One term that doctors throw around a lot when they talk about GERD is "pH". This is used to express the acidity or alkalinity of a solution according to a 14-point scale. Acidity starts at 1, on the lower end of the scale, and can be as high as 6.9. A neutral pH is 7.0. Alkalinity starts above 7.0 and ends at 14.0, the most alkaline.
Acid is not "bad" and alkaline is not good. We all need some acid in our stomachs to break down foods and kill bacteria, and acid blockers don't halt all production of acid forever. But when you have GERD, it's best if you can reach the ideal level of acidity in the esophagus.
Most gasroenterologists hope that their GERD patients will eventually have a pH of 4.0 in the esophagus. Levels lower than 4.0 can be very damaging to your esophagus when you have GERD
There are several aspects of the concept of pH that can be a little confusing for many people. A tricky part to keep in mind is that a lower pH is equal to more acid. When it comes to acidity, less is mmore.
Basics on How Acid Reflux Medication Works
You don't need a heavily scientific or chemical explanation of how all the various GERD medications work in your system, but it's good to have a basic understanding.
Antacid drugs work to neutralize the level of already existing acid in your stomach. These medications don't prevent stomach acid from backing up when you have GERD, but they make what does reflux up into your esophagus a lot less acidic than what backed up before you took the antacid. imagine a five-alarm fire, with fire trucks rushing forward to put out the flames. You, on the other hand, have a fire in your belly that is backing up into your esophagus. You douse your acidic "flames" with antacids.
Antacids are good for occasional bouts of heartburn, but they are not very good for healing esophagitis.
Some prescribed drugs, such as acid blockers, cut back on the production of acid in your stomach; in that sense, they go one step farther back than do the antacids. In fact, acid blockers prevent the fire in your stomach from happening in the first place. And by diminishing acid production, acid blockers give your esophagus a chance to heal from any erosion or damage that has occurred during your previous GERD episodes and that added to your pain. Thus, acid blockers are usually more effective than antacids for people who have GERD. Pepcid Complete is a unique formulation combining antacids plus an H2 blocker in a single chewable tablet.
There are two primary types of acid blockers, which I will discuss later in this blog: H2 blockers and PPIs. Of the two categories, PPIs are stronger.
Other drugs work on other functions, such as speeding up stomach emptying or improving the strength of the LES. They are called prokinetic drugs.
Antacid drugs work to neutralize the level of already existing acid in your stomach. These medications don't prevent stomach acid from backing up when you have GERD, but they make what does reflux up into your esophagus a lot less acidic than what backed up before you took the antacid. imagine a five-alarm fire, with fire trucks rushing forward to put out the flames. You, on the other hand, have a fire in your belly that is backing up into your esophagus. You douse your acidic "flames" with antacids.
Antacids are good for occasional bouts of heartburn, but they are not very good for healing esophagitis.
Some prescribed drugs, such as acid blockers, cut back on the production of acid in your stomach; in that sense, they go one step farther back than do the antacids. In fact, acid blockers prevent the fire in your stomach from happening in the first place. And by diminishing acid production, acid blockers give your esophagus a chance to heal from any erosion or damage that has occurred during your previous GERD episodes and that added to your pain. Thus, acid blockers are usually more effective than antacids for people who have GERD. Pepcid Complete is a unique formulation combining antacids plus an H2 blocker in a single chewable tablet.
There are two primary types of acid blockers, which I will discuss later in this blog: H2 blockers and PPIs. Of the two categories, PPIs are stronger.
Other drugs work on other functions, such as speeding up stomach emptying or improving the strength of the LES. They are called prokinetic drugs.
Bernstein Test
A variety of other tests are available to the gastroenterologist who is seeking to diagnose a patient, although the most commonly used tests have already been discussed in this blog. One additional option that some doctors may still use is the Bernstein test, a procedure that is used specifically to diagnose the sensitivity of your esophagus to acid.
In this two-part test, a solution of weak hydrochloric acid is infused into the esophagus via a tube. Then a saline solution is infused. If the patient develops symptoms upon acid infusion but not on saline infusion, then the esophagus is sensitive to acid. if a patient has symptoms with both or neither, then something else is going on.
The disadvantage of this test is that it tells the doctor only if the esophagus is abnormally sensitive to acid, not whether there is an abnormally increased acid reflux into the esophagus.
The Bernstein test may be done in parts of the country where the doctor doesn't have access to pH monitoring tests. It is not considered as useful as other tests. However, it may be useful if the primary symptom is unexplained chest pain and all other tests are negative.
In this two-part test, a solution of weak hydrochloric acid is infused into the esophagus via a tube. Then a saline solution is infused. If the patient develops symptoms upon acid infusion but not on saline infusion, then the esophagus is sensitive to acid. if a patient has symptoms with both or neither, then something else is going on.
The disadvantage of this test is that it tells the doctor only if the esophagus is abnormally sensitive to acid, not whether there is an abnormally increased acid reflux into the esophagus.
The Bernstein test may be done in parts of the country where the doctor doesn't have access to pH monitoring tests. It is not considered as useful as other tests. However, it may be useful if the primary symptom is unexplained chest pain and all other tests are negative.
Esophageal Manometry
Esophageal manometry is a test that is performed by inserting a special catheter that measures pressure in the esophagus and the LES. It is not used for diagnosing GERD per se, but it is a useful test to do on patients prior to GERD surgery. It is also used for patients who have noncardiac chest pain. It may provide important information to physicians who are trying to decide whether surgery is the right course of action. Not only that, the type of GERD surgery that is performed may be influenced by the results of this test.
For example, for patients with normal pressure in esophageal contractions, fundoplication surgery would involve wrapping the stomach all around the esophagus (360 degrees). On the other hand, if contraction pressures are weak, then the surgeon may prefer to wrap the stomach around only partially so that weak contractions can push the food through the lower esophageal sphincter.
For example, for patients with normal pressure in esophageal contractions, fundoplication surgery would involve wrapping the stomach all around the esophagus (360 degrees). On the other hand, if contraction pressures are weak, then the surgeon may prefer to wrap the stomach around only partially so that weak contractions can push the food through the lower esophageal sphincter.
Ambulatory pH Monitoring Test
The term pH refers to acidity or alkalinity. In this case, what's most important is the acidity level of your esophagus. The number most doctors think is good for GERD is an acidity level of 4 or more in the esophagus.
But you can't measure esophageal acidity from the outside- the doctor has to go in to get that measurement, using a special pH monitoring device. This is not information your doctor can obtain from an endoscopy. As a result, this test may be done if your symptoms indicate GERD but your endoscopy results were negative.
This test is also often used if the patient has atypical or unusual symptoms of GERD, such as asthma, unexplained chest pains, or other symptoms that are often characteristic of or linked to GERD. In such cases, the doctor is suspicious but may not want to treat for GERD when there is no proof that it exists. The pH test will provide the proof, if the disease is present.
The ambulatory pH procedure involves spraying the nostrils with numbing medication and then inserting a fine catheter through the nose, down the throat, and into the esophagus. It stays there for twenty-four hours while the equipment collects information. The procedure is very comfortable and painless. Except for a slight gagging when the catheter is inserted, there is no problem. Patients can go about their normal routine and can even go to work afterwards, if they wish. However, many patients decide against going to work because of the embarrassment of the rather unsightly catheter in their nose.
The reason the test is done over twenty-four hours rather than simply at one time is that you can't get an idea of a true pattern unless data are recorded for a twenty-four-hour period. In addition, some degree of acid reflux is considered normal. Only when the reflux exceeds normal parameters or causes problems is it considered GERD.
Connected to the probe is a data recorder, which you can carry in your pocket, that will provide information to the doctor; it's sort of your won little flight recorder black box of information. The recorder will determine incidences and durations of reflux while ou drink and eat and go about your daily life as best you can with this contraption inside you. individuals may even smoke if they wish, althought smoking will undoubetedly cause the probe to reflect a worsening of reflux symptoms.
As to any disadvantage, the ambulatory pH test may not be available where you live. Also, some patients find it inconvenient and cumbersome.
But you can't measure esophageal acidity from the outside- the doctor has to go in to get that measurement, using a special pH monitoring device. This is not information your doctor can obtain from an endoscopy. As a result, this test may be done if your symptoms indicate GERD but your endoscopy results were negative.
This test is also often used if the patient has atypical or unusual symptoms of GERD, such as asthma, unexplained chest pains, or other symptoms that are often characteristic of or linked to GERD. In such cases, the doctor is suspicious but may not want to treat for GERD when there is no proof that it exists. The pH test will provide the proof, if the disease is present.
The ambulatory pH procedure involves spraying the nostrils with numbing medication and then inserting a fine catheter through the nose, down the throat, and into the esophagus. It stays there for twenty-four hours while the equipment collects information. The procedure is very comfortable and painless. Except for a slight gagging when the catheter is inserted, there is no problem. Patients can go about their normal routine and can even go to work afterwards, if they wish. However, many patients decide against going to work because of the embarrassment of the rather unsightly catheter in their nose.
The reason the test is done over twenty-four hours rather than simply at one time is that you can't get an idea of a true pattern unless data are recorded for a twenty-four-hour period. In addition, some degree of acid reflux is considered normal. Only when the reflux exceeds normal parameters or causes problems is it considered GERD.
Connected to the probe is a data recorder, which you can carry in your pocket, that will provide information to the doctor; it's sort of your won little flight recorder black box of information. The recorder will determine incidences and durations of reflux while ou drink and eat and go about your daily life as best you can with this contraption inside you. individuals may even smoke if they wish, althought smoking will undoubetedly cause the probe to reflect a worsening of reflux symptoms.
As to any disadvantage, the ambulatory pH test may not be available where you live. Also, some patients find it inconvenient and cumbersome.
Other Diseasm
Other diseases that may cause or contribute to GERD are hypothyroidism, Crohn's disease, cancer, and developmental and neurological disorders. In addition, some diseases of the stomach can cause or contribute GERD; for example, the stomach of patients who have gastrinoma (Zollinger-Ellison synodrome) generate copious quantities of hydrochloric acid that easily penetrate the LES and cause a reflux of food backwards from the stomach to the esophagus.
Now that you've got some knowledge of why people get GERD, the next question is how doctors figure out if you have GERD.
Now that you've got some knowledge of why people get GERD, the next question is how doctors figure out if you have GERD.
Bed Confinement
When people are confined to their beds for long periods, they lose the benefit of gravity in moving their food downward into the stomach. If there is any tendency for acid reflux disease to occur because of other health problems, or if the overall digestive system is sluggish, confinement to bed may be the last straw that causes a person to have acid reflux.
It's also true that people who are confined to bed for long periods usually have serious health problems and may take many medications that contribute to GERD, or they may be elderly and have had undiagnosed GERD for years.
It's also true that people who are confined to bed for long periods usually have serious health problems and may take many medications that contribute to GERD, or they may be elderly and have had undiagnosed GERD for years.
Weakened System/Wearing Tight-Fitting Clothing
Weakened System
Problems with acid reflux may arise when a person's overall immune system is weakened, perhaps because of a combination of chronic illnesses, overwork, stress, or other factors.
Wearing Tight-Fitting Clothing
Especially if you are overweight - but even if you are not- if you frequently wear clothes that are at least two sizes too small, then eventually you are headed for trouble. Overly tight clothes can directly contribute to forcing the acid back up from your stomach. So do not let fashion cause you to develop GERD or worsen the acid reflux that you already have. Wear garments that are comfortable and loose-fitting, whether you are on the chubby side ot you are thin. Also, avoid tight belts. Make a new notch on your belt or buy a new belt. or wear suspenders.
Problems with acid reflux may arise when a person's overall immune system is weakened, perhaps because of a combination of chronic illnesses, overwork, stress, or other factors.
Wearing Tight-Fitting Clothing
Especially if you are overweight - but even if you are not- if you frequently wear clothes that are at least two sizes too small, then eventually you are headed for trouble. Overly tight clothes can directly contribute to forcing the acid back up from your stomach. So do not let fashion cause you to develop GERD or worsen the acid reflux that you already have. Wear garments that are comfortable and loose-fitting, whether you are on the chubby side ot you are thin. Also, avoid tight belts. Make a new notch on your belt or buy a new belt. or wear suspenders.
Obesity
A thin person can have GERD, too, but it is less likely. In studies that looked at obesity alone or at genetic risk factors for GERD, being overweight clearly was a major problem, and appears to be a risk factor leading to GERD.
How does overweight cause or contribute to acid reflux? One reason is that gravity and the extra pounds in the body place ore stress on the digestive system. You might assume that gravity would cause food to go down rather than up. More weight would seem to mean more gravity - or so one would think. But more weight causes increased bulk in the upper abdomen and greater difficulty in the esophagus getting the food into the stomach fast and keeping it there. Similarly, extra pressure on the stomach prevents food from being efficiently propelled into the small intestine, causing a backup of the system.
Heavier people are also more prine to hiatal hernia. A hiatal hernia is a condition in which part of your upper stomach moves through the diaphragm and into the chest. This condition weakens the antireflux barriers and may cause retention of acidic fluid or food in the hernia pouchm which is then backed up into the esophagus.
How does overweight cause or contribute to acid reflux? One reason is that gravity and the extra pounds in the body place ore stress on the digestive system. You might assume that gravity would cause food to go down rather than up. More weight would seem to mean more gravity - or so one would think. But more weight causes increased bulk in the upper abdomen and greater difficulty in the esophagus getting the food into the stomach fast and keeping it there. Similarly, extra pressure on the stomach prevents food from being efficiently propelled into the small intestine, causing a backup of the system.
Heavier people are also more prine to hiatal hernia. A hiatal hernia is a condition in which part of your upper stomach moves through the diaphragm and into the chest. This condition weakens the antireflux barriers and may cause retention of acidic fluid or food in the hernia pouchm which is then backed up into the esophagus.
Aging
The rate at which aging affects internal organs varies from person to person; one fifty-year-old man may be much stronger than another fifty-year-old man. However, most people's systems slow down as they age, and with some exceptions, even the virile and athletic fifty-year-old man is probably not at the same level of health as when her was thirty years old. So in this sense, he is more prone to experiencing heartburn.
Diminished muscle tone and slackening physical abilities affect the digestive system, too, which is anther reason why GERD is more prevalent among middle-aged and older people.
Diminished muscle tone and slackening physical abilities affect the digestive system, too, which is anther reason why GERD is more prevalent among middle-aged and older people.
Excessive Athletic Activity
Certainly exercise is an important part of most healthy people's lives. However, there are some studies that indicate that some athletic activities may contribute to the formation and exacerbation of GERD. One study looked at athletes who averaged 4.8 days per week exercising. The study revealed that competitive weight lifters were more prone to experiencing GERD.
A sampling of nineteen weight lifters showed that 68 percent had problems with heartburn. Competitive bicyclists also were studied. They, too, were likely to have problems with GERD. Keep in mind, however, that these were professional athletes who spent an enormous amount of time exercising.
Other studies have shown that competitive long-distance running leads to increase in acid reflux. In addition, jogging is problematic and generally causes more acid reflux than bicycling.
A sampling of nineteen weight lifters showed that 68 percent had problems with heartburn. Competitive bicyclists also were studied. They, too, were likely to have problems with GERD. Keep in mind, however, that these were professional athletes who spent an enormous amount of time exercising.
Other studies have shown that competitive long-distance running leads to increase in acid reflux. In addition, jogging is problematic and generally causes more acid reflux than bicycling.
Slow Stomach
Some conditions can cause the stomach to move food out at a much slower rate. Because of this delayed functioning, the stomach can become overloaded and food backs up into the esophagus. Examples of diseases or conditions that delay stomach emptying are diabetes, scleroderma, anorexia nervosa, nervous system disorders such as stroke, brain tumors, head injury, multiple sclerosis, and Parkinson's, inadequate thyroid, pregnancy, and chronic kidney failure.
In addition, various operations on the stomach and duodenum, including ulcer and gastric bypass surgery, may delay stomach emptying. Use of alcohol and various medications may also slow down the stomach.
In addition, various operations on the stomach and duodenum, including ulcer and gastric bypass surgery, may delay stomach emptying. Use of alcohol and various medications may also slow down the stomach.
Salivary Problems
In some cases, a person has trouble creating sufficient saliva, a condition known as "xerostomia." When saliva is insufficient, not only is there less neutralization of acid, but also food goes dwown the esophagus very slowly, and consequently the esophagus is not protected adequately. Diminished saliva often stems from an underlying illness, such as Sicca syndrome. But there are other causes; for example, some medications may greatly reduce saliva. Radiation treatments for cancer patients will also reduce the volume of saliva. And sometimes elderly people have problems producing sufficient quantities of saliva.
It's also true that some patients with GERD have an excessive amount of saliva. Too much saliva doesn't rule out GERD.
It's also true that some patients with GERD have an excessive amount of saliva. Too much saliva doesn't rule out GERD.
Medication That Cause or Contribute to GERD
Virtually all medications have side effects, and one side effect of some medications is the development or worsening of GERD. The medication may lower he strength level of the LES, or it may impair performance in some other way. When possible, it's best to substitute other medications that don't cause or exacerbate GERD.
The following types of drugs have been implicated as causing or exacerbating acid reflux symptoms. If you have a serious or chronic illness, you may not be able to avoid taking them, but at least you will be aware of the problem. For example, if you have asthma, you may still need theophylline. In some cases, your doctor can order a lower dosage of the medication you are currently taking, or maybe prescribe a deffent medication.
The following types of drugs have been implicated as causing or exacerbating acid reflux symptoms. If you have a serious or chronic illness, you may not be able to avoid taking them, but at least you will be aware of the problem. For example, if you have asthma, you may still need theophylline. In some cases, your doctor can order a lower dosage of the medication you are currently taking, or maybe prescribe a deffent medication.
- Calcium channel blockers, such as Adalat, Cardizem, and Calan. These are treatments for hypertension and heart disease.
- Sedatives, such as Valium, Librium, and Butisol
- Theophylline, treatment for asthma
- Anticholinergic drugs, such as Bentyl and Levsin. These are treatments for spasm.
- Opiates such as Demerol and codeine, treatments for pain.
- Beta-agonists, such as Isuprel, a treatment for asthma and bronchitis.
- Beta-antaginists, such as Inderal and Tenormin. These are treatments for hypertension and heart disease.
- Estrogen and progesterone, female hormones in birth control pills and menopause medications.
- Nitrates for angina, such as Isordil, Nitrostat, and Nitro-Bid
- Imitrex, a treatment for migraine headaches.
Genetic Factors
With many chronic ailments, there is often an underlying genrtic predisposition, and there are indicators that GERD may run in families. Researchers reported their findings in the American Journal of Medicine in 2007 on questionnaires from 2000 people in Minnesota. They identified those individuals who experienced reflux symptoms at least weekly and then compared their histories with other GERD sufferers.
The predominant factors the researchers found that related to GERD were, in this order:
Researchers found that GERD was significantly prominent in the biological family member of patientss who had Barrett's esophagus (a precancerous condition that untreated GERD can lead to) compared ato the control group of spouses. The researchers also looked at patients with esophageal adenocarcinoma, a form of cancer, and found that GERD was more prevalent among the parents and siblings of patients than among the control group.
Does this mean that if you have a family member who has esophageal cancer or evren GERD, you are doomed to develop GERD yourself? Or does it perhaps mean that, for example, if another family member is obese, then youa are doomed to being overweight yourself, which in turn, will lead inexorably to GERD?
The good news is that even though GERD appears to have a strong genetic component, humans can make choices. For example, they may have a predisposition to substance abuse - and alcohol is one of the contributors to the development of GERD. But with the help of their physician and other experts, individuals with alcoholics in their famil can make the choice to "just say no" to the harmful lifestyle, if not to their aberrant genes. They can also seek out support from such organizations as Alcoholics Anonymous and others.
If you come from a family in which many members are obese or exhibit negative behaviors that are linked to the development or worsening of GERD, such as smoking or drinking alcohol, I strongly recommend you make the choice to resolve these issues.
The predominant factors the researchers found that related to GERD were, in this order:
- obesity
- another family member with heartburn or diseases of the stomach or esophagus
- a history of smoking
- alcohol consumption of seven or more drinks per week.
Researchers found that GERD was significantly prominent in the biological family member of patientss who had Barrett's esophagus (a precancerous condition that untreated GERD can lead to) compared ato the control group of spouses. The researchers also looked at patients with esophageal adenocarcinoma, a form of cancer, and found that GERD was more prevalent among the parents and siblings of patients than among the control group.
Does this mean that if you have a family member who has esophageal cancer or evren GERD, you are doomed to develop GERD yourself? Or does it perhaps mean that, for example, if another family member is obese, then youa are doomed to being overweight yourself, which in turn, will lead inexorably to GERD?
The good news is that even though GERD appears to have a strong genetic component, humans can make choices. For example, they may have a predisposition to substance abuse - and alcohol is one of the contributors to the development of GERD. But with the help of their physician and other experts, individuals with alcoholics in their famil can make the choice to "just say no" to the harmful lifestyle, if not to their aberrant genes. They can also seek out support from such organizations as Alcoholics Anonymous and others.
If you come from a family in which many members are obese or exhibit negative behaviors that are linked to the development or worsening of GERD, such as smoking or drinking alcohol, I strongly recommend you make the choice to resolve these issues.
Connective Tissue Disorders Such as Scleroderma
Scleroderma and other connective tissue diseases affect the nerves and muscles of the esophagus. As a result, the lower esophageal sphincter becomes very lax and lethargic, resulting in increased acid reflux. In addition, the walls of the esophagus and their contractions become weak and ineffective. Thus, any food or acid that refluxes up is not promptly milked back down into the stomach.
Hiatal Hernia
A hiatal hernia is a medical problem in which part of the stomach protrudes through the diaphragm into the chest and stays there. This can cause pain and bleeding and make GERD much worse. The hiatal hernia then weakens the mechanism that is meant to prevent acid reflux from the esophagus. Some studies hav demonstrated that the hiatal hernia itself causes a retention of stomach acid and thus promotes GERD.
Because hiatal hernia is a major problem for many people with GERD, an entire section is devoted to the subject in this blog.
Because hiatal hernia is a major problem for many people with GERD, an entire section is devoted to the subject in this blog.
Asthma
In many cases, asthma and GERD may coexist in the same patient. Some experts may disagree on whether asthma causes GERD or results from GERD; however , we do know that at least half of all patients with asthma suffer from GERD. One possible cause could be the medication that asthmatics take, which can slow down the muscles of the esophagus and stomach. Another possible cause could be the extreme coughing and wheezing that asthmatics frequently suffer, which place a burden on the upper gastrointestinal system.
It is also possible that GERD causes asthma. This may happen in one of two ways. First, the aspiration of small amounts of acid into the lung causes spasm of the air passages. Second, acid causes bronchospasm by stimulating esophago-bronchial reflexes.
It is also possible that GERD causes asthma. This may happen in one of two ways. First, the aspiration of small amounts of acid into the lung causes spasm of the air passages. Second, acid causes bronchospasm by stimulating esophago-bronchial reflexes.
Diabetes Mellitus
Some disease are specifically associated with GERD; for example, according to a 2007 issue of Diabetes Forecast, as many as 75 percent of those with diabetes have problems with esophageal motility, or the movement of the food along the esophagus. Diabetes also causes delayed gastric emptying - a double whammy. This happens largely because of the nerve damage resulting from diabetes. Most people have no symptoms at first; however, the problem can progress to GERD.
Medical Problems That Cause or Are Associated with GERD
By now you are probably wondering what else can make your digestive system malfunction. Some diseases are associated with GERD. They are either probable causes of GERD or disease that make the symptoms associated with GERD worse. In some cases, the disease is associated with GERD but it may not be clear at all which is the driver - does the other disease cause GERD or does GERD cause the other disease?
Here are the key causes of or contributors to GERD:
Here are the key causes of or contributors to GERD:
- diabetes mellitus
- asthma
- hiatal hernia
- connective tissue disorders such as scleroderma
- genetic factors
- medications
- salivary problems
- slow stomach, due to diabetes, medication, or other factors
- excessive athletic activity
- aging
- obesity
- weakened system
- wearing extremely tight clothing
- confinement to bed, such as that experienced by nursing home patiennts
- other disease
Why do some people suffer from GERD while others do not
Does it have something to do with aging or genetics or something else? The simple answer is yes. In some cases, a variety of risk factors are present, such as:
- Sedentary life. Tom is a computer programmer whose job requires a lot of sitting. He also spends a lot of time watching television while lying down on the sofa at home and eating snacks.
- Age. Tom is middle-aged. Risk goes up with age.
- Weight. Excess weight contributes to the incidence of GERD. All that weight bearing down on the body can create considerable stress on his system.
- Medication. Sometimes medication exacerbates GERD, and heartburn was probably aggravated by the antiasthma drug.
- Genetic factor. Some parents are likely to have GERD. GERD can precede the development of esophageal cancer, an illness suffered by nonsmoking mother.
- Meal size. For years, some people have been downing large meals with plenty of spicy foods and red wine, frequently topped by his favorite, chocolate cake. Big meals aggravate GERD. Alcohol exacerbates GERD, as does chocolate. Red wine see,s to cause a much stronger negative reaction than white wine.
Myth: Difficulty in Swallowing Is All in My Head
Difficulty in swallowing, technically known as dysphagia, may have a variety of causes. One cause of this often frightening problem involves conditions associated with the nerves and muscles of your throat that prevent a coordinated transfer of food from the throat to the esophagus.
Another type of swallowing difficulty results from an abnormal esophagus that fails to push food down into the stomach. The abnormality may be an obstruction to the downward flow, or may involve abnormal functioning of the muscles. Stress does not cause dysphagia, but may worsen it, especially when the functioning of the nerves and muscles is involved.
Another type of swallowing difficulty results from an abnormal esophagus that fails to push food down into the stomach. The abnormality may be an obstruction to the downward flow, or may involve abnormal functioning of the muscles. Stress does not cause dysphagia, but may worsen it, especially when the functioning of the nerves and muscles is involved.
Is Heartburn Always Due To Excess Acid?
This popular question - that people with GERD always have an overabundance of acid - has been reinforced because physicians frequently treat chronic heartburn with antacids and acid blocking medications. But heartburn is rarely due to excess acid. In fact, the actual amount of acid in the stomach of the GERD sufferer is usually normal, although it can be above average. So don't assume that your stomach acid is unusually acidic.
The problem actually lies with the location of the acid, not the quality or the quantity. When you suffer from heartburn, the acid is in the wrong place; that is, it is going the wrong way, moving up from the stomach into the esophagus. Because of a lack of effective drugs aimed at the underlying factors causing the actual acid reflux, the treatment is targeted at the acid instead.
The problem actually lies with the location of the acid, not the quality or the quantity. When you suffer from heartburn, the acid is in the wrong place; that is, it is going the wrong way, moving up from the stomach into the esophagus. Because of a lack of effective drugs aimed at the underlying factors causing the actual acid reflux, the treatment is targeted at the acid instead.
I Can't Do Anything to Help My Heartburn?
Of course you can! When stomach acid regurgitates upward into the upper part of the esophagus, it causes heartburn and indigestion. This becomes a real problem when it's chronic. However, few patients with this abnormal acid reflux go to see a doctor, even when it's happening everyday. Even fewer consult with a digestive disease specialist.
This is too bad, because as I have mentional earlier, a 1999 study on acid reflux sufferers and their life quality revealed that untreated people with GERD reported significantly lower scores in measures of emotional and physical well-being. Even people with diabetes or high blood pressure scored higher.
But when treatment did occur and patients responded, the researchers found that the self-reported scores of the GERD patients on emotional and physical well-being increased dramatically.
Of course, treatment involves more than just taking one or two pills a day, as Clarisse, described earlier in this blog, learned. Changes in lifestyle can also have a positive impact on acid reflux disease. Some important dietary changes include avoidance of heavy meals, chocolate, onions, peppers, and other irritating foods. Sit down to dinner at least two hours before bedtime and also forgo bedtime snacks.
Sometimes chewing gum helps a person with GERD. Gum chewing causes you to salivate more, which in turn hastens the clearance of acid from your esophagus. It also dilutes and neutralizes acid.
This is too bad, because as I have mentional earlier, a 1999 study on acid reflux sufferers and their life quality revealed that untreated people with GERD reported significantly lower scores in measures of emotional and physical well-being. Even people with diabetes or high blood pressure scored higher.
But when treatment did occur and patients responded, the researchers found that the self-reported scores of the GERD patients on emotional and physical well-being increased dramatically.
Of course, treatment involves more than just taking one or two pills a day, as Clarisse, described earlier in this blog, learned. Changes in lifestyle can also have a positive impact on acid reflux disease. Some important dietary changes include avoidance of heavy meals, chocolate, onions, peppers, and other irritating foods. Sit down to dinner at least two hours before bedtime and also forgo bedtime snacks.
Sometimes chewing gum helps a person with GERD. Gum chewing causes you to salivate more, which in turn hastens the clearance of acid from your esophagus. It also dilutes and neutralizes acid.
Acid from GERD Causes Problems Only in My Esophagus?
While heartburn is a well-known symptom of abnormal acid reflux, this acid may also affect parts of the body other than the digestive system; for example, asthma may be caused or exacerbated by acid reflux.
Similarly, some people experience chest pain that feels like angina of the heart. Chronic cough, hoarseness, and loss of dental enamel may also occur with GERD. As you can see, when acid reflux goes untreated for too long, it can create many problems throughout your body.
Similarly, some people experience chest pain that feels like angina of the heart. Chronic cough, hoarseness, and loss of dental enamel may also occur with GERD. As you can see, when acid reflux goes untreated for too long, it can create many problems throughout your body.
Does Stress Cause Heartburn?
The idea that stress directly causes heartburn is a very popular misconception, and has been passed along through generations. The fact is that routine stress plays only a small role, if any, in creating the original problem of GERD. However, I distinguish the daily stresses of life from the extreme physical stress encountered in very sick and very traumatized patients.
By very sick, I mean ill enough to require admission to an intensive care unit after a serious head injury, severe burns, or injuries requiring machines to help with breathing and so forth. Under such circumstances, ulcers can develop in the stomach and can be accompanied by heartburn. Other significant problems, such as severe stomach bleeding, also may occur in these extreme cases.
Although I want to emphasize that stress doesn't usually cause heartburn, it's important to acknowledge that stress can play major role in worsening heartburn as well as in impeding recovery from GERD. For this reason, I have included a chapter on stress in this blog, offering you practical and easy stress-reduction tips and tactics.
By very sick, I mean ill enough to require admission to an intensive care unit after a serious head injury, severe burns, or injuries requiring machines to help with breathing and so forth. Under such circumstances, ulcers can develop in the stomach and can be accompanied by heartburn. Other significant problems, such as severe stomach bleeding, also may occur in these extreme cases.
Although I want to emphasize that stress doesn't usually cause heartburn, it's important to acknowledge that stress can play major role in worsening heartburn as well as in impeding recovery from GERD. For this reason, I have included a chapter on stress in this blog, offering you practical and easy stress-reduction tips and tactics.
All Antacids Are The Same?
Antacids vary in their acid neutralizing capacities, which is their primary function. They can also have highly variable actions on the rest of the bowel. For example, antacid medications containing calcium (Tums) or aluminum (AlternaGel) may have a constipating effect on the bowel. On the other hand, magnesium-only antacids (Mag-Ox and Milk of Magnesia) may have a laxative effect.
When I do recommend antacids, I usually suggest alternating these two types so that the opposing effects on the bowel can offset each other. This can minimize the side effect, while providing you with the required antacid result.
So, for example, if you were taking antacids at four-hour intervals, you might take Tums at 8 am, then Mag-Ox at noon, followed by Tums at 4 am, and Mag-Ox at 8 pm (Of course, if you are taking antacids this frequently, you should consult with a physician. If you haven't already done so, make that appointment!)
An easier option is to take a combination preparation such as Maalox or Mylanta. These over-the-counter medications include opposing ingredients that counteract each other's effect on the bowel. Newer medications such as Pepcid Complete contain not only antacids but also a histamine 2 (H2) blocker (famotidine) medication. Such a combination offers the advantage of acid neutralization by antacid as well as blocking acid secretion by the H2 blocker.
When I do recommend antacids, I usually suggest alternating these two types so that the opposing effects on the bowel can offset each other. This can minimize the side effect, while providing you with the required antacid result.
So, for example, if you were taking antacids at four-hour intervals, you might take Tums at 8 am, then Mag-Ox at noon, followed by Tums at 4 am, and Mag-Ox at 8 pm (Of course, if you are taking antacids this frequently, you should consult with a physician. If you haven't already done so, make that appointment!)
An easier option is to take a combination preparation such as Maalox or Mylanta. These over-the-counter medications include opposing ingredients that counteract each other's effect on the bowel. Newer medications such as Pepcid Complete contain not only antacids but also a histamine 2 (H2) blocker (famotidine) medication. Such a combination offers the advantage of acid neutralization by antacid as well as blocking acid secretion by the H2 blocker.
GERD Can become Dangerous When Ignored or Untreated
It's easy to ignore the symptoms of acid reflux by taking a few antacids, telling yourself it's just nothing, and letting things slide until the next attack. But it can be very dangerous to follow this course, especially if you are experiencing heartburn every day or nearly every day. As the disease progresses, it may cause damage to your esophagus that could lead to Barrett's esophagus, a precancerous condition. You may also suffer from esophageal bleeding and other illnesses that can accompany chronic untreated GERD.
I have seen the consequences of people waiting too long. I have treated some patients whose food tubes were so narrowed by their GERD that they had trouble swallowing or eating. It may sound like a great way to lose weight, but I can assure you, it is no fun.
One of my patients who waited too long was Stan. He was very scared when he arrived at the emergency room with a small piece of meat stuck in his esophagus. It wouldn't come up and it wouldn't go down, and his saliva was bubbling up because of the lack of room in his esophagus.
Using an endoscope, a special tool that goes into he food tube and allows the doctor to see the interior, as well as forceps and other instruments, I broke up and removed most of the food particle, except for a leftover piece that was small enough to pass through his very narrowed esophagus. I then prescribed a double does if a strong acid blocker of the proton pump inhibitor type.
Several weeks later, I had Stan come back so I could check his esophagus again. Stan's esophagus was very narrow, so I recommended a procedure in which I would widen his esophagus with special equipment. He agreed, and the endoscopy was performed. Stan felt much better afterwards; however, I urged him to follow my food guidelines, plus take the medication I had prescribed so that his GERD wouldn't become so bad that the earlier distressing situation of the stuck food would happen again.
Both times I treated Stan - when I removed the meat and later when he returned for follow-up - I couldn't help thinking that it was very unfortunate that no one had treated his chronic heartburn years ago. This painful and frightening incident could easily have been avoided if Stan had been treated for his acid reflux earlier.
I have seen the consequences of people waiting too long. I have treated some patients whose food tubes were so narrowed by their GERD that they had trouble swallowing or eating. It may sound like a great way to lose weight, but I can assure you, it is no fun.
One of my patients who waited too long was Stan. He was very scared when he arrived at the emergency room with a small piece of meat stuck in his esophagus. It wouldn't come up and it wouldn't go down, and his saliva was bubbling up because of the lack of room in his esophagus.
Using an endoscope, a special tool that goes into he food tube and allows the doctor to see the interior, as well as forceps and other instruments, I broke up and removed most of the food particle, except for a leftover piece that was small enough to pass through his very narrowed esophagus. I then prescribed a double does if a strong acid blocker of the proton pump inhibitor type.
Several weeks later, I had Stan come back so I could check his esophagus again. Stan's esophagus was very narrow, so I recommended a procedure in which I would widen his esophagus with special equipment. He agreed, and the endoscopy was performed. Stan felt much better afterwards; however, I urged him to follow my food guidelines, plus take the medication I had prescribed so that his GERD wouldn't become so bad that the earlier distressing situation of the stuck food would happen again.
Both times I treated Stan - when I removed the meat and later when he returned for follow-up - I couldn't help thinking that it was very unfortunate that no one had treated his chronic heartburn years ago. This painful and frightening incident could easily have been avoided if Stan had been treated for his acid reflux earlier.
Illness Linked To GERD
People with certain diseases are more likely to suffer from GERD. Studies have indicated that over half of all asthma sufferers have GERD, and there is an increased risk for GERD if you have thyroid disease, heart disease, or diabetes.
Some illnesses may indirectly cause you to develop GERD. For example, medication you take for other ailments may make you prone to developing GERD.
Weather related Flare-ups.
In one major study, researchers in Denmark decided to look at the impact of the weather on symptoms of heartburn and stomach upset. These scientists reviewed data on over 7,000 patients and compared their symptomatic outbreaks to various weather patterns. They found a correlation: acid-related symptoms were most likely to occur in highly humid, cold, and dark conditions. It sounds as if in the United States, people in the Pacific Northwest better watch out. As for the rest of us, be on guard for those dark and stormy nights in the wintertime.
Some illnesses may indirectly cause you to develop GERD. For example, medication you take for other ailments may make you prone to developing GERD.
Weather related Flare-ups.
In one major study, researchers in Denmark decided to look at the impact of the weather on symptoms of heartburn and stomach upset. These scientists reviewed data on over 7,000 patients and compared their symptomatic outbreaks to various weather patterns. They found a correlation: acid-related symptoms were most likely to occur in highly humid, cold, and dark conditions. It sounds as if in the United States, people in the Pacific Northwest better watch out. As for the rest of us, be on guard for those dark and stormy nights in the wintertime.
GERD Is Often Not Diagnosed
For a variety of reasons, many people who suffer from GERD are misdiagnosed or not diagnosed at all. Some are misdiagnosed with ulcers, while others are misdiagnosed with sinus disease and even heart or psychiatric problems. Sometimes patients are told they are "just fine" and sent home. As a result, they don't get relief from their chronic heartburn and the problem may worsen.
For example, Clarisse, thirty-three, told me that she had been sick for over four years before gaining any relief. First she saw a cardiologist, who thought that she was experiencing heart spasms because she described her pain as feeling like a fist pressing down on her sternum. But he was wrong: all the cardiac tests came out normal.
Next Clarisse saw an internist, who was certain she had an ulcer and put her on Tagamet for eight weeks. That didn't help much. Then Clarisse had ultrasounds of her gallbladder, pancreas, and liver-all normal.
Becoming increasingly frustrated, Clarisse paid a visit to doctor number three, a physician who suspected GERD. The doctor put on Tagament again, and again Clarisse found little relief. He had diagnosed the problem correctly, but didn't treat it seriously or properly.
Finally, four years later, in exasperation and desperation, Clarisse saw doctor number four, who at last gave her some help and relief for her problem. This doctor told Clarisse that she needed to take stronger medications, to change her diet, and to elevate her bed at night.
Clarisse followed these recommendation and at last feels better. But she still remembers the intense frustration she felt, along with the pain and physical suffering, as she struggled to find a physician who was willing and able to treat her problem.
Hundreds of other patients have stories similar to Clarisse's. These patients have gone from doctor to doctor in a fruitless quest to relieve their increasingly worse pain. Often they have begun to wonder if the problem could be all in their head and if they might be better off with a psychiatrist.
Of course, psychiatrists are medical doctors, so they can treat GERD. But if the psychiatrist instead focuses on a possible emotional issue, the GERD will remain untreated and the patient will become sicker and sicker. The illness can progress until he or she has a severely eroded esophagus. It's shocking, but we see this kind of situation happening every day to too many people.
For example, Clarisse, thirty-three, told me that she had been sick for over four years before gaining any relief. First she saw a cardiologist, who thought that she was experiencing heart spasms because she described her pain as feeling like a fist pressing down on her sternum. But he was wrong: all the cardiac tests came out normal.
Next Clarisse saw an internist, who was certain she had an ulcer and put her on Tagamet for eight weeks. That didn't help much. Then Clarisse had ultrasounds of her gallbladder, pancreas, and liver-all normal.
Becoming increasingly frustrated, Clarisse paid a visit to doctor number three, a physician who suspected GERD. The doctor put on Tagament again, and again Clarisse found little relief. He had diagnosed the problem correctly, but didn't treat it seriously or properly.
Finally, four years later, in exasperation and desperation, Clarisse saw doctor number four, who at last gave her some help and relief for her problem. This doctor told Clarisse that she needed to take stronger medications, to change her diet, and to elevate her bed at night.
Clarisse followed these recommendation and at last feels better. But she still remembers the intense frustration she felt, along with the pain and physical suffering, as she struggled to find a physician who was willing and able to treat her problem.
Hundreds of other patients have stories similar to Clarisse's. These patients have gone from doctor to doctor in a fruitless quest to relieve their increasingly worse pain. Often they have begun to wonder if the problem could be all in their head and if they might be better off with a psychiatrist.
Of course, psychiatrists are medical doctors, so they can treat GERD. But if the psychiatrist instead focuses on a possible emotional issue, the GERD will remain untreated and the patient will become sicker and sicker. The illness can progress until he or she has a severely eroded esophagus. It's shocking, but we see this kind of situation happening every day to too many people.
Pregnancy and GERD
We know that 80 percent women experience chronic heartburn during their pregnancies, often in the last trimester. You probably thought that I would say the first trimester was the primary time for problems, when many women experience nausea and vomiting. Heartburn, however, is worse for most during the last part of pregnancy.
Why Do These People Get GERD?
We can only speculate about why these groups of people are so plagued by heartburn. It could be too much fast food, which may also be combined with smoking, drinking, or other habits that are contributors to worsening GERD. Stress can be another contributing factor. Although it doesn't cause GERD, stress can make the symptoms much worse. We also know that medications and certain illnesses cause GERD.
Perhaps the stress of managing two careers, a house and children, and who knows what other responsibilities causes people to ignore their health and their mental early warning systems. I am referring to the dos and don't eat so much junk food, don't eat on the run, get some rest and relaxation, and so forth. When your life is overburdened, it's hard to pay attention to doing the right thing.
I am absolutely not saying that if you have GERD, then it's all your fault. Instead, my purpose in this blog is to help you identify if you may have GERD. And if you do have the illness, my purpose here is to help you formulate a plan to combat it.
Keep in mind that if you fit the profile of average heartburn consumer and suffer from any symptoms of chronic heartburn, it's a very good idea to take action now to avoid more serious problems later.
Perhaps the stress of managing two careers, a house and children, and who knows what other responsibilities causes people to ignore their health and their mental early warning systems. I am referring to the dos and don't eat so much junk food, don't eat on the run, get some rest and relaxation, and so forth. When your life is overburdened, it's hard to pay attention to doing the right thing.
I am absolutely not saying that if you have GERD, then it's all your fault. Instead, my purpose in this blog is to help you identify if you may have GERD. And if you do have the illness, my purpose here is to help you formulate a plan to combat it.
Keep in mind that if you fit the profile of average heartburn consumer and suffer from any symptoms of chronic heartburn, it's a very good idea to take action now to avoid more serious problems later.
Who Gets GERD
Both men and women suffer from GERD, although the age of onset is apparently gender-related. A 1999 study of 2,000 chronic heartburn sufferer revealed that women reported the onset of heartburn at an old age than men. Many athletes suffer from GERD, particularly weight lifters and runners. Infants and children may also experience severe chronic heartburn, and too often the illness goes untreated when a child suffers.
A study identified different perceived causes of severe heartburn for men and women. Women were 70 percent more likely to identify stress within the family as a key precipitant to heartburn. Men, on the other hand, were 24 percent more likel to view long hours at work as the problem and 50 percent more likely to view business travel as the cause.
Researchers also found a male/female difference in dietary paterns that probably affected their heartburn. Men were 64 percent more likely to report alcohol as a precursor to their heartburn. Women, on the other hand, reported that they had a greater problem with eating foods that can induce heartburn, such ass chocolate, fatty foods, and tomatoes.
Heavy antacid users are also more likely to live in suburbia than in a big city. Married adults with children tend to be bigger purchasers of heartburn products than single childless individuals.
A study identified different perceived causes of severe heartburn for men and women. Women were 70 percent more likely to identify stress within the family as a key precipitant to heartburn. Men, on the other hand, were 24 percent more likel to view long hours at work as the problem and 50 percent more likely to view business travel as the cause.
Researchers also found a male/female difference in dietary paterns that probably affected their heartburn. Men were 64 percent more likely to report alcohol as a precursor to their heartburn. Women, on the other hand, reported that they had a greater problem with eating foods that can induce heartburn, such ass chocolate, fatty foods, and tomatoes.
Heavy antacid users are also more likely to live in suburbia than in a big city. Married adults with children tend to be bigger purchasers of heartburn products than single childless individuals.
Common And Uncommon Symtoms of Acid Reflux
A fake heart attack is not the only problem that acid reflux can cause. Here are a few of the other symptoms or medical problems related to GERD. You may have one or more of these symptoms if you have GERD, but I hope you will not experience them all!
You also may experience some less common symptoms, particularly if the illness goes untreated for years. Some of these more advanced symptoms are:
Does this mean that if your upper abdomen feels out of sorts once in a while, then ou must have GERD and you should rush off to the doctor? Not necessarily. Just about everyone suffers from occasional heartburn. Think about that huge Thanksgiving meal that made you feel like you could barely walk, let alone breathe!
Or do you remember that spicy Mexican food you and your coworkers ate for lunch, joking that you'd all have to be rolled back to work? As an old advertisement once put it, you can't believe you ate the whole thing.
Many people who have occasional heartburn from overeating or eating very spicy foods take a few antacids and wait awhile for the food to digest and health to be restored. Problem over - if you don't have GERD. But if you do, the pain will recur and will start to happen more frequently unless you receive treatment.
- sever heartburn
- asthma
- difficulty swallowing
- tightness or discomfort around the chest
- chronic cough
- pain or uncomfortable pressure in the chest or upper abdominal area
- acidic taste in the mouth
- burning feeling in the throat
You also may experience some less common symptoms, particularly if the illness goes untreated for years. Some of these more advanced symptoms are:
- wearing down of the enamel of your teeth and increased cavities
- gingivitis
- chronic sore throat
- constant throat clearing
- waking up at night coughing and choking
- copious salivation
- chronic sinus infections
- constant bad breath that doesn't improve with mouthwash, toothpaste, or other remedies
- chronic vomiting
Does this mean that if your upper abdomen feels out of sorts once in a while, then ou must have GERD and you should rush off to the doctor? Not necessarily. Just about everyone suffers from occasional heartburn. Think about that huge Thanksgiving meal that made you feel like you could barely walk, let alone breathe!
Or do you remember that spicy Mexican food you and your coworkers ate for lunch, joking that you'd all have to be rolled back to work? As an old advertisement once put it, you can't believe you ate the whole thing.
Many people who have occasional heartburn from overeating or eating very spicy foods take a few antacids and wait awhile for the food to digest and health to be restored. Problem over - if you don't have GERD. But if you do, the pain will recur and will start to happen more frequently unless you receive treatment.
Stomachache - Solutions
Spit out the gum. If your stomach problem is gas, bloating, and diarrhea, it could be caused by sorbitol. Our stomachs can't absorb sorbitol, but the bacteria in our stomachs thrive on it. The bacteria break it down, which releases a lot of gas.
Three sticks of gum a day can have 6 grams of sorbitol, which is about the amount that can cause problem. Other sources of sorbitol include some milk of magnesia, cough syrups such as Sudafed and Dimetapp, asthma medications, antibiotics, and even some vitamins. So read your labels if you haven't found an obvious cause for your stomachche.
Think pink. One medicine very likely to help people quickly is Pepto-Bismol. It was developed to help fight cholera in the eighteenth century, but we are learning more and more about all the positive benefits that it has. It blocks inflammation, affects motility, and protects against noxious chemicals. Pepto-Bismol may also be helped for various forms of indigestion, nausea, or diarrhea. Just follow the instructions on the bottle, whether you use the liquid or the tablets.
Use antacids and acid-blockers sparingly. They work, there's no question about that, but medicines such as Tagamet, Zantac, Axid, and Pepcid AC, sometimes "cause tolerance". In other words, if you take them regularly over long periods of time, you might have to keep using them, and using more of them, to get relief.
You have two options when it comes to antacids. You can block the production of the acid by using Tagamet, Zantac, Pepcid AC, or Axid. Or you can neutraize the acid with Mylanta, Maalox, or Tums. Either way, you should consider these short-term solutions.
There are two potential problems with using antacids long-term. First, they can ake a more serious problem. It's okayto reach for these medicines for fast relief, but if you find yourself using them more and more often, go see a doctor.
Reach for the baking soda. Dissolve a teaspoon of baking soda in warm water, toast to a calmer belly, and drink up. Baking soda has been using to relieve upset sstomachs for generations, and with good reason: It works. Just don't use it every day.
Three sticks of gum a day can have 6 grams of sorbitol, which is about the amount that can cause problem. Other sources of sorbitol include some milk of magnesia, cough syrups such as Sudafed and Dimetapp, asthma medications, antibiotics, and even some vitamins. So read your labels if you haven't found an obvious cause for your stomachche.
Think pink. One medicine very likely to help people quickly is Pepto-Bismol. It was developed to help fight cholera in the eighteenth century, but we are learning more and more about all the positive benefits that it has. It blocks inflammation, affects motility, and protects against noxious chemicals. Pepto-Bismol may also be helped for various forms of indigestion, nausea, or diarrhea. Just follow the instructions on the bottle, whether you use the liquid or the tablets.
Use antacids and acid-blockers sparingly. They work, there's no question about that, but medicines such as Tagamet, Zantac, Axid, and Pepcid AC, sometimes "cause tolerance". In other words, if you take them regularly over long periods of time, you might have to keep using them, and using more of them, to get relief.
You have two options when it comes to antacids. You can block the production of the acid by using Tagamet, Zantac, Pepcid AC, or Axid. Or you can neutraize the acid with Mylanta, Maalox, or Tums. Either way, you should consider these short-term solutions.
There are two potential problems with using antacids long-term. First, they can ake a more serious problem. It's okayto reach for these medicines for fast relief, but if you find yourself using them more and more often, go see a doctor.
Reach for the baking soda. Dissolve a teaspoon of baking soda in warm water, toast to a calmer belly, and drink up. Baking soda has been using to relieve upset sstomachs for generations, and with good reason: It works. Just don't use it every day.
Stomachache - Problem And Cause,
Problem
Where's the pain? and What does it feel like? are the two questions a doctor will ask if you complain of a stomachache. So, in order to treat yourself, you will need to learn how to decipher your pain. Doctors divide the stomach into four quadrants:
Middle of your chest, under the breastbone: You probably feel burning and are most likely burping. This usually signifies acid indigestion or heartburn. You could also possibly have an ulcer, if the pain happens when your stomach is empty or in the middle of the night.
Upper right side of the abdomen: There's probably pain but no other symptoms. You might need to have your gallbladder checked out.
Under your belly button: Discomfort n this area is usually accompanied by bloating, cramping, and diarrhea. your lower intestine is probably irritated.
Lower right quadrant: If there's gas, bloating, and diarrhea, it's still your lower intestine. But if it is severe and persistent or associated with a fewer or it hurts to walk, it could be your appendix.
Cause
Two things tend to cause stomach problems: putting sometimes in your mouth or not putting something in your mouth, namely, food. Determining if it's food or the lack f food that caused your stomachache is the first step toward treating yourself. It's good to know, for example, that heartburn is worsened with certain foods, while most ulcers hurt when you don't eat.
A lot of stomachaches are due to misbehavior. Overeating, eating too fast, swollowing air, drinking a lot of hot and cold beverages, and smoking all give people stomachaches.
On the other hand, not eating also can cause a stomachache, but that usually feels more like a gnawing or burning sensation. If the burning is in the upper abdomen, suspect n ulcer. If it's heartburn, the burning is behind the breastbone, higher than where an ulcer hurts.
Where's the pain? and What does it feel like? are the two questions a doctor will ask if you complain of a stomachache. So, in order to treat yourself, you will need to learn how to decipher your pain. Doctors divide the stomach into four quadrants:
Middle of your chest, under the breastbone: You probably feel burning and are most likely burping. This usually signifies acid indigestion or heartburn. You could also possibly have an ulcer, if the pain happens when your stomach is empty or in the middle of the night.
Upper right side of the abdomen: There's probably pain but no other symptoms. You might need to have your gallbladder checked out.
Under your belly button: Discomfort n this area is usually accompanied by bloating, cramping, and diarrhea. your lower intestine is probably irritated.
Lower right quadrant: If there's gas, bloating, and diarrhea, it's still your lower intestine. But if it is severe and persistent or associated with a fewer or it hurts to walk, it could be your appendix.
Cause
Two things tend to cause stomach problems: putting sometimes in your mouth or not putting something in your mouth, namely, food. Determining if it's food or the lack f food that caused your stomachache is the first step toward treating yourself. It's good to know, for example, that heartburn is worsened with certain foods, while most ulcers hurt when you don't eat.
A lot of stomachaches are due to misbehavior. Overeating, eating too fast, swollowing air, drinking a lot of hot and cold beverages, and smoking all give people stomachaches.
On the other hand, not eating also can cause a stomachache, but that usually feels more like a gnawing or burning sensation. If the burning is in the upper abdomen, suspect n ulcer. If it's heartburn, the burning is behind the breastbone, higher than where an ulcer hurts.
Heartburn Overview
Problem
This painful burning sensation behind the breastbone strikes more than 60 million Americans a month, usually an hour or two after eating. It can be felt as high up as in the jaws and the back of the throat, resulting in hoarseness, and can even radiate into the arms and back.
Cause
The flame to blame is stomach acid, which enters into the esophagus via the lower esophageal sphincter at the top of the stomach. When things go awry, this muscular valve – which normally opens and shuts to let food pass – can reopen, allowing acid to shoot upward. Some contributing factors are high-fat and spicy foods, including chocolate, peppermint, and garlic; certain medications, such as aspirin; smoking; beverages that contain carbonation, caffeine, or alcohol; and hiatal hernia.
How Serious
Occasional heartburn is not serious. However, chronic, severe heartburn is a symptoms of a reflux problem, meaning that stomach acid is regularly flowing upward, often due to a faulty esophageal sphincter. Reflux can result in complications such as bleeding, shortness of breath, difficulty swallowing, and even weight loss. Self-treating this condition long-term also can mask more serious problems, namely, cancer of the esophageal. Between the early 1970s and the early 1990s, the death rate for esophageal cancer in men increased by 24 percent, according to the American Cancer Society. Since this cancer is far more common in males, many doctors recommends seeing a physician if your heartburn occurs three or four times a week for weeks at a time.
Solutions
Pop an antacid. Yes, it’s painfully obvious, but taking an antacid makes sense because it contains chemicals that neutralize acid instantaneously. Be aware, however, that the four types of antacids have their own side effects. Magnesium salts are more likely to cause diarrhea and should not be taken by people with kidney disease. Aluminum salts can trigger constipation and can weaken bones with overuse. Calcium salts such as Tums can lead to kidney stones if taken long-term. And some sodium salts ,such as those Alka-Seltzer products that contain aspirin, can cause stomach irritation.
Many of the antacids out there are a combination of these ingredients. Maalox and Mylanta, for example, contain both magnesium and aluminum. And Rolaids contains magnesium and calcium. So, which antacid works best? Well, it’s no exact science, but many experts recommend the antacids that contain a combination of magnesium and aluminum such as Maalox, which is best been taken one hour and three hours after a meal and at bedtime in a dose of about two to three teaspoons at a time. You can use these for your heartburn pain unless you have kidney disease. And if you are taking a prescription drug, you should check with your doctor before taking any antacid.
Quench the fire. Drinking an eight-ounce glass of water may bring temporary relief. Water can wash acid back down the esophagus and dilute the acid in the stomach. But since water absorbs quickly in the stomach, don’t expect this relief to last long. This is best used to buy yourself some time until the antacid kicks in.
Don’t be fooled by milk. The worst thing you can do for heartburn is drink a glass of milk before bedtime. Sure, milk neutralizes acid when you take it, but during the night, it produces more acid. So you wake up two to three hours after you go to bed with intense heartburn from that glass of milk.
Outsmart gravity. If you must lie down within several hours of eating, raise the head of your bed. Prop six-inch blocks under the headboard bed legs or place a foam, triangular-shape wedge under your shoulders. But don’t use pillows to prop yourself up. Often, people end up with the pillows under their heads, not their shoulder. So they don’t get the elevation they need. If sleeping in chairs has become a habit to get relief at night, he warns, it’s time to see your doctor.
Alternative Approaches
Sip soy. Unlike cow’s milk, soy milk soothe heartburn without making it worse hours later. Mix 2 tablespoons chlorophyll with 1/2 cup soy milk, and drink it slowly. You can do this two to four times a day for up to two weeks. If you haven’t gotten relief from your heartburn after those two weeks, you should see a doctor, he advises. And if you are allergic to soy, you should not try this remedy, he adds.
Mix a vinegar cocktail. As unpleasant as it sounds, apple cider vinegar aids digestion and eases heartburn by neutralizing excess acid. And since the pH in the cider is not the same as antacids, it’s more natural and doesn’t damage the stomach like antacids can. Mix 1 teaspoon apple cider vinegar with 8 ounces water and 1/2 to 1 teaspoon honey. Take this once in the morning and once at night, as needed. You can also drink this mixtures after a meal if you are having digestive problems.
Position your belly. A common heartburn cause, hiatal hernia can keep food from going down the esophagus. To bring quick relief, press the fingers of both of your hands just snug underneath the “V” in the center of your rib cage and push the top of your stomach downward. You can do one swift push or several different pushes. This is not a dangerous procedure, though a chiropractor trained to do this will tend to do it more effectively and faster.
Heat things up. Putting a heating pad on a certain spot in your back can help bring relief from heartburn. The spine is related to the digestive organs. In particular, the area just below your shoulder blades has nerves that supply the upper gastrointestinal tract, which includes the esophageal sphincter – a major player in heartburn .
Lie on the back with a heating pad under the spot between your shoulder blades for 20 minutes and put your feet up on a pillow or two. Just make sure that you wear a shirt to prevent getting burned. Lying in this position and applying heat helps you to relax. Since tension and stress often cause heartburn, alleviating that stress can also alleviate your heartburn.
Preventive Measures
Eat light. A very full stomach increases incidence of heartburn, probably by forcing the LES open. So keep portions small. In fact, you shouldn’t eat anything within two to three hours of going to sleep.
Plan and prevent. When anticipating a fattening or spicy meal, it makes sense to take an over-the-counter H2 receptor antagonist (such as Zantac or Pepcid AC) 20 to 40 minutes beforehand, which neutralize acid, H2 receptors block acid production, preventing heartburn.
H2 receptors also work when taken after meals. But remember that, unlike the immediate relief of antacids, they take 20 to 40 minutes to kick in. The effects, however, last hours longer.
Eat your enzymes. With age, our bodies produce fewer enzymes, and we rarely eat enough enzyme-supplying fruits and vegetables. So it’s good idea to supplement. If you are eating primarily proteins and fats, you are not getting enough enzymes in your food and your body has to use its own supply. For those concern, it recommends taking one digestive food enzyme capsule about 15 minutes before meals to help digestion. Some men may have to take an enzyme capsule everyday before every meal, while others may only need to take it occasionally. You can buy digestive food enzymes at most health food stores.
Turn out stress. So many people eat in front of the TV or discuss problems at the dinner table, creating a nervous stomach and, as a result, heartburn. To control your postmeal outcome, declare dinnertime a stress-free zone by eating slowly in a pleasant atmosphere and listening to relaxing music.
This painful burning sensation behind the breastbone strikes more than 60 million Americans a month, usually an hour or two after eating. It can be felt as high up as in the jaws and the back of the throat, resulting in hoarseness, and can even radiate into the arms and back.
Cause
The flame to blame is stomach acid, which enters into the esophagus via the lower esophageal sphincter at the top of the stomach. When things go awry, this muscular valve – which normally opens and shuts to let food pass – can reopen, allowing acid to shoot upward. Some contributing factors are high-fat and spicy foods, including chocolate, peppermint, and garlic; certain medications, such as aspirin; smoking; beverages that contain carbonation, caffeine, or alcohol; and hiatal hernia.
How Serious
Occasional heartburn is not serious. However, chronic, severe heartburn is a symptoms of a reflux problem, meaning that stomach acid is regularly flowing upward, often due to a faulty esophageal sphincter. Reflux can result in complications such as bleeding, shortness of breath, difficulty swallowing, and even weight loss. Self-treating this condition long-term also can mask more serious problems, namely, cancer of the esophageal. Between the early 1970s and the early 1990s, the death rate for esophageal cancer in men increased by 24 percent, according to the American Cancer Society. Since this cancer is far more common in males, many doctors recommends seeing a physician if your heartburn occurs three or four times a week for weeks at a time.
Solutions
Pop an antacid. Yes, it’s painfully obvious, but taking an antacid makes sense because it contains chemicals that neutralize acid instantaneously. Be aware, however, that the four types of antacids have their own side effects. Magnesium salts are more likely to cause diarrhea and should not be taken by people with kidney disease. Aluminum salts can trigger constipation and can weaken bones with overuse. Calcium salts such as Tums can lead to kidney stones if taken long-term. And some sodium salts ,such as those Alka-Seltzer products that contain aspirin, can cause stomach irritation.
Many of the antacids out there are a combination of these ingredients. Maalox and Mylanta, for example, contain both magnesium and aluminum. And Rolaids contains magnesium and calcium. So, which antacid works best? Well, it’s no exact science, but many experts recommend the antacids that contain a combination of magnesium and aluminum such as Maalox, which is best been taken one hour and three hours after a meal and at bedtime in a dose of about two to three teaspoons at a time. You can use these for your heartburn pain unless you have kidney disease. And if you are taking a prescription drug, you should check with your doctor before taking any antacid.
Quench the fire. Drinking an eight-ounce glass of water may bring temporary relief. Water can wash acid back down the esophagus and dilute the acid in the stomach. But since water absorbs quickly in the stomach, don’t expect this relief to last long. This is best used to buy yourself some time until the antacid kicks in.
Don’t be fooled by milk. The worst thing you can do for heartburn is drink a glass of milk before bedtime. Sure, milk neutralizes acid when you take it, but during the night, it produces more acid. So you wake up two to three hours after you go to bed with intense heartburn from that glass of milk.
Outsmart gravity. If you must lie down within several hours of eating, raise the head of your bed. Prop six-inch blocks under the headboard bed legs or place a foam, triangular-shape wedge under your shoulders. But don’t use pillows to prop yourself up. Often, people end up with the pillows under their heads, not their shoulder. So they don’t get the elevation they need. If sleeping in chairs has become a habit to get relief at night, he warns, it’s time to see your doctor.
Alternative Approaches
Sip soy. Unlike cow’s milk, soy milk soothe heartburn without making it worse hours later. Mix 2 tablespoons chlorophyll with 1/2 cup soy milk, and drink it slowly. You can do this two to four times a day for up to two weeks. If you haven’t gotten relief from your heartburn after those two weeks, you should see a doctor, he advises. And if you are allergic to soy, you should not try this remedy, he adds.
Mix a vinegar cocktail. As unpleasant as it sounds, apple cider vinegar aids digestion and eases heartburn by neutralizing excess acid. And since the pH in the cider is not the same as antacids, it’s more natural and doesn’t damage the stomach like antacids can. Mix 1 teaspoon apple cider vinegar with 8 ounces water and 1/2 to 1 teaspoon honey. Take this once in the morning and once at night, as needed. You can also drink this mixtures after a meal if you are having digestive problems.
Position your belly. A common heartburn cause, hiatal hernia can keep food from going down the esophagus. To bring quick relief, press the fingers of both of your hands just snug underneath the “V” in the center of your rib cage and push the top of your stomach downward. You can do one swift push or several different pushes. This is not a dangerous procedure, though a chiropractor trained to do this will tend to do it more effectively and faster.
Heat things up. Putting a heating pad on a certain spot in your back can help bring relief from heartburn. The spine is related to the digestive organs. In particular, the area just below your shoulder blades has nerves that supply the upper gastrointestinal tract, which includes the esophageal sphincter – a major player in heartburn .
Lie on the back with a heating pad under the spot between your shoulder blades for 20 minutes and put your feet up on a pillow or two. Just make sure that you wear a shirt to prevent getting burned. Lying in this position and applying heat helps you to relax. Since tension and stress often cause heartburn, alleviating that stress can also alleviate your heartburn.
Preventive Measures
Eat light. A very full stomach increases incidence of heartburn, probably by forcing the LES open. So keep portions small. In fact, you shouldn’t eat anything within two to three hours of going to sleep.
Plan and prevent. When anticipating a fattening or spicy meal, it makes sense to take an over-the-counter H2 receptor antagonist (such as Zantac or Pepcid AC) 20 to 40 minutes beforehand, which neutralize acid, H2 receptors block acid production, preventing heartburn.
H2 receptors also work when taken after meals. But remember that, unlike the immediate relief of antacids, they take 20 to 40 minutes to kick in. The effects, however, last hours longer.
Eat your enzymes. With age, our bodies produce fewer enzymes, and we rarely eat enough enzyme-supplying fruits and vegetables. So it’s good idea to supplement. If you are eating primarily proteins and fats, you are not getting enough enzymes in your food and your body has to use its own supply. For those concern, it recommends taking one digestive food enzyme capsule about 15 minutes before meals to help digestion. Some men may have to take an enzyme capsule everyday before every meal, while others may only need to take it occasionally. You can buy digestive food enzymes at most health food stores.
Turn out stress. So many people eat in front of the TV or discuss problems at the dinner table, creating a nervous stomach and, as a result, heartburn. To control your postmeal outcome, declare dinnertime a stress-free zone by eating slowly in a pleasant atmosphere and listening to relaxing music.