Why Heartburn Has Become the Managerial Disease of the New Era

Written by: Prof. Dr. Nadan Rustemović, Specialist in Gastroenterology

Heartburn, gastroesophageal reflux disease (GERD), is one of the most common digestive disorders of today – a disease driven by the modern lifestyle: stress, irregular diet, large meals at late hours, lack of sleep, and physical activity.

GERD occurs when stomach contents flow back into the esophagus because the muscle ring (lower esophageal sphincter), which should prevent acid reflux, does not function properly. Stomach acid then damages the esophageal lining and causes the typical sensation of heartburn, as well as a range of other extraesophageal symptoms such as a burning sensation in the chest, bitterness in the mouth, hoarseness, cough, or even chest pain that can mimic a heart attack.

While occasional heartburn can occur in almost everyone, the problem arises when symptoms become frequent — more than twice a week. This is when we refer to GERD, a chronic condition that can, if left untreated, lead to complications such as esophagitis, narrowing of the lumen, and even precancerous changes (Barrett’s esophagus).

Why Managers Are at Greater Risk

Research shows that GERD is more common among individuals who lead a stressful, sedentary, and overloaded life – a typical managerial profile.

The main triggers include: stress (not directly, but affecting hormones and digestive rhythm, stress reduces intestinal motility, increases acid secretion in the stomach, and promotes poor eating habits); irregular diet (skipping breakfast, late meals, snacking on the go, or eating while walking); coffee, alcohol, and carbonated drinks (regular ‘allies’ of business meetings and strong reflux provocateurs); obesity and lack of movement (excess fat tissue increases pressure in the abdomen and facilitates acid reflux); and smoking (nicotine relaxes the lower esophageal sphincter and further worsens symptoms).

Interestingly, many patients only seek help when problems become serious – because they perceive heartburn as something ‘normal’. In reality, it is the first signal that the body is out of balance.

What Medicine Can Do, and What You Can Do

The diagnosis of GERD is based on a conversation with a doctor and, if necessary, additional tests – endoscopy, pH-metry, and esophageal manometry. In a large number of cases, the clinical picture itself and a positive response to the ‘proton pump inhibitor (PPI) test’, i.e., prescribing a full daily defined dose of PPI for at least fourteen days, are sufficient.

Treatment usually begins with PPI medications that effectively block the secretion of acid from certain cells in the stomach lining. In most patients, symptoms disappear after a few days, but it is important to follow the treatment as directed by the doctor, not self-initiate, and not prolong it without control.

However, medications are only part of the story. Without changing lifestyle habits, the problem almost always returns. Therefore, one should eat smarter – smaller meals, but more frequently, and avoid eating two to three hours before sleeping. Limit fatty and fried foods, chocolate, citrus juices, and carbonated drinks.

Reduce stress. Stress itself does not create acid, but it affects hormones that slow digestion and increase esophageal sensitivity. Taking short breaks, practicing mindful breathing, walking, or exercising will have a real physiological effect. Pay attention to body weight; losing a few kilograms can significantly reduce pressure on the stomach and reflux symptoms. Sleep with an elevated headrest; gravity helps prevent acid from returning during the night. And of course – limit alcohol, coffee, and cigarettes, as they relax the muscle that should prevent reflux. If you cannot completely eliminate them, reduce intake and observe how your body reacts.

When Medications Are Not Enough

In a smaller number of patients, despite therapy, symptoms return or remain pronounced. Additional options are then considered: detailed diagnostics, changing therapy, or endoscopic fundoplication, i.e., surgical treatment – most often a minimally invasive procedure that creates a fold in the lining that acts as a barrier between the stomach and esophagus.

Globally, and in Croatia, there is an increasing emphasis on the connection between GERD and more serious complications if left untreated: inflammation, bleeding, esophageal narrowing, and conditions that carry an increased risk for esophageal cancer. The impact on quality of life and work efficiency is equally important. Chronic discomfort, insomnia, reduced appetite, and a constant need for medication long-term reduce energy, concentration, and stress resilience. In the managerial world, where constant ‘peak performance’ is expected, this is a silent enemy of productivity.

Regain the Feeling of Lightness

Unlike many other diseases, GERD can be successfully controlled – primarily through one’s own behavior. A healthy diet, regular physical activity, quality sleep, and a balance between work and rest are not just ‘lifestyle tips’ but also real medical therapy. However, if symptoms occur, do not ignore them.

Early recognition and examination by a gastroenterologist can prevent chronic disease and restore that feeling of lightness after eating that should be natural. Recognizing the first symptoms, reacting in time, and changing habits – that is the smartest decision you can make for your health and business longevity. Managerial success requires energy, focus, and good sleep – and for all that, a healthy digestive system is essential.

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