Gastroesophageal Reflux Disease - Patients Suffer For Two Years Before Seeking Medical Help

Main Category: Acid Reflux / GERD
Also Included In: GastroIntestinal / Gastroenterology
Article Date: 17 Sep 2005 - 19:00 PST

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People are suffering with distressing symptoms of gastroesophageal reflux disease (GERD) for an average of two years before seeking care and advice from their primary care physician.1 Results from the Burning Desires survey, revealed today, indicate that this may be due to a perception amongst sufferers that while over-the-counter (OTC) medications are effective, prescription medications will not help. This is despite the fact that prescription medication in the form of proton pump inhibitors (PPIs) has been proven to provide relief from one of the main symptoms of GERD - heartburn - within five days in most people.2

Symptoms such as heartburn place a considerable burden on sufferers' lives, with more than 80 percent of those surveyed having made lifestyle modifications, such as avoiding certain foods, to try to control their symptoms.

Commenting on the results of the survey, Professor Roger Jones, Wolfson Professor of General Practice, King's College London said that the results of the survey highlight that many GERD patients are suffering unnecessarily.

"There is a mistaken belief amongst many GERD sufferers that prescription medications will not be able to help them, as they feel they can control their symptoms with over the counter remedies. However, these remedies only relieve occasional heartburn and should not be relied upon for long-term symptom control. It is important that sufferers visit their physician to discuss their disease as they may be prescribed a more effective treatment, such as proton pump inhibitor therapy, which can have a significant impact on controlling symptom severity and improving quality of life."

Using a seven-point scale, with seven being the most important, participants were asked to rate the influence that various factors had on restricting or inhibiting them from consulting a primary care physician for care and advice about their disease. Amongst 924 un-diagnosed patients, the most common factors included a belief that their OTC medicine was effective (mean score = 4.4), they had suffered no increase in the severity or frequency of symptoms (mean score = 4.1) or that their symptoms were already controlled (mean score = 4). In addition, the belief that prescription medications could not help had an influence on preventing them visiting their physician (mean score = 3.8).

In contrast to this, of those 984 diagnosed GERD sufferers surveyed, the most influential factors that drove them to visit their physicians for advice and care included a belief that their physician could help (mean score = 5.8), a belief that their physician would take them seriously (mean = 5.7) and that effective treatment options existed (5.7).

Further data from the Burning Desires survey show that GERD sufferers who did seek medical advice and who were treated with PPI therapy reported a greater improvement in their symptoms compared with those on alternative treatments, including H2-receptor antagonists or antacids. In the seven days before the survey was undertaken, 31 percent of PPI users questioned had had no symptoms, compared to only 8 percent of those survey responders who were using alternative methods to control their symptoms. In addition, self-treated individuals were significantly more likely to report heartburn in the seven days before questioning (83 percent) compared to those who were medically treated (67 percent).

The latest PPI, Nexium� (esomeprazole) can provide freedom from heartburn within five days in most people and has been shown to provide an improvement in areas of health-related quality of life (HRQL).2,3 Nexium� works by deactivating the proton (acid) pumps that produce stomach acid, thus reducing the amount of acid that is in the stomach, helping to treat heartburn and other symptoms of GERD. Several comparative clinical trials with more than 15,000 patients with Nexium�, including the EXPO, the EAZEE and Metropol studies, confirm that Nexium� provides superior acid control which translates into clinical benefits.2,4,5,6,7,8 Nexium� is only available on prescription. The most common side-effects with Nexium� are headache, diarrhoea, and abdominal pain, which occur in around one per cent of patients.

References

1. Jones R et al Barriers and influencing factors affecting the likelihood of patients with GERD consulting a physician: results of a multinational survey. Poster presented at the World Congress of Gastroenterology Congress, 2005
2. Kahrilas P et al. Esomeprazole improves healing and symptom resolution as compared with omeprazole in reflux oesophagitis patients: a randomized controlled trial. The Esomeprazole Study Investigators. Aliment Pharmacol Ther 2000; 14: 1249-1258
3. Ingela Wiklund et al Symptom relief improves patients' lives: the Canadian feeling thermometer study. Poster presented at the Digestive Disease Week Congress�, 2005
4. Labenz J et al A randomized comparative study of esomeprazole 40 mg versus pantoprazole 40 mg for healing erosive oesophagitis: the EXPO study. Aliment Pharmacol Ther 2005; 21: 739-746
5.Castell D et al Esomeprazole (40 mg) compared with lansoprazole (30 mg) in the treatment of erosive esophagitis. Am J Gastroenterol 2002;97:575-83
6.Lauritsen K et al Esomeprazole 20 mg and lansoprazole 15 mg in maintaining healed reflux esophagitis: Metropole study results. Aliment Pharmacol Ther 2003;17:333-41
7.Fennerty MB et al Efficacy of esomeprazole 40 mg vs. lansoprazole 30 mg for healing moderate to severe erosive oesophagitis. Aliment Pharmacol Ther 2005;21(4):455-63
8.Richter J et al Efficacy and safety of esomeprazole compared with omeprazole in GERD patients with erosive esophagitis: a randomized controlled trial. Am J Gastroenterol 2001;96:656-65

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About the Burning Desires Survey

The survey adopted quantitive research methods to question 1,908 GERD sufferers in Germany, France, UK and USA. A total of 1,306 patients were surveyed in Europe and 602 in the USA. Individuals answered questions concerning their disease, lifestyle and choice of drug through face-to-face interviews and a 100-item questionnaire.

Respondents suffering from GERD were identified from a random telephone screening of >200,000 households. Of the 1,908 participants, 984 were diagnosed and 924 were undiagnosed as GERD sufferers.

About GERD

Gastroesophageal reflux disease (GERD) is characterised by the regular reflux (rising backward flow) of gastric acid from the stomach into the esophagus.

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