Are you one of the 20% of adults that suffer from heartburn?
Gastrointestinal reflux disorder (GERD) can mimic heart attack, cause a chronic cough, swollen tonsils or sore throat in addition to having an upset stomach.
20% of adults in America suffer from heartburn. And a lot of them are taking medications to manage those symptoms. Many of them are available over the counter: Pepsid, Prilosec, Prevacid Nexium and others. Do you know that proton pump inhibiting medications like omeprazole (Prilosec) are only meant to be taken for a short period of time for most patients? Like for 4-8 weeks?
There are exceptions. For example, if a person suffers from a condition that overproduces acid (Zollinger-Ellison syndrome).
But for most, the recommended course is less than 2 months, reducing acid secretion and allowing the esophagus or stomach or small intestine time to heal. This means that GERD (Gastro-esophageal reflux disorder), erosive esophagitis, ulcers, h.pylori infections, and frequent heartburn should not be taking these meds for long periods of time.
Long term use of proton pump inhibitors can impair absorption of certain nutrients like vitamin B12 and magnesium and may increase the risk of osteoporosis.
So why does one get heartburn and what can one do about it?? The esophagus runs from the back of the throat down to the stomach. It has a little “valve” at the bottom called the lower esophageal sphincter that keeps acid that is produced from the stomach from getting into the esophagus. Acid from the stomach triggers the sphincter to close. Therefore, blocking acid long term can exacerbate reflux. In fact, many people have low acid levels in their stomach which trigger their symptoms. These people find that taking apple cider vinegar in water or bitters before a meal helps with their GERD symptoms.
There are structural problems like hiatal hernia and obesity that can impair the closure of the sphincter as well.
Food matters. Triggers for reflux include coffee and chocolate, tomatoes, fried foods, high fat foods, high sugar foods (including dried fruit), spicy foods and overeating. Eat smaller meals, more frequently to keep from overfilling. And mint, a common thing to take when a person is having gastrointestinal symptoms can aggravate symptoms too.
Avoid eating or drinking much within 2 hours of bedtime. Raising the head of the bed a bit so that a person sleeping on a slant can reduce reflux.
Simple, safe things that can help soothe heartburn symptoms are aloe vera juice (not gel), deglycyrrhizinated licorice root, slippery elm and zinc carnosine. Things like tums or calcium carbonate can help soothe acute symptoms.
If you are having GERD and have been taking a proton pump inhibitor, it is important to wean off the medication slowly. Initiate changes in your diet first. Then skip a pill every few days. Rebound acid is often a problem.
It is also very important to get an endoscopy if you have had GERD symptoms for a long time. Reflux can be caused by something much more serious that may require stronger interventions or other tests.
Dr. Jennifer Means welcomes you for Primary Care for the whole family: Nutrition, IV Therapy, Naturopathy, and Acupuncture. Contact us at 503-641-6400.
