Heart Burn

hen Sumati H.
went to her physician complaining of hoarseness and chronic cough,

little did she realise that she'd come back with a diagnosis of acid reflux. The first
doctor she saw thought it was a form of chronic bronchitis. But when she consulted the
specialist, he told her she had gastroesophageal reflux disease (GERD), a condition in
which the acid contents of the stomach move back into the esophagus, the muscular tube
that connects the throat to the stomach.
Heartburn (or acidity, as it is commonly referred to) is its most common symptom,
but there are others. Kalpanath Rao discovered he had GERD when his dentist pointed
out that something was eroding the enamel on his teeth - namely, the backwash of
Feel like somebody stuck a blowtorch

down your throat? You may be one of the millions
who suffer from acid-reflux problems.
Here's your fire extinguisher
stomach acid. Other typical symptoms include bloating, burping, water brash (that sour
acid taste in the back of the throat) and nausea.
r
According to Deepak Amarapurkar, consulting gastroenterologist, Bombay Hospital,
atypical symptoms, as in Sumati's case, can include, hoarseness, coughing, tooth burns,
ear ache and even asthma. The last happens, says Amrapurkar, "when the acid goes so
far up the esophagus that it spills over into the windpipe; this can trigger an asthma
l
, attack in people who are already susceptible to the condition."
A RISK OF CANCER?
The symptoms seem mild compared with the risks you face when you have GERD. A
recent study by researchers at the University of Miami School of Medicine found that
the risk of esophageal cancer is more than seven times higher among people who
regularly suffer acid reflux.
This is especially so in those who have a weakness or malfunction of the lower
esophageal sphincter (LES) valve that joins the stomach and the esophagus. Its function
is to allow food to pass but prevent acid from returning. GERD is like having a leaky
lid on a top-loading washing machine, only instead of foam building up over the washer,
you have acid boiling up into the esophagus.
Whether your acid-spitting monster is life-threatening or life-bothering, easy solutions
and new medical treatments can help stop the burning. Here are some put-out-the-fire
options that Dr. Deepak Amrapurkar offers.
,
(
L1FESlYLE OPTIONS
Hold the mutton curry and butter naan Fat triggers a hormone that relaxes the
lower esophageal sphincter (LES). That sphincter is important because it's the valve
\
HEAL T H II NUTR IT ION May 2002 43
(
that stops acid from flowing back into your lying on the couch or in bed. After dinner, loosen
esophagus. When the LES relaxes, acid can creep your belt or slip into something comfortable.
into your throat. Relieving the pressure on your gut can keep the
Fatty foods also delay digestion, giving acid acid from squirting up into your esophagus.
more time to do its dirty work. Sleep on your left side. Quick anatomy lesson:
Sip with discretion. Alcohol, coffee, colas and The stomach is on your left side, and the esophagus
other aerated beverages, all irritate the lining of enters it from the right. When you lie on
the esophagus, says Dr. Amrapurkar. Avoid totally, your left side, the esophagus is higher than
or limit your consumption. As for water, drink up your stomach, so stomach contents pool
"but not in the course of a meal," he warns, "That away from the organ. You have a tendency to
will dilute the stomach acids and delay digestion." GERD is roll over often in the night? Put a pillow behind
The result? Same as above. like having your back.
Chew gum. Saliva contains a natural bicarbonate Prop yourself up. If you elevate the head of your
that neutralizes stomach acid, helping to clear it
a leaky lid bed 6 inches, acid will be less likely to flow into
from the esophagus. Gum chewers generate a on a top- your esophagus. (Don't elevate your head by
lot of saliva.
loading piling up the pillows; you'll end up with one
Cool it! Hot beverages damage the tissues of the more misery to deal with - neck strain).
esophagus, which makes the tube more vulnerable
washing
to acid. Studies show that people with heartburn machine, MEDICAL OPTIONS
prefer their drinks hotter than people who don't only Try an OTC remedy. A combination of antacids
have the disease, so you'll consciously have to instead of (to make stomach contents less acidic) and H2
cool your drinks. Stick to this simple rule: If your
tea is too hot to put a finger in, it's too hot to drink. foam blockers (to cut down on acid production) often
provides symptomatic relief. But if you're using
Watch out for triggers. Seemingly innocent foods building up antacids more than twice a week, see a doctor.
such as tomatoes, salt, citrus fruits and juices, over the Get a prescription. If OTCs aren't effective, your
chocolate, even after dinner mints can cause acid
doctor may suggest taking an H2 blocker to control
reflux in some people. How? They'll keep your washer, you the symptoms and prescribe a proton pump inhibitor
LES relaxed and trigger the burn. In addition, have acid (PPI) to both control reflux and heal a damaged
spices like chilli, mustard and even onions are
thought to irritate the esophagus lining.
boiling up esophagus. According to Amrapurkar, the proton
Not everyone reacts to every food though. To into the pump inhibitor is "one of the most effective
treatments for GERD."
understand what causes your symptoms, keep a esophagus It reduces acid secretion by turning down the
diary of your meals and episodes of intolerance.
pump that produces acid in the stomach, and provide
Stop smoking. Smoke relaxes the esophageal sphincter,
which can lead to GERD. symptom relief in the majority of patients who have chronic
reflux symptoms.
Lose weight, if you are overweight.
A new study has found that you may not need to stay on PPIs
Eat 4 to 5 smaller meals instead of 3 large meals, to avoid
forever. Researchers at the University. of Michigan Medical
an empty stomach for acid to work on. School in Ann Arbor were able to wean more than half of
Don't lie down for 3 hours after you eat.
71 GERD patients from their daily dose of PPIs, substituting
Loosen up. Most people don't suffer from heartburn during
less expensive and less powerful drugs to be taken as
the day. That's because gravity helps keep acid out of your
needed. And 15% of the patients needed no medication at all,
esophagus. The trouble comes after dinner - when you're
because they remained symptom-free.
Clean out your medicine cabinet. Heart, blood-pressure,
a t A ~/ ?
Wh Ut
Ur ger~
although a number of surgica tions have b en.tes~ed
,
recently, most physician~ believe th~t fundophcatl,on.

ibuprofen can worsen an mflammed esophagus. Ask your
and asthma medications ca~ cause reflux, while aspirin and
any subsrtutes can be made.
doctor if ~hereare any medications you can ditch, and whether
Take the test. If you're older than 50 and
you've had heartburn for at least 5 years, you're
is the best alternative for chrOniC GERD patients who can t get rehef from probably going to need an endoscopy. A doctor
medication or diet and lifestyle changes. In this operation, the upp~r will insert a very slender tube with a tiny video
portion of the stomach (the fundus) is wrapped (plicated) around the camera through your nose into your esophagus.
lower portion of the esophagus, which increases lower esophageal The thin tube is so unobtrusive you won't need
sphincter (LES) valve pressure. sedation for the IS-minute procedure. The doctor
More than 9 out of 10 patients with heartburn and other typical GERD will detect or rule out the presence of chronic
symptoms can be cured by this procedure. Use of a laparoscope (a.tiny inflammation of the esophagus (esophagitis),
video camera) enables smaller incisions and decreases recovery time. an esophageal ulcer, or esophageal cancer. m
HEALTH & NUTRITION May 200245

Heart Burn

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Heart Burn

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hen Sumati H.

went to her physician complaining of hoarseness and chronic cough,

Feel like somebody stuck a blowtorch

recently, most physician~ believe th~t fundophcatl,on.

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