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Doctors in UK Promoting Awareness of Gastro-oesophageal Reflux Disease

Heartburn could be a precursor to gastro-oesophageal reflux disease, British doctors warn and note that// the diagnosis of the disease is a relatively new phenomenon.

Statistics show that over a quarter of Britons have gastro-oesophageal reflux disease, also known as the GORD, and thousands of these are not getting the treatment they need. A noted general practitioner, Dr Rob Hicks, said that the GORD as a diagnosis was a relatively new phenomenon and that although most medical practitioners were aware of it, many patients could still be suffering in ignorance. "What we are trying to do is to raise awareness, because there are many people still suffering from heartburn two or three times a week. I would advise them to see their doctor," Hicks said.

He also noted that although heartburn might in the past have been dismissed by some as trivial, it was now recognised as a serious affliction, which could, in a few cases, lead to ulcers and even pre-cancerous cells. "National guidelines point to PPI's as the first line of treatment for the GORD because they treat the condition and help the healing process," Hicks added.

Proton pump inhibitors (PPIs) are a group of prescription medications that prevent the release of acid in the stomach and intestines.

Doctors prescribe the PPIs to treat people with heartburn (acid reflux), ulcers of the stomach or intestine, or excess stomach acid (Zollinger-Ellison Syndrome).

Gastro-oesophageal reflux is a condition where the lower oesophageal sphincter (the muscular ring at the lower end of the oesophagus) is abnormally relaxed and allows the stomach's acidic contents to flow back or 'reflux' into the gullet (oesophagus). It can also cause heartburn.

Gastro-oesophageal reflux is a common condition and the most frequent cause of indigestion in the UK.

What are the symptoms of gastro-esophageal reflux oesophagitis?
· A painful or burning sensation in the upper abdomen or chest, sometimes radiating to the back (heartburn).
· The acid reflux may reach the pharynx (throat) and mouth. It is sour and may burn.
· A small number of patients have difficulties breathing and suffer from hoarseness because the refluxed fluid irritates the larynx and respiratory tract.
· Excess belching is common.
· Symptoms typically occur after eating a large or fatty meal or drinking alcohol.
· Lying down, bending over or bending and lifting can all cause reflux.
· It is made worse by smoking.
· Reflux symptoms may have no apparent cause.
· The frequency with which the symptoms occur varies. For most people, they are rare but weekly and daily episodes of refluxes are not uncommon.

Why does stomach acid travel up the oesophagus?
The trouble is caused by the faulty oesophageal sphincter, the muscular ring at the lower end of the oesophagus, near the diaphragm. The sphincter is designed to prevent the stomach contents from flowing upward - it functions as one-way valve.

If the sphincter does not work properly, stomach acid flows into the oesophagus. The reflux tendency increases when the stomach contains a lot of gastric juice or food and when there is increased pressure in or on the stomach.

The following changes in lifestyle can reduce the risk of developing reflux:
· try to lose weight if you are overweight
· avoid large, high-fat meals and bedtime snacks
· limit coffee intake
· reduce alcohol consumption
· stop smoking.
If the symptoms are not frequent - less than five times a month - they can be treated with over-the-counter medications such as antacids and histamine antagonists (drugs to counter histamines).

Histamines are chemicals found in plant and animal tissue and released from certain type of cells as part of an allergic reaction in humans. It stimulates gastric secretion and causes dilation of capillaries, constriction of bronchial smooth muscle, and decreased blood pressure.

If the heartburn is frequent or the symptoms very unpleasant, see your doctor. He or she will consider whether further tests, such as a gastroscopy, should be carried out, and whether stronger medication is required. If you have any difficulty swallowing, you should see your doctor as soon as possible

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