Thursday 31st May 1990   Morning  surgery 11.30

I have seen quite a few patients with gastro-oesophageal reflux. My Dad isn’t interested. He regards it as a minor, mechanical failing of the upper gastrointestinal tract, a leaky valve. It is not really a disease, Dennis. He uses terms like a touch of heartburn or a splash of acid. He tries his best to subtly blame the patient for their symptoms recommending small meals, swapping tea or coffee for milky drinks, losing weight and avoiding alcohol. He will advise the more severely affected patient to elevate the head of the bed. Gravity helps keep the acid in the stomach, Dennis. Occasionally, he’ll prescribe an antacid medicine or one of those tablets that helps the stomach empty.

Dr Lewis has a completely different approach. She understands how the peptic acid produced in the stomach can burn and eat away at the lining of the gullet and how, at night, it can creep up into the back of the throat and wake the patient, coughing and spluttering. She realises that even drinking a hot, normally refreshing, cup of tea can be agony. She is aware that enjoying a Chicken Tikka Masala, our curry night favourite (apart from Declan and Gran), is impossible. She knows that two glasses of red wine can lead to much more than a hangover.

The capsules that Dr Lewis prescribes reduce gastric acid production by 90%. They have an almost immediate, miraculous effect and, within a week, her patients are usually eating and drinking whatever they want.