The Tribune, Chandigarh, India - Chandigarh Stories

HEALTH

Heartburn and dyspepsia — an overview
Tribune News Service

CHANDIGARH, Feb 17 — Doctors say that after a heavy meal at a party, if you suffer a heartburn, ignore it. However, if you have been getting the feeling regularly, even when you have not eaten much, then it requires a visit to the doctor and an investigation.

The Tribune caught up with leading specialists of the country here today, who are here in the city in connection with the II National Update CME in Gastroenterology and spoke about what they refer to as the most common gastrointestinal problem of the Indian population. For a country like India, with spices and fried food forming the basis of our diet, gastroesophageal reflux disease or heartburn and dyspepsia are common problems.

Explaining the reason behind heartburn, Dr Shobna Bhatia from Nair Hospital, Mumbai, says that the problem usually occurs when the valve called lower oesophageal splinter, connecting food swallowing pipe or oesophagus and stomach starts dysfunctioning.

“In normal conditions, the valve opens as you swallow and closes as you stop eating. When this valve comes under pressure, it becomes loose and opens up easily, even when not required. This condition is called the gastroesophageal reflux or heartburn,” Dr Bhatia adds.

With the valve becoming loose, hydrochloric acid produced by the stomach goes up in the pipe and causes the burning sensation which is commonly referred to as heartburn. At times with acid, food also comes back. As the condition worsens, the acid causes ulcers in the food pipe and later if not treated , the person develops difficulty in swallowing due to the tube becoming narrower.

Prof Kartar Singh, Head, Department of Superspeciality of Gastroenterology, PGI, says that the problem is very common. “Interestingly, 90 per cent of the cases can be diagnosed by just talking to the patient about his or her life style. In these parts of the country, fried food, besides spices and snacks like namkeen are the commonest culprits. Even garlic and onion masala, a very integral part of our Indian gravies also causes heartburn,” he says.

A majority of heartburn attacks, as many as 80 per cent, says Prof Kartar Singh, occur before the person falls asleep. “At this time, if no saliva is secreted, it upsets the Ph balance in the oesophagus. However, the rest 20 per cent are due to a condition when part of the stomach pushes into the chest. These conditions are resistant to conventional treatment and require surgery,” he says.

Doctors attribute heartburn to four major factors — stress, food, over-eating and age. Dr Deepak Bhasin, Additional Professor, Department of Superspeciality of Gasteroenterology, PGI recommends some essential steps to avoid the condition. “The valve is loose in the lying down position. Walking after a meal is good for the health, as well as for treating heartburn,” he says.

“Since heartburn is due to damage because of the acid, it is essential to control this by giving antacids. Heartburn is aggravated by smoking and drinking aerated drinks,” says Dr Bhasin, while adding that when the problem becomes acute, stronger drugs may have to be given to stop the secretion of the acid altogether.

Dr Bajrang Pratap from Hyderabad adds, “It is a disease which is otherwise mild, but causes lot of discomfort and morbidity to the patients. There are drugs available which can tighten the valve. However, it is important that the condition be treated as early as possible. An undetected condition in children may also cause pneumonia. At times, the condition may get so bad that it may resemble a heart attack,” he adds.

Doctors add that asthma patients in particular, need to be more careful as they are more prone to gastroesophageal reflux. Reflux perpetuates asthma. For them, it is important that they eat less and take acid inhibitors.

Specialists, however, add that heartburn could also be indicative of yet another common disorder — dyspepsia. Dr P. Abraham from K.E.M. Hospital, Mumbai, says, “when patients, also complain of fullness, vomiting and upset stomach besides heartburn it could also be due to abnormality of acid secretion. Due to abnormality in functioning, there may be delay in emptying. The person keeps feeling full despite having eaten nothing. it overlaps with reflux problems.” he adds.

Dr Abraham says that management of dyspepsia and heartburn are more or less the same. “Besides, the patients need to be assured that there is nothing wrong with them, but they just need to modify their lifestyle. The person needs to eat smaller meals, take less oil, spices and fried starchy food and eat slowly,” he adds.

Dr P. Advaitham, president of the Indian Society of Gasteroenterology, says that people with functional bowel disease develop dyspepsia and diarrhoea. The problem manifests without any structural changes and any visible abnormality. “However, a lot can be related to stress,” he explains.

Dr Advaitham says that whenever there is stress, the bowel reacts violently and produces dyspepsia-like symptoms. “Even while persons shows discomfort, endoscopy shows normal results. The reason is that the gut has its own nervous autonomous connection which acts under local stimulus.”

Since it is a stress-induced disorder, Dr Advaitham says that ideally it is best to lead a carefree life style “But it not possible to lead a totally stress-free life. However, the secret is to act without sentiment and work without expectations.”

Stress is the commonest cause of absentism, in industry and lack of performance, Prof A. Koshy from Bangalore says. “I would recommend that you do your duty but with a little detachment. Modify your lifestyle and lead a relatively stress-free life.”

Stress causes gastrointestinal disorders: experts
Tribune News Service

CHANDIGARH, Feb 17— The two-day Update CME Gastro —2001, started in the PGI, here today, with the aim to disseminate latest information about the gastrointestinal diseases and infections amongst general physicians, gastroenterologist and liver experts. The seminar has been organised by the Department of Superspeciality of Gastroenterology, PGI.

Speaking about the approach to adult cholestatic liver disease, Dr A. Koshy from Bangalore said that the disorder was as common as jaundice. While in jaundice, bilirubin levels are high, in cholestatic, the bile salts increase.

Dr Koshy said that conventional approach to cholestatic included ultrasound scanning, followed by ERCP and liver biopsy. the newer techniques included a look into the mechanism by which the bile salts are transported in and out of liver cells. It has been identified that cholestatic requires treatment specific to the type of hepatitis. Talking about the newer approach, Dr Koshy said that scientists abroad were working on sequencing the gene to locate the mutants.

Dr P. Advaitham from Madurai spoke about the instable bond syndrome which is one of the commonest problems faced by the gastroenterologist. According to him the altered movement of the gut was directly related to the stress and strains of the life.

In a discussion on the idiopathic ulcerative colitis, Dr Bajrang Pratap from Hyderabad talked about the recent advances in the therapy. He said that while the cause was not known, with newer drugs, the condition was treatable.

Dr George Kurian from Vellore discussed the Indian perspective of Crohn’s Disease, while Dr M.P. Sharma talked about the diagnosis of stomach infections and ulcers. Discussing the various aspects of Helicobacter Pyroli, Dr Sharma said that the micro organism was responsible for ulcers, lymphoma and cancer of the stomach.

Talking about Hydatit Disease — Dr S.A. Zargar discussed the status of non-surgical management. It is a liver disease caused by infection through handling dogs. Dr A.K. Jain from Varanasi gave an over view about the diagnosis of abdominal tuberclosis and its current status.

In a special symposium on pancreatitis, Dr V. Saraswat from Lucknow, Dr R.R. Rai from Jaipur, Dr Nirmal Kumar from New Delhi talked about the current perspectives in surgical and medical management.

Later in the day, various aspects of imaging and interventions of gastro-intestinal diseases were discussed by Dr K. Vanketashwarlu from Kurnool, Dr V.V. Chaudhary from New Delhi and Dr S.S. Bajpai from Lucknow. Dr D.P. Chauhan discussed the DNA microsatellite instability in carcinoma colon and its clinical relevance.

In the symposium on hepatitis, various aspects of vaccines and recent advances in the field were discussed by the experts.

1,500 die of cancer in USA daily: Kochhar
Tribune News Service

CHANDIGARH, Feb 17 — “Cancer and Old Age” was the theme of the public awareness lecture organised by the Servants of the People Society in collaboration with the Indian Medical Association (Chandigarh branch) at Lajpat Rai Bhavan here today.

The President of IMA, Dr G.S. Kochhar, in his welcome address said cancer was the result of uncontrolled growth of abnormal cells derived from normal tissue. He said: “There are about 200 types of cancer. Even in advanced countries like the USA 1500 persons died of cancer every day. Globally cancer is the second leading cause of death”.

It is estimated that in India 10 lakh new cases of cancer are added every year. At a given time 50 lakh patients of cancer are present in the country.

Dr S.M. Bose, Professor and head of the Surgery Department, PGI, Chandigarh, highlighted the cause and risk factors of cancer. He said smoking was the major cause of cancer. The key to control and cure of cancer was its early detection, for which awareness among the people was the most important. He clarified a lot of methods about cancer and answered their questions.

One book on cancer written by Dr Bose for the common man found great favour with the participants.

Dr V.K. Kapoor, urologist (retd) PGI gave details about prostate and urinary bladder cancer.

At the end Mr Onker Chand, Secretary, Servants of the People Society, thanked Dr Kochhar Dr S.M. Bose and Dr (Col) Kapoor. He said the next lecture “Diabetes and Old Age” would be held in March in collaboration with the Indian Medical Association.

Plea to shift dispensaries
Tribune News Service

CHANDIGARH, Feb 17 — Government Homoeopathic Dispensary in Sector 47 and civil/ayurvedic dispensary in Sector 33 have been functioning in government quarters, even though new buildings are complete in all respects in the two sectors. This has been highlighted by the president of the Residents Welfare Society, Mr S.P Jand in a letter written to the Adviser to the UT Administrator, Mrs Neeru Nanda.

Mr Jand has urged her to shift the above said dispensaries to the newly constructed buildings in the two sectors for the convenience of public.