The Philippine Star

GERD: It’s more than just heartburn

- By ROEL LEONARDO R. GALANG, MD

“Doctor...I feel a sour taste going up my throat that wakes me up in the middle of the night. I have tried several medication­s and nothing seems to be working.”

“Doctor...there are times I cannot breathe and I get this disturbing lump in my throat but my current chest X-ray is normal.”

“Doctor... I frequently experience chest pain but all my heart tests are normal, it’s giving me anxiety.”

“Doctor...I have been in the Emergency Room several times because of heartburn attacks and these attacks have caused me to skip work.”

Are these statements too familiar? These are the landscapes of Gastroesop­hageal Reflux Disease (GERD) patients that physicians usually encounter during their clinic consults. GERD occurs when acid and stomach content go up the esophagus. This acid reflux can irritate or damage the lining of the esophagus, which may lead to inflammati­on. Over time, others with chronic inflammati­on may reach the end of the spectrum of GERD and develop esophageal complicati­ons.

Everyone can experience acid reflux. However, others are more sensitive and experience an array of discomfort. Most people can manage the discomfort of GERD with lifestyle changes and overthe-counter medication­s. On the other hand, some may need stronger medication­s, further investigat­ion into the condition, or even surgery to relieve the symptoms.

Epidemiolo­gical data have shown that the prevalence of symptomati­c GERD has been rising in the Asia Pacific Region. In 2005, the prevalence of GERD in Eastern Asia was approximat­ely 2.5-4.8% and has increased to 5.28.5% by 2010.

Erosive Esophagiti­s (EE), a common complicati­on of GERD, has more than doubled in the past two decades in the Philippine­s, according to previously reported time trend studies.

A similar gradual rising trend of EE has been noted at St. Luke’s Medical Center-Global City Institute of Digestive and Liver Diseases (IDLD) since 2010. In most cases, the grading of severity of Erosive Esophagiti­s remains mild. Unfortunat­ely, bothersome symptoms of GERD and the associated morbiditie­s have resulted to a significan­t loss in one’s productivi­ty due to work absences and diminished quality of life.

In addition, long-term symptomati­c GERD may be a risk factor for adenocarci­noma of the distal esophagus. This awareness and heightened consciousn­ess has created anxiety for both physicians and patients.

Here are ten tips that can be done to better manage one’s GERD: • Lose weight • Eat small but frequent meals • Exercise • Limit alcohol intake • Reduce caffeine intake • Elevate head of bed • Avoid excessive liquids during a meal • Do not smoke • Substitute water for soda • Talk to your doctor This week, St. Luke’s Medical Center – Global City celebrates the GERD Awareness Week and will concentrat­e on the “Burning Issues in GERD” with scientific lectures focused on the latest advances and knowledge on GERD, including a lay forum and free clinic. Sources: 1. CPG. Diagnosis and Treatment of GERD. Philippine Journal of Internal Medicine. 2015 2. Asia Pacific Consensus on GERD. 2015

3. St. Luke Medical Center. Institute of Digestive and Liver Diseases. 2017

4. Mayo Clinic. Patient Care and Health Informatio­n. 2017 Dr. ROEL LEONARDO R. GALANG is a Fellow of the Philippine College of Physicians (PCP), Philippine Society of Gastroente­rology (PSG), Philippine Society of Digestive Endoscopy (PSDE), and is an active Consultant Staff of St. Luke’s Medical Center – Global City’s Institute of Digestive and Liver Diseases (IDLD).

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