'I took it until pain stopped'
Acid reflux patient would randomly take medicine for her condition
Since she was a teenager, she would reach for her stash of over-the-counter medicine whenever she felt a gnawing pain in her upper abdomen.
Business manager Rachel Lee, now 36, would sometimes pop as many as 10 antacid pills a day to try to ease the pain caused by gastroesophageal reflux disease (Gerd), more commonly known as heartburn or acid reflux.
Acid reflux is a digestive disorder where the acidic content of the stomach flows back into the throat (the oesophagus).
"I didn't know when or how often I was supposed to take the medicine. I just took it until the pain went away," she told The New Paper.
A local survey shows that 40 per cent of acid reflux patients, such as Madam Lee, do not take their medicine regularly.
Conducted by the Gastroenterological Society of Singapore ahead of World Digestive Health Day on Thursday, the survey shows that a busy lifestyle is the most common reason for not taking the medication as prescribed. (See report on right.)
Even when Madam Lee was prescribed Dexilant for her acid reflux a month ago, she failed to keep up with her two-week prescription. It should be taken once daily, but she neglected to take it on a few days.
"Every day, I have to take iron, calcium and omega-3 supplements because I am breast-feeding. The pills are big so I have to space them out," said the mother of a one-year-old daughter.
"Nobody likes to be popping pills all the time."
Madam Lee said the prescription drug is more effective than over-the-counter medicine and the pain now strikes her only once in a while.
But such irregular consumption may mean that the patient will continue to feel the burning sensation from the acid for prolonged periods, said Dr Daphne Ang, a consultant gastroenterologist at Changi General Hospital (CGH), and the survey's chief investigator.
"If the medication has to be taken 12-hourly and (patients) only take it once a day, it may lead to symptoms when the medication has worn out and they are due for the next dosage," she said.
For patients with erosions in the lining of the oesophagus, CGH's gastroenterology chief Ang Tiing Leong said taking medicine irregularly may lead to complications like strictures, which is the narrowing of the oesophagus due to healed ulcer scar tissues.
Prescription and over-the-counter treatments for Gerd work slightly differently, explained Dr Jarrod Lee, a gastroenterologist in private practice.
The former helps to reduce the acidic content of the acid reflux so it does not irritate the lining of the oesophagus, while the latter neutralises the acidic content in the stomach and oesophagus. But neither reduces the number of acid reflux episodes, he added.
If the medication has to be taken 12-hourly and (patients) only take it once a day, it may lead to symptoms when the medication has worn out...
- Consultant gastroenterologist Daphne Ang
40% of patients don't take medicine as told: Study
Many patients who suffer from acid reflux may complain that their medicine does not work. But this could be because they fail to pop the pills as instructed, a local study has found.
Conducted by the Gastroenterological Society of Singapore (GESS) between last December and last month, the study showed that 40 per cent of the 202 patients surveyed did not take their medicine around meal times, as instructed.
And out of this 40 per cent, close to half said they were too busy to keep to the timings.
These numbers helped shed light on the habits of patients with acid reflux, which doctors do not always have the luxury to delve into during consultations, said GESS president Ang Tiing Leong.
Dr Ang, who heads the gastroenterology department at Changi General Hospital (CGH), added that the results helped to explain why prescribed medication sometimes fails to alleviate discomfort.
As the prescribed drugs have a 90 per cent efficacy, patients should ideally become well, he said.
The irregular consumption of medicine may mean that patients have to deal with a burning sensation or a sour taste in the mouth for prolonged periods.
In most cases, this will result in an altered quality of life, like sleep disruption, said Dr Daphne Ang, the study's chief investigator and a consultant gastroenterologist at CGH,
Five to 10 per cent of these cases will result in strictures, the narrowing of the gut due to healed scar tissues. This may then result in food getting stuck in the gut, she said.
Only 0.1 per cent of these patients end up with cancer, Dr Ang added.