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News Flash: Acid Reflux Caused by Too Little Acid, Not Too Much...
Mercola has been 5 years ahead of everyone else for the last 20 years.....and has been right about every major issue he has pushed in that time....You may have seen him on Dr Oz on TV (I am sure Oz sees Mercola as one of the top authors of Health Solutions in the world today--and has him on his show almost monthly).
In a nutshell, the drugs you are taking are NOT fixing your problem, though as a treatment category, this does make the poor starving pharmaceutical industry plenty of money to cover their lifestyle needs. In fact, these drugs are extremely BAD for you, and this diving issue should be seen by you as a good time to drop these drugs, use the Mercola solutions, and then fill out the form again with NO drug issues to report
Before I start the rest of the post first I'd like to say that this is NOT a personal attack on Dan. I really respect the fact patients take an interest in their health and I personally encourage my patients to seek non-medicinal forms of therapy. I have absolutely no issues with alternative medicine and alternative therapies when they are not in conflict with standard medical recommendations.
The Latin root for doctor loosely means teacher. I am presenting the following simply as education.
The correct medical term for "heartburn" is GastroEsophageal Reflux Disease/Disorder or GERD for short. There is normally a ring of muscles at the bottom of the esophagus as it meets the stomach referred to as the Lower Esophageal Sphincter (LES). It normally relaxes as the food we swallow enters the stomach and then tightens up again to prevent the stomach contents from "refluxing" or moving back into the esophagus. When that happens stomach acid can irritate the lining the of the esophagus and cause discomfort. Gradually over time as we age that LES becomes weaker and has a harder time keeping closed. And as it weakens it allows food and acid to come back up at very low pressures and patients become more symptomatic.
Technically a hiatal hernia is when the stomach actually pushes through it's hole in the diaphragm and enters the chest cavity. It is not in and of itself a cause of heartburn but will most often contribute to and make the symptoms worse. It serves to increase intra-stomach pressures and helps push the stomach acid back up into the esophagus. It doesn't, however, affect the production of stomach acid.
Normally the stomach produces acid to help in the digestion of food. The measured pH is under 4 and often close to 2. In chemical terms that's a pretty significant acid. It normally doesn't eat away at our stomachs because it protects itself by creating a mucus lining that forms a protective coating. The problem is in the presence of Helicobacter pylori a bacteria that causes stomach ulcers it causes increased amounts of stomach acid to be produced.
There is a medical saying, "no acid, no ulcer." There are many different ways to treat or reduce stomach acid. Antacids (Rolaids, Tums, Mylanta), Histamine blocker (H2 Blockers) Pepcid, Tagamet, Zantac; and, Proton Pump Inhibitors (PPI) including over the counter medications Prilosec and Prevacid. As with any medication there is always the notion of benefit to risk analysis. That is, what is the risk of the medication versus the benefit to the patient. In regards to all the medications for ulcers or heartburn they are generally innocuous by medical standards and provide a significant benefit in relief of symptoms. One of the other considerations are long term side effects and monitoring.
The overwhelming vast majority of patients will do well whether or not they treat their symptoms with meds or ignore the symptoms and just put up with the discomfort. The biggest concern from a doctor's perspective are the chronic heartburn patients who experience symptoms almost daily. There are a subset of patients who will develop a condition referred to as Barrett's Esophagitis. In that instance, the normal lining of the esophagus and the normal lining of the stomach gets mixed up and starts to develop precancerous characteristics. It is not in and of itself malignant or cancer but becomes a precancerous potential. That is why those medications have a 14 day disclaimer. Do not use for over 14 days without consulting with a physician.
I describe the effects of chronic acid and heartburn on the esophagus very much like sunburns. One sunburn isn't going to cause a problem. Lot's of sunburns and you won't be surprised if that person develops skin cancer. Well, the chronic irritation on the esophagus from chronic GERD is very similar. In a very practical sense it is your stomach's equivalent of sunscreen, with or without a hiatal hernia. They are not necessarily "bad" medicines and for certain patients are protective. I've seen a patient actually present with esophageal cancer from chronic heartburn. Not a pretty sight. And, when asked (he came to me as a new patient) was taking meds or ignoring his symptoms for years.
Now, that being said, the best and most effective ways to treat and deal with heartburn are lifestyle modifications and dietary changes. That is, lose weight if you are overweight. Avoid foods that promote or exacerbate your symptoms. Even elevating the head of the bed a few degrees (they recommend a brick under both posts of your headboard) is a very effective way of mitigating your symptoms. And, those lifestyle changes are often more effective and long lasting remedies than what your doctor could prescribe. If your symptoms are chronic or severe then see your doctor.
