UP FRONT
Hematology Link
Managing GERD/Acid Reflux:
The Gastroenterologist’s Perspective
In this edition, ASH Clinical
News speaks with Aline
Charabaty, MD, about managing acid reflux/gastroesophageal reflux disease symptoms
in patients with hematologic
malignancies. Dr. Charabaty is
associate professor of medicine
and director of the IBD Center at
MedStar-Georgetown University
Hospital in Washington, DC.
of acid reflux/GERD and making these
symptoms more severe or painful.
Patients with mucositis can also have
difficulty swallowing large pills, meaning
they are unable to take their acid reflux/
GERD medications; in turn, these patients have worse heartburn symptoms.
Patients with malignancies also frequently require narcotic analgesics to manage their pain; constipation is often a side
effect of these types of medications which,
again, can exacerbate symptoms of acid
reflux/GERD, such as heartburn and nausea.
Do you treat many patients for
acid reflux/GERD who also have
hematologic malignancies or
bleeding disorders?
Gastroesophageal reflux disease (GERD)
or acid reflux is a common disorder among
the general U.S. population, with up to 20
percent of Americans reporting acid reflux/
GERD symptoms at least twice a week,
such as a sensation of burning behind the
chest that radiates from the stomach upward (i.e., heartburn). Acid reflux/GERD,
however, has multiple other manifestations,
such as nausea, cough, change in voice/
raspy voice, asthma attack, bad taste in the
mouth, enamel erosions, regurgitation of
food, vomiting, and other symptoms affecting the mouth and throat.
Certain factors increase the incidence
of acid reflux/GERD, including stress,
smoking, age >40 years, change in weight,
certain foods, and certain medications.
So, it is not uncommon for the gastroenterologist to see patients with hematologic
malignancies or bleeding disorders with a
primary diagnosis of acid reflux/GERD, or
with acid reflux/GERD developing through
the course of their hematologic disease.
When and how should the hematologist consult the gastroenterologist in the treatment of patients with acid reflux/GERD?
For hematologists treating patients with
acid reflux/GERD, there are a few definite
situations where referral to the gastroenterologist is absolutely necessary. For
instance, if the patient:
Aline Charabaty, MD
Do certain anti-cancer therapies
increase the risk of developing
acid reflux/GERD?
For patients diagnosed with blood cance