Acid Reflux. Could It Be Eating You?

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If the proliferation of ads for Nexium, Prilosec, Prevacid and other proton-pump inhibitors is any indication of our national disease du jour, then my vote goes to acid reflux disorder. Here’s what our Well-Being Editor Mary Carpenter had to say last fall. 

OVER THE PAST FEW YEARS, friends have begun suffering from GERD— a nicer-sounding name than the real one, gastro-esophageal reflux disorder, or the more familiar, acid reflux.  Also known as heartburn and acid indigestion, GERD can cause burning pain felt internally around the lower chest area, as well as trouble swallowing and a dry cough.  One friend with GERD who had the dry cough needed to eat very small meals to avoid nausea; another had to sleep in an almost-upright position and had trouble getting enough rest.

According to a 2011 Norwegian study, in the previous ten years the incidence of at least once-weekly acid reflux symptoms rose nearly 50 percent.  Women were the least likely to have acid reflux under age 40, but by ages 60 to 69 were the mostly likely sufferers.  The American College of Gastroenterology estimates that at least 15 million Americans experience acid reflux daily. Currently acid reflux is one of the top health-related internet search queries.

GERD results when the ring of muscle that normally protects the esophagus from the contents of the stomach weakens.  Stomach acid can then flow up the esophagus and into the gullet, which moves food down from the mouth. Stomach acid, composed partly of hydrochloric acid, helps with efficient digestion and protects the stomach against bacteria. Excess stomach acid in the esophagus can lead to painful and irritating inflammation, called esophagitis, and rarely to more serious problems including ulcers and increased risk of esophageal cancer.

Triggers of acid reflux vary from person to person, with the most common being rich food such as meats as well as fats, oils and sweets; fruits, vegetables and juice, especially tomatoes; grains; and beverages including liquor, coffee and tea. According to WebMd, larger and higher-fat meals “tend to stay in the stomach longer before moving into the small intestine,” creating longer periods of exposure to stomach acid.  GERD is commonly a result of excess weight: increased incidence of obesity over the past few decades may help explain the soaring incidence of acid reflux.  GERD can also be triggered by lying down too soon after eating, and by increased pressure on the abdomen from wearing tight belts or doing too many sit-ups.

My friend who couldn’t sleep had  some temporary relief from a gluten-free diet, but, after reading New York Times columnist Mark Bittman’s blog, switched to eliminating all dairy– including the slightest smidge of butter for cooking–and after several years of suffering seems completely cured.  For years Bittman had relied on Tums and Prevacid, which blocks some of the stomach’s acid production, until his doctor convinced him to “break the Prevacid addiction.”

Among over-the-counter drugs, many people take Gaviscon, which creates a mechanical barrier against the stomach acid.  But the most common recommendations include watching portion size, reducing consumption of high-fat foods, and if needed, losing weight.

–Mary Carpenter