Why do patients develop reflux?
Dr Tan Chi Chiu looks at the symptoms and causes of gastroesophageal reflux disease
Generally, there are two areas of concern when it comes to symptoms in the upper digestive tract, says Dr Tan: the oesophagus and the stomach or the small intestines. Occasionally, the liver, the gall bladder and the pancreas can be areas of concern as well, he adds.
As for the oesophagus, one of the most common syndromes is gastroesophageal reflux disease, when acid gets into the oesophagus from the stomach. A valve should prevent this problem, but if the valve is weak or the patient has got a lining of the oesophagus that is particularly sensitive, the amount of acid that does get into the oesophagus may irritate it and may even cause inflammation leading to erosions or ulcers and, at worst, scarring or bleeding.
Sometimes the inflammation can be so persistent that patients develop a condition called Barrett's Oesophagus, from which adenocarcinoma - cancer of the lower oesophagus - arises.
In addition, there are other causes of reflux. Anti-blood pressure medicines may cause weakness of the valve allowing acid to come up. While a category of painkillers called non-steroidal anti-inflammatories make the oesophageal lining more susceptible to inflammation. Some antibiotics can be quite caustic and, if not swallowed properly, they can directly cause oesophagitis or inflammation.
Obese patients and those who drink a lot of alcohol are also at a greater risk of having reflux.
Dr Tan Chi Chiu is a clinical gastroenterologist, hepatologist and specialist in internal medicine at Gastroenterology and Medicine International. He can be reached at +65 6471 2212.
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