GERD Alert!

GERD is one of those ailments that sounds a lot worse than it actually is. Look, I am not trying to minimise it, but it does sound like the kind of thing you’d pick up in the trenches of the western front, or from some rare butterfly in the Amazon. Or perhaps it sounds like a Scandinavian death metal band. The fact that it is commonly referred to as Heartburn doesn’t help the death metal angle... In reality, it is an acronym for gastroesophageal reflux disease, and as many as one in five people suffer from it. Think of four people; if they seem fine, it could be you! But seriously, some people might endure GERD without ever realising that that level of discomfort is not normal. Here are some dead giveaways:

• Do you ever feel a sense of burning in your chest, particularly after a meal? ❑
• Do you feel a burning in your chest when you lie down? ❑
• Do you ever taste your food after you have swallowed it? ❑
• Is swallowing harder than it used to be? ❑
• Do you feel as though there is a lump in your throat? ❑
• Do you have an ongoing cough during the night? ❑
• Are you constantly losing your voice? ❑
• Has asthma shown up recently? ❑

If you answered yes to a number of these, you might want to see your GP. You may well be the one in five! Disclaimer: This blog post is not a trained physician. See a doctor, not a webpage.

Great, so I have GERD, you think to yourself. What is going on? Basically, your stomach has a circular muscle at the bottom of your oesophagus to make sure that food can enter you stomac, but it doesn’t go back the way it came. This little fella is the reason handstands aren’t horrific affairs. But sometimes, this muscle doesn’t close properly and so the contents of your stomach (chewed foods and various acids designed to break it all down) start spilling back up your throat. Now the thing is, the human oesophagus wasn’t designed to deal with acid, and so over time it gets inflamed - this explains the sore throat and loss of voice.

Why me, you think to yourself. I am too young and beautiful to have something called GERD. Well, there are a number of lifestyle choices which might contribute.

1. Smoking: For those playing along at home, here is my obligatory plea for you to quit because it seems to be a comorbidity in just about every disease under the sun.
2. Eating large meals late at night: You are putting unnecessary pressure on that circular muscle and if you lie horizontally, the chances of it all coming back up are greatly increased.
3. Drinking alcohol or coffee: Dagger.
4. Taking specific medications like asthma

There are also some conditions you might have which increase your risk of developing GERD, but they aren’t really your choice. We are talking about pregnancy, obesity, a hiatal hernia and a slower metabolism.

OK, that is unfortunate, you think. What are my options. Well, you are asking all the right questions. Fortunately, as threatening as GERD sounds, there are plenty of very mellow options which will sort it out for the majority of people.

1. Watch your weight: If you’ve got excess fat around your abdomen, it puts pressure on your stomach which pushes the acid back up your throat. Picture a balloon half filled with water: if it has plenty of room to hang, the water more or less stays put. But squeeze that balloon, and hey presto! You’re soaked!
2. Stop smoking: For all of its other detrimental effects on your body, smoking causes that circular muscle to function less effectively.
3. Chock up your bed: If you can lift up the top end of your bed 15cms or so, you are employing gravity to your advantage. Your food doesn’t sit pressed against the muscle all night and it has to stay put in your stomach!
4. Eat slower: There are so many benefits to this. You’ll enjoy your meal more. You will feel full more quickly so you eat less
5. Don’t lie down straight after a meal: As a dad, this is tantamount to heresy for me, but it does have a marked effect on my physical health
6. Pick up a bottle of an antacid like Gavsicon: The sodium alginate in Gaviscon acts a bit like a tarpaulin over a broken roof. It battens down the hatches of your food so that it doesn’t come back up for round two. And better yet, the anaesthetic qualities in Gaviscon soothe the oesophagus so that your poor acid burnt throat can have a minute in peace. It works in about 4 minutes, so you get relief straight away. Pick up a bottle of Gaviscon today and keep it nearby. You never know when you will need it. 

There are plenty of other, more serious medical interventions. The vast majority of people can sort out their GERD using the steps above, but if you are in the minority, rest assured: There are prescription medicines, and even surgeries that can sort out that faulty ring at the bottom of your oesophagus 

OK, it doesn’t sound too bad, you’re thinking. I probably don’t need to worry about that at all. Yes! And also, not quite. GERD, if left untreated can lead to various complications.

1. Oesophagitis: The acid can eventually burn your throat so badly that you develop an open wound back there. This is like a nuclear sore throat. 0/10, would not recommend.
2. Esophageal stricture: All the acid inflames your throat to the point that scar tissue begins to form. This makes your oesophagus more narrow and all of a sudden, you can’t really swallow anything that hasn’t been pureed.
3. Barrett oesophagus: This puts you at a really high risk of developing esophageal cancer.

So there is GERD in a nutshell. Whilst its bark is certainly worse than its bite, it is worth sorting out before it becomes a bigger issue.

Floyd - Senior Pharmacist 

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