Eliminate certain foods to help ease acid reflux
DEAR DOCTOR: What are the best medications for acid reflux? I’ve tried doxycycline and metronidazole (Flagyl), for H. pylori infections, which made me sick, as well as Prilosec and Pepto-Bismol.
DEAR READER: Some degree of reflux normally occurs after eating. However, when a significant amount of the stomach’s acidic contents rises up to the esophagus, it injures the esophageal tissue and causes pain. The thick lining of the stomach can handle the acidity; the esophagus cannot. Chronic irritation of the esophagus can cause abnormal cells to form within the esophageal lining, and sometimes these abnormal cells can develop into esophageal cancer. So, although GERD is common, it should not be taken lightly.
Acid reflux is normally prevented by a sphincter between the stomach and the esophagus — and there are chemicals in our diets that relax this sphincter, allowing the acidic contents to rise up. These chemicals, found in chocolate, alcohol, caffeine, nicotine and mint, can allow the lower esophageal sphincter to loosen, as can, to a lesser degree, onions and garlic. I would look closely at this short list, focusing on the first five, and, if you have not already done so, eliminate them. If these chemicals are causing greater acid reflux, removing them will help relieve your symptoms.
For some people, acid reflux will persist even with dietary changes. When the reflux is severe and enduring enough to damage the esophagus, treatment is necessary. The best treatment is to decrease the acidity of the material coming up. Antacids like calcium carbonate or aluminum hydroxide can help in the short-term, but they do not provide long-term relief; H2 blockers (Zantac, Pepcid, Tagamet) can.
For persistent or severe symptoms, or for severe esophageal inflammation, a proton pump inhibitor (like the Prilosec you took) is necessary; it can be used for up to eight weeks (and sometimes longer if symptoms persist). In addition to the PPI, an H2 blocker taken at bedtime and possibly during the day can boost the relief. Lastly, there’s the muscle relaxant Baclofen.