Page 35 - Retail Pharmacy March 2021

It’s not just HEALTH GORD 33 HOT AIR By Peter Howard. Is it love ... or lunch? At least once in our lives we should all let our hearts burn with passion. We’ll become irrational, irresponsible and incredibly immature, which is a whole heap of fun. It’s also nothing like the behaviour of those with heartburn, who are irritable, in pain and incredibly inconvenienced. While the causes and effects of passion aren’t yet fully understood, scientists do have an in-depth understanding of gastroesophageal reflux disease (GORD) and can control its impact on the lives of those suffering heartburn and other debilitating effects. Professor Jane Andrews, Head of the IBD Service & Education and Department of Gastroenterology and Hepatology at the Royal Adelaide Hospital and a Clinical Professor at the University of Adelaide’s School of Medicine, spoke to Retail Pharmacy about the current best practice to identify and treat GORD. “What you’ll notice is that GORD is gastrooesophageal reflux disease,” she said. “If people present just with epigastric discomfort and indigestion, which are all felt in the abdomen, it’s usually not reflux, which is felt in the chest. Most epigastric discomfort or indigestion has no function or structural correlation with GORD.” “There are a lot of physiologically inaccurate ideas about GORD, such as it being acidic foods causing the oesophageal pain.” Despite our awareness of the aetiology and potential treatments of GORD, there remains a significant lack of understanding of the disease among the general public, many of whom incorrectly believe it’s caused by too much acidic food. The cause of GORD (also known as acid reflux) is stomach acid or bile irritating the lining of the oesophagus, having leaked through the sphincter at the oesophagus base, which generally prevents such upward egress. “There are a lot of physiologically inaccurate ideas about GORD, such as it being acidic foods causing the oesophageal pain,” Professor Andrews said. “In fact, the amount of acid you produce from your stomach is far more than the amount you’re going to consume, even if you were to drink pure orange juice. “The acidity in the fluid has very little to do with GORD, although if you’ve got ulceration and you drink an acidic drink, it will give you pain because it’s touching ulceration on the way down. However, generally it’s not the acidity in food that causes the acid reflux. “The reason people get reflux is because things move upwards from the stomach into the oesophagus. This is compounded if you’re overweight and have excess fat around your middle, because your organs, including the stomach, are under pressure. “As your oesophagus needs to relax from time to time, for example to swallow saliva and also to let the food we eat enter the stomach, that relaxing allows things to move upwards due to the excess pressure of being overweight, or through overindulgence.” TO PAGE 34 RETAIL PHARMACY • MAR 2021