Heartburn common in Western countries

NEW YORK, June 24 (Reuters) Heartburn, resulting from gastro-esophageal reflux disease (GERD) in which stomach acid seeps into the esophagus causing burning and pain in the chest, is a common malady in Western populations, much more so than in other parts of the world, according to report in The Lancet this week.

Two doctors who reviewed 31 published studies reporting on the prevalence of heartburn symptoms estimate that 25 per cent of people in Western countries suffer from heartburn at least once a month, 12 per cent at least once per week, and 5 per cent suffer daily with symptoms of heartburn.

In contrast, in east Asian countries, only 11 per cent of people suffer heartburn at least once per month, 4 per cent weekly, and 2 per cent report daily symptoms of heartburn.

''There is a paucity of information about the prevalence of heartburn in other geographical regions, but symptoms of GERD are uncommon in non-Western populations,'' note Dr Nicholas J Talley from the Mayo Clinic in Rochester, Minnesota and Dr Paul Moayyedi from McMaster University in Hamilton, Ontario note in the report.

The exact cause of heartburn remains unknown but genetic factors are thought to be involved. Obesity and lifestyle factors, such as eating certain foods, drinking alcohol and smoking also appear to increase the risk that a person will develop GERD.

Some studies have shown that losing weight and elevating the head of the bed at night may relieve heartburn caused by GERD, although it's less clear whether avoiding spicy foods, carbonated beverages, coffee or that late night meal, which are often recommended, will relieve GERD-associated heartburn.

''Unfortunately, most patients do not respond to lifestyle advice and require further therapy,'' Talley and Moayyedi note.

Their options, at the moment, include, medications that suppress acid, such as proton pump inhibitors, endoscopic therapy, and anti-reflux surgery.

Drug therapy looks to be ''better than placebo,'' Talley and Moayyedi report, although ''most patients need long-term treatment because the disease usually relapses.'' Endoscopic therapy to treat GERD may entail the use of suturing devices, the application of radiofrequency energy to the lower esophagus, or the injection of bulking agents. The authors say these approaches are of ''great interest,'' but so far their value is uncertain.

Surgery seems to work as well as proton pump inhibitor therapy ''although there is a low operative mortality and morbidity,'' the authors note.

GERD is also a costly problem for Western societies. In the United States, the annual direct cost for managing the disease is estimated to be more than 9 billion dollars.

REUTERS SBA RAI1016