Santa’s reflux oesophagitis

After a long night on the town (and country), Santa noticed a burning sensation in the upper abdomen and in the middle of the chest, sometimes up to his throat. It got worse after his evening meal and after bending down and lifting all those presents.

Under the jolly exterior Santa’s stomach acid (part of his digestive juices) was allowed to move up (to ‘reflux’) into his lower oesophagus (‘gullet’) and caused inflammation of the gullet lining (‘oesophagitis’). The special muscle (sphincter) at the bottom of the gullet, which closes tightly, preventing the passage of acid into the gullet, stopped functioning well and allowed reflux of acid to occur..
During the long night Santa did a fair bit of eating, smoking and drinking. This made his reflux worse as he increased the pressure on the stomach (intra-abdominal pressure) and it lead to the failure of the sphincter muscle in the gullet and caused his reflux. The fact that Santa is overweight and wears very tight clothes did not help at all. As he traveled widely he could not help enjoying all sorts of exotic, spicy and fatty foods which worsened his reflux further. .

When the last parcel was delivered Santa went to see his doctor, who took the history and examined him. The doctor also considered further investigation such as endoscopy, during which a flexible tube is passed into the gullet and stomach to see and take a sample of the lining for analysis. X-ray, which involves swallowing a special contrast liquid that shows up on an X-ray film was also contemplated. It may even be necessary to measure the acid level in Santa’s gullet during a 24-hour period. A fine tube is passed into the end of the gullet and a special tip at its end measures the acid levels..

The doctor suggested some simple lifestyle measures that can be helpful. Santa was told: "Eat small regular meals. Avoid eating late at night. Limit alcohol and avoid smoking. Wear loose clothes and avoid tight waistbands or belts. Try to avoid bending or stooping and strenuous physical activity after meals. You might have to stop that night delivery lark for a while. Try to lose weight. If you suffer with reflux at night it may be helpful to raise the bed head to prevent reflux." The doctor recommended antacid tablets or liquid to neutralise the acid in the stomach and in the lower gullet..

Santa may also require other drugs such as special anti-histamines and proton pump inhibitors, which reduce the production of the stomach acid..

If Santa does not appear next year it may mean that he abandoned his reckless life style and took his doctor’s advice seriously or that he didn’t and developed other health problems associated with obesity such as heart disease or diabetes.

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