The link between GERD and Fatty liver
According to research done by the Emirates Gastroenterology Society, UAE is on the list of countries that are severely affected by GERD. Gastroesophageal reflux disease, commonly known as GERD is a chronic digestive disorder affecting around 3 million people in the U.A.E today.
GERD is a condition in which the stomach acid or occasionally, contents from the stomach, flow back into the food pipe (esophagus). The backwash (reflux) irritates the lining of the esophagus and causes GERD. The most common indication of having developed this condition is the presence of heart burn. Other symptoms include chest pain, difficulty in swallowing, dry cough, hoarseness of voice or a sore throat and the sensation of having a lump in the throat.
GERD being a digestive disorder, the primary causes of the condition involve a person’s dietary habits. In a country like U.A.E, with a number of residents experiencing long working hours coupled with a propensity to limit their consumption of home cooked meals, GERD cases have risen over the years. The advent of a number of fast food chains and unhealthy and untimely eating habits, smoking, consumption of caffeinated products and alcohol has resulted in increasing incidents of acidity and heartburn. The condition is further exacerbated in individuals who are overweight or obese. Studies indicate that obese individuals are three times more likely to have heartburn than people with normal weight, because the extra fat around the belly increases the pressure on the stomach, forcing the stomach acid to back up into the esophagus. Obesity also increases the risk of having fatty liver, a condition describing the buildup of fat (adipose tissue) in the liver. While it is normal for the liver to have some amount of fat, a fat buildup of more than 5 to 10 percent of the organs weight is called fatty liver. Individuals who have fatty liver, are at a greater risk of being diagnosed with GERD.
Fatty liver disease is of two types, Alcohol Liver Disease (ALD), that manifests itself through the excessive use and abuse of alcohol and Non-Alcoholic Fatty Liver Disease (NAFLD) which is far more common. Both these conditions involve the accumulation of fat in the liver, leading to enlargement of the organ.
NAFLD has been found to be an independent risk factor for GERD. A study conducted by the University of Catania in 2014, involving 206 patients diagnosed with NAFLD, revealed that the presence of typical symptoms of GERD was higher is those with NAFLD.
NAFLD is usually asymptomatic and causes patients to run the risk of developing insulin resistance, liver inflammation and scarring, and even liver failure, if not diagnosed on time. This condition may be caused due to genetic factors, obesity, diabetes, side effects of medicines or hyperlipidemia which is excess cholesterol in the blood.
GERD and NAFLD are both more prevalent in obese individuals. Prevalence of both these conditions in the U.A.E can be traced back to the high rates of obesity in the society. A 2015 survey conducted by Zurich International Life, ascertained that 47.5% of all U.A.E. residents were over-weight with 13% of all residents being obese. Furthermore, a profile on the U.A. E. by Health and Data listed high body mass index (BMI) as the 2nd most prevalent risk factor in deaths and disabilities, and this includes conditions like GERD.
Since GERD and NAFLD are largely lifestyle disorders, they are preventable to a great extent. Medical management of GERD and NAFLD include lifestyle changes, which primarily entails an individual to ensure that their lifestyle is structured in a way to avoid falling into the vicious cycle of weight gain, elevated BMI and obesity. The easiest and most important step an individual can take to prevent GERD, NAFLD and weight gain is to adopt a healthy, balanced diet. Focusing on what we eat, how much we eat and when we eat, can significantly lower the risks of contracting disorders like GERD.
For those who seek to lose weight, a healthy diet coupled with frequent exercise would pay large dividends in terms of the quality of the life you lead. Avoiding food that triggers the conditions and reducing consumption of alcohol, caffeine and cigarettes would not only alleviate heartburn and indigestion but would also significantly reduce the risk of liver disease.
Effective medicines are available for management of reflux.
For those patients who are unable to take these medications, surgery is an option that can provide long-term relief.
Despite the frequency in its prevalence, GERD is manageable and preventable if one adopts a healthy and balanced approach in all facets of their lifestyle. This becomes even more important for those who are already diagnosed with some degree of GERD, because just like any other disorder, GERD too can have detrimental long term effects, if not treated at the earliest.
Dr. Amal Premchandra Upadhyay
Consultant in Gastroenterology
Aster Hospital Mankhool