Acid Reflux

SOMETIMES REFERRED TO AS “HEARTBURN”

DESPITE its caustic sounding name, ‘acid reflux’ is not the newest rock band that young people are listening to. Acid reflux is sometimes referred to as ‘heartburn’– a condition where your stomach contents rise up into your esophagus. Like loud music, heartburn can be painful and irritating. Luckily for most of us, we simply take an antacid and the pain goes away. For others, the pain can be quite intense and return frequently. This month, we shall learn what acid reflux is and what it isn’t.

What normally happens when we eat or drink is that food travels down our esophagus and then into our stomach. There is a tight band of muscles at the top of our stomach called the ‘lower esophageal sphincter’ (LES) which keeps all of your stomach contents where they should be. Sometimes the muscles of the LES can relax, allowing the acidic contents of the stomach to come up into the esophagus. This is referred to as ‘acid reflux’. The resulting irritation to the esophagus causes a burning sensation, which is usually felt just behind the breastbone and below the throat. The onset of this pain can be quite intense, but it usually goes away when a person takes antacids.

There is one thing that acid reflux is not: a medical condition called ‘gastroesophageal reflux disease’ (GERD). GERD can be thought of as a persistent form of acid reflux. The symptoms of GERD are the same as for acid reflux except that people who have GERD may also show symptoms of a dry cough or have difficulty swallowing. GERD can also cause asthma-like symptoms. If you have persistent acid reflux symptoms more than twice a week, it might be wise to bring these symptoms to the attention of your physician.

For many people, non-drug options work well. The first thing to do is to avoid any foods or beverages that trigger your acid reflux. Some common heartburn triggers are coffee, mint teas and spicy or fatty foods. If you must eat your trigger foods, take an antacid prior to or just after the meal. If you smoke, stop. Try not to lie down for at least three hours after eating a meal. If acid reflux is a problem at night, try raising the head of your bed. You only need to raise it by approximately six to eight inches, about the thickness of a large phonebook. Some people find it helpful to eat smaller meals more frequently, about five or six meals throughout day.

One health tip that I feel is often overlooked is to eat slowly. People tend to eat their meals too fast, and this can cause them to eat too much. This is an old weight loss tip that can be helpful for heartburn sufferers, too. Consciously eat your meals. As a parent, I am often at fault for this. I fill my plate and stuff my face so fast that I am done before my little one is finished. The next time you have a meal, take reasonably-sized bites, put your fork or spoon down between bites, and chew your mouthful at least 20 times. This delay in eating may seem odd at first, but it can be very helpful. It allows your stomach to fill slowly and sends you the signal when you are full – before you eat too much and feel ‘stuffed’, which can lead to heartburn.

The other way to help treat acid reflux is to reduce stomach acid content. The best treatment for mild and infrequent heartburn is calcium carbonate tablets (Tums, Rolaids,

etc). These products neutralize stomach acid and help reduce that burning feeling caused by the stomach acid. They tend to work well and have few side effects. You can also get sodium bicarbonate products that act in a similar way to calcium carbonate tablets. Usually these products are effervescent (ie.

Bomoseltzer), and contain a lot of sodium. This might be contraindicated for people with high blood pressure. Ask your physician or Heart pharmacist if these antacids are right for you.

Another option for acid reflux relief is an alginic acid containing product

(Gavison, etc). This is a natural product, derived from brown seaweed. The alginic acid forms a layer of foam that floats on top of the stomach content. This helps protect the esophagus from the acidic content of the stomach, and thus stops any burning sensation.

If these two options do not help your heartburn, you can try the group of medicines referred to as H2 blockers, known also as ranitidine

(Zantac) or famotidine (Pepcid). These medications stop your body from producing stomach acid. They are especially helpful if you know that a certain meal will cause heartburn. They are more effective than antacids, and should be taken about an hour before meals.

There are a few side effects with taking medications to help reduce stomach acid. The most common ones are digestive problems; bloating, gas, diarrhea or constipation. This is because your body needs some stomach acid to completely digest your food. With prolonged use, these medications can lead to vitamin and mineral deficiencies. The most common deficiencies include: vitamin B12, calcium, magnesium and other minerals. If you are taking acid suppressing medications, you might want to consider taking a multivitamin. Make certain any mineral supplements you are taking are in the citrate form (ie. calcium citrate). The citrate form of minerals is not as dependent on stomach acid for adequate absorption. I hope this article has answered all of your burning questions about acid reflux. If you do suffer from acid reflux, first try the non-drug ideas I mentioned above. These options will usually help relieve your symptoms. Another worrisome issue is that pain from a heart attack is similar to that caused by acid reflux. If chest pain appears suddenly, does not occur after eating or happens after physical exertion, you should seek medical attention quickly. Eat well and eat slowly; you should only have to experience your meal once.