Lifting the Burden of GERD

What makes life worth living? Ask any Malaysian and they would probably have “enjoying food” on their list. Food plays a major role in our lives. It is a daily conversation topic, a compass to plan social events, a display of love, a cause for competition, and a source of adventure. No one really thinks about the inability to enjoy food, given that eating is something that we do almost automatically from birth. 

However, the inability to enjoy food is a reality for those suffering a specific tummy affliction which has been sweeping the nation. This was what happened to Raymond. With a thriving career, Raymond was at his peak. Unfortunately, his tummy got in the way. 

Raymond experienced heartburn years back but the symptoms would go away with a gulp of antacids. In the last year, however, Raymond would have great discomfort especially after eating. He would feel the food coming back up and a sour taste in his mouth. Not just that, there was gas and bloating too. Each day was a struggle as he would feel tired, not being able to sleep well at night because of the reflux. Tests at the hospital finally showed that Raymond was experiencing a chronic form of heartburn called gastroesophageal reflux disease or GERD for short.

Understanding GERD

When we eat something, the food travels down a tube called the esophagus into the stomach. At the bottom of the esophagus, before the opening to the stomach, lies a circular tube of muscle known as the lower esophageal sphincter (LES). When the LES becomes damaged or weakened, it fails to close all the way, causing the acidic contents of the stomach to move back up (reflux) into the esophagus. Stomach acid has a pH close to battery acid. When this acid contacts the esophagus and sometimes rises up into the mouth, damage and pain ensues.

Acid reflux causes a burning pain in the chest commonly known as heartburn. When acid reflux symptoms happen more than twice a week or is accompanied by difficulty in breathing or swallowing, it could denote a more serious condition known as gastroesophageal reflux disease (GERD). The prevalence of GERD has been found to be rising across Southeast Asia, numbers of which are up to 20% from data recorded after 2005.   

Many people with acid reflux or GERD believe that their condition is caused by stress or from eating spicy or acidic food. While stress is not a cause, it is one of the factors that can aggravate GERD. Scientists have found that people are more sensitive to stomach acid when they are stressed. Besides stress, obesity is also another driving factor of GERD development. As weight accumulates in the belly area, it creates pressure on the diaphragm and LES to cause further weakening of the LES muscles. With Malaysia ranked as the fattest nation in Asia, it is not surprising that more and more people are suffering GERD. Smoking is another risk factor for GERD as the nicotine in cigarettes cause a relaxing effect on the LES, hence allowing stomach acid to escape into the esophagus.

GERD Development

In an event titled “Oh My GERD” hosted by NuvaPineA®, a panel of experts came together to discuss the severity of the GERD epidemic, to help the public to recognise the signs and symptoms of GERD and more importantly to manage the condition successfully. The panel comprised Dr. Raja Affendi Raja Ali, Consultant Physician and Gastroenterologist from Universiti Kebangsaan Malaysia; Dr. Vagif Soultanov, a Gastroenterologist and Naturopathic Doctor from Melbourne, and Datin Swanee Teh, Pharmacist and Natural Therapies Advocate. 

“GERD is a condition that worsens over time if left untreated,” stated Dr. Affendi. “Because it’s a disease driven both by structural and lifestyle factors, patients need to take proactive steps to manage it well. Think of it this way, if you had a wound and did nothing about it, that wound will fester to cause greater harm. Similarly, GERD needs to be addressed.”

GERD has a significant negative impact on patients’ quality of life. Imagine being constantly stressed about what you should eat or not besides having to limit social dining engagements all in a bid not to trigger GERD symptoms. A 2003 study showed that GERD patients have a poorer quality of life in terms of mental health, social functioning and vitality when compared to the general population.  A separate study showed that having GERD decreased work productivity, even more than someone having a chronic condition like arthritis.  In effect, GERD affects the very core of those things human beings take greatest pleasure in – food enjoyment, restful sleep, and meaningful work.  

“Most people don’t expect the dramatic changes GERD makes in their lifestyles. GERD literally sucks all the fun out of life. According to clinical data, GERD can lead to anxiety and depression and vice versa. GERD also affects productivity and sleep which drains a person’s sense of purpose,” explained Dr. Soultanov on the topic of how miserable it is living with the disease.

What does GERD look like?

Heartburn is one of the hallmark symptoms of acid reflux. The other symptoms of GERD include a sour-tasting fluid at the back of the throat (stomach acid has a sourish taste), difficulty swallowing or a sensation that something is stuck in the chest or throat, gas build-up, and excessive belching. Some patients may even experience a chronic dry cough or breathlessness, which is triggered by the acid reflux. Should the acid rise up further into the mouth, bad breath can develop as the acid kills off good bacteria in the mouth. Tooth decay is another consequence of acid damaging teeth and gums.

Is there a solution?

Conventionally, heartburn and GERD are treated with medications that control acid. Routinely, the use of acid-blocking drugs called proton pump inhibitors (PPIs) is initiated. Examples of PPI drugs include deslansoprazole, pantoprazole, omeprazole, and esomeprazole. PPIs are potent stomach acid suppressants. They are popular choices to help patients deal with symptoms as they work fast.

However, the symptoms of GERD are sometimes impossible to control, even with the most powerful PPI drugs. Some studies have already demonstrated that up to 40% of patients with heartburn reported either a partial or complete lack of response to PPIs. Not just that, acid blockers are not meant to be used for the long-term because of adverse effects, the result of compromised digestion and immune protection when acid production is suppressed over time. 

Current guidelines recommend that PPIs be used for only 4 - 6 weeks after which they should be withdrawn or stepped down to less-potent therapy.  In reality however, patients continue their PPIs indefinitely as symptoms tends to recur.

Clinical Pine Therapy

GERD is not a simple condition to manage. As a naturopathic doctor as well as a researcher, Dr. Soultanov was at hand to share the results from a recent clinical study done on a pine conifer green needle extract called Bioeffective® A and its effects on gastrointestinal health and GERD. 

“We know that Bioeffective® A possess cellular healing properties. In this study, we wanted to see the extent of its effects amongst patients with pre-cancerous stomach conditions who were also experiencing GERD. The administration of Bioeffective® A resulted in a 92% improvement in dyspeptic symptoms (GERD), including improvement in symptoms such as gastritis, gas and bowel disorders. Not only that, patients also regained normality of stomach function besides a reversal in pre-cancerous lesions,” shared Dr. Soultanov.

“Instead of sitting around worrying more and more about GERD, Bioeffective® A as a natural medicine, can offer patients added arsenal to deal better with their condition. By helping to strengthen damaged or weakened esophageal valves, as well as to support the normalisation of digestive juices in the stomach, Bioeffective® A will help get you, your normal tummy back,” said Datin Swanee Teh.

The session was also attended by former Prime Minister Tun Dato’ Sri Haji Abdullah bin Haji Badawi who shared a few words on how Bioeffective® A has helped improve his health. “At this golden age, all I can hope for is to be as healthy as possible. I have been taking Bioeffective® A for almost 10 years now for my defences and anti-aging needs. It is a very safe natural medicine and my doctors will affirm that my tummy, liver and kidneys are all in excellent condition. I’m glad to have found such a safe and reliable friend in health,” he said.

Goodbye GERD

When one understands the crushing grip GERD has on the many things we enjoy in life, it’s difficult not to be disheartened. However, the combined knowledge from both mainstream and naturopathic medicine can now offer patients a more holistic way of managing their condition successfully. 

Raymond discovered Bioeffective® A online after surfing the net one night when he couldn’t sleep. Raymond went on a dose of 320mg three times a day as advised by his pharmacist. Over the weeks, his GERD symptoms gradually improved. He noted how he was able to tolerate his foods so much better without those familiar gas and reflux symptoms. Raymond has arrived at a point where he can actually plan a “makan get-together” without a care in the world.

Bioeffective® A is made in Australia and is available at leading pharmacies throughout Malaysia. For more information please call Nuvanta’s Nuvaceuticals® division at 03-56363758 or email pharmacist@nuvanta.com.