THINK IT'S COUGH? It Could be GERD

Gastroesophageal reflux disease may often lead you to believe that it is a persistent throat
problem, while the cause lies in your stomach. Lifestyle changes may have the answer, writes
Saliha Nasline

Many people continue to suffer from itchy throat and cough even if it isn't winter. Visits to
the doctor do not always help as they may probably be told that it is just an infection. But it
may actually be a serious form of acidity called gastroesophageal reflux disease (GERD).

While most patients experience occasional acid reflux, it may turn severe in some cases.
Kabir, who moved from Delhi to Bengaluru after landing a job with one of the most soughtafter
startups in the country , is one such example.All was well with him until the pressure of
working day and night got to him. He was constantly ill and kept complaining about
persistent cough and sore throat. After consulting several doctors, he found that he was
indeed suffering from GERD.

“GERD is a digestive disorder which affects the lower oesophageal sphincter (LES), the ring
of muscle between the oesophagus and the stomach,“ said Dr Jayshri Shah, gastroenterologist
at Mumbai's Jaslok Hospital and Research Centre.“In normal digestion, the lower
oesophageal sphincter opens to allow food to pass into the stomach and closes to prevent
food and acidic stomach juices from flowing back into the oesophagus. In GERD, the LES
becomes weak, allowing the stomach's contents to flow back into the oesophagus.“

According to an estimate, as much as 60-70% of the adult population experiences GERD in a
year.Changing lifestyles and obesity are the major reasons of increasing incidence, said Dr
Ravindra BS, chief of medical gastroenterology , BGS Gleneagles Global Hospitals in
Bengaluru.

“GERD means acid from stomach refluxes into the food pipe resulting in heartburn. If
neglected, it results in oesophagus ulcers and in a few who have smoking habits, it can lead to
cancers in the long run,“ he said.

RISK FACTORS FOR GERD
Although heartburn and other symptoms of acid reflux are common, certain factors put some
people at a higher risk of frequent bouts of indigestion and developing GERD. These risk
factors can be related to lifestyle, diet and certain medications.

General physician Dr Gowri Kulkarni, head of medical operations, DocsApp, said, “Certain
individuals are at a higher risk of GERD. The various causes for acid reflux could be obesity ,
consumption of spicy food, alcohol, smoking, inadequate exercise, untimely meals, irregular
sleep pattern and certain medications.“

Stress can be hard on your gut. This may be especially true when the work environment is
extraordinarily stressful.

Shah said that patients should seek immediate medical attention in case of chest pain,
especially if it is accompanied by other symptoms such as shortness of breath or pain
radiating to jaw, arm or shoulder. “Sometimes these symptoms may be due to heart attack,“
she said.

She said that recurrent backwash of acid can irritate the lining of the oesophagus (food pipe),
causing inflammation. Over time, the inflammation can heal, but if acid reflux persists, the
oesophageal lining can get ulcerated, causing complications such as bleeding, oesophageal
narrowing or Barrett's oesophagus (a precancerous condition).There is a high association of
GERD with oeosphageal adenocarcinoma (cancer).

Ravindra said, “Patients should visit the doctor if heartburn and cough persist for more than
three weeks. The other symptoms that definitely need a visit to the doctor are loss of appetite,
persistent difficulty in swallowing, blood in vomiting and weight loss. If medicines don't
work or on stopping medicines symptoms recur, endoscopy is needed. Sometimes special
tests like PH metry and manometry must be done.“

RELATIONSHIP BETWEEN GERD AND COUGH
Kulkarni said, “There is a dual relationship between GERD and chronic cough; GERD can
cause cough and chronic cough could also lead to GERD.Due to acid reflux, you might feel
an irritation in the throat which could lead to bouts of cough. Due to chronic coughing, the
sphincter might become lax which could lead to acid reflux.“

LIFESTYLE MODIFICATIONS HOLD CURE
“Patients are advised to make lifestyle modifications, including reducing stress, and will be
prescribed medication if needed. The medicines will help in increasing the motivity of the
gut,“ said Kulkarni. “If the patient does not show any improvement even after six-eight
weeks of medication, they will be advised to undergo an endoscopy . If the condition is
severe heshe might have to undergo surgery .“ There are many ways to tackle GERD.
“Maintain a healthy weight. Excess weight can put pressure on your abdomen, pushing up
your stomach and causing acid to back up into your oesophagus,“ said Shah. “If you are
overweight try to lose 0.5 to one kg per week.Avoid alcohol, smoking and tight-fitting
clothing.Clothes that fit tightly around your waist put pressure on your abdomen and the
lower oesophageal sphincter. Avoid foods that trigger heartburn. Everyone has their own
dietary triggers.These need to be identified and avoided. Common triggers such as fatty or
fried foods, alcohol, chocolate, mint, garlic, onion and caffeine may worsen your symptoms.“
Dr Vidyasagar Ramappa, consultant-gastroenterology at Columbia Asia Referral Hospital in
Bengaluru said weight loss is important for those who are overweight or have had recent
weight gain. Similarly , elevation of the head of the bed helps those who have nocturnal
symptoms, as does having small frequent meals and avoiding heavy meals, and not lying
down after eating.

People who mostly eat outside should avoid spicy and oily food, said Ramappa. “This can not
only lead to acid reflux but also increase the risk of upper abdominal discomfort or stomach
bloating. Avoid using tobacco and alcohol, limit caffeinated drinks like coffee and carbonated
beverages, and avoid meal two-three hours before bed,“ he said.

Source: The Economic Times

More efforts needed to sensitise all about mental health: Experts

Applauding the government's move to pass the new mental healthcare bill in Parliament,
experts pointed at the need to sensitise all stakeholders of society , including caregivers and
police, for effective implementation of the new law.
Highlighting the gaps in infrastructure and human resources, doctors, psychiatrists and social
workers said society has a long way to go before ensuring equal rights for mentally ill
patients, even though the bill is a move in the right direction.
“Just passing a new law is not enough -we need to ensure that everyone, especially the
caregivers, as well as the police and other stakeholders in society are sensitised to this new
paradigm that sees a person with mental disorder as someone having the same rights as
everyone else in society and makes it incumbent upon society to provide those rights,“ says
Dr Pallab Maulik, deputy director and head of research and development, George Institute for
Global Health India.
On Monday , Parliament passed the mental healthcare bill, decriminalising attempt to suicide
and defining mental illness in a broader and more inclusive way . While recognising suicide
attempts as a cry for help, the new law takes a rights-based approach and is patient centric.
For instance, the bill allows people a chance to choose someone who can take care of them or
method of treatment if they suffer mental illness in future. In other words, people suffering
from a mental illness will have the right to choose their mode of treatment by nominating
representatives who will ensure that their choices are carried out. The bill also repeals section
309 of the Indian Penal Code which provided for a yearlong imprisonment for a failed suicide
bid.
“The bill is a welcome progressive step in the right direction. It is definitely aspirational and
shows a high level of intent but how quickly it will see the management of the gaps between
the ground realities and the aspirations set by it, is something to be seen,“ says Dr Nimesh
Desai, director, Institute of Human Behaviour and Allied Science (IHBAS).
Estimates show at least 13.7% of Indians suffer from mental illness and around 10% of them
suffering from common disorders such as depression, anxiety disorders and substance abuse
needing immediate medical intervention.
The study also showed that there are less than 4,000 doctors in the country to treat the large
number of mental patients. Apart from epilepsy , the treatment gap for all mental disorders is
over 60%. Nearly 1% of the population also run suicidal risk.

Source: The Times of India

National Health Policy is high on ambition, but sketchy on achieving targets

The health policy does not address key issues such as human resources gaps, especially in the

rural areas, underutilisation of resources, poor quality control and poor track record in scaling up

experiments in public-private partnerships to meet challenges (Representative Photo)(AFP)

India’s ambitious National Health Policy, which plans to increase public spending on health from

1.15% to 2.5% by 2025 and offer “assured healthcare to all”, is a step down from the policy’s

original draft in 2015 that had proposed health be considered a fundamental right and set the

deadline for raising spending on health to 2.5% by 2020.

The policy outlines an ambitious plan to optimise primary care delivery in the public sector and

fill critical gaps by strategically purchasing secondary-care hospitalisation and tertiary care

services from the public sector and NGOs. It also wants to reinforce trust in the public 
healthcare system by providing treatment for infections and chronic diseases, eliminating 
leprosy, kala-azar and lymphatic filariasis, lowering under-five deaths, stabilising population 
growth and increasing longevity.

It acknowledges the need to prioritise the prevention, diagnosis and management of 
noncommunicable diseases (NCDs), which account for 39.1% of India’s disease burden 
and have replaced communicable diseases as the leading cause of death, and halve premature 
deaths from heart diseases, cancer, diabetes or chronic respiratory diseases by 25% by 2025.

World’s heaviest woman Eman Ahmed loses 140kg in 5 weeks in India, weighs 358kg

Deadlines have been set for each deliverable, but what’s missing is the path India needs to take

to meet these targets.

Union health and family welfare minister JP Nadda has reiterated that since public health, along

with hospitals, dispensaries and sanitation is on the state list, the onus of implementing is with

the states. The Centre will help, but each state will have to find more money to give their state’s

health indices a boost.

The policy has scrapped the initial proposal to use taxation, including a special health cess, to

finance the increased budget, and has instead suggested the state sector health spending to be

increased to more than 8% of the state budget by 2020. Currently, the average annual health

spending of most states is less than 5%, with only a handful — Delhi, Goa, Kerala and Rajasthan

— spending more than 5% on their citizens’ health.

The health policy does not address key issues such as human resources gaps, especially in the

rural areas, under-utilisation of resources, poor quality control and a patchy track record in

scaling up experiments in public-private partnerships to meet challenges. With the poor

implementation of existing legislation, such as the Clinical Establishment (Registration and

Regulation Act), accountability and quality standards vary widely across India.

The new health policy can help India achieve universal coverage

Why a rich, orderly Himalayan state has India’s highest suicide rate

Close to one in three persons calling themselves allopathic doctors are educated to Class 12,

while 57% practitioners had no medical qualification. India needs to fill gaps in healthcare

delivery and meet infrastructure and human resource shortfalls in public centres to lower 
out-of pocket spending and save people from catastrophic spending on health.

Source: Hindustan Times

Maha may test device that detects cancer in 15 mins

The state government may carry out a pilot project to test the efficacy of a new blood test-based device that claims to detect breast cancer within 15 minutes.

State health minister Dr Deepak Sawant said at the global launch of the device, MammoAlert, in Mumbai, “We will run a pilot in areas where the incidence of breast cancer is high.“

He said over 1.5 lakh women are diagnosed with breast cancer across India every year and 70,000 die due to its complications every year. Breast cancer is the most common among Indian women. “With this innovation, we can aspire to save many lives. This technology makes cancer screening within the reach of the common man across geographies,“ Sawant added.

The Centre recently announced a population-based screening programme to detect cancers of the breast, cervix and oral cavity .

A Silicon Valley company on Wednesday unveiled the device that “can be carried on a motor bike“ from village-to-village for testing, said owner Sanjeev Saxena. He added that the test has over 95% accuracy and zero rate of false positive. He likened the test to a rapid blood sugar test to detect diabetes.

The inauguration was also attended by Amruta Fadnavis, wife of chief minister Devendra Fadnavis, and women & child development minister Vidya Thakur.

Saxena said the test will soon get US FDA and European CE clearances, and they are looking at a July launch.

Source: The Times of India

Improved gender ratio