Lifestyle modification prevents GERD recurrence

Prof. Dr. dr. Ari Fahrial Syam, Sp.PD-KGEH, MMB, FINASIM.
Prof. Dr. dr. Ari Fahrial Syam, Sp.PD-KGEH, MMB, FINASIM. Photo: Esti/IO

IO – Incommunicable diseases are on the rise, an unfortunate result of lifestyle changes during the pandemic. Among illnesses prevalent nowadays is stomach acids hurting the throat, officially known as Gastro Esophageal Reflux Disease (GERD) or acid reflux. Even though this condition is not directly life-threatening, GERD may trigger serious complications like throat inflammations or even esophageal cancer, which will impair the quality of its sufferers’ lives. 

GERD global prevalence is 8%- 33%. It indiscriminately hits people of all ages and genders. An official study of the disease in Indonesia shows that its prevalence among our urbanites is 9.35%. However, the GERD-Questionnaire (GERD-Q) online survey held by University of Indonesia Faculty of Medicine/Cipto Mangunkusumo Hospital Jakarta recorded a stunning fact: 57.6% out of the 2,045 respondents suffer from GERD, with 38.7% of sufferers a high impact on daily life. “Male gender”, “obesity”, and “smoking” are the top three risk factors for suffering GERD. 

“GERD should be detected early. Its symptoms generally include heartburn, a taste of bitterness in the mouth, a feeling like something rose up the throat and made itself felt in the mouth,” said General Chairman of the Indonesian Gastrointestinal Endoscopy Association Prof. Dr. dr. Ary Fahrial Syam, Sp.PD-KGEH, MMB, FINASIM, in a media briefing held by Wellesta CPI in Jakarta on Tuesday (08/02/2022). 

Extra caution concerning GERD is needed when the following symptoms appear in a person aged 40 years or older: significantly lowered weight, paleness, vomiting blood, and excretion of blackened feces. You also need to be more alert if you find it hard to swallow and it hurts when you do, or if your family has a history of esophageal cancer. “Initial check can be performed using high dose proton pump inhibitor (“PPI”) test for 1-2 weeks while monitoring the sufferer’s response. The test is considered to be positive if 50%-70% of symptoms are alleviated,” Prof. Ari said. 

Manage Your Stress 

If the patient is really suffering from GERD, a doctor will usually suggest a lifestyle modification. This is meant to prevent recurrence. “Maintaining stomach pH level at > 4 is importance in GERD mitigation. Immediately stop smoking and drinking alcohol, reduce your weight, adopt a low-fat diet, and avoid eating foods that trigger stomach acid production like chocolate, cheese, coffee, and soda. Managing your stress will also help,” Prof. Ari said. 

Infection of Helicobacter pylori bacteria may also injure the stomach. We need to take this infection seriously, because it is a triggering factor for stomach cancer. In global medication guidelines, only regimens with an eradication level of > 90% may be used as first line treatment of Helicobacter pylori infection. However, limited availability of PPI and patients’ general resistance to antibiotics may result in failure to eradicate the bacterial infection. 

“Studies show that Vonoprazan is able to provide better clinical results than PPI. New therapies available for acid-related illnesses such as GERD and Helicobacter pylori infection are expected to improve the success of therapies, prevent recurrence, and avoid complications up to and including stomach cancer,” Prof. Ari said. 

His statement was corroborated by PT Wellesta CPI Country Head, Yohannes Sinaga, who declared that Vonoprazan is expected to be beneficial as first-line treatment for GERD patients and efforts to eradicate the Helicobacter pylori bacteria. (est)