Don’t ignore heartburn

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At some point in your life, you will probably have eaten too much or eaten something spicy and felt a burning sensation in your chest. Whether you call it heartburn, indigestion, or a sour stomach, it is indicative of acid reflux. Although a one-off instance is usually the result of a meal and no cause for concern; frequent and consistent acid reflux may be caused by gastroesophageal reflux disease (GERD). The International Foundation for Gastrointestinal Disorders has dedicated the week of November 21 to 27, to GERD awareness.اضافة اعلان

What is GERD?

When we eat and swallow our food, the chewed food goes down a long tube called the esophagus and eventually ends up in our stomach. Our stomach is the main organ responsible for the digestion of food and in order to break down solid food into smaller, more usable particles; it utilizes acid. On a daily basis, the stomach produces roughly 1.5 liters of extremely strong acid composed of hydrochloric acid, potassium chloride, and sodium chloride.

This acid mixture is so strong in fact that on a pH scale it registers as a one or two. To put that into perspective, acid used in car batteries has a pH level of zero and has been known to dissolve materials such as metal and bone. With this mixture having the potential to cause serious damage to tissue in the body, especially to the stomach itself, the stomach has to have a way to protect itself from its own secretions.

This protection comes in the form of enzymes but most importantly, mucus. The lining of the stomach will secret mucus to form a protective film along the inside to act as a barrier, which is the primary line of defense.

In someone who is suffering from GERD, or chronic acid reflux, the stomach acid flows back up the esophagus. Similar to the stomach, the esophagus has a protective lining of mucus in case of acid reflux. Unfortunately, the mucus lining is not present to the same extent as in the stomach, and frequent reflux can result in degradation of this lining and ultimately irritation or tissue damage. GERD is typically defined has having symptoms of acid reflux more than twice a week and the need for medical intervention may be required.

Prevalence of GERD

There has been no specific study conducted in Jordan to assess the prevalence of GERD among the population. Nevertheless, a 2020 study found that Saudi Arabia has a prevalence rate of around 35 percent. Based on that study, it was projected that the Middle East has one of the highest prevalence rates of any other region globally.

Signs and symptoms of GERD

Symptoms of heartburn or acid reflux can appear differently based on gender and weight but generally is indicated by a burning sensation in the center of the chest. Other common symptoms include regurgitation, the feeling of food stuck in your throat, mild chest pain, coughing, difficulty swallowing, vomiting, sore throat, bad breath, or hoarseness when talking. In children and infants, symptoms may be similar to that of adults but can also include frequent but small vomiting episodes, excessive crying in infants, not wanting to eat, breathing difficulties, difficulty sleeping after eating, or choking that may wake the child.

Who are at risk for GERD?

Generally speaking, GERD tends to be moderately more prevalent in women than in men. There are also many conditions that can increase your risk of developing GERD. Common conditions include obesity, hiatal hernias (bulging of the top of the stomach up into the diaphragm), pregnancy, connective tissue disorders such as scleroderma, and delayed stomach emptying.

Along with these conditions, there are also lifestyle habits and factors that can aggravate acid reflux. These include smoking, eating large meals, eating shortly before bed, eating fatty, fried, or spicy foods, drinking certain drinks such as coffee or alcohol, as well as some medications such as aspirin.

Complications of GERD

Due to the severity of damage caused by acid reflux, there are many complications that are associated with GERD. One such complication is esophagitis. Esophagitis is inflammation and irritation of the esophageal lining caused by stomach acid. Although it does not sound that severe on its own, esophagitis may result in a slew of other complications such as trouble swallowing, ulcers, and even bleeding.

Similarly, another complication of GERD is strictures. Much like your skin, when tissue is damaged, it has the potential to form a scar. After constant damage to the tissue of the esophagus, the lining may become scarred, which ultimately causes the tube or lumen to become narrower. These strictures have the potential to make eating and drinking difficult by obstructing passage into the stomach.

There are also more severe diseases that occur as a result of GERD. Barrett’s esophagus is a condition that occurs in roughly 10 percent of people with long-term GERD. After years of acid reflux damage to the esophageal tissue, the cells have the potential to change and increase the risk for developing esophageal cancer.

How to treat GERD

Before considering medication, especially in acute instances of acid reflux, try to change some lifestyle habits. For those that are obese or overweight, try to lose weight and if you smoke, try to quit. Avoid big and heavy meals, especially in the evening before bed and avoid fatty, spicy, or acidic foods and drinks.

There are many types of over the counter (OTC) medications used to treat acid reflux, primarily in the form of antacids. Antacids are a quick and easy solution to treat acute bouts of acid reflux but do not solve the core issue, may interfere with other medications, and chronic use can result in side effects. If you are taking OTC medications for heartburn more than twice a week or you are experiencing severe or frequent symptoms of GERD, you should consider seeing your healthcare professional.

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