Heartburn is a hot topic.
Tune in to television and lay off the DVR’s fast-forward button during the commercial breaks. We’re talking heartburn and acid reflux problems, which are on the rise.
“The problem is half the people in this country experience reflux. It’s very common and a lot of that may have to do with obesity,” said Dr. Michael Sternthal, medical director of the Endoscopy Center at Baptist Hospital in Coral Springs. “People are gaining weight and that’s certainly a big risk factor. Some of that is due to more awareness. We used to have the old [Alka-Seltzer] commercial — ‘plop-plop, fizz-fizz’ — now we are inundated with the [Nexium] ‘purple pill’ and you go to the drug store and see lines of pill bottles.”
Some of the reflux can be relatively harmless. Most everybody can relate to that roiling, boiling sensation that bubbles up from the stomach to the throat after a big or spicy meal. Often, the symptoms are traceable to that second helping of nachos and are not regular occurrences.
Changes in diet and exercise to control weight gain, avoiding alcohol and smoking, and listening to mom’s admonishment — “Don’t lie down after dinner!” — can quench the fire. When that doesn’t work, over-the-counter medications, primarily proton pump inhibitors (PPI) like Prevacid and Prilosec that block acid production, can alleviate the symptoms.
But gastroesophageal reflux disease, or GERD, can be more serious. GERD, which affects an estimated 25 percent of the U.S. population , or about 50 million Americans, can make swallowing difficult and lead to chronic throat and chest pain. Left untreated, GERD eats away at the lining of the esophagus, a 10-inch tube with which we swallow food and drink, and renders the esophageal sphincter flap, which keeps stomach acid, bile and other contents, out of the throat, relatively ineffective. Cancer of the esophagus can result, though it is not as prevalent as colon cancer, which is the second-leading cause of cancer death behind lung cancer.
“The alarms are if you are losing weight, food is getting stuck when you swallow, or you vomit blood or have a dark stool then you should see your doctor,” Sternthal said.
Obesity can increase pressure in the abdominal area and push the stomach into the chest, known as a hiatal hernia, which leads to a higher chance of acid spilling into the esophagus, said Dr. Baharak Moshiree, an associate professor of medicine and director of motility at the University of Miami Miller School of Medicine.
Raising the head of the bed by six to eight inches with a block, not just pillows, and not eating late at night or within three hours of bedtime can alleviate symptoms or reduce the risk of reflux.
“Acid reflux-inducing foods like Hispanics love, cafe con leche, because of the caffeine which is hard to tell patients to avoid, causes inflammation of the stomach and causes impairment of the muscles in the lower esophageal sphincter,” Moshiree said. “Caffeine weakens the muscles which predisposes us to more reflux. Same with chocolate and alcohol. Peppermint, fatty and fried foods does the same thing. Smoking neutralizes the saliva in our mouth and saliva can neutralize acid so this can cause more symptoms.’’