Reflux – GERD

• common, much more common than a few decades ago
• can have serious effects on quality of life
• can have serious consequences, both short-term and long-term
• is often missed, as the symptoms may be mild or over-looked or seem unrelated – such as cough or damage to teeth
• a number of factors can underlie the reflux. One of the commonest risk factors is obesity
• medications can be very effective

Resiliency:

• the available medications can be very effective. However, all medications have potential side effects and there is a financial cost – whether paid by the individual directly or indirectly via government programs or insurance coverage. Still, the risks and costs of the medications will, for most people most of the time, be worthwhile compared to the harms of on-going reflux. It may be possible to lessen the need for medication, or resolve the reflux, by lifestyle and other measures within your control.
• finding effective and worthwhile means to avoid weight gain will help prevent this condition or help prevent worsening.
• finding effective and worthwhile means to reduce higher body weight or simply reduce weight around the tummy should help prevent or lessen reflux.
• in some people, one of the contributing factors to the development of reflux may be nerve damage related to diabetes and pre-diabetes. If so, steps can be taken to aim for more normal levels of blood sugar.
• there are a number of common medications which can increase the risk of developing GERD (such as calcium-channel blocking agents, see list LINK ), so using resiliency to possibly reduce your need for those medications may lead to reduced reflux.
• there are a number of topics to consider about specific foods and about meal patterns and timing. In one person versus another, specific dietary measures may be more or less important, so one or another dietary change may be highly worthwhile for one person and not useful for another.

GERD: the basics:

A summary of information, from the U.S. National Institute of Health: LINK  You can click on each topic to see more.

GERD and Diabetes:

(1)  A review article in WebMD

“When Diabetes Causes Stomach Problems”  LINK

(2)  A study from 2013 found low-grade dysplasia was more common in the type 2 diabetes group studied. Dysplasia is a type of change in cells that is shift towards a malignant state. “Mild dysplasia” is the very first degree of shift from normal, and far from actual established malignancy. Full text of the study here: LINK .

“Gastro-oesophageal reflux disease in type 2 diabetics: symptom load and pathophysiologic aspects – a retro-pro study”  BMC Gastroenterology 2013, 13:132 doi:10.1186/1471-230X-13-132

Quotes from the study:

• Gastro-oesophageal reflux disease (GERD) is one of the most common disorders of the upper gastrointestinal tract in developed countries.
• Up to 40% of the adult population suffers from reflux symptoms [1].
• At the same time, diabetes mellitus (DM), especially DM type 2 (T2D), which accounts for up to 95% of diabetes cases, is dramatically increasing worldwide.
• In 2010, 284.8 million people were affected. It has been estimated that that number will rise to 438.7 million diabetic adults in the year 2030 [2].”

Conclusions: 

• T2D patients exhibit different GERD symptoms,
• higher LES pressures and a decreased prevalence of hiatal hernia than non-diabetics,
• which may be related to worse oesophageal motility and, thus, a more functional rather than anatomical cause of GERD.
• Low-grade dysplasia was more than twice as high in T2D than in non-diabetics patients.