Introduction
Gastroesophageal Reflux Disease (GERD) affects millions worldwide, yet its prevalence often goes unnoticed due to a lack of public awareness. This article aims to shed light on GERD, exploring its epidemiology and viable solutions to alleviate its impact on individuals’ lives.
Epidemiology of GERD
GERD is an inflammatory and digestive disorder where stomach acid or bile irritates the lining of the food pipe. This condition occurs when the lower esophageal sphincter becomes weak or relaxes when it shouldn’t. This causes stomach acid to repeatedly flow back into the esophagus, causing symptoms like heartburn and regurgitation.
According to the Montreal definition, “GERD is a condition of troublesome symptoms and complications that result from the reflux of stomach contents into the esophagus”. It is an important health concern that is associated with decreased quality of life and significant morbidity. However, despite its prevalence, it remains shrouded in mystery for many.
The esophageal sphincter refers to the muscular valves at the top and bottom of the esophagus that control the flow of food and prevent backflow. GERD can lead to complications over time if left untreated. This causes esophagitis, and inflammation of the esophagus, leading to pain and swallowing problems. Aspirating stomach contents can cause respiratory problems and pneumonia, and increases esophageal cancer risk and affects quality of life. Its diagnosis involves a thorough physical examination, symptom description, and medical history review.
Helicobacter Pylori
Helicobacter pylori (H. pylori) is a bacterium that causes stomach and duodenal ulcers by weakening the stomach lining and increasing acid production. It infects the stomach lining and causes various gastrointestinal issues, including gastritis and peptic ulcers, and is often treated with antibiotics and acid-reducing medications.
Symptoms & Causes of GERD
Symptoms include heartburn, chest pain, difficulty swallowing, and atypical symptoms like sore throat and coughing. Other symptoms include non-burning chest pain, lung symptoms and shortness of breath.
Dietary triggers, including acidic, spicy, or fatty foods, and lifestyle factors like alcohol, smoking, and obesity, weaken the esophageal sphincter, leading to reflux. Also, hiatal hernia; a condition where the upper part of the stomach protrudes into the chest cavity disrupts the normal functioning of the esophageal sphincter, leading to reflux during pregnancy also contributes to GERD.
Healthcare Hurdles
This section explores the intricate web of challenges that prevent GERD patients in Africa from receiving quality treatment.
Lack of awareness
In Africa, GERD is frequently underdiagnosed and undertreated because of a lack of knowledge about the condition. Many people may dismiss symptoms as a normal discomfort and attribute it to other causes. This hinders treatment which may cause complications if not untreated.
Dependency on symptom-based approach
A symptom-based approach is frequently utilized as the first diagnostic technique for GERD in primary care settings, especially in the absence of advanced diagnostic testing since it is a practical and cost-effective method. However, the sensitivity of symptoms such as regurgitation and heartburn in GERD diagnosis is not suboptimal.
Prevalence Data Gaps
There is a lack of information regarding the prevalence of GERD in Africa, and is noticeably absent from international epidemiological studies on the disease. Effective management and public health initiatives may be hampered by the absence of comprehensive data of its prevalence in Africa.
Intersection with Other Conditions
According to Nwokediuko et al (2020), “more than 50% of GERD cases also have dyspepsia and or irritable bowel syndrome (IBS)”. This overlap affects the severity of the sickness, making diagnosis and treatment more complex. Therefore, if diagnostic and therapeutic failures are to be reduced or avoided, clinical treatment must take these overlaps into account. This results in some treatment protocols being disease-specific and paying little or no consideration to these overlaps function as confounders.
Managing GERD
Life lifestyle changes, medications like antacids and proton-pump inhibitors (PPIs) like omeprazole, esomeprazole, and surgeries like fundoplication can treat GERD effectively.
Conclusion
Understanding GERD is vital for early detection and effective management. Addressing healthcare hurdles, such as lack of awareness and prevalence data gaps, can lead to better outcomes. Recognizing GERD’s intersection with other conditions and implementing tailored treatment approaches are essential as holistic care can significantly improve the condition.