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Please do not ignore that heartburn

Dr Allan Rajula, Consultant Gastroenterologist at Aga Khan University Hospital explains the structure of the oesophagus in his clinic.

A heartburn that will just not let up should not be ignored or taken lightly.

It could very well be a sign of gastroesophageal reflux disease (GERD) which causes the stomach acid and digestive enzymes to leak backwards into the oesophagus (the tube that carries food from the mouth to the stomach).

Acid reflux is very common and most people experience it at some point in their lives.

In Kenya, although no studies have been done to determine the exact figures, about one to two in every ten people suffer from acid reflux. Further, over 50 per cent will have reflux symptoms over a 12-month period.

This condition, therefore, only becomes a problem when it persists and affects one’s daily activities.

According to Dr Allan Rajula, Consultant Gastroenterologist at Aga Khan University Hospital, Nairobi, frequent heartburns and regurgitation are the most common symptoms of GERD, which seems to be increasing world-wide with obesity and advancing age.

“Long-standing severe GERD causes changes in the cells within the lining of the oesophagus, which can become either pre-cancerous, or cancerous. The condition occurs in about ten per cent of people found with the ailment,” he said.

Most patients with GERD have either non-erosive reflux disease or erosive oesophagitis. For those with ongoing reflux but experience little to no relief from acid blocking medications, Dr Rajula said this is indicative of the non-erosive type.

“While these individuals will have GERD-like symptoms, they do not show any signs of injury to the esophagus when further examination is conducted,” he said.

Treatment for most people with GERD incorporates lifestyle changes and medication.

There are some specific foods people suffering from GERD should avoid because they promote reflux. These foods include peppermint, chocolate, caffeinated drinks, alcohol, fatty foods, and spicy or acid-containing foods.

Dr Rajulla added: “Recently, a 45-year-old male patient was referred to my clinic with long-standing discomfort, difficulty sleeping and heartburn with reflux and regurgitation symptoms. He was sensitive to acidic foods, fruits and vegetables and often had to use over the counter antacids.”

Further examination revealed the man had an abnormality that was causing part of his stomach to slide up into the chest cavity, past the diaphragm. It was this that was causing the reflux since the abnormality meant the stomach acid was backing up into his esophagus.

“I put him on medication that offers long lasting reduction of gastric acid production. He took the medicine for eight weeks and his condition has since improved. He is sleeping better and living a normal life,” Dr Rajulla said.

The doctor, however, notes the duration of taking these drugs depends on severity of the acid reflux and can be anything from eight weeks to life.

He recommends seeking medical advise as opposed to taking normal antacids which offer very limited relief.

In Western populations, GERD has been identified as the leading cause of cancer of the esophagus. It affects approximately 10 to 20 per cent of the population with the prevalence rate found to be highest among adults 50 years and above.

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