Visit a chemist in Kashmir and you are likely to find someone asking for ‘Aciloc’, ‘Zintac’, ‘Domperidone’, or similar medicines to cure what they describe vaguely as an irritation in the stomach. In reality, in most cases, it is a case of gastroesophageal reflux disease (GERD) that demands proper diagnosis and care, rather than just over-the-counter medicine.
Repeated backflow of acid from the stomach into the food pipe or mouth is called gastroesophageal reflux disorder (GERD).
Three conditions can cause GERD: Poor tone of the lower part of the esophagus (food pipe), too much acid in the stomach, and delayed stomach emptying.
The lower esophageal sphincter is a muscle that controls the passage of food between the esophagus (food pipe) and stomach. Sometimes, this muscle does not close completely, leading acid from the stomach to flow back into the throat or esophagus. This abnormal condition is called gastroesophageal reflux or acid reflux.
Symptoms of gastroesophageal reflux include a sour taste in the mouth, a dry cough, and a burning sensation in the throat. Sometimes, it may cause heartburn (pain in the upper abdomen and chest that sometimes feel like an individual is having a heart attack).
When these symptoms become recurrent and severe, it is called GERD.
Entitled, “Prevalence and risk factors of gastroesophageal reflux disease (GERD) in adult Kashmiri population”, the study was conducted with the objective of studying the prevalence of gastroesophageal reflux disease (GERD) and to evaluate various factors associated with it in the adult Kashmiri population.
The findings revealed that the overall prevalence of GERD in the Kashmiri community is 20.3% with females being more prone with a definite role of factors like Body Mass Index, smoking, physical activity, posture after meals, dinner to a sleep time interval, intake of spicy foods, drugs and also the co-morbidities.
One of the biggest challenges in determining the number of people living with GERD is identifying who actually has the disease. Many people with GERD symptoms don’t consult a healthcare provider. According to the Healthcare Cost and Utilization Project (HCUP), there were 995,402 hospitalizations for GERD in 1998. In 2005, there were 3.14 million, an increase of 216 percent. In both years, approximately 62 percent of all GERD hospital discharges involved women.
The same study showed that the number of adults hospitalized for GERD decreased by 2.4 percent between 1998 and 2005. During the same period, the rate increased by 42 percent for babies. It increased by 84 percent for children aged two to 17.
In 2010, 4.7 million hospitalizations and 1,653 deaths were a result of GERD, reports the National Institute of Diabetes and Digestive and Kidney Diseases.
Here are some lifestyle changes which can prevent you from developing GERD:
Eating sparingly and slowly: Patients can try eating small meals more frequently rather than three large meals daily to reduce acid reflux symptoms. The food must be eaten in small bites and chewed properly.
Reducing weight: Obesity causes the lower esophageal sphincter to go lax, decreasing the pressure that holds the sphincter closed. This leads to reflux and heartburn. Maintaining a healthy lifestyle with reducing body weight can help in decreasing the symptoms of acid reflux.
No smoking: Nicotine relaxes the esophageal sphincter causing symptoms of heartburn, so quitting the habit of smoking may help in reducing the symptoms of acid reflux.
Avoiding carbonated beverages: Carbonated beverages may make a person burp, which sends acid into the esophagus. Quitting the habit of or avoiding carbonated beverages and drinking water instead of sparkling water can curb the symptoms of acid reflux.
Avoiding certain foods: People with acid reflux may be instructed to eliminate some foods that are more likely than others to trigger reflux, including fatty foods, spicy foods, tomatoes, onions, garlic, coffee, tea, chocolate, and alcohol.
Staying up after eating: When standing, or even sitting, gravity alone helps keep acid in the stomach, where it belongs. It is recommended to finish eating three hours before going to bed. This means no naps after lunch and no late suppers or midnight snacks.
Don’t move too fast: Avoiding vigorous exercise or strenuous workouts for a couple of hours after eating can curb the symptoms of acid reflux.
Taking medication: Some medications such as postmenopausal estrogen, tricyclic antidepressants, and anti-inflammatory painkillers can relax the sphincter or can irritate the esophagus. Identifying and curbing such medications after discussing with a doctor can curb acid reflux symptoms.
Adjusting sleeping position: Most acid reflux occurs during sleep. To prevent nighttime attacks, patients may need to position their head at an angle, higher than the abdomen. The head of the bed should be elevated to a minimum of 30°, perhaps with a firm foam-rubber wedge or by putting bricks under the bedposts. Lying flat down should be avoided, especially right after eating.
Limit caffeine intake: Coffee temporarily weakens the lower esophageal sphincter, increasing the risk of acid reflux. Similar to coffee, caffeine weakens the lower esophageal sphincter.
Limit citrus juice: Drinking citrus juice makes acid reflux symptoms worse as citrus juice irritates the lining of the esophagus.
(Hirra Azmat covers health at The Kashmir Monitor. Email: Azmathirra@gmail.com)
