TV commercials about heartburn are not telling you the whole truth. Displaying a bottle of acid-lowering medicine surrounded by bottles of hot sauce and chicken wings only encourages you to indulge in tempting food, then take a pill to solve the problem.
Although certain drugs can be effective in relieving unpleasant symptoms of acid reflux, they don't really deal with the underlying issue.
Acid reflux happens when the valve that separates the stomach from the esophagus fails to stay closed when it should. This valve is called the lower esophageal sphincter or LES. As a result, stomach contents go back up into the esophagus, and may travel all the way to the mouth. Symptoms can include heartburn, regurgitation of food, sore throat, hoarse voice and cough.
Acid-lowering drugs like Prilosec and Zantac are not good at preventing reflux. They simply reduce the acid, and the reflux often remains. For many, this non-acid reflux can be just as irritating.
You need stomach acid to help digest protein and absorb minerals. Stomach acid is part of your body's defense system, because the acid works to kill bacteria that enter the stomach.
By reducing levels of stomach acid, acid-lowering drugs may produce serious side effects, especially when used for several months or longer. These side effects have been well documented in medical journals such as the Journal of the American Medical Association and the Archives of Internal Medicine.
Some of the side effects associated with acid lowering drugs include:
• Increased rate of hip fractures, (1)
• Increased risk of intestinal infection, including Salmonella (2) and colitis caused by C. difficile bacteria, (3)
• Increased risk of pneumonia, even in otherwise healthy young adults. (4)
Calcium. Calcium tightens the LES valve. This is not an antacid effect. In fact, the best type of calcium, because it is the most soluble, is calcium citrate, which is itself mildly acidic. The most effective preparation is calcium citrate powder. Take 250 mg, dissolved in water, after every meal and at bedtime (for a total daily dose of 1,000 mg). Swallowing calcium pills does not prevent reflux because the calcium is not instantly dissolved. You can find more information on the various types of calcium supplements here.
Digestive enzymes. These can help decrease distension of the stomach. The enzymes should be acid-resistant, so they work in the stomach itself, not in the small intestine. A powdered enzyme preparation (1/2 teaspoon) can be mixed together with the calcium powder above and taken after each meal. Digestive enzymes are available in health food stores and drug stores.
People who have been taking acid-lowering drugs for several weeks or more on a daily basis may have difficulty discontinuing them. When the stomach is deprived of acid, it produces more acid-secreting cells in order to compensate. The result is that even though the initial symptoms are not due to hyperacidity, attempting to stop the drug can create hyperacidity. The solution is to slowly taper off the drug, under a doctor's supervision, while taking steps to remedy the underlying cause.
Heartburn and indigestion might be symptoms of a serious medical problem like a heart attack, gallbladder disease, or an ulcer. These possible diagnoses must be evaluated medically. Please seek immediate attention from a health care professional if you experience any symptoms.
1) Calcif Tissue Int. 2006 Aug;79(2):76-83. "Proton pump inhibitors, histamine H2 receptor antagonists, and other antacid medications and the risk of fracture." Vestergaard P, Rejnmark L, Mosekilde L.
2) Pediatrics. 2006 May;117(5):e817-20. "Therapy with gastric acidity inhibitors increases the risk of acute gastroenteritis and community-acquired pneumonia in children." Canani RB, Cirillo P, Roggero P, Romano C, Malamisura B, Terrin G, Passariello A, Manguso F, Morelli L, Guarino A; Working Group on Intestinal Infections of the Italian Society of Pediatric Gastroenterology, Hepatology and Nutrition (SIGENP).
Infect Control Hosp Epidemiol. 2007 Oct;28(10):1202-5. Epub 2007 Aug 27. "Role of acid-suppressing medications during a sustained outbreak of Salmonella enteritidis infection in a long-term care facility." Bowen A, Newman A, Estivariz C, Gilbertson N, Archer J, Srinivasan A, Lynch M, Painter J.
3) Int J Infect Dis. 2007 Mar 2; "Association between gastric acid suppressants and Clostridium difficile colitis and community-acquired pneumonia: analysis using pharmacovigilance tools." Hauben M, Horn S, Reich L, Younus M.
JAMA. 2005 Dec 21;294(23):2989-95."Use of gastric acid-suppressive agents and the risk of community-acquired Clostridium difficile-associated disease." Dial S, Delaney JA, Barkun AN, Suissa S
4) Arch Intern Med. 2007 May 14;167(9):950-5."Use of proton pump inhibitors and the risk of community-acquired pneumonia: a population-based case-control study." Gulmez SE, Holm A, Frederiksen H, Jensen TG, Pedersen C, Hallas J.
JAMA. 2004 Oct 27;292(16):1955-60. "Risk of community-acquired pneumonia and use of gastric acid-suppressive drugs." Laheij RJ, Sturkenboom MC, Hassing RJ, Dieleman J, Stricker BH, Jansen JB
Source: Huffington Post, May 3, 2010
Last modification 10/05/2010