Health observance week targets chronic heartburn
GERD often is mistaken for something else
It is not uncommon for people with gastroesophageal reflux disease, or GERD, to rush to the emergency department thinking that they are having a heart attack. Left untreated, the severe heartburn caused by GERD mimics cardiac chest pain. Of the 5 million people with chest pain admitted to the emergency department each year, about half are not experiencing a heart attack. About 60% of the noncardiac chest pain sufferers eventually will be diagnosed with GERD.
"Millions of Americans are affected by GERD, and they just don’t know about it unless they have been diagnosed properly. GERD can essentially be like heartburn," says Staci Sigman-Dennison, director of development for the International Foun-dation for Functional Gastrointestinal Disorders (IFFGD) in Milwaukee.
That’s why the foundation designated Nov. 24-30, 2002, as GERD Awareness Week. It is intended to help those suffering from the condition receive information needed for productive discussions with their physicians so that they can seek treatment options to improve their health.
To improve dialogue between patient and physician, IFFGD has created a seven-day diary for tracking heartburn frequency and eating habits. It is a tool to help patients discuss their symptoms with a physician so that they will be diagnosed and given appropriate treatment.
Most people have experienced that burning feeling in the chest that signals heartburn and over-the-counter medication will help it subside. Many Americans have frequent heartburn with about 40% experiencing it once a month and 15%-20% once a week. For this group, the symptoms are not cause for concern. However, those who experience heartburn more than twice a week should be checked for GERD, says Sigman-Dennison.
While GERD is painful, improving one’s lifestyle only is one reason to seek treatment. Another reason is that it can cause Barrett’s esophagus, where cells on the lining of the esophagus become transformed, which is a precancerous condition.
People who suffer from GERD have a chronic problem of acid reflux, or the backflow of acidic stomach contents into the esophagus. This condition is caused when the band of muscles at the junction of the stomach and esophagus relax at inappropriate times, allowing for acid reflux to occur. Normally, these muscles, called the lower esophageal sphincter, act as a barrier to prevent the backflow of stomach contents only relaxing to allow food into the stomach.
For a proper diagnosis of GERD, people must see their physician and discuss their symptoms. Diagnostic tests may be used to confirm the diagnosis or to look for complications such as inflammation or Barrett’s esophagus, according to IFFGD.
Tests may include giving the patient a medication used to treat GERD, called a proton pump inhibitor, on a trial basis to see if his or her symptoms are relieved in two weeks. Relief from symptoms usually means that the patient has GERD. An esophageal manometry may be ordered to determine if the esophagus and the lower esophageal sphincter are working properly. This test is done by inserting a thin tube through the nose into the esophagus.
A thin tube also is used to measure the amount of acid in the esophagus over a 24-hour period. This test is called esophageal pH monitoring and can determine how often reflux occurs and how much acid is present during reflux.
When the diagnosis of GERD is confirmed, medications usually are prescribed. H2 blockers and proton pump inhibitors are the two classes of drugs prescribed to treat GERD, according to IFFGD. Lifestyle modifications also are recommended.
Patients may be advised to reduce the amount of fat in their diet as well as caffeine and chocolate. The consumption of acidic foods, such as citrus or tomato products, either may need to be reduced or eliminated. Alcohol and smoking also adversely effect acid secretion, so patients will be advised to eliminate the use of both alcohol and tobacco products. Refraining from going to bed within three to four hours after eating also helps.
Surgery may be needed if medical management cannot control patients’ symptoms or complications occur.
[Editor’s note: The International Foundation for Functional Gastrointestinal Disorders publishes a variety of booklets that can be ordered for educational purposes in bulk. The Daily Diary to help track symptoms can be purchased for $1 per single copy or $40 for 100 copies. A GERD brochure can be purchased for $30 for 100 copies or at $1 each. The shipping cost for orders more than $50 is 10% of the total order. For bulk orders less than $50, the shipping cost is $5. A complete list of publications can be obtained from the foundation. Call (414) 964-1799 for more information.]
For more information about GERD Awareness Week, contact:
- Staci Sigman-Dennison, Director of Development, International Foundation for Functional Gastrointestinal Disorders, P.O. Box 170864, Milwaukee, WI 53217-8076. Telephone: (888) 964-2001 or (414) 964-1799. Web site: www.aboutgerd.org.
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