaysia ranked as the fattest nation in Asia, it is not surprising that more and more people are suffering from GERD.
Smoking is another risk factor for GERD as the nicotine in cigarettes have a relaxing effect on the LES, hence allowing stomach acid to escape into the oesophagus.
GERD development
In an event titled “Oh My GERD”, a panel of experts came together to discuss the severity of GERD, its signs and symptoms, and more importantly, how to manage the condition successfully.
The panel comprised Universiti Kebangsaan Malaysia consultant physician and gastroenterologist Dr Raja Affendi Raja Ali, gastroenterologist and naturopathic doctor Vagif Soultanov from Melbourne, Australia, and pharmacist Datin Swanee Teh.
“GERD is a condition that worsens over time if left untreated,” stated Dr Affendi.
“Because it’s a disease driven both by structural and lifestyle factors, patients need to take proactive steps to manage it well.
“Think of it this way, if you had a wound and did nothing about it, that wound will fester to cause greater harm. Similarly, GERD needs to be addressed,” he added.
GERD has a significant negative impact on patients’ quality of life. Imagine being constantly stressed about what you should eat and having to limit social dining engagements, all in a bid not to trigger GERD symptoms.
A 2003 study showed that GERD patients have a poorer quality of life in terms of mental health, social functioning and vitality when compared to the general population.
A separate study showed that having GERD decreased work productivity, even more so than someone having a chronic condition like arthritis.
In effect, GERD affects the very core of those things human beings take the greatest pleasure in: food enjoyment, restful sleep and meaningful work.
“Most people don’t expect the dramatic changes GERD makes in their lifestyles. GERD literally sucks all the fun out of life.
According to clinical data, GERD can lead to anxiety and depression, and vice versa. GERD also affects productivity and sleep, which drains a person’s sense of purpose,” explained Dr Soultanov.
What does GERD look like?
Heartburn is one of the hallmark symptoms of acid reflux.
The other symptoms of GERD include a sour-tasting fluid at the back of the throat (stomach acid has a sourish taste), difficulty swallowing or a sensation that something is stuck in the chest or throat, gas build-up, and excessive belching.
Some may even experience a chronic dry cough or breathlessness, which is triggered by the acid reflux.
Should the acid rise up further into the mouth, bad breath can develop as the acid kills off good bacteria in the mouth.
Tooth decay is another consequence of acid damaging teeth and gums.
Conventionally, heartburn and GERD are treated with medications that control acid.
Routinely, the use of acid-blocking drugs called proton pump inhibitors (PPIs) is initiated.
Examples of PPI drugs include deslansoprazole, pantoprazole, omeprazole and esomeprazole.
PPIs are potent stomach acid suppressants. They are popular choices to help patients deal with symptoms as they work fast.
However, the symptoms of GERD are sometimes impossible to control, even with the most powerful PPI drugs.
Some studies have demonstrated that up to 40% of patients with heartburn reported either a partial or complete lack of response to PPIs.
Not just that, acid blockers are not meant to be used for the longterm because of possible adverse effects, the result of compromised digestion and immune protection when acid production is suppressed over time.
Current guidelines recommend that PPIs be used for only four to six weeks after which they should be withdrawn or stepped down to less potent therapy.
In reality however, patients continue their PPIs indefinitely as symptoms tends to recur.
Pine therapy
GERD is not a simple condition to manage. As a naturopathic doctor and a researcher, Dr Soultanov was at hand to share the results from a recent clinical study done on a pine conifer green needle and its effects on gastrointestinal health and GERD.
“We know that the extract possesses cellular healing properties. In this study, we wanted to see the extent of its effects amongst patients with pre-cancerous stomach conditions who were also experiencing GERD.
“The administration of the extract resulted in a 92% improvement in dyspeptic symptoms (GERD), including improvement in symptoms such as gastritis, gas and bowel disorders.
“Not only that, patients also regained normality of stomach function, besides a reversal in pre-cancerous lesions,” he shared.
“Instead of sitting around worrying more and more about GERD, the extract can offer sufferers added options to deal better with their condition.
“By helping to strengthen damaged or weakened oesophageal valves, as well as to support the normalisation of digestive juices in the stomach, the extract will help you get your normal tummy back,” said Teh.
When one understands the crushing grip GERD has on the many things we enjoy in life, it’s difficult not to be disheartened.
However, the combined knowledge from both mainstream and naturopathic medicine can now offer patients a more holistic way of managing their condition successfully.
This article is courtesy of NuvaPineA. The information provided is for educational purposes only and should not be considered as medical advice. The Star does not give any warranty on accuracy, completeness, functionality, usefulness or other assurances as to the content appearing in this column. The Star disclaims all responsibility for any losses, damage to property or personal injury suffered directly or indirectly from reliance on such information.