Take acid reflux more seriously
General practitioner and family physician Dr Ryan Kellman sees at least five to ten patients a week suffering from acid reflux or gastro-oesophageal reflux disease (GERD).
He’s concerned that this could just be a small portion of the number of Barbadians affected by the chronic digestive disorder which is often treated lightly.
“There are many people who have reflux disease or GERD that will not come to the doctor,” he says, while warning that serious complications can result from the disorder if it is left untreated or mismanaged.
“. . . As benign as people think it is, it can eventually lead to adenocarcinoma –– cancer of the oesophagus.”
Dr Kellman points out that everybody has acid reflux, but it is only when the lining of the oesophagus is damaged that you can call it GERD.
“GERD is basically when those stomach contents are not leaving the stomach to enter into the small bowel; so some of them reflux. So you have, one, the sphincter is relaxing, allowing contents to go back into the oesophagus, or the stomach is not emptying enough or fast enough; so it allows the gastric contents to remain there.
“You can also have a condition where the person is obese and it leads to compression on the stomach actually forcing the contents of the stomach in the oesophagus.”
People who suffer from the condition will most likely experience heartburn: a pain or burning sensation in the lower chest region just below the breast bone or regurgitative symptoms which include a sour or acid taste coming into the back of the throat.
“To call it GERD I would want to know the frequency it occurs, because it has to be two or more episodes in one week. Two attacks per week we call mild; greater than two we call that moderate. You may have somebody having eight or ten episodes of GERD per week; that is severe.”
Common risk factors for GERD include, obesity, pregnancy, diabetes, peptic ulcers, smoking and excess alcohol. And in most people, certain foods can trigger reflux.
As a matter of fact, Dr Kellman says diet is one of the first things acid reflux patients must address.
“Types of food that would normally do this: chocolate, garlic. These ones specifically decrease the contractability of the lower parts of the swallow pipe; so it allows content to get back from the stomach into the oesophagus, or you may have a situation with certain foods, spicy foods; red wine.”
He also listed fruits, cured and smoked meats; and stressed that fried foods must be avoided.
Dr Kellman notes it’s common for sufferers to use over-the-counter drugs such Tums, Dica, Pepto Bismol and the like for relief, but he warns users should not use these medications for more than a week. For more severe cases, the doctor will prescribe a course of treatment.
While many don’t see acid reflux as a serious illness, it can have a significant impact on the lives of patients. Dr Kellman is particularly concerned that while Barbadians can identify symptoms, they are unaware of its serious and potentially life-threatening complications.
“The lining of the oesophagus which is the swallow pipe, may actually change its form and become something called barium oesophagram, and that of itself is pre-cancerous or a legion that may ultimately lead to a cancer of the oesophagus.”
“There is an asthma associated with acid reflux disease. The acid that is coming up is actually causing bronchospasms; a person will get the area closed off due to acid that is regurgitating back there and you can have a laryngitis where the back of the throat becomes inflamed. You can also have caries based on the acid coming back and eroding there, it is also thought that sinusitis maybe secondary to GERD.”
Still he says, there’s no need for anxiety on the part of sufferers. Dr Kellman advises if you’ve been diagnosed with acid reflux disease it simply means learning how to manage and prevent your symptoms
“So you can limit alcohol usage to moderation. Stop smoking. Correct eating; correct eating is not only what you eat but the also the frequency of how you eat; for instance, not having a heavy meal and going and lie down. So there are little things like that you can actually address.
“Decreasing the amount of spices in foods. You know in the Caribbean we like a lot of garlic and onions in our food to make it tasty and we have a little problem with greasy foods; so limiting these things in the diet, fatty foods, alcohol and smoking can lead to a decrease in the incidence of GERD.”