On Twitter, that’s how Alan Cassels – drug policy researcher at the University of Victoria, British Columbia – referred to the Wall Street Journal’s reporting in this column, “Emerging Type of Heartburn Defies Drugs, Diagnosis.”
And I see what he means.
First, the column sets you up with the numbers game:
Some 44% of Americans have heartburn at least once a month, and 7% have it daily, according to the International Foundation for Functional Gastrointestinal Disorders.* Heartburn that frequent is the most common symptom of gastroesophageal reflux disease, a diagnosis believed to be rising world-wide with obesity and advancing age. One 2004 study cited a 46% increase in GERD-related visits to primary-care physicians over a three-year period alone.
But up to one-half of GERD patients don’t get complete relief from even the strongest acid-reducing medications, called proton-pump inhibitors (PPIs), and most don’t have any evidence of acid erosion when doctors examine their esophagus with an endoscope.
* This foundation receives support from more than 30 drug companies. Is this the best source of incidence data? The very people who are trying to sell more drugs to more people? And the bigger they can make the problem seem, the bigger their market potential? This estimate seems so precise, so huge.
A reasonable way to cite any such guesstimate would include a clause such as “The exact incidence of these problems is almost impossible to determine….”
Next, the story hits you with the sucker punch that – voila – there’s a new name for this newly recognized condition.
Gastroenterologists have dubbed this condition non-erosive reflux diseases, or NERD.
It has become a hot topic for discussion and research. “It used to be thought that all GERD was the same—you give patients PPIs and they’ll all respond,” says Prateek Sharma, a gastroenterologist at the University of Kansas School of Medicine. “But we’re finding that a subset of these patients don’t have acid as a cause of their symptoms.”
Then it hits you with more mind-numbing numbers about NO-IT’S-NOT-GERD-BUT-NERD:
Gastrointestinal experts now estimate that 50% to 70% of GERD patients actually have NERD, and studies show they are more likely to be female—and younger and thinner—than typical acid-reflux sufferers. They are also about 20% to 30% less likely to get relief from acid-blocking drugs. But their episodes of heartburn are just as frequent, just as severe and just as disruptive of their quality of life, studies show.
Which studies? What exactly did they show? In all, three times the story talked about what “studies show” without giving adequate or any details.
The WSJ thought so highly of this column, it devoted video time and space to a discussion about it.
So while the journalists joked about whether “you’re a GERD or a NERD,” I’m not sure readers left with any better grasp of what to do if they might have one of these problems.