How You Can Spell 'Relief'
Nov. 13, 2000 -- Television ads for the over-the-counter tablets designed to relieve heartburn often are almost comical. But the disorder is no laughing matter for the 60 million Americans who experience it at least once a month. Long-term, severe cases often result in destruction of the esophagus and may lead to one of America's most rapidly increasing forms of cancer.
Fortunately in recent years, doctors have found effective ways of treating acid indigestion, chronic cases of which are called gastroesophageal reflux disease (GERD). But many of the treatments people often rely on, such as sleeping with their head propped up, or avoiding spicy foods, might not always be what it takes to get rid of heartburn, according to a recent study.
Doctors from the Medizinische Klinik der TU München in Germany, say that lack of scientific evidence to support lifestyle and dietary changes as a mode of treatment, and availability of effective drugs, means doctors must carefully and individually consider each patient before recommending such behavioral modification.
Alexander Meining, MD, and Meinhard Classen, MD, reviewed clinical studies of diet and lifestyle measures used to control acid reflux and published their findings in the most recent issue of The American Journal of Gastroenterology. They say that while these modification therapies have not been conclusively shown to be generally beneficial, for some individuals, they might be appropriate.
Although called heartburn, GERD is actually an illness of the digestive track, most specifically a defect of a muscle called the lower esophageal sphincter. When this juncture of the esophagus and the stomach is not working properly, stomach acid flows backward into the esophagus. Doctors believe that this happens because the lower esophageal sphincter relaxes too often rather than contracting to prevent acid reflux.
According to the American College of Gastroenterology (ACG), the symptoms of heartburn, or acid indigestion, are more common among the elderly and pregnant women. The most frequent symptom is a burning feeling behind the breastbone, that moves up the neck and throat and can last for hours. Some people even taste the acid's bitterness at the back of their throats.
But in severe cases, known as GERD, when heartburn strikes two or more times a week, food may stick in the area of the lower esophageal sphincter, and regurgitation of blood and weight loss may occur. Approximately 15 million Americans suffer from acid indigestion daily, says the ACG.
"If you have it once a month, modifying your lifestyle and eating habits will handle it," says Rajeev Jain, MD, a gastroenterologist at Presbyterian Hospital of Dallas. "If you have it every day, this won't do it. However, if you have recurring episodes, then use of lifestyle and diet changes will help."
These changes include avoiding greasy and spicy foods, tomatoes, citrus products that contain a lot of acid, alcohol, smoking, and carbonated drinks. Doctors also warn that obesity contributes to GERD and that wearing tight fitting clothing or doing anything that increases pressure on the abdomen can worsen symptoms.