打工仔日忙夜忙,壓力又大,睡眠欠佳可令身體無法充分休息,不但會影響生活質素,工作表現更會大打折扣。除了精神壓力及生活節奏紊亂,夜間胃酸倒流的症狀亦有機會影響上班一族的睡眠質素,患者若吃得太飽及太夜進食,會加劇胃酸逆流至食道,以致半夜出現胸口灼痛(火燒心)、胃氣及胃脹等症狀,使人難以入睡或半夜痛醒,需要盡早接受適當治療,病人才能有一覺好眠。
過量進食或吃了可誘發大量胃酸分泌的肥膩或刺激性食物,會刺激胃酸分泌,使症狀變得嚴重。而且香港上班一族多應酬,夜收工,若飯後立刻躺臥睡眠,胃部會和食道對齊成一水平,沒有了地心吸力的牽制,胃酸會更易湧進食道,做成食道灼傷,引起火燒心及胃酸上湧等症狀,影響睡眠質素。有些病人為了舒緩不適,會選擇側卧睡姿,並利用枕頭墊高身體,從而減少胃酸倒流的症狀。

長效PPI助持續控制胃酸

胃酸倒流與飲食及生活習慣有很大關係,但要改善病情,除要調整生活習慣之餘,包括控制食量、保持清淡及保持睡前四小時不進食等,病人亦可能需要藥物的幫助,「質子泵抑制劑」(PPI)便是現時最常用的抗胃酸藥物,可有效舒緩胃酸倒流引起的症狀,晚上不再因胸口絞痛而影響睡眠,保持最佳精神狀態去應付日常工作。

質子泵抑制劑有助控制胃酸分泌,避免胃部持續分泌大量胃酸而引起倒流,對於由胃酸倒流引起的侵食性食道炎更有理想療效。有些較新的質子泵抑制劑,藥效較為持久,能長效抑制胃酸分泌,舒緩症狀,且毋須在餐前服用,可隨時服藥,適合工作繁忙或時常忘記服藥的患者。

胃酸倒流在香港十分常見,多達一至兩成上班一族都有相關症狀,西化飲食令問題愈趨普遍,若長期未有妥善控制胃酸倒流,可引發相關併發症,如食道發炎、食道潰瘍及食道縮窄,甚至出現巴洛氏食道症的癌前病變,增加患上食道癌的風險。因此任何人如頻繁出現胃酸倒流的症狀,應盡快尋求醫生的專業診斷。

參考資料:
  1. Wong CY. Gastro-esophageal reflux disease: Optimizing proton pump inhibitor therapy to improve symptom control. JSPHK.2014;6:1-2.
  2. Mayo Foundation for Medical Education and Research. Definition. Available at:http://www.mayoclinic.org/ diseases-conditions/gerd/basics/definition/con-20025201 (Accessed on 09 Mar 2015).
  3. Mayo Foundation for Medical Education and Research. Symptoms . Available at: http://www.mayoclinic.org/diseases-conditions/gerd/basics/symptoms/ con-20025201(Accessed on 09 Mar 2015).
  4. American Academy of Family Physicians. Atypical Presentations of Gastroesophageal Reflux Disease.Available at: http://www.aafp.org/afp/2008/0815/ p483.html#afp20080815p483-t1 (Accessed on 25 Mar 2015).
  5. Mayo Foundation for Medical Education and Research. Causes. Available at: http://www.mayoclinic.org/diseases-conditions/gerd/ basics/causes/con-20025201(Accessed on 09 Mar 2015).
  6. MedlinePlus. Gastroesophagal reflux disease. Available at: https://medlineplus.gov/ency/article/000265.htm (Accessed on 5 Dec 2017)
  7. Mayo Foundation for Medical Education and Research. Risk factors. Available at: http://www.mayoclinic.org/ diseases-conditions/gerd/basics/risk-factors/con-20025201(Accessed on 09 Mar 2015).
  8. Healthline. Can Stress Cause Acid Reflux? Available at: https://www.healthline.com/health/gerd/stress#1 (Accessed on 5 Dec 2017)
  9. Mayo Foundation for Medical Education and Research . GERD: Can certain medications increase serverity? Available at: https://www.mayoclinic.org/diseases-conditions/gerd/expert-answers/heartburn-gerd/faq-20058535 )(Accessed 5 Dec 2017)
  10. GI Motility online. Medical management of gastroesophageal reflux disease. Available at: https://www.nature.com/gimo/contents/pt1/full/gimo54.html (Accessed 5 Dec 2017)
  11. Mayo Foundation for Medical Education and Research. Complications. Available at: http://www.mayoclinic.org/diseases-conditions/ gerd/basics/complications/ con-20025201(Accessed on 09 Mar 2015).
  12. American College of Gastroenterology. Diagnosis and Management of Gastroesophageal Reflux Disease. Available at:http://gi.org/guideline/diagnosis-and-managemen-of-gastroesophageal-reflux-disease/(Accessed on 25 Mar 2015).
  13. 香港專科醫護基金. 胃酸倒流引致胸痛 嚴重影響生活質素Available at http://www.hkscf.org/cn/index/headline/?newsid=109 (Accessed on 13 Mar 2015).
  14. WebMD. GERD. Controlling Heartburn by changing your habits. Available at: https://www.webmd.com/heartburn-gerd/lifestyle-modifications-for-gastroesophageal-reflux-disease (Accessed on 5 Dec 2017)
  15. MedlinePlus National Institutes of Health. Heartburn. Available at: https://medlineplus.gov/ency/article/003114.htm (Accessed on 04 Jan 2018)
  16. Fass R, et al. The Effect of Dexlansoprazole MR on Nocturnal Heartburn and GERD-Related Sleep Disturbances in Patients With Symptomatic GERD. Am J Gastroenterol 2011; 106:421-31.
  17. Hunt R, et al. World Gastroenterology Organisation Global Guidelines . GERD Global Perspective on Gastroesophageal Reflux Disease. J Clin Gastroenterol Volume 51., Number 6, July 2017
  18. Mayo Clinic. Histamine H2 Antagonist (Oral Route, Injection Route, Intravenous Route). Available at: https://www.mayoclinic.org/drugs-supplements/histamine-h2-antagonist-oral-route-injection-route-intravenous-route/proper-use/drg-20068584 (Accessed on 27 Dec 2017)
  19. Kwong MF, et al. Asia-Pacific consensus on the management of gastroesophageal reflux disease: Update. Journal of Gastroenterology and Hepatology 23 (2008) 8-22. doi:10,1111/j.1440-1746.2007.05249.x.
  20. Abdel-Hamid H. Modified PPIs (a search for the better). Al-Azhar Assiut Med J 2016;14:8-10
  21. Medscape. Laparoscopic Nissen Fundoplication. Indications. Available at: https://emedicine.medscape.com/article/1892517-overview#a2 (Accessed on 5 Dec 2017)
  22. David Armstrong, et al. Validation of a short questionnaire in English and French for use in patients with persistent upper gastrointestinal symptoms despite proton pump inhibitor therapy: The PASS (Proton pump inhibitor Acid Suppression Symptom) test. Can J Gastroenterol Vol 19 No 6 June 2005
HK/GI/2018-00034