In 2005 two researchers Barry Marshall and Robin Warren won a Nobel Prize in Physiology or medicine, they Discovered Helicobacter pylori, a Bacteria. They gave the role of H-pylori in the development of Peptic Ulcer. It was a revolutionary Phase in the world of medicine and health. The Medical treatment and strategy to treat the condition shifted from surgery to the use of effective Drugs. A combination of medications prescribed by healthcare providers depends on the clinical representation of the patient- a better patient outcome at a lower cost.
Heartburn is one of the symptoms of peptic ulcer, but usually, it is a symptom of reflux. It is a defining symptom of reflux – that somewhat less serious but a very common condition which, when occurs frequently and becomes troublesome, is known as “gastro-oesophageal reflux disease” or simply GORD.
Reflux happens when what goes down the oesophagus – that is the “food pipe” to the stomach – comes back up again to where it’s not meant to be. And it comes back up again mixed with stomach acid and other chemicals. So it’s not surprising that the regurgitation or backward movement of swallowed food causes a burning sensation. This is generally described by reflux sufferers as beginning in the stomach or lower chest and moving upwards behind the breastbone towards the neck or throat.
Most of us will have experienced reflux now and again. And when it’s only just a little, and just now and again, it doesn’t cause too much discomfort. We have a circular band of muscle which acts like a valve at the top of the stomach; it’s called the lower oesophageal sphincter (LOS). Normally it works pretty well but when the lower oesophageal sphincter is weak or faulty, problems of backflow of food with acid can occur.
Prolonged exposure to gastric acid causes inflammation of the oesophagus, possibly leading to ulceration and haemorrhage. Scar tissues can occur and there is a little increased risk of oesophageal cancer. So the prevention and management of reflux are important.
Occasional heartburn usually responds well to antacids. As the name implies, antacids are the agents which neutralise the acid in the stomach. They provide quick relief from the mild symptoms of the reflux however, the effects are not long-lasting. Ingredients include aluminium hydroxide, magnesium salts, calcium carbonate and sodium bicarbonate – often taken in combination. Other ingredients such as alginates and simethicone are sometimes added to the antacids. Alginates can form a protective layer around the Oesophageal lining to protect it from stomach acid. Simethicone is an antifoaming agent, usually given with antacids to prevent and relieve the flatulence. Despite their wide availability, antacids are not suitable for everyone (so, if you are taking other medicines, check with your pharmacist first as to whether antacids are appropriate) and they are not the best choice medication for people with persistent heartburn symptoms.
More effective treatment for frequently occurring or more severe symptoms of reflux includes the so-called “histamine-2 blockers” (for example Zantac) and the “proton pump inhibitors” (PPIs) (such as Somac) which are now available in different strengths without prescription. They work by reducing the production of acid in the stomach. They act slowly comparative to the antacids, but they provide long-lasting and more complete relief. Currently, the PPIs cannot be advertised directly to the public or self-selected at the pharmacy, so you’ll need to ask your pharmacist as to whether they are suitable for you.
In any event, it’s important to remember, a faulty LOS doesn’t happen by accident, and often there’s a trigger factor. It could be obesity, tobacco smoking, spicy foods, excess alcohol, carbonated or caffeinated drinks; and certain medicines can also loosen the muscle around that sphincter. Along with the medications, people with GORD are advised to avoid excessive consumption of alcohol, avoid the use of spicy food, weight reduction, smoking cessation and raising the head of the bed whilst sleeping or resting.
If you have any questions or would like to learn more about GORD. Please do come in and have a chat with one of our friendly pharmacists.
