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Feeling a Little Sick to Your Stomach?

June 02, 2009

Washington Hospital Seminar Addresses Stomach Problems

Do you ever feel a little sick to your stomach? Do you get heartburn after you eat? You may be wondering if it's just mild indigestion or something more serious.

"Acid reflux is a very common problem," said Dr. Annamalai Veerappan, who specializes in gastroenterology at Washington Hospital. "Stomach cancer is not as common in this country, but deadly because early detection is difficult."

He will talk about both at the upcoming seminar "Do You Suffer From Stomach Problems?" scheduled for Tuesday, June 16, from 1 to 2:30 p.m., at the Conrad E. Anderson, M.D. Auditorium located at 2500 Mowry Avenue (Washington West) in Fremont. To register, call (800) 963-7070.

Veerappan will provide an overview of gastroesophageal reflux disease, or acid reflux as it is commonly called. The chronic condition occurs when the liquid content of the stomach regurgitates back up into the esophagus.

"Acid from the stomach can inflame and damage the lining of the esophagus," he said. "In a small number of patients, the inflammation causes a narrowing of the esophagus."

Symptoms include heartburn, hoarseness, chronic cough, sore throat and chest pain. "Even the most experienced gastroenterologists and cardiologists can't always distinguish the chest pain of heartburn from the chest pain of a heart attack," Veerappan said.

About 10 percent of people with acid reflux develop Barrett's esophagus, which occurs when the cells lining the esophagus become precancerous. According to Veerapan, about 10 percent of Barrett's cases actually turn into cancer.

"There is a new endoscopic procedure to treat people with Barrett's who are about to develop cancer," h said. "We are waiting for more data on this procedure and hopefully someday it can be used to treat other Barrett's patients."

Treatment Options

Veerappan will discuss treatment options available for acid reflux, which include lifestyle modifications, medication and surgery.

"Lifestyle changes include losing weight and avoiding foods that trigger acid reflux, which could include fatty foods, fried foods, onions, tomatoes, mints, chocolate, alcohol and caffeine," he said. "Eating smaller meals can also help. And don't eat and go to bed right away. Wait at least three hours after eating."

It's also important for people with acid reflux to sleep with their upper bodies propped up. Lying flat allows the acid to sit in the esophagus without the force of gravity pulling it down, Veerappan explained.

While there are a number of medications on the market, most people with acid reflux still rely on antacids, which neutralize the acid in the stomach. He will talk about some of the medications available today.

"Some patients can benefit from surgery," Veerappan said. "Younger patients are often good candidates for surgery, which can help them avoid taking medications for many years."

Cancer Goes Undetected

He will also discuss stomach cancer, including the risk factors and treatment options. While less common in the United States, stomach cancer has a high death rate because it is hard to diagnose in the early stages. Most people don't experience symptoms until the cancer has progressed and many of the symptoms - including unintended weight loss, indigestion, heartburn and stomach pain - can be caused by other health problems.

According to Veerappan, the risk of developing stomach cancer increases with age. Diet also seems to play a role. Eating large amounts of smoked foods, salted fish and meat, and pickled vegetables increases the risk.

"Stomach cancer is more prevalent in countries like Japan and Korea," he said. "It's more common where people consume less vitamin C and A, and eat more fried food and processed meats. People who have had stomach infections caused by the H. pylori bacteria also are at much higher risk for stomach cancer."

To learn more about acid reflux and stomach cancer, register for the seminar by calling (800) 963-7070.

For more information about Washington Hospital and its programs and services, visit