GERD: A Story of Sleep, Sex and Suffering
15 November 1999, Rome -- Up to 40 percent of Europeans suffer from burning chest pain and an 'acid taste', according to a recent survey of more than 5,000 people questioned from the general population. These symptoms can ruin an individual's quality of life by interfering with a number of normal daily activities, such as eating and drinking, sleeping, working, and even romance and sex, the survey shows.
Sufferers of these symptoms responded that they had experienced difficulty in sleeping (10-24 percent of the sample, depending on the country surveyed), and avoided or altered activities, such as eating or drinking (46-53 percent), working (7-11 percent), and their romantic/sex life (4-13 percent).
However, the disorder that is the most likely cause of these symptoms - GERD (gastroesophageal reflux disease) is not a well-known condition. While it is estimated that as many as 50 million Europeans are affected by GERD, most people in the survey had not even heard of this common gastroenterological problem.
Furthermore, after having been given a description of GERD,note1 many of the people surveyed mistakenly believed that it would be lifestyle factors, like stress, eating certain foods, being overweight and smoking, that would be primarily responsible for the symptoms.
These are just some of the findings from a pan-European survey,note2 which were presented for the first time today, during the 7th United European Gastroenterology Week.
What are the facts about GERD?
Recently published international guidelines, produced by a team of medical
experts (the Genval Guidelines1), emphasise that the correct first-choice
treatment for GERD should NOT begin with lifestyle changes. 'Lifestyle
measures are of minimal, if any, benefit for initial and long term therapy
of patients with GERD', said Dr David Armstrong, of McMaster University,
Hamilton, Canada, who was a participant in the development of the
guidelines.
'Unfortunately, many of the people who suffer from the symptoms of GERD have their lives ruined, because they are not aware that they actually have a medical disorder that needs drug treatment. As a result of focussing only on altering their lifestyle, they are missing out on a treatment that could restore their quality of life to normal in such areas as eating, sleeping and even their romantic life,' Dr Armstrong said.
According to the Genval Guidelines, effective therapy is essential because of the severe negative impact GERD can have on health-related quality of life. 'The objective of treatment should therefore be to control GERD symptoms so that, at least, they do not impair health-related quality of life', Dr Armstrong added.
Treatment for anyone with troublesome GERD should begin with the most effective therapy available, currently proton pump inhibitors such as omeprazole, stepping down to the lowest dose that controls symptoms to minimise the cost of long-term therapy.
When challenged on the availability of treatment for GERD, many of the sample population reported that they believed it would be treatable. However, only some of these were aware of any prescribable medication and, only in Sweden, did a significant proportion give the PPI omeprazole as the best treatment. Despite the recommendation of the Genval Guidelines, 4-18 percent of those surveyed still believe that antacid preparations are the most effective treatment.
'The answer to this lack of public awareness about GERD, and its treatment, is a widespread education programme in each European country', said Dr Armstrong. 'And one critical part of this programme involves, the media, raising awareness of GERD, in order to dispel myths and raise its profile as a common disorder that is serious but eminently treatable', Dr Armstrong concluded.
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References:
1. Dent J, Brun J, Fendrick A, et al. An evidence-based appraisal of reflux disease management - the Genval Workshop Report. Gut 1999; 44 suppl 2: S1 - S16
Summary table
| France | Germany | Italy | Sweden | UK | |
| Have experienced 'acid taste in mouth, burning pain in chest' | 21% | 29% | 32% | 40% | 38% |
| OF WHOM | |||||
| Experienced difficulty sleeping | 24% | 11% | 15% | 10% | 19% |
| Avoided eating or drinking | 47% | 46% | 47% | 52% | 53% |
| Altered working patterns | 9% | 10% | 11% | 11% | 7% |
| Avoided playing sport | 12% | 20% | 8% | 12% | 9% |
| Avoided romance / sex | 8% | 13% | 5% | 4% | 9% |
Note 1 -- GERD (or GORD) stands for Gastroesophageal Reflux Disease, a clinical condition in which reflux (backward flow) of stomach acid into the esophagus (gullet) is severe enough to cause recurrent symptoms that affect patients' lives and/or to damage the esophagus
Note 2 -- The survey was conducted by the independent firm, Research International. In total, more than 5,000 members of the general population were surveyed from France, Germany, Italy, Sweden and the UK