Keith is a web designer. He spends hours in front of the computer busily designing websites for clients. He played rugby and five a side football. The training and the games he played kept him fit and his weight down. Unfortunately Keith had a nasty accident playing rugby and severely damaged his left knee. Re-constructive surgery worked but his knee has not been right ever since. His specialist advised him to avoid contact sport.

This made Keith sad. He ate more, drank more alcohol and smoked more. He felt he could not do exercise and spent more time in front of his computer screen.

In no time Keith gained three stones in weight. He started having heartburn. He knew it was heartburn because the antacids took it away. The heartburn got worse and he started feeling fluid rush up into his throat. Sometimes he felt wheezy even though he never had asthma. The antacids were now only helping a little. He developed a dry irritating cough which he thought was due to the extra cigarettes he was smoking.

When he slept he used four pillows because he was waking up during the night with reflux up into his throat and nocturnal heartburn.

One night before retiring, he decided it was time he paid a visit to his doctor. He decided he would do so the next day. That night, however, he woke up with severe chest pains and had difficulty breathing.

Panic struck. He felt he was having a heart attack. Sweat poured down his anxious face. He phoned the emergency services and the ambulance came very quickly. He was nebulised and rushed to Accident and Emergency.

Following tests, he was diagnosed with GERD and he was advised to see his doctor for further tests and acid reflux treatment. His doctor referred him for endoscopy. He had esophagitis and histology confirmed he had Barrett’s esophagitis. He was prescribed omeprazole as acid reflux treatment.

He asked the Gastro-enterologist about Barrett’s esophagus. The specialist explained the condition and the small risk of adenocarcinoma. He also told him that his Barrett’s esophagus had a large ulcer and that he was lucky it did not cause him other problems such as vomiting blood or passing tarry stools (melaena). It could have perforated and discharge nasty acids into his chest.

Keith lost weight, stopped smoking and reduced his alcohol intake. He exercises regularly to the limit his knee permitted. He is now symptomless but is on maintenance dose of omeprazole and has endoscopies and biopsies yearly because of his Barrett’s esophagus.

Keith’s problems could have been sorted out earlier and who knows, perhaps the damage to the esophageal lining might have been avoided and similarly Barrett’s esophagus.

The bottom line is: GERD needs effective acid reflux treatment. The sooner the better.

Dr. Phil Hariram.