High incidence of GERD in UAE
According to Healthline, up to 60 percent of the adult population worldwide experiences some form of acid reflux and about 20 to 30 percent of people complain about having weekly symptoms in a 12 month period.
An increasingly common digestive disorder, gastroesophageal reflux disease (GERD) occurs when the stomach acid or contents of the stomach make their way back into the esophagus (food pipe). This backwash creates a feeling of uneasiness and irritates the esophageal lining resulting in severe heartburn, which is the primary indicator of having GERD.
According to the Scientific and Research Committee of the Emirates Gastroenterology Society, as of 2014, more than 30 percent of the population of UAE suffered from acid reflux.
The most common signs and symptoms of GERD include a burning sensation in the chest (heartburn) which sometimes spreads to the throat along with a sour taste in the mouth, chest pain, difficulty in swallowing, dry cough, hoarseness of voice or a sore throat, the sensation of a lump in the throat etc.
The primary causes of GERD rest on an individual’s eating habits. However, there are also other factors that can exacerbate the symptoms of GERD, such as obesity, smoking and heavy consumption of alcohol and caffeine.
UAE has seen a rise in the cases for chronic GERD over the last decade. The concurrent rise in obesity rates is a cause that has contributed the most to the alarming rise in GERD. According to a disease study report, obesity in UAE is double the world’s average. A report entitled “Global Burden of Disease Study 2013” shows that over 66% of men and 60% of women living in the UAE are obese or overweight. Almost 47.5 percent of UAE residents are overweight, with a BMI between 25 and 30 and about 13 % are obese with a BMI of over 30.
Obesity is the accumulation of body fat to a degree that it makes a person more susceptible to diseases and health problems, one of which is the prevalence of GERD. 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. Individuals who have fatty liver are also at a greater risk of being diagnosed with GERD.
Obesity is the result of risk factors such as genetics, lifestyle, inactivity, unhealthy diet, medical problems, certain medications etc. The rise in the consumption of fast food explains the rise in the levels of obesity across the UAE. Long working hours coupled with the lack of time to cook and eat healthy, has caused people to gravitate towards fast food.
Furthermore, due to the extremely hot summers that last for nearly half the year, residents of UAE do not engage in too many physical activities or sports. The scorching temperatures prevent people from walking or cycling to their destinations, resulting in them using air conditioned cars everywhere they go. Lack of physical activity coupled with the rampant fast food consumption has resulted in UAE having one of the highest rates of obesity in the world, which has, in turn, caused the prevalence of GERD in nearly 3 million people across the seven Emirates.
Another key factor in rising levels of GERD cases amongst UAE residents, is the high rates of smoking present in the UAE. According to the WHO report on the “Global Tobacco Epidemic”, 12.8 percent of adults in the UAE smoked some form of tobacco daily. Doctors say that smoking contributes to GERD by relaxing the lower esophageal sphincter (a ring of muscle connecting the esophagus and stomach) which is one of the body’s main defences against GERD. Smoking also reduces saliva, that contains an acid-neutralizing substance called bicarbonate, which is a natural antacid. Smoking is harmful to mucus membranes that help protect the esophagus from acid damage. It also prompts the stomach to produce more acid, increasing the risk of gastric juices being refluxed into the esophagus.
The symptoms of GERD can be prevented by simple changes that individuals can make in their everyday lifestyle. A change in one’s diet can be a great help. Furthermore, by quitting smoking an individual can not only greatly reduce their chances of getting heartburn and GERD but also eliminate the possibility of being diagnosed with pulmonary disorders.
Dr . Amal Premchandra Upadhyay
Consultant in Gastroenterology
Aster Hospital Mankhool