Archive for January 5th, 2008

 


Acid reflux affects millions of people every day.

Heartburn is the major symptom of acid in the esophagus, characterized by burning discomfort behind the breastbone (sternum). Findings in gastro-esophageal reflux disease (GERD)  include esophagitis (reflux esophagitis) — inflammatory changes in the esophageal lining (mucosa) —, strictures, difficulty swallowing (dysphagia), and chronic chest pain. Patients may have only one of those symptoms. Typical GERD symptoms include cough, hoarseness, voice changes, chronic ear ache, burning chest pains, nausea or sinusitis. GERD complications include stricture formation, Barrett’s esophagus, esophageal spasms, esophageal ulcers, and possibly even lead to esophageal cancer, especially in adults over 60 years old.

Occasional heartburn is common but does not necessarily mean one has GERD. Patients with heartburn symptoms more than once a week are at risk of developing GERD. A hiatal hernia is usually asymptomatic, but the presence of a hiatal hernia is a risk factor for developing GERD.

Here is some interesting information about acid reflux drugs. In 2006, over 100 million prescriptions for proton pump inhibitors (acid reflux drugs) were filled at a cost of $13.6 billion.  It is true that acid reflux drugs definitely help in the short term.  They reduce acid.

Unfortunately, the more powerful acid blockers (omeprazole, esomeprezole) can interfere with calcium adsorption and can aggravate preexisting hypocalcaemia and hypomagnesemia which are more common in celiac disease. [1]

They can also cause problems for people with cirrhosis. Use of proton pump inhibitors (PPIs) in patients with cirrhosis was associated with a risk of spontaneous bacterial peritonitis and Clostridium difficile-associated disease, according to two retrospective studies. [2]

Finally, long term use can also lead to Vitamin B12 deficiency. Vitamin B12 deficiency is already a common deficiency among people with celiac disease. The medications work by blocking acid secretion from the parietal cells of the stomach, but these cells also make a substance called intrinsic factor, which is critical for vitamin B12 absorption. Because proton-pump inhibitors such as Prilosec also reduce intrinsic factor secretion, long-term use can lead to a vitamin B12 deficiency. [3] 

Vitamin B12 deficiency is serious because it can lead to neurologic disorders. The neurologic symptoms of vitamin B12 deficiency include numbness and tingling of the arms and, more commonly, the legs, difficulty walking, memory loss, disorientation, and dementia with or without mood changes. Although the progression of neurologic complications is generally gradual, such symptoms are not always reversible with treatment of vitamin B12 deficiency, especially if they have been present for a long time. [4]  

Here are some things what work well for acid reflux and won’t destroy your health:

Dietary Changes:

1) Maintain a 100% strict gluten-free diet.  The immune reaction to gluten starts in the mouth and works all the way through the gastrointestinal tract, so avoid it. 

2) Doctors also now suggest that heartburn sufferers keep a daily food diary, so they are better able to see what food triggers are present in their day-to-day life. Once a list of common triggers have been found, begin eliminating foods one by one. Common heartburn triggers include chocolate, fried and fatty foods, and spices.  [5]

3) While suffering heartburn, you’re advised to refrain from consuming alcohol, caffeine, over-the-counter pain relievers, and other stimulants, which change the acidity of the stomach, and irritate the lining of the stomach further. [5]

4) Decrease sugar intake.  Sugar causes acid reflux in some individuals. [5]5) Increase fiber. Consuming more fiber nutrient foods is another natural way to alleviate future suffering. Bulk foods help to absorb excess acid and gas, and allow your body to rid itself of toxins more quickly. For those who respond poorly to high fiber vegetables, fiber pills and beverages are an easy alternative. [5]

6) Drink more water. The more water you drink, the less likely you are to suffer the pains of heartburn. Drinking at least 8-glasses of water each day will rid the body of toxins and allow your body to expel acid naturally.

Remedies:

Here are some quick home remedies that can help. 

1) Baking soda – take a 1/2 teaspoon of baking soda and mix with 4 oz. of water.  Drink it.  Baking soda is a base and counteracts the acid almost immediately.  It also has another benefit in that it cuts the reaction of the gluten proteins that cause the reflux in the first place. (If you accidentally ingested gluten.) It works quickly and is about as cheap a remedy as you’ll find.

2) Alka Seltzer Gold – this is gluten-free and works quickly. 

3) Apple cider vinegar – this remedy was suggested Alisa Weeks,  a member of the Knoxville Celiac Support Group. “We use the apple cider vinegar with great success. We take about a teaspoonful with some juice.”

4) Food enzymes – which help to speed the digestive process often eliminate heartburn altogether. Papaya enzymes are sold in chewable capsule form, and are taken immediately following a meal with a full glass of water. Both ginger and digestive enzymes are not medically proven to help with symptoms. [5]

Sources:

[1] Robb-Nicholson C (2007). “By the way, doctor. I heard that taking a proton-pump inhibitor could cause hip fractures. I’ve been taking 20 mg of Prilosec every day for a year. Should I be concerned?”. Harvard women’s health watch 14 (7): 8. PMID 17396273.

[2] Bajaj JS, et al “Proton Pump Inhibitor Use is Associated with a High Risk of Spontaneous Bacterial Peritonitis” Abstract 740 presented Nov. 4.

[3] http://www.everydayhealth.com/publicsite/index.aspx?puid=f0ed5fe5-034e-4196-997b-f976c293a99c&p=1

[4] http://lpi.oregonstate.edu/infocenter/vitamins/vitaminB12/

[5] http://heartburn.about.com/gi/dynamic/offsite.htm?zi=1/XJ/Ya&sdn=heartburn&cdn=health&tm=12&gps=89_111_1020_570&f=00&su=p284.8.150.ip_&tt=14&bt=0&bts=0&zu=http%3A//nhnh.essortment.com/heartburnhomer_rwel.htm