I’m often asked why I think it’s so important to change the way today’s medicine To explain I like to compare where we were with heart disease 40 years ago to today’s treatment of acid reflux, or GERD.
GERD has many similarities to the coronary artery disease that causes heart disease. Both are the result of the dietary excess that plagues modern Western society. In coronary artery disease, dietary excess results in lipid plaques being deposited in the coronary artery causing narrowing. In GERD, the dietary excess causes damage to the lower esophageal barrier. Both are associated with obesity, but can occur in people of normal weight. Most people will go through life without the effects of coronary artery disease or esophageal barrier damage, even though they may have mild disease. A few people progress to more severe damage, including coronary artery disease, severe disease causes angina, heart attacks, and death. In GERD, the most severe disease causes Barrett’s esophagus, esophageal cancer, and death.
In the past 40 years, the treatment of acid reflux and the treatment of coronary artery disease have gone in two completely different directions. In the 1970s, coronary artery disease was rapidly increasing in frequency and severity, but there was little doctors could do to treat it. Today, the number of people dying from heart disease has decreased dramatically, because we have drugs that control lipids, conduct tests that detect early coronary disease, and use stents and bypass surgery to correct damage. Medicine has succeeded in controlling the disease.
In the 1970s, Barrett’s esophagus and esophageal adenocarcinoma resulting from GERD were very uncommon. Over the past 40 years, these conditions have increased 6-10 fold, now representing the most rapidly increasing cancer type in the Western World. Present treatment of acid reflux disease does nothing to prevent, detect, or treat these complications. We are with GERD today where we were with coronary artery disease in the 1970s.
Now is the time to change the treatment of acid reflux. I believe we are in the midst of a GERD epidemic, but by raising awareness about the disease, educating physicians and patients alike, and pushing for better treatment options, I know we can accomplish what we did with heart disease. And 40 years from now, we’ll be able to say we are able to detect premalignant conditions earlier and prevent the development of a deadly cancer.