Let gut instinct lead you to your family doctor

WE all suffer with indigestion, particularly at this time of year, however for some it may be a little bit more complicated than over indulgence in the festive turkey and trimmings.

Gastroesophageal reflux disease (GERD) is a digestive disorder that affects the esophageal sphincter which is the muscular valve between the esophagus and the stomach. Many people suffer from symptoms like heartburn. In most cases symptoms can be relieved through diet and lifestyle changes, however, sometimes it may be necessary to consider medication or surgery.

Gastroesophageal refers to the stomach and oesophagus. Reflux means to flow backwards. Therefore, gastroesophageal reflux is the return of the stomach’s contents back into the esophagus. In normal digestion, the lower esophageal valve opens to allow food to pass into the stomach and closes to prevent food and acid from flowing back. Certain triggers in our diet including fried or fatty foods, coffee, or alcohol may cause reflux and heartburn. Obesity, cigarette smoking and pregnancy can also cause symptoms.

Heartburn, also called acid indigestion, is the most common symptom of GERD and often feels like a burning sensation beginning behind the breastbone and moving upward to the throat. The burning, pressure, or pain of heartburn can last as long as several hours and is often worse after eating.

Heartburn pain is sometimes mistaken for the pain associated with heart disease. It can be difficult to tell the difference, so it is best to get medical help if you have chest pain.

The gastroenterology team at Mater Private Cork recommend initial lifestyle and dietary changes for most people needing treatment for GERD with an aim to decrease the amount of acid thus reducing damage to the lining of the oesophagus. You can achieve this through avoiding foods and drinks that trigger symptoms. Also it helps to eat smaller portions and to plan your meals at least a couple of hours before bedtime. Like most health conditions, stopping smoking will certainly help too.

Antacids can help neutralise acid in the esophagus and stomach and stop heartburn. Many people find that over-the-counter treatments provide temporary or partial relief, however long-term use of antacids can result in side effects, including diarrhoea, and altered levels of calcium and magnesium in the body.

It is never appropriate to continue trying to treat your own symptoms — firstly because your problem may not indeed be your stomach and secondly you may develop more serious complications down the line. So if your symptoms continue or they are causing some concern, discuss them with your family doctor. Your GP may recommend medications to reduce acid in the stomach. These medicines include proton pump inhibitors which inhibit the enzyme necessary for acid secretion.

People with severe, chronic esophageal reflux or with symptoms not relieved by the treatments described above may need more in-depth investigation. Your family doctor can refer you to a specialist called a gastroenterologist for a procedure called a gastroscopy.

A gastroscopy is performed using a thin flexible tube (gastroscope) which has a camera and a light on the tip, used to look at the area being examined. The stomach needs to be empty for this procedure so you will be fasting for usually eight hours prior to the test. The test itself is quite short, lasting approximately five to 10 minutes. However you can expect to be in the department for a couple of hours, depending on whether or not you have sedation. The test is not painful.

There is a small chance that GERD can develop over time into eventually a form of cancer, however, don’t worry just visit your family doctor to get the right advice and treatment and if necessary you can see a specialist to help manage your symptoms.

www.materprivate.ie/cork; 021-6013200