Stop Acid Reflux Blog

More than six million people in the UK are affected every day by indigestion: it accounts for almost one in 20 visits to the GP.

Also known as dyspepsia, it is a discomfort or burning feeling in the upper abdomen which can be accompanied by bloating, wind and nausea. It can be caused by eating too much too quickly, eating fatty foods or eating while stressed.

It may also indicate an underlying medical condition such as gallstones, ulcers or irritable bowel.

For some, the pain is so bad they feel like they are having a heart attack.

Heartburn, which is also called acid reflux, is a common form of indigestion which occurs when acid and digestive juices flow back up from the stomach to the gullet.

There are hundreds of remedies for indigestion, but which are the best?

# EAT MORE OFTEN

Smaller, more frequent meals will help prevent indigestion. The condition is often caused when acid needed in the digestion of food builds up in the stomach, causing inflammation and pain. The build-up can occur because of long gaps between meals, so try eating smaller meals more often.

Be careful about what you eat, too. Low-fat foods are thought to be beneficial, because fats in general are the most difficult part of the diet to digest.

# STOP SMOKING

Research based on more than 70,000 people shows that smoking is strongly linked to indigestion and acid reflux, when stomach acids flow back into the oesophagus.

Those who smoked daily for 20 years were 70 per cent more likely to have acid reflux. It is thought that smoking reduces the strength of the valve which stops stomach acids flowing into the oesophagus. Smoking may also cause greater movement of bile salts from the intestine to the stomach, making the stomach acids more harmful.

# HERBS

Many different herbs are used for treating the condition, but there is little research on most of them. However, doctors at the University of Dresden Hospital tested a combination of extracts of bitter candy tuft, matricaria flower, peppermint leaves, caraway, liquorice root and lemon balm on patients with indigestion and found that symptoms in those who had the treatment improved significantly over four weeks compared with those who had a dummy preparation.

Artichoke leaf extract in capsule form is available in the UK and is also used widely in Germany. Research on 247 patients at the University of Essen showed that it not only reduced symptoms, but also improved quality of life. It is thought to speed up the flow of bile, which hastens the passage of food through the digestive system.

# CHEWING GUM

The physical act of chewing raises saliva levels of bicarbonate, a naturally occurring antacid that may act against acids in the digestive system.

“The alkaline saliva can neutralise acid that remains in the oesophagus after swallowing,” say researchers at Southwestern Medical Center in Dallas.

# ANTACIDS

The most widely used overthe-counter medication, they come in liquids, drinks, powder or tablet form, and often contain chalky compounds designed to neutralise acid.

Some contain magnesium or aluminium. Aluminium salts dissolve slowly in the stomach and start to work gradually to provide long-lasting relief, while magnesium salts act fast and neutralise acids effectively.

However, according to a report in Chemist & Druggist, magnesium salts can cause diarrhoea, while aluminium salts can cause constipation. Calcium salts are also quick acting.

# SODIUM BICARBONATE

One of the cheapest ways to tackle indigestion, baking soda - or sodium bicarbonate - neutralises acid quickly.

Stomachs naturally contain hydrochloric acid and too much of it leads to indigestion. The so-called ‘baking soda burp’ is a sign that this antacid is working. The burp is caused by the release of carbon dioxide gas - a natural byproduct when sodium bicarbonate reacts with the acid in the stomach.

# ALGINATES

Some antacids contain alginates, a range of purposemade compounds called rafting agents designed to sit on top of the acid like a foam raft and prevent it escaping into the oesophagus.

Taken at meals and bedtime, it creates a barrier to prevent the stomach contents splashing back up into the gullet.

Sodium alginate and magnesium alginate are among the compounds to look out for in antacid ingredients.

# H2 BLOCKERS

If antacids don’t work, these may. They work by reducing the amount of acid produced by the stomach and are available on prescription or lower doses can be bought at pharmacies.

They can reduce the amount of acid in the stomach by as much as 85 per cent and are available as both prescription and non-prescription medications. On prescription they are available as tablets, capsules, liquid and injections.

They can also be bought in pharmacies in lower doses for short-term relief.

# BISMUTH

Bismuth subsalicylate is a non-prescription drug that works by coating the stomach lining to protect it against the acid attack, as well as neutralising toxins and reducing inflammation.

It stimulates the passage of fluid across the wall of the intestinal tract, and neutralises some bacteria. It is also thought to increase the activity of intestinal muscles and lining.

Research on 48 patients in Germany shows that those who had half-hourly doses of bismuth had much reduced symptoms.

“It provided greater and faster relief than placebo for nausea, sense of fullness, heartburn, feeling of abdominal distention, and flatulence,” say the researchers. Bismuth is available as bismuth salts.

# PILLOWS

People who suffer from indigestion and heartburn can get some relief by raising the sleeping position of the head. Gravity helps ensure reflux is less likely. Research shows that night-time symptoms can be reduced by raising the head of the bed on blocks by 6 in.

# SURGERY

When all else fails, surgery for hiatus hernia and heartburn are possibilities.

Hiatus hernia is when part of the stomach slides through the diaphragm, the muscular sheet of tissue that separates the lungs and chest from the abdomen below.

This causes pain and heartburn. An operation called a fundoplication involves replacing the stomach back to its original position under the diaphragm.

The surgeons then wrap the upper few centimetres of the stomach around the oesophagus to make a new valve. This prevents acid reflux and heartburn recurring. Permanent stitches are used to keep the stomach in place.

(info from http://www.dailymail.co.uk/pages/live/articles/health/healthmain.html?in_article_id=356310&in_page_id=1774)

One-third of Irish adults confuse the symptoms of heartburn and indigestion with pain associated with heart attack or angina, according to a new survey.

The study of 1,000 adults further shows that nearly 50% of Irish adults suffer from heartburn or indigestion, while 23% report that heartburn affects their sleep patterns.

Those who suffer from heartburn or indigestion say they have developed a number of coping strategies, according to the survey.

*Over 25% said they avoid certain foods

*16% admitted they watch their weight

*Over half use medication bought in a pharmacy or supermarket

*16% treat their heartburn or indigestion with prescription medicine

*15% do not treat their symptoms at all.

Heartburn is a burning sensation that is felt in the chest when stomach acid moves from the stomach up to the food pipe. This backflow from the stomach is also termed acid reflux.

Dublin GP Dr Micheal O’Brien said anyone suffering from heartburn or indigestion should consult their local pharmacist or GP.

The research was commisisoned by Gaviscon.

(info from http://www.irishhealth.com/?level=4&id=7881)

GERD is a very simple disease to keep under control. If it is left untreated, however, complications may result

A late-night snack can sound appealing, but for the estimated 60 million Americans currently living with gastroesophageal reflux disease, or GERD, it could mean a restless night. Bedtime eating is among the culprits of occasional acid indigestion, also known as heartburn. While not uncommon or a major concern, heartburn becomes a problem when it occurs more than once a week.

A little ring of muscle located at the bottom of the esophagus, known as the lower esophageal sphincter (LES), separates the stomach from the esophagus. It opens and closes in response to food moving from the esophagus into the stomach. In normal function, the LES is supposed to remain closed while stomach acids help to promote digestion.

When this muscle is weakened, it cannot completely close off the stomach from the esophagus. This “leaky seal” allows the stomach acids to flow back up through the esophagus toward the mouth. This burning feeling in the esophagus — which is located behind the breastbone — is what we call heartburn or acid indigestion. It is the most common symptom of gastroesophageal reflux disease.

The weakening or relaxation of the muscle is what causes GERD. Not everyone who has GERD experiences heartburn, however, so it is important to be aware of the other symptoms of this disease. Wheezing or coughing, frequent burping, pain in the chest, difficulty swallowing, bad breath and hoarseness in the morning are all symptoms of the disease. Symptoms may also be worse after eating, bending over or lying down.

A hiatal hernia can form at the opening (hiatus) of the diaphragm where the esophagus joins the stomach. When the muscle tissue around the hiatus becomes weak, the upper part of the stomach may bulge through the diaphragm into the chest cavity. The size of the hernia often correlates with the severity of GERD.

GERD is a very simple disease to keep under control. If it is left untreated, however, complications may result, such as a bleeding ulcer in the esophagus or the formation of scar tissue, called a stricture, which prevents swallowed food and liquids from moving through the esophagus.

Of even greater concern is a complication of chronic GERD — relatively unknown to the public — called Barrett’s Esophagus. The condition develops in 10 to 15 percent of patients with chronic GERD. A cellular change takes place in the esophagus known as metaplasia, which can predispose to dysplasia, which are precancerous cells. Occasionally, Barrett’s Esophagus can develop into a form of cancer known as esophageal adenocarcinoma.

The good news is that, in most cases, the incidence of acid reflux can be prevented or drastically reduced through lifestyle and diet changes. Avoiding spicy foods, chocolate, caffeine, tomato-based products, citrus fruits, garlic, and onions, as well as fried and fatty foods, can reduce symptoms significantly.

When considering mealtime, eat the last meal of the day three to four hours before bedtime and avoid bedtime snacks. Pay attention to portion sizes. Even overeating healthy food can have the same adverse effect as eating foods which precipitate GERD.

Just as diet changes can inhibit the occurrence of acid reflux, lifestyle adjustments can also eliminate GERD. Maintain a healthy weight, exercise (but not too soon after eating), quit or significantly reduce smoking, and elevate the head of the bed about six inches.

Making these changes early on can arrest the development of complications related to GERD.

If you are experiencing heartburn, indigestion or belching more than once a week, and/or regularly using over-the-counter antacids, visit a gastroenterologist to receive an EGD test. This test involves the passage of a lighted flexible tube through the mouth into the esophagus, stomach and upper intestines. The EGD is the single best test to evaluate the esophagus for damage from GERD. The gastroenterologist can take both pictures and tissue samples — a biopsy. Early detection of GERD may prevent the more complicated conditions of Barrett’s Esophagus and possible esophageal cancer.

For more information about GERD, Barrett’s Esophagus or endoscopy, contact the American College of Gastroenterology at (301) 263-9000 or visit www.acg.gi.org. To find a University Medical Center at Princeton gastroenterologist near you, call (888) 742-7496.

©PACKETONLINE News Classifieds Entertainment Business - Princeton and Central New Jersey 2005

(info by Glenn L. Osias, M.D. in collaboration with Gloria N. Beck from http://www.pacpub.com/site/news.cfm?BRD=1091&dept_id=535412&newsid=14865592&PAG=461&rfi=9)

According to Dr. Richard Seitz of Fremont, over-the-counter medication gor acid reflux should only be used for several weeks and then if symptoms don’t get better, or come back when medication is stopped, a doctor should be consulted. If however, it gets worse even with medication, it is best to see a physician. Prescriptions are more potent than over-the-counter medicines, but if the over-the-counter medication works well, Seitz said it can be taken long term with no adverse effects.

Sometimes, a more serious esophageal problem can develop. When the sphincter is weakened so acid flows into the esophagus, the stomach may try to protect itself.

The esophagus may develop a more acid-resistant lining and this is Barrett’s Esophagitis.

This change in the lining isn’t normal and if the lining continues to change it can lead to cancer of the esophagus eventually. If problems persist, or don’t respond to normal treatment, doctors can do an upper endoscopy.

Unexplained weight loss, trouble swallowing, passing blood in the stool or vomiting up blood, all need an upper endoscopy to make sure there is no cancer, and to see what is causing the problems.

Sometimes, Seitz said, there is also scarring in the esophagus. The endoscopy is an out-patient procedure completed under a mild sedative and used to remove scar tissue or polyps if they are evident.

“Cancer of the esophagus is rare, but there is a 120 times greater chance for cancer if Barrett’s Esophagus is evident. Depending on how severe it is, we use the scope every year or two to keep track of any changes,” Seitz said.

One of Seitz’s patients is Sandra Kiichler of Fremont. She was diagnosed eight years ago.

“I had symptoms. I would eat so much, and then my food would get caught,” Kiichler said.

What Seitz found was a narrowing of her esophagus and that led to discovering the acid reflux. Kiichler had the endoscopy and Seitz also found polyps and scarring, which he removed, and he also stretched out the sphincter muscle.

Although that has helped, Kiichler will always be on prescription medication.

“I’m careful of what I eat. I don’t eat a lot of lettuce and I stay away from spices and salsas,” she said.

Those things bother her stomach but she said otherwise she eats most everything else with no problems.

She was on Prevacid but was switched to Nexium twice a day.

“I don’t have many problems on the medication, but I also try to eat smaller bites and chew my food well because it goes down easier that way,” Kiichler said.

She goes in every three months for a general check up.

With lifestyle changes, medication, diet and endoscopy when needed, acid reflux can be controlled.

Usually Kiichler said once the sphincter is stretched it doesn’t have to be done again.

Kiichler has made the lifestyle changes and diet changes she needed to, and with her medication, she said, “So far mine is doing just fine.”

(info by Carolyn Gibbs from http://www.fremontneb.com/articles/2005/07/15/news/news6.txt)