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Blame Game Puts Patients At Risk

May 28, 2004

Experts call for a change in attitudes on World Digestive Health Day

[London, 29th May 2004]. Leading medical experts today called for increased recognition of gastroesophageal reflux disease (GERD) - a common digestive disease that critically affects the quality of life of millions of people and can result in serious complications in a substantial minority of these patients. Despite this significant burden, and the risks of leaving it undiagnosed and untreated, GERD is frequently trivialised and not given the proper medical attention it requires.

GERD is a very real problem - about two in five people suffer from at least episodic heartburn, and one in five people have at least weekly symptoms, which when unresolved and persist are the hallmarks of the disease diagnosis of GERD. However, according to Professor. Roger Jones, a UK-based primary care practitioner and Chairman of the European Society for Primary Care Gastroenterology (ESPCG), GERD is too often endured needlessly by sufferers, who feel they are to blame for their symptoms.

"People can wait years before seeing a doctor because they are made to feel they are at fault and that their lifestyle choices are the main cause of their symptoms," said Professor Jones.

The most common symptom of GERD is heartburn, a feeling of burning pain or discomfort rising from the stomach or lower chest towards the neck and throat. A common misconception is that GERD is caused by dietary trigger factors, such as spicy, fatty, or acidic foods and beverages, excesses of alcoholic beverage consumption, or stress, and there is little acknowledgement of the underlying disease process and potential for tissue damage. GERD is the result of an ineffective anti-reflux mechanism at the junction between the esophagus and the stomach, which normally prevents acid from flowing back up into the esophagus.

Left unmanaged, GERD can lead to serious complications such as ulceration of the lining of the esophagus with bleeding, Barrett's esophagus (a pre-cancerous condition), and in rare cases as a complication of Barrett's esophagus, esophageal adenocarcinoma (cancer).

In contrast to general belief, GERD affects women and men of all ages and becomes more common with aging. The impact of GERD on individuals is significant, and not only limited to eating habits, work productivity or social activities. Regular sleep disturbance, and living with the consequences of sleep deprivation, is a reality for many people.1 In addition, everyday activities that involve bending, such as routine chores and housework, as well as forms of exercise often provoke painful symptoms.

Many people experiencing the symptoms of GERD, especially heartburn pain, rely on over-the-counter medicines from the pharmacy, however these pharmacy medicines are inappropriate for use in treating symptoms of GERD without a doctor's advice. The recommended prescription treatment is proton pump inhibitor (PPI) therapy, which inhibits the production of stomach acid.2 PPIs effectively treat GERD and may significantly improve people's quality of life.

Doctor Harley Liker, Assistant Clinical Professor of Medicine David Geffen School of Medicine at UCLA believes a major challenge is changing attitudes toward GERD - both the perception of the disease and awareness of the treatments available. Improved recognition of GERD is important.

"People who experience heartburn two or more times a week should visit their doctor to ask for a proper diagnosis and effective treatment of GERD. They shouldn't have to suffer unnecessarily," said Dr Liker.

Hill and Knowlton (London)