Gastroesophageal reflux disease (GERD) — a disorder that has become increasingly common during the past decade — is caused by an unhealthy lifestyle. And therefore to alleviate GERD means changing one's habits, especially with regard to eating.
"Urban lifestyles, plus the way of life influenced by Western countries, has a direct impact on the occurrence of GERD. As a result, lifestyle change is the most important and most effective cure," said gastroenterologist Dr Boonchai Kowadisaiburana.
GERD is a chronic digestive disorder that affects the oesophagus up to the larynx. The disease happens when stomach acids flow back up the oesophagus instead of staying in the stomach, leading to irritation.
According to an article published by the Royal College of Otolaryngologists Head and Neck Surgeons of Thailand, up to 60% of the population in some Western countries reportedly suffer GERD. In Thailand, however, only 10% of people were found to have fallen prey to the disease. However, the number of GERD patients has constantly been on the rise in recent years.
GERD is characterised by heartburn or burning chest pain which can move upwards to the throat. Some might experience a bitter taste in the mouth as a result of the stomach acid flowing back.
In severe cases, the stomach acid might irritate the larynx too, said Dr Jiravadee Chatuthasri, an ear, nose and throat specialist. This results in coughing, sore throat and inflammation of the vocal cords.
"If the tissues around the throat are severely inflamed, patients will feel as if there is something blocking the throat. The inflamed tissues might press against the oesophagus, making it difficult for patients to swallow," said Dr Jiravadee.
In most cases, GERD is caused by external factors, particularly diet, added Dr Boonchai. Food that might trigger the excessive release of stomach acid and gas include coffee, tea, fermented food, oily food, spicy food and raw vegetables. Smoking and alcohol consumption are also contributory factors. Uncontrollable stress and poor eating habits, especially among city people who do not eat at regular times, eat too close to bedtime and consume too much, especially for dinner, are also likely to lead to GERD.
"Ladies who regularly wear a weight-loss waistband that is too tight also put themselves at risk of developing GERD because the garment is likely to increase the pressure on the stomach and subsequently push the acidic liquid up through the oesophagus," said Dr Boonchai.
Pregnant women have a higher chance of suffering GERD, noted gynaecologist Dr Wanicha Panyakhamlerd, due to hormones released during pregnancy.
"Several hormones lower the ability of the sphincter, which serves like a door between the stomach and the oesophagus," she said. When the door does not shut properly, stomach acid can flow back into the oesophagus.
Medicinal treatments are advised by specialists in most cases. These days medicines used to treat GERD, such as antacids, stomach-lining protectors and drugs to relieve heartburn, are quite effective. They are able to cure up to 90% of GERD patients.
But for the cases in which medication cannot heal the symptoms, patients might need to undergo an endoscopy to look inside the oesophagus for abnormalities. Among the latest treatments for GERD include a technique called Bravo, designed to monitor the pH level inside the stomach and the oesophagus. This is to check the severity of the disease so that specialists can provide treatments accordingly.
"Bravo involves the attachment of a capsule onto the esophageal wall," explained Dr Boonchai. "This capsule will check the pH level and this way we know how severe the disorder is. The capsule will then send a signal to its receptor which the patient has to carry with him/her for 24 hours. Data from the receptor will be analysed for further treatment and prescription." The Bravo capsule will automatically fall off the esophageal wall a week after the test and the body will get rid of it naturally.
To many, GERD seems like an on/off disease, meaning it never goes away completely. But if left unattended, it can bring about other more serious complications, such as the narrowing of the oesophagus and the inflammation of the bronchus and lungs. If left improperly treated for over 20 to 30 years, it may lead to cancer.
"For cases in which GERD affects the larynx, the reflux disease might turn into laryngeal cancer if left unattended for only five years," warned Dr Jiravadee. After all, lifestyle adjustment is key to a cure.
"Controlling stress, not eating too fast, and having a meal on time are among the first things to start with," said Dr Wanicha. "Avoid food which triggers the release of stomach acid, which includes orange juice and tomato juice. Also do not eat too much in one go. Pregnant women should not drink milk close to bedtime, allowing insufficient time for it to be digested. In short, lifestyle change is the best treatment for GERD."
GERD occurs when stomach acids flow back through the oesophagus instead of staying in the stomach — mainly a result of poor eating habits.
