| Bill Poston 2006-02-23, 11:48 am |
|
Feeling the Burn
When heartburn lingers, take steps to put out the fire
Karen Cavanagh remembers the very first time that the pain woke her
from a sound sleep. “I thought I’d inhaled some sort of toxic gas,”
recalls the California resident. “It felt as if someone had poured
acid down my throat.” Cavanagh was on target about the acid, but
wrong about the source. She had been shocked awake by gastric acid
regurgitation, one of the classic symptoms of the chronic heartburn
known as gastroesophageal reflux disease (GERD).
It’s estimated that more than 60 million people in the United
States--one out of every five residents--experience heartburn or acid
regurgitation at least once a month. A small percentage of these
people may never even notice the symptoms. But most, like Cavanagh,
are all too aware of the burning pain and the searing, bitter taste at
the back of their throats. “The fundamental issue in GERD is that
gastric juice is entering into the esophagus-- where it doesn’t
belong,” notes G. Richard Locke III, M.D., director of the Esophageal
Interest Group at the Mayo Clinic college of Medicine in Rochester,
MN. “And though we know what is happening, we still don’t know
precisely why it happens.”
Surprised? Well, here’s another surprise for you: Most medications
that are for GERD are designed to curb acid production. However, many
experts believe the problem actually has more to do with muscles than
with acid.
What’s the connection between GERD and muscles? “The most popular
theory is that there is a relaxation of the lower esophageal sphincter
[muscle] that allows acid and stomach contents to migrate back into
the lower esophagus and sometimes even the upper esophagus and
throat,” explains Joel J. Heidelbaugh, M.D., of the university of
Michigan Medical School in Ann Arbor, and coauthor of the clinical
guidelines on the treatment of GERD. “The problem can be particularly
pronounced at night or when lying down.”
Although the exact cause of GERD may still remain a mystery, a great
deal is known about the factors that make GERD worse, including excess
weight, cigarette smoking and eating certain foods. There are,
luckily, a number of behavioral and lifestyle changes that can help
reduce the symptoms of GERD. These include giving up smoking; limiting
alcohol consumption (particularly before bed); losing weight if
necessary; eating small meals; avoiding lying down for three hours
after a meal; and raising the head of your bed six to eight inches by
putting blocks of wood under the bedposts.
When behavioral change isn’t sufficient, don’t give up hope. There are
many over-the-counter and prescription medications that can reduce the
production of stomach acid. The choice of medication depends on how
significant your symptoms are and how often they occur.
“The first issue in reflux is just how common the person’s symptoms
are,” says Dr. Locke. “For now-and-then symptoms you can do
now-and-then treatment. But people who are having symptoms a few days
a week or every day will do better on a daily medicine.”
If the proper use of medication fails to get GERD under control,
laparoscopic surgery can be done to strengthen the esophageal
sphincter and prevent acid from getting through.
The vast majority of people tend to treat themselves, particularly now
that some medicines formerly available only by prescription can be
purchased over the counter. But in rare cases, GERD can progress to
more serious problems, including chronic esophageal inflammation and
esophageal cancer. So it’s important to let your doctor know if you
are regularly taking medication for GERD symptoms. And see a doctor if
you experience any of the following:
Difficulty swallowing
Early satiety (a sense of fullness when eating)
Blood in stool
Painful swallowing
Vomiting
Coughing up or vomiting blood
Unexplained weight loss
The Signs
Heartburn and acid reflux are the classic symptoms of GERD, but
out-of-place stomach acid can also lead to other, less obvious,
problems, including:
Asthma
Chest pain
Chronic cough
Dental enamel loss
Recurrent laryngitis
Recurrent sore throat
Foods To Limit or Avoid
Citrus fruits
Chocolate
Caffeinated drinks
Fatty and fried foods
Garlic and onions
Peppermint and mint flavorings
Spicy foods
Tomato-based foods, like spaghetti sauce and pizza
Bill Poston
To reply correct [at] and [dot]
|