Rising GERD cases in Malaysia due to poor lifestyle choices

Malaysia has the highest prevalence of obesity among adults in the South-East Asian region 

by AZALEA AZUAR / pic source Google

GASTROESOPHAGEAL reflux disease (GERD) is emerging and becoming more prevalent among Asians. 

According to Ara Damansara Medical Centre consultant physician and gastroenterologist Dr Loong Yik Yee, GERD cases are rising not only in Malaysia but globally due to poor lifestyle choices and obesity. 

According to the 2019 National Health and Morbidity Survey, Malaysia has the highest prevalence of obesity among adults in the South-East Asian region where 50.1% of adults are overweight (30.4%) or obese (19.7%). 

“If we tend to become more obese, which is a very common thing in Malaysia, the incidence of GERD will increase. The same goes to a poor and sedentary lifestyle,” he said. 

One of the main causes of GERD is when people eat too much food. 

Dr Loong explains that the lower oesophageal sphincter is the part of the oesophagus which will constrict when our stomach is full to prevent it from going up. 

“Any food that causes digestion difficulties such as an oily meal or eating too much, the things in the stomach can go up to the oesophagus so the most important thing is to not eat a large meal,” he explained. 

The symptoms of GERD include a burning sensation in your chest (heartburn) usually after eating, chest pain, difficulty swallowing, regurgitation of food or sour liquid and a sensation of a lump in your throat. 

“If the acid goes up to the oesophagus, which is not made to withstand acid, it will cause problems,” he explained. 

GERD can sometimes be confused as heart, ear, nose and throat, and respiratory problems since the acid reflux can sometimes go as high as the respiratory tract so it makes the patient cough, sore throat and have shortness of breath at night. 

“Sometimes patients can actually present to the wrong specialist and doctors who are not trained to diagnose who may actually do the wrong kind of investigation and excessive investigation,” he said. 

To ensure it is not mistaken as a heart disease, patients would have to undergo electrocardiogram and x-ray screening. 

One of the methods to diagnose GERD is through an oesophageal pH monitoring to measure the patient’s acid in the oesophagus where doctors would use a scope and place a small probe at the bottom of the oesophagus to see whether acid comes up or not. 

Endoscopy is also used for accurate results, in an event where the patient’s symptoms are confusing. 

Dr Loong would advise the patients to modify their lifestyle and diet to improve the symptoms. 

If the conditions persists, patients who do not want surgery would be given the option for endoscope therapy 

The more drastic approach would be a surgery fundoplication where a surgeon would wrap the part of the stomach around the oesophagus to tighten the lower oesophageal sphincter or a bariatric surgery where patients are required to lose their weight so the surgeons would decrease the size of the stomach. 

There is a misconception that when one becomes older, they would have more difficulties in digesting food. 

In reality, however, Dr Loong clarifies that once we hit the age of 40, our metabolism would slow down so it is easier to put on weight. 

“When we put on weight, it will increase the incidence of GERD and the other thing is probably because of medication, because they do affect the closure of the job.” 

How can we prevent being diagnosed with GERD? The answer is fairly simple and Dr Loong has explained it earlier which is to avoid being overweight and not overeat. 

“I always tell my patients; you need to be at least 70% to 80% full because it takes a while for the stomach to send signals to the brain. 

“If you are 100% full and you start drinking some more water after that, it’s a bit too much already,” he said.